Drug interactions

Drug interactions that compromise or affect gut health.

Older man selecting medication from a store shelf.

Relying on Heartburn Drugs Too Much?

You may have experienced a big jolt when you saw the news about the FDA alerting consumers to the presence of a human carcinogen in the over-the-counter (OTC) heartburn drug ranitidine, most commonly known by its brand name, Zantac.

N-nitrosodimethylamine (NDMA) is the very same carcinogen that prompted a recall of some prescription medications containing the generic drug valsartan (used to treat heart failure and high blood pressure).

Although the FDA was quick to say the amounts of NDMA found in ranitidine were barely above what may be found in common foods, that didn’t stop Sandoz/Novartis from halting the distribution of Zantac, pending a deeper investigation.

In the meantime, national drug store chains — Walgreens, Rite Aid and CVS — have removed Zantac and its generic counterparts off their shelves.

A lot of heartburn drugs are sold via the OTC route, including proton pump inhibitors (PPIs) like omeprazole magnesium (Prilosec) and lansoprazole (Prevacid) and H2 blockers like ranitidine and famotidine (Pepcid).

It’s no stretch to say that many of the 15 million Americans who are prescribed these heartburn drugs and the countless numbers of people who take them via the OTC route, do so for far longer than they should, even after their health problem has cleared up.

Even years!

Previously, we’ve warned you that taking PPIs creates unhealthy imbalances in the bacteria in your stomach that can leave you vulnerable to serious Clostridium difficile (C. diff) superbug infections.

Imagine side effects that are far worse…

Death due to heartburn drugs

A recent report featured in The BMJ tracked the mortality rates among more than 200,000 U.S. soldiers who had been newly prescribed either a PPI or H2 blocker drug for a decade.

Overall, long-term use of PPIs was associated with a 17 percent greater risk of death compared to H2 blockers. The uptick in mortality rates among PPI users was attributed to cardiovascular disease, stomach cancer and chronic kidney disease.

Two more factoids that should catch your attention, especially if you take PPIs or other heartburn drugs, either over-the-counter or by prescription:

  • More than 80 percent of PPI users were taking low doses of their prescribed drug, about the same as doses offered in OTC versions.
  • More than half of the patients were taking a PPI for no medical reason, even though it was prescribed to them.

“Most alarming to me is that serious harm may be experienced by people who are on PPIs but may not need them,” says Dr. Ziyad Al-Aly, senior author of the study and assistant professor at Washington University’s School of Medicine. “Overuse is not devoid of harm.

“For those who have a medical need, PPI use should be limited to the lowest effective dose and shortest duration possible.”

What can you do?

Are you taking heartburn drugs based on your doctor’s advice or doing it on your own?

Have you been taking them longer than two weeks?

Do you schedule breaks between rounds of taking a heartburn drug by at least four months?

If you aren’t able to answer those questions immediately, it’s time to see your doctor for some advice.

In the meantime, here are some steps you can take to ease your heartburn symptoms without taking a drug:

  1. Cut out smoking for good.
  2. If you’ve been putting off losing weight, the time is now.
  3. Leave about two hours between the time you eat an evening meal and the time you go to bed.
  4. Before hitting the sack, elevate your pillow slightly to avoid a nighttime surge of stomach acid.
  5. Prevent disruptions in the critical balance of healthy bacteria in your gut — and avoid superbug infections — by taking a probiotic like EndoMune Advanced Probiotic containing 20 billion CFUs and 10 strains of beneficial bacteria.
sterile white couch

Your House Paint May Contain Gut-Harming Antimicrobials

I’ve talked about all of the trouble associated antibacterial products (preventing the development of bacteria) and antimicrobial products (preventing the spread of fungi, viruses and bacteria) too many times to count on my blog.

Over-sterilizing your life creates lots of problems for your gut microbiome. And, this doesn’t include exposures to all sorts of things under our very noses — from yoga mats to common personal care products like toothpaste — that contain gut bacteria-robbing chemicals.

Could the latex paint that lines the walls of your home be another problem hiding in plain sight?

Antimicrobial latex paints put to the test

Researchers at Northwestern University and the University of Chicago tested the effect of three kinds of antimicrobial, synthetic latex paints (formulated to improve indoor air quality) on bacteria in a study featured in the journal, Indoor Air.

To reproduce the typical home environment, scientists painted a group of 2×2-inch squares of drywall twice (with a day in between applications for drying), added tiny drops of water and placed them in sealed glass jars.

Then, some of the samples were exposed to five forms of bacteria taken from gym facilities that are commonly found in homes.

Within a day, all but one of the bacterial species — the spore-forming Bacillus timonensis — had died. The concern: Most bacteria die on dry, cold surfaces, but why not this one?

Spreading bacteria where it shouldn’t be

When bacteria are attacked with antimicrobial chemicals, they will mount a defense, says lead researcher Erica Hartmann. “Bacillus is typically innocuous, but by attacking it, you might prompt it to develop more antibiotic resistance.”

Spore-forming bacteria like Bacillus timonensis protect themselves on painted surfaces by lying dormant for a time, and resisting harsh conditions until they reactivate.

By now, you’re probably wondering why paint companies don’t test their antimicrobial products on common forms of bacteria. That was the gist of the test, Hartman says.

All too often, companies test their products on how E. coli — considered by some to be the “lab rat” of the microbial world — and Staphylococcus survive, yet ignore other microbes people encounter every day.

“We should be judicious in our use of antimicrobial products to make sure that we’re not exposing the more harmless bacteria to something that could make them harmful,” Hartmann says.

Protecting your immune health

The presence of antimicrobial cleaners and paints in our lives can create a “too clean for our own good” environment that hurts our health in many ways.

Exposure to antibacterial and antimicrobial products, even those seemingly as benign as paint, can harm us by eroding the delicate balance of bacteria in our gut.

Maintaining a healthy balance of gut bacteria helps our body do critical things like fortifying our immune systems and creating nearly all of the serotonin our bodies need.

Taking a good probiotic, ideally with multiple strains of beneficial bacteria like EndoMune Advanced Probiotic, is an easy way to protect your overall health and your gut from antibacterial products that may hiding on your walls, countertops and elsewhere.

woman holding white pill tablets in hand with glass of water

How Drugs Interact With Your Gut

The gut microbiome is a vital and important part of human health that touches so many aspects of our daily lives, yet it works in very unpredictable ways.

For example, consider how certain drugs interact with the human gut. Sometimes, they do work but not so well at other times, as we learned about statin drugs.

The very same thing may be true about metformin, the go-to drug prescribed for type 2 diabetic patients to control high blood sugar, according to a study appearing in EBiomedicine.

“For example, certain drugs work fine when given intravenously and go directly to the [blood] circulation, but when they are taken orally and pass through the gut, they don’t work,” says senior study author Dr. Hariom Yadav, a researcher at the Wake Forest School of Medicine.

As we’ve seen previously, metformin works well with the gut, although some patients who take it tend to experience more side effects (nausea, diarrhea and flatulence).

Based on their review of studies, Wake Forest researchers determined the metabolic capacity of a patient’s microbiome may influence how various drugs aimed at treating type 2 diabetes are absorbed and function in effective, inactive or even toxic ways.

“We believe that differences in an individual’s microbiome help explain why drugs will show a 90 or 50 percent optimum efficacy, but never 100 percent,” Dr. Yadav said.

Now, Wake Forest researchers are taking the next important gut-friendly step by testing prebiotics, a natural component of non-digestible plant fiber that feeds the good bacteria living in your gut, and probiotics that may help diabetes drugs work more effectively.

Could a multi-species probiotic containing 10 kinds of beneficial bacteria plus a handy prebiotic (FOS) like EndoMune Advanced Probiotic make gut-friendly difference in the way patients take their drugs?

The evidence is growing!

Are You Over-Sterilizing Your Life?

Keeping your body clean hasn’t been easier than it is today, but is there such a thing as being too clean?

No matter where you go — the supermarket, your local gym or even a neighborhood yoga class — antimicrobial chemicals have invaded our living spaces, creating an environment that’s become “too clean” for our own good.

The use of antimicrobial chemicals like triclosan may have seemed like a good idea at one time. However, that perception changed radically a few years ago when health problems related to the hygiene hypothesis and its lingering effect on our immune systems began lessening the natural ability of our bodies to fight disease.

Although triclosan has been the main focus for these problems, some of its notoriety faded when the FDA took the major step of banning it from antibacterial soaps and most body washes in 2016.

Despite the ban, triclosan can still be found in some personal care products (review the Environmental Working Group’s most current list) including some toothpastes as well as lining common consumer products like yoga/exercise mats and gym equipment.

That’s where a new health problem lies in plain sight…

Antibiotic resistance in dust?

This stealth invasion of triclosan in our environment may be creating antibiotic-resistant dust, according to a recent study appearing in mSystems.

Researchers at Northwestern University discovered this problem after collecting dust samples from 42 athletic facilities in the Pacific Northwest.

Study leader and associate professor Dr. Erica Hartman chose gyms due to the contact people have with mats, floors and gym equipment and how many clean them before and after using them with antimicrobial wipes.

Concerns arose when Hartman’s team collected dust from athletic spaces, hallways and offices, then examined the bacteria hiding in dust, and its genetic makeup.

Antimicrobial chemicals were the most concentrated in dust found in moist spots and gym spaces and in higher levels in rooms with carpeted floors or rubber mats.

In samples with higher levels of triclosan, scientists found genetic markers directly linked to antibiotic resistance and, specifically, medically relevant antibiotic drugs.

“There is this conventional wisdom that says everything that’s in dust is dead, but that’s not actually the case. There are things living in there,” says Dr. Hartman, according to Northwestern Now.

Trying to keep workout spaces clean for yourself and others creates a larger health problem with antibiotic-resistant infections, potentially leaving you vulnerable to superbugs.

Unfortunately, manufacturers of products like yoga mats aren’t required to disclose antibacterial chemicals like triclosan in their labeling, because their safety is governed by the EPA, not the FDA, Dr. Hartman says.

So, how do you protect your health and environment surrounding you from being “too clean?”

  1. Avoid products that are labeled with terms like fights germs, fights odors or antibacterial, according to experts at the National Resources Defense Council Health Program.
  1. Review the product labels of any personal care products you’re buying at the grocery store for anything that you suspect includes antibacterial chemicals (look for a future blog about triclosan in toothpaste).
  1. Protect your immune health the safe and natural way by taking a probiotic like EndoMune Advanced Probiotic that contains 10 strains of beneficial bacteria, plus a prebiotic (FOS) that feeds the good bacteria in your gut.
person holding painkiller

Probiotics and Common Painkillers

Many medicines are available over-the-counter (OTC) at your local drug store and not prescribed by a physician, but that doesn’t mean taking them is completely risk-free.

A good example is acetaminophen (better known in America as Tylenol), probably the most common OTC painkiller available besides aspirin. (It’s also available in a prescription form as Percocet or Vicodin.)

Acetaminophen is available in lots of ways — syrups, capsules and drops — so it’s very easy to take their safety for granted.

One of the most common risks associated with taking acetaminophen is liver damage, when you take too much of it (no more than 3,200 mg per day). It’s enough of a concern the FDA devotes an entire web page that explains the risks of taking too much acetaminophen and how to avoid them.

So, how does taking too much of an OTC painkiller have anything to do with your gut health?

We warned you recently about an intriguing way your gut microbiome may be used to spot signs of nonalcoholic fatty liver disease, the most common form of chronic liver disease, based on subtle drops in genetic gut health diversity.

Not surprisingly, probiotics may limit the damage to your liver from taking too much acetaminophen, according to a study presented by Emory University researchers at a recent meeting of the American Society of Investigative Pathology.

In fact, one of the primary strains of beneficial bacteria contained in EndoMune Advanced Probiotic — a proprietary strain of Lactobacillus rhamnosus — was the active ingredient in the report.

The problem with taking too much acetaminophen, not to mention serious liver damage or death, is a marked increase in free radicals that triggers oxidative stress.

Based on tests with mice, animals fed a probiotic in their food for just two weeks suffered less damage when given an overdose of acetaminophen than those receiving no probiotic at all.

These results build upon previous research which targeted the molecular process in which probiotics containing Lactobacillus rhamnosus protect the body from oxidative liver injury thanks to a protein (Nrf2) that regulates genes involved in fighting free radicals.

There’s a lot of work be done to determine if this same gut-friendly protection holds up for humans too. That said, it’s a good idea to stay on the safe side and follow some common sense precautions to avoid any problems with acetaminophen in the first place.

an x-ray of a broken shoulder bone

How Probiotics May Increase Bone Volume

Recently, we shared the results of an interesting report about the benefits of taking probiotics to protect the health and longevity of your bones

That’s great news, but how do probiotics really work to make a bone-healthy difference?

A new study featured in the medical journal Immunity provided an answer with the help of a proprietary blend of Lactobacillus rhamnosus, and it’s a familiar one too.

During a four-week testing period, scientists discovered female mice that were given Lactobacillus Rhamnosus also enjoyed a healthy boost of short-chain fatty acids known as butyrate.

The production of butyrate already does a lot of good behind the scenes to protect your gut from inflammation and harmful bacteria like Salmonella and E. coli.

Giving female mice living in an open environment a probiotic stimulated the growth of butyrate in their tiny bodies and increased the formation of bones too.

Supplementation with a probiotic or butyrate also triggered the growth of regulatory T cells in the gut and bone marrow of mice. These extra T cells in bone marrow were also responsible for secretions of a unique protein (Wnt10b) that’s vital for bone development.

(Interestingly, mice raised in a germ-free environment didn’t enjoy the same bone-building benefits, leading scientists to speculate that a probiotic works better when it interacts with other microbes in the gut.)

“We were surprised by the potency of the gut microbiome in regulating bone and by the complexity of the mechanism of action of probiotics,” says senior study author Dr. Roberto Pacifici of Emory University.

And, despite recent controversies in the press about the true health value of probiotics, “We show that they work for real in bone,” Dr. Pacifici says.

Emory University researchers plan to continue their exploration of gut health in relation to other bone diseases, how supplementation with butyrate may treat osteoporosis and if probiotics are versatile enough to improve bone health in varying disease states.

Lactobacillus rhamnosus is just one of 10 species of beneficial bacteria contained in EndoMune Advanced Probiotic that may do a world of good for your health in addition to your bones.

pet store puppy looking up at owner

Did your pet store puppy make you sick?

Recently, we’ve talked about how a dog’s gut health may be very similar to our own, a great boon to researchers examining the human gut.

Unfortunately, one of the greatest problems in human health — the overuse of antibiotics — may be affecting the health of our canine friends and sicken us too, based on a recent CDC report about pet store puppies spreading antibiotic-resistant infections to humans.

More than 100 people in 18 states (including pet store employees) were made sick from exposure to puppies carrying Campylobacter jejuni, one of the most common causes of foodborne illness from bacteria in America, over nearly two years, according to the CDC.

Testing on eight dogs and 10 humans revealed resistance to seven common antibiotics (including ciprofloxacin, erythromycin and tetracycline) that are typically used to treat human Campylobacter infections.

How did this happen?

Based on drug records of nearly 150 pups, nearly all of them received at least one round of antibiotics before they arrived at the pet store or during their time there.

This practice of treating puppies with antibiotics is not surprising and largely unnecessary, but is used to offset poor infection control and management by larger breeding companies, according to experts.

“Antibiotics should only be used to treat illness, not to compensate for poor practices — whether it’s trucking dogs long distances and having poor hygiene in the process along the way,” says Matthew Wellington, antibiotics program director for the Public Interest Research Group in STAT.

“These are lifesaving medicines that should only be used to treat sick animals or sick people.”

As a result, the CDC created educational materials specifically for pet store employees to remind them to wear gloves when cleaning pet cages, eat meals away from areas where animals are fed and wash their hands.

Contact with animals that have been infected with antibiotic-resistant bacteria isn’t a new thing. Investigators have been studying these problems for more than a decade.

In addition to keeping your hands clean with plain old soap and water (avoid antibacterial soaps), one of the best things you can do to protect your health and maintain the proper balance of bacteria in your gut is to take a probiotic.

Maintaining the diversity of bacteria in your gut is so much easier when you take a probiotic with multiple species of beneficial bacteria like EndoMune Advanced Probiotic.

a jar of pills

The Impact of Medication on Gut Health

Science is well aware of the problems antibiotics and heartburn drugs can create for your gut health, all while leaving you vulnerable to even deadlier infections if you rely on them a lot.

Unfortunately, the list of non-antibiotic drugs that can affect your gut has grown sharply too (coming on the heels of a report that found metformin, a go-to drug for diabetes alters gut health).

Out of more than 1,000 drugs tested by researchers at the European Molecular Biology Laboratory, 24 percent affected the growth of at least one bacterial species in the human microbiome, according to a study appearing in Nature.

Overall, 250 out of 923 non-antibiotic drugs tested on 40 samples of selected species of human gut bacteria (including one species of Lactobacillus) altered their growth.

What’s more, 40 drugs affected at least 10 strains of gut bacteria, and 14 of them were previously unknown to have an antibacterial effect on gut bacteria. The most dramatic inhibitors of gut bacteria include these commonly prescribed medications:

  • Calcium-channel blockers that treat an array of conditions, from Raynaud’s to high blood pressure.
  • Antineoplastic drugs that treat cancer.
  • Antipsychotic drugs that treat bipolar disorder and schizophrenia.

What concerns researchers the most?

“This shift in the composition of our gut bacteria contributes to drug side effects but might also be part of the drugs’ beneficial action,” says Peer Bork, according to a press release.

“This is scary, considering that we take many non-antibiotic drugs in our life, often for long periods,” says Nassos Typas. “Still, not all drugs will impact gut bacteria and not all resistance will be common. In some cases, resistance to specific non-antibiotics will trigger sensitivity to specific antibiotics, opening paths for designing optimal drug combinations.”

Since this study finds that individuals taking any prescription medications are inadvertently harming their gut health, they should consider taking EndoMune Advanced Probiotic to ensure their gut health isn’t being comprised by their prescribed medications.

a person holding a handful of grain

Antibiotics Hurt Your Whole Grain Intake

It’s amazing how incorporating whole grains into your diet reduces your risks of serious health problems – stroke, cancer, chronic inflammation and type 2 diabetes – while delivering important minerals, vitamins and antioxidants your body needs.

Adding whole grains to your diet can be as simple as replacing white rice in your favorite meals with brown rice or quinoa, swapping out white flour tortillas with ones made with stone-ground corn or eating a little popcorn (just forget the fatty movie theater butter and salt).

However, all of that dietary goodness you’ve done for your health may evaporate when you take antibiotics, drugs that doctors prescribe too often.

Researchers at Aarhus University discovered this critical problem while examining the health of more than 2,200 Danish patients who developed cancer over a 13-year period in a 2016 study appearing in Molecular Nutrition & Food Research.

The problem occurs when antibiotics disrupt one component of whole grains, lignans (beneficial polyphenols found in a host of plant-based foods, including flaxseeds and sesame seeds), in the human gut.

Antibiotics prevent the conversion of lignans in the gut to enterolignans, chemical byproducts that behave like estrogen and have been associated with lower mortality rates among breast cancer patients.

Concentrations of enterolignans in women who had taken antibiotics dropped by 41 percent less than three months before giving blood samples and 12 percent among men, both compared to patients who didn’t take them.

Those numbers remained relatively low (26 and 14 percent among women and men, respectively) up to a year later too.

A follow-up study by part of the same Danish research team on pigs found enterolignan concentrations dropped 37 percent in animals treated with antibiotics, compared to a control group.

The easy advice would be to avoid taking broad spectrum antibiotic drugs as much as possible, but that’s just one part of the solution.

Unfortunately, our bodies are exposed to soaps, toothpastes and cosmetics on a daily basis that contain antimicrobial compounds like triclosan.

Constant exposure to these chemicals creates a backlash known as the hygiene hypothesis, in which your body’s ability to develop its own immunities to disease is weakened significantly. In other words, your environment may be “too clean” for its own good.

Protecting your body from the damage antibiotics and harmful chemicals can do to your gut is as easy and effective as taking a probiotic containing multiple strains of beneficial bacteria like EndoMune Advanced Probiotic for adults and EndoMune Junior Probiotic for kids.

How Antibiotics Caused an Epidemic

If you do a random search of my blog, one of the most popular topics you’ll find is antibiotics, and for a good reason too.

Not so long ago, antibiotics were considered “the Holy Grail” of modern medicine. Unfortunately, that advantage lasted only until our bodies had absorbed way too much of a good thing.

Additional exposure to antibiotics in flesh foods we eat and powerful anti-microbial substances contained in cleaning solutions and hand soaps have done much to tip the scales in the opposite direction, however.

The result: Creating unintentional and serious harm to human health via our overtaxed and compromised immune systems.

Along those lines of too much being a bad thing for your health, the very same concerns are true about overdoing antibiotics, especially for those who never needed them in the first place.

A good case in point is a recent study conducted at Johns Hopkins University School of Medicine that appeared in the September 2017 issue of JAMA Internal Medicine.

Researchers reviewed medical records of some 1,500 patients admitted to Johns Hopkins for many reasons, including chronic diseases and trauma, and all were treated with antibiotics for a minimum of 24 hours.

No surprise, 20 percent of the patients who were tracked experienced unexpected health issues, including kidney, blood and gastrointestinal problems. Also, between 4-6 percent of patients were stricken with Clostridium difficile (C. diff) infections and other antibiotic-resistant superbugs.

Although scientists reported no deaths associated with antibiotics, many suffered complications just the same.

  • More diagnostic testing
  • Repeat admissions to the hospital
  • More visits to the emergency room or local clinics
  • Longer hospital stays

The real takeaway of concern for you and me in this study: Nineteen percent of patients were prescribed antibiotics they didn’t need. Of that subgroup, 20 percent sustained adverse effects from taking medically unnecessary drugs.

One way you can protect your health from unnecessary antibiotics: Don’t be afraid to ask your doctor questions about potential side effects and how to recognize them, says lead study author Dr. Pranita Tamma, director of John Hopkins’ pediatric antimicrobial stewardship program, according to a press release.

“Too often, clinicians prescribe antibiotics even if they have a low suspicion for a bacterial infection, thinking that even if antibiotics may not be necessary, they are probably not harmful. But that is not always the case.”

Even when taking antibiotics are necessary, however, be aware they can do great harm by affecting the balance of beneficial bacteria in your gut that governs your health and recovery from disease in so many ways.

That’s why taking a probiotic, ideally with multiple species of beneficial bacteria like EndoMune Advanced Probiotic, is the best, safest and most effective way to protect your gut and boost your immune system, even when you need to take an antibiotic.

If you need guidance on how and when to take a probiotic, especially when you’re sick, be prepared by reviewing my updated probiotic protocol for kids and adults today.

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