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RadioMD Presents: HER Radio | Original Air Date: May 7, 2015
Host: Michelle King Robson and Pam Peeke, MD

Dr. Pam Peeke, founder of the Peak Performance Center and renowned nutrition and fitness expert and
founder of EmPowHER.com and leading women's advocate Michelle King Robson have cut through the confusion and shared the naked bottom line truth about all things women. It's HER radio.

DR PAM: I am Dr. Pam Peeke. Michelle's off today. Alright. So, you get a prescription from a doctor, right? Are you supposed to just take then go, "Oh. Okay." No. Not so fast because we have seven questions women should ask their doctor before accepting prescription medications. Isn't this a cool segment? And to help guide us through the seven questions is Suzanne Robotti, founder of MedShadow Foundation. The website is medshadow.org. Suzanne founded MedShadow several years ago. It's an online patient advocacy source that educates the public about the side effects and long-term effects of prescription medication.

Suzanne, welcome back to HER radio. We're so happy you're here and we want to really get into this very unique topic. The seven questions. What got you started with MedShadow in the first place?

SUZANNE: Well, I met the DES daughter, so many years ago before when my mother had given a drug that had a very long-term side effect. She was told it would be helpful. It was not. There are many DES daughters and sons about my age, which is anywhere between forty and sixty and I'm not going to be more specific than that, who are the DES daughters and sons and have long-term fertility issues because of it. So, partly because of that and partly because my son was being pushed to take drugs for ADHD and I was uncomfortable with the long-term effects of those drugs and I thought, "I want to learn more about it. I bet other people want to, also."

DR PAM: I think that that is fabulous and for everyone out there DES is Diethylstilbestrol. That's the full name of the medication that was given a million years ago. Dear God, to mothers and we're still feeling the effects. So, let's get these seven questions because first of all, I'm so happy that you became an advocate for women on this because we really need that kind of guidance when it comes to the number of prescriptions just being thrown around, right and left, and we should be asking questions. The first question, "What is the lowest effective dose?" Tell us about that.

SUZANNE: Well, what you want to do is not take more medicine then you need. Ever. The more medicine in your body, the more the possibility of an interaction with a food or another drug or its own side effect. Most drugs can be very effective at a very low dose. Aspirin, for example if you take it, is effective with one pill or two pills. So, start with one pill, and your headache doesn't go away, take another pill in an hour but you don't need to take a high dose of everything. Ask your doctor what's the lowest dose I can take.

DR PAM: Okay. Excellent. So, what's the second question? Can this cause dependency or rebound effect. Let's go there.

SUZANNE: The rebound effect is really sneaky and I think it's kind of mean-spirited of medicine to do that. If you take a drug that just, for example, there are many drugs to do this but a sleep aid drug. Many of the sleep aid drugs have a rebound effect which means you'll sleep great the first night but, the very next night you won't be able to fall asleep unless you take that drug and now, that's the rebound effect. Indigestion drugs like acid reflux drugs, often have that same effect, so you get caught in a, once you start taking it, you are a little bit trapped into continuing to take it. And then the dependency issue comes in when you want to stop taking it, something like a sleep aid, it's not recommended that you just stop when you want to. You need to step down and you need to let your doctor know because there's a process so it's not so simple as to take the pill. Stop taking the pill. It has consequences.

DR PAM: I gotcha. So, now number three, what's the shortest amount of time I need to be on this drug and do I have to wean myself off of it?

SUZANNE: Well. That goes back and ties into the previous question. Before you commit to taking a drug, you want to know, at least internally is a lifetime commitment or is this for seven days or three days or as needed because, honestly, if it as needed drug and you can take it whenever you need it, somehow I, personally, am a little less concerned than if I'm to take it for forever like as statin. Then, I really get concerned. What's the build-up in my body? Can it become toxic so that's why you ask, what's the shortest amount of time I can be on the drug and how do I wean myself off it or can I just stop?

DR PAM: Oh, yes. And then, number four, what are the potential side effects such as waking, low libido, liver or kidney problems. Oh, boy, do remember this one when Tomoxifen9 first came out for a breast cancer and women were gaining weight right and left and the drug company said, "Oh, no. No, no, no. You don't gain weight with that." Really? No. I mean, for crying out loud, tell them and the same thing goes with the anti-depressants, right?

SUZANNE: Oh, yes.

DR PAM: So, there you go. Let's go to that place.

SUZANNE: It's so frustrating. Let's just go there. It's so frustrating. You go, and let's say you're depressed and you're a woman and you're seeing a therapist who says, "I think you know you could use a little boost from an SSRI or some other antidepressant." And if they don't...Those women could gain weight. If you don't know that ahead of time and you just start gaining weight, how is that going to help you with your depression? It will upset you much more deeply and potentially lead you to feel out of control. That's not the purpose of drugs--to make you feel bad.

DR PAM: Exactly. Exactly. Well, now, let's go to a woman centric question. What I'm planning to get pregnant or what if I have an unplanned pregnancy?

SUZANNE: You know, fifty percent of pregnancies in America are unplanned. So, even if you're not planning on getting pregnant, if you still have the ability to get pregnant, it could happen without you expecting it to happen. Half of them are unexpected, so you should ask this question whether or not you're planning on getting pregnant because there are some that are very dangerous to a newly developing fetus, the zygote.

You know, the first month or two or pregnancy, so much goes into creating the fetus that there are drugs that should never be taken with that. So, you need to just mentally prepare. It's rare. It doesn't happen often but you need to have clear in your mind that if you do get pregnant on it, you need to get to the doctor fast. You and the doctor need to make a care plan.

DR PAM: Absolutely. There's no question about that. So, women listen up on that one.

SUZANNE: Let me, if I could just add to that, what people forget is there are a lot of women out there that are perfectly healthy; have no illness whatsoever but then they're on a very powerful drug--oral contraceptives. Women take it so routinely, those for whom it works well and who are in the habit of taking it, so routinely, they're often known to forget to even remind their doctor that they're taking that drug. That's a very powerful drug.

DR PAM: Well, there's that but they're also doing other lifestyle things like smoking, etc. which increases their risk for clots and all the rest of it. Then, to finish this off we've got two more and it's really important that people ask this question.

Women, listen up. Will alcohol or other meds or, I'm going to add to that, the things you're taking over the counter, your herbal supplements, etc., exaggerate or block the medications effect and then, finally, should I make lifestyle changes or consider alternative therapies. These are really important questions that Suzanne Robotti has helped guide us through as we're really saying should you ask your doctor these questions before you.

Absolutely. Suzanne Robotti is the founder of MedShadow Foundation. The website is medshadow.org. It's a wonderful patient advocacy source that's educating you about issues like this. Suzanne, thank you so much for sharing your wisdom on her radio.

I'm Dr. Pam Peeke with Michelle King Robson. Like us on Facebook or follow us on Twitter and whatever you do, make sure to stay well.