Adulthood has ushered in yet another thing that cries out for organization: the pills we pop for our health.

By Dana Wood
Updated April 16, 2021

At my last checkup, my primary care physician declared me to be in peak health. Yes, I could be more diligent about my vitamin D, but overall, this 58-year-old tennis addict's lab results were pretty stellar—no problems with sugar, cholesterol, or blood pressure. But if I'm so hale and hearty, why is the baggie of meds I bring to my doc- tor getting bigger each year? I feel like I'm swallowing a daily fistful of drugs and supplements, and it's making me uncomfortable.

There's levothyroxine for my sluggish thyroid, prescription eye drops to ward off glaucoma, allergy meds for my itchy eyes and sniffling, and a two-pronged hormone replacement therapy protocol (progesterone pills and estrogen-testosterone cream). On the over-the-counter front, I gobble melatonin, Tylenol PM, and Olly Sleep gummies to help me drift off at night, plus anxiety fixes for the 3 a.m. wake-ups: the amino acid GABA, the herb ashwagandha, and a wannabe-Xanax supplement called Pirate Chill that I pop despite the label's cartoonish skull and crossbones.

According to the Centers for Disease Control and Prevention, 23.5 percent of Americans ages 40 to 79 take five or more prescription drugs over a 30-day period. As we approach midlife, the ailments can add up. Menopause can bring a host of symptoms, from insomnia to migraines, says Richard Baron, MD, president and CEO of the American Board of Internal Medicine. "Given our faith in pills, we think, 'Maybe if I take this, I'll feel better.'"

Just ask Heather Stahl, 49, who's taking 11 prescription medications—including three for anxiety alone. That's a massive uptick from the two meds she was on five years ago: "Perimenopause brought on sleeplessness, migraines, and more anxiety."

My friend Julia is on two antidepressants, Strattera for ADHD, and birth control pills to regulate her hormones. Plus, she has a drawerful of vitamins and supplements. "I'm 50, so I grew up in the age of microwave popcorn— the age of quick fixes," Julia says. "Why suffer?"

Nicole Rochester, MD, founder of the health advocacy company Your GPS Doc, says to be prepared to speak up for yourself when talking with your provider. "The instinct for many physicians is to prescribe," she says. "Most doctors have very little time to explore the underlying cause of chronic health problems like daily headaches. The typical response is to pull out the prescription pad."

I decided that my annual appointment was the perfect opportunity for a top-down medication assessment. I discovered that a close partnership with your doctor and some concrete steps can streamline your medicine cabinet.

Write It Down (and Keep It Updated)

Keep at least a two-week log of your prescription and OTC meds to review with your doctor, recommends Joanne Doyle Petrongolo, a pharmacist for Massachusetts General Hospital’s Integrated Care Management Program. List everything you’re taking, along with dosages.

If you don’t have insurance or need to find a provider to review your meds, the virtual service JustAnswer connects you to a pharmacist for a monthly fee (from $46). And Walgreens offers the free Pharmacy Chat, which lets you print your conversation.

Cut Sneaky Duplications

Work with your doctor or pharmacist to identify similar meds and supplements. For example, do you need a daily allergy tablet and a prescription nasal spray? Turns out I didn’t, once I was safely past high-pollen season. We also swapped out my self-prescribed anxiety busters (including my Pirate Chill) for low-dose Xanax. Given that the FDA doesn’t regulate supplements the same way it regulates prescription medication, my doc opted for the drug with the proven track record.

One big trap to avoid, Dr. Baron says, is taking both the brand-name and generic versions of the same drug, which can happen all too easily when you switch doctors or pharmacies.

He asks patients to bring in every pill so he and his team can scrutinize them. “I’ve had people come in with shopping bags.”

Take Exactly as Prescribed

Be disciplined about your meds. As many as 50 percent of patients don’t take their drugs at the right time, in the right way, or with the right frequency. That can worsen your condition, misleading doctors into thinking you need more treatments. The solution can be as simple as setting a phone alert. For complicated regimens, your pharmacy or certain apps may be able to help. For example, CVS Pharmacy’s ScriptPath system reviews patients’ prescriptions and provides a schedule for taking them, says Ryan Rumbarger, senior vice president of retail store operations for CVS Pharmacy. The app Medisafe (free for iOS and Android) reminds you to take your meds, scans for drug interactions, and allows you to manage family members’ medications as well.

Do the Right (No-Pill) Stuff

Popping a pill is sometimes unavoidable. But there’s so much we can do to improve our health before we get to that stage. Anxiety, for example, affects approximately 40 percent of women. Lifestyle shifts, like starting a meditation practice, might not eliminate the need for meds, but could reduce your stress and make you more mindful of your emotional state.

Another good move: getting more physical activity, a proven mood-booster that’s also associated with a lower risk of the major metabolic disorders that tend to appear by midlife. “Exercise can favorably impact high blood pressure, diabetes, and heart disease,” Dr. Baron says. “There are lots of people who could wind up not needing a medication if they exercise regularly.”

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