Experts Suggest Bathroom Cabinets Might Not Be the Most Secure Location for Storing Medications

January 5, 2024

Storing medications in the bathroom cabinet can lead to unfavorable and potentially hazardous outcomes.

Bathrooms, known for their elevated humidity levels, pose a risk to the stability of medications. Shazia Zafar, RPh, a pharmacist from Lake Oswego, OR, warns against keeping medications in the bathroom, explaining that the humidity from showers can permeate and break down medicines. According to the National Library of Medicine, moisture and humidity can compromise the potency of medications or cause them to deteriorate before their original expiration date.

Maintaining a medication’s potency is crucial, as changes in potency can undermine the certainty of receiving the correct dose. Heat and moisture can particularly harm pills and capsules, altering their composition. For example, the change in atmosphere can break down aspirin into vinegar and salicylic acid, potentially causing stomach discomfort.

However, while bathroom humidity has the potential to impact medications negatively, it may not always occur. Lisa Gualtieri, PhD, an associate professor of public health and community medicine at Tufts University School of Medicine, notes that most homes have bathroom ventilation, which mitigates the impact of humidity. Michelle A Chui, PharmD, PhD, a professor in pharmacy administration at the University of Wisconsin-Madison School of Pharmacy, expresses skepticism about medicines spoiling in the medicine cabinet due to shower or bath moisture or general home humidity.

Understanding where medications are stored is essential, along with general safety tips to preserve the expiration and potency of medications.

Majority of People Don’t Properly Store Medication

In a 2021 study analyzing 154 U.S. households, only 23.3% stored all their medications appropriately. Among the 457 medications in these spaces, approximately 17% experienced temperature issues, 11% faced moisture problems, and 9% encountered both. A 2022 survey revealed that 31.9% stored medications in the kitchen, 28.9% in bathrooms, and 21.3% in bedrooms, with 31.7% leaving medications out on counters in these rooms.

The optimal location for storing medications varies based on their composition and form (liquid, gel, pill, etc.). According to Lisa Gualtieri, PhD, the key is integrating medication storage into one’s routine, making it more convenient to adhere to. She emphasizes the importance of tailoring the storage location to individual routines.

While considering safe storage practices is essential, the primary focus should be on storing medications in a place easily remembered by individuals.

Moisture and Temperature Are Key Factors

While having proper ventilation in the bathroom can contribute to better medication storage, it’s crucial to pay attention to both the moisture and temperature levels in this area.

The recommended humidity for storing medications is below 60%, yet a study found that bathroom humidity in surveyed households ranged from 33% to 100%. Additionally, the temperature of a space plays a significant role in medication storage. The ideal temperature for most medicines falls between 59 and 86 degrees, but bathroom temperatures in the study varied from 56.8 to 88.7 degrees.

Certain medications, such as antibiotics and insulin, are particularly sensitive to temperature fluctuations. For example, some forms of birth control, like the ring, require refrigeration. Relocating medications to kitchen cabinets, which are generally cool and dry, can be an improvement, offering the added benefit of being out of reach for young children.

Regardless of the storage location, it’s essential to keep medications in their original containers. These containers are designed to protect the medication from environmental factors, including reasonable humidity, as explained by Michelle A Chui, PharmD, PhD. Storing medications away from bright windows and areas affected by outdoor weather is recommended. Avoid spaces with fluctuating temperatures, such as those near ovens, and refrain from storing medications in cabinets above stoves or sinks. Refrigeration should only be considered if advised by the pharmacist, label, or package insert after opening.

Additional Factors to Consider When Storing Medications

While medicine cabinets present their own set of challenges, Michelle A Chui expresses more significant concerns about the potential impact of temperature changes during medication shipping, particularly with mail-order services.

Chui considers mail order to be a potentially risky method due to the uncertainty of packages being exposed to less-than-ideal temperatures during transportation and upon delivery. To mitigate these risks, she recommends using brick-and-mortar locations whenever possible.

When receiving medications by mail, especially those requiring refrigeration, Jennifer Young, PharmD, a medication safety specialist, emphasizes the importance of checking that the medication is cool to the touch upon opening. Some pharmacies include temperature tracker cards in their packages, alerting patients if the temperature within the compartment goes out of the recommended range.

Another aspect to be mindful of when storing medications is the potential risk of storing everyone’s medications together in a household, increasing the likelihood of accidentally taking someone else’s medicine.

Safe Medication Storage Practices

Experts offer some straightforward tips for safely storing medications:

Follow Instructions: The primary guideline is to read and adhere to the instructions provided with the medication or on its packaging. Michelle A Chui emphasizes the importance of checking the expiration date on the bottle.
Unpacking Safely: Properly unpack medications by removing items like cotton balls placed on top of the medication to prevent moisture absorption.
Monitor Changes: Regularly check for any unusual alterations in your medication. Do not consume medications that have changed color, or if pills are harder/softer than usual, or if they are sticking together.
Traveling Safely: When traveling, prioritize keeping pills in their original packaging to prevent light exposure. Shazia Zafar advises travelers to store medications in carry-on luggage and in their original containers to facilitate security checks.
Pharmacist Consultation: Don’t hesitate to consult with your pharmacist for a review of your medications. Pharmacists can identify any abnormalities and provide guidance on optimal storage practices tailored to your specific medications.

Study Find Eating More Tomatoes Might Help Prevent and Manage High Blood Pressure.

January 4, 2024

Ditch the apples—incorporating a daily tomato into your diet could prove beneficial for heart health, as suggested by a recent study published in the European Journal of Preventive Cardiology. The research indicates that tomatoes and tomato-based products may contribute to the prevention and management of high blood pressure.

Tomatoes, belonging to the nightshade vegetable family, are notably rich in potassium—a nutrient recognized for its ability to lower blood pressure by counteracting the effects of sodium in the body. They also hold a significant place in heart-healthy diets.

Rosa Maria Lamuela-Raventos, PharmD, co-author of the study and director of the Institute for Research on Nutrition and Food Safety at the University of Barcelona, emphasized the global popularity, wide availability, and affordability of tomatoes. She stated, “They are an important part of some of the best diets, including the Mediterranean diet.”

Understanding the potential role of tomatoes in managing high blood pressure and optimizing the benefits of this nightshade vegetable is crucial.

Increased Tomato Consumption Associated with Lowered Risk of Hypertension

In the recent study, over 7,000 Spanish adults, deemed high-risk for cardiovascular disease, participated by providing information on their lifestyles, health status, and dietary habits, particularly focusing on tomato consumption.

The participants’ daily intake of tomatoes, whether raw or in various forms like tomato sauce and gazpacho, was detailed in the questionnaires. The study categorized tomato consumption into four groups based on serving sizes:

Lowest (<44 grams)
Intermediate (44–82 grams)
Upper-intermediate (82–110 grams)
Highest (>110 grams)

The findings indicated an inverse relationship between tomato consumption and hypertension risk in the lowest and intermediate groups, with a notable association observed in the highest group. The research highlighted a 36% reduction in hypertension risk with higher tomato consumption, emphasizing that even moderate intake has a positive effect on lowering blood pressure.

For participants with higher initial blood pressures, the changes in blood pressure were less significant. The authors hypothesize that this could be attributed to their older age, longer-standing high blood pressure, and other pre-existing risk factors, making substantial changes more challenging.

Why Eat Tomatoes for Heart Health

Tomatoes were chosen as the focus of this research due to their widespread availability and affordability, making them a staple in various global diets.

The American Heart Association (AHA) recommends tomatoes as part of a heart-healthy diet, particularly for their role in reducing hypertension. Tomatoes are high in potassium, a key factor emphasized by the AHA in the endeavor to lower blood pressure.

Gregory Katz, MD, a cardiologist at NYU Langone Health, highlights the substantial data linking higher potassium intake to lower blood pressure. However, it remains unclear whether this association is indicative of a generally healthful diet or if potassium serves as a proxy for a reduced sodium intake, or if potassium itself is the primary influencing factor.

The established lifestyle modification of reducing sodium and increasing potassium is a recognized strategy for minimizing hypertension risk. Elevating potassium intake through tomatoes, rich in this essential nutrient, proves to be an effective approach.

Beyond potassium, tomatoes are also a valuable source of lycopene, a carotenoid with various cardiovascular benefits, including antioxidant, anti-inflammatory, anti-atherogenic, and antiplatelet effects. Research suggests that these properties contribute significantly to lycopene’s antihypertensive effects.

Tomatoes as Part of a Heart Healthy Diet

While there is a limited number of randomized clinical trials specifically focusing on tomatoes for reducing hypertension risk, their potential role is likely attributed to their potassium and lycopene content.

It’s important to note that the current study is observational, and its design restricts the ability to establish causal relationships, as pointed out by Katz. However, incorporating tomatoes into a daily diet has no known downsides or negative effects.

Numerous clinical trials have extensively researched diets known to reduce blood pressure, such as the Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH). These studies emphasize the efficacy of eating patterns rich in fruits, vegetables, and whole grains for blood pressure reduction.

Simply adding a tomato a day to your diet may not independently lower blood pressure. It is essential to include tomatoes as part of a well-balanced, heart-healthy diet that incorporates whole grains, legumes, and healthy fats. Additionally, consuming a variety of high-potassium foods ensures meeting potassium needs while obtaining essential vitamins, minerals, and antioxidants.

Gregory Katz emphasizes that the most effective diet for lowering blood pressure is one that individuals can adhere to over the long term. Physical activity, potentially even more than diet, is also crucial.

Other potassium-rich foods recommended for a heart-healthy, antihypertensive diet include avocados, yogurt, bananas, oranges and orange juice, spinach, raisins, tuna, and beets. However, individuals with kidney disorders, often associated with high blood pressure, should be cautious about excessive potassium intake. Kidneys regulate potassium levels, and inefficient kidney function can lead to hyperkalemia, a serious condition associated with elevated potassium levels. Before making significant changes to potassium intake or considering potassium supplements, it is advisable to consult with a healthcare provider or a registered dietitian, particularly for individuals with kidney disorders.

Exploring the Connection: Ozempic and Colorectal Cancer Risk Reduction

January 3, 2024

New findings suggest that medications used to address obesity, particularly GLP-1 receptor agonist medications like Ozempic, may play a role in lowering the risk of colorectal cancer (CRC), as per a recent study published in JAMA Oncology. Analyzing electronic health records of over 1.2 million patients receiving antidiabetic agents from 2005 to 2019, researchers focused on the impact of GLP-1 RAs on CRC incidence compared to other antidiabetic drugs. The results indicated a 44% reduction in CRC incidence among those treated with GLP-1 RAs compared to insulin-treated patients and a 25% reduction compared to those on Metformin.

Considering the drug class’s effectiveness in combating obesity, it’s essential to weigh the correlation against associated risk factors. Obesity, type 2 diabetes, and being overweight are known contributors to increased CRC incidence and worsened prognosis. Elevated glucose and insulin levels in diabetes patients can promote tumor growth, according to Cedrek McFadden, MD, a member of the Colorectal Cancer Alliance medical scientific advisory committee.

While GLP-1 RAs, such as Ozempic, contribute to weight loss, Nathan Berger, MD, co-lead researcher of the study, suggests that weight reduction may not be the sole factor in CRC risk reduction. The study primarily focused on cancer prevention rather than mechanisms, and GLP-1 RAs significantly reduced CRC incidence in patients with or without overweight and obesity.

To delve deeper into the association between GLP-1 RAs and cancer risks and progression, extensive and prolonged clinical trials are essential, according to McFadden. He emphasizes that the decreased CRC risk observed in GLP-1 users likely stems from factors like weight reduction, improved insulin sensitivity, and adopting a healthier lifestyle, rather than being a direct consequence of the medication itself.

Evaluating the Likelihood of Developing Colorectal Cancer

Colorectal cancer stands as the second leading cause of cancer-related deaths in the United States, with an estimated 153,020 new diagnoses projected by the Colorectal Cancer Alliance this year. While the median age for diagnosis is 66 years for both genders, there has been a notable 2.2% annual increase in rates for individuals under 50 between 2007 and 2016.

African Americans face a higher incidence and mortality rate, experiencing a 20% higher incidence and a 35% elevated risk of colorectal cancer-related death. Cedrek McFadden, a member of the Colorectal Cancer Alliance, attributes these disparities to genetic factors, aggressive tumor biology, lower screening rates, and socioeconomic differences. A lingering stigma associating the disease primarily with older white men may also contribute to a lack of preventive strategies among African Americans.

Various risk factors, including family history, tobacco and alcohol use, age, inflammatory bowel disease, diet, obesity, and previous radiation exposure, are associated with colorectal cancer. Nathan Berger emphasizes the use of comprehensive algorithms to assess CRC risk, particularly heightened by factors like overweight/obesity and diabetes. Screening methods, such as FIT, colonoscopy, and Cologuard, are available. For those with a significant family history or specific genetic syndromes, genetic testing is often recommended to evaluate inherited risk factors. Regardless of family history, prompt reporting of any unusual digestive system symptoms, such as changes in bowel habits, blood in stool, abdominal pain, or unintended weight loss, is crucial for early detection and intervention.

Proactive Screening: The Optimal Defense Against Colorectal Cancer

Regular screenings play a crucial role in the prevention of colorectal cancer, making it one of the most preventable cancers. Screening typically commences at the age of 45 with a colonoscopy. However, if there is a family history of colorectal cancer or polyps, screenings should begin ten years prior to the family member’s diagnosis, as explained by McFadden.

Regardless of age, individuals experiencing symptoms associated with colorectal cancer, such as rectal bleeding, changes in bowel habits, abdominal pain, fatigue, or unexplained weight loss, should undergo a colonoscopy. The Colorectal Cancer Alliance has taken steps to address disparities in screening and treatment through the Health Equity Fund. This initiative aims to enhance outcomes for those disproportionately affected by the disease and facing barriers to quality care.

The Health Equity Fund offers free colonoscopies for Black Americans, online screening quizzes, financial assistance for non-medical expenses related to CRC screening and treatment, among other resources. In the event of a colorectal cancer diagnosis, McFadden emphasizes that doctors will assess the cancer stage and explore appropriate treatment options, which may involve surgery, chemotherapy, radiation therapy, or a combination of these. For complex cases or challenging treatment decisions, seeking a second opinion from another qualified healthcare professional can provide additional perspectives and insights.

Can You Take Medication Past Its Expiration Date?

January 2, 2024

How Are Medication Expiration Dates Determined?

How Medication Expiration Dates Work and When to Worry

When it comes to medication expiration dates, the FDA plays a crucial role in setting guidelines. Companies must submit stability testing data to the FDA, demonstrating the medication’s effectiveness and safety duration. After the expiration date, the manufacturer cannot guarantee the drug’s full effectiveness and safety, prompting the FDA’s advice against using expired medications.

While some medications may still be usable a few months after their expiration, it’s not a one-size-fits-all scenario. Compressed dry powder forms, like tablets and capsules, may have a longer usable period, but risks increase the further past the expiration date. For liquid medications and those containing aspirin, adhering to the expiration date is crucial, as they may harbor bacteria or break down over time.

The storage conditions also influence a drug’s stability. Medications exposed to sunlight, heat, or moisture may expire faster. Factors like age, health conditions, and storage methods should be considered, particularly for vulnerable populations such as children or older individuals.

To assess whether an expired medication is safe, observe its physical characteristics. If it appears crumbly, discolored, or irregular, it’s safer to discard it. Ultimately, while some medications may still offer partial effectiveness after the expiration date, caution is advised, and adherence to expiration guidelines is recommended, especially for critical medications like those used for cold and flu symptoms.

Clearing Out Your Cold and Flu Medicine Stash

Before considering expired cold and flu medications, the advisable course is to seek new medication promptly, according to Garling-Nañez. Utilizing same-day delivery services or seeking assistance from friends or family members can facilitate this process.

If the medication has recently expired, particularly within the last couple of months, there’s a likelihood that it may still retain some effectiveness, as indicated by Curtis. However, opting to use recently expired medication involves a degree of risk.

Prevention becomes crucial in steering clear of the decision to use expired medications. Garling-Nañez suggests dedicating around 20 minutes to review all medications, paying special attention to expiration dates.

Disposing of expired medications is a necessary step, and the procedure varies by state, notes Curtis. Interested individuals can find drug take-back locations through an FDA website.

In cases where drug take-back is unavailable, proper disposal involves mixing expired drugs with substances unappealing to animals and humans, such as coffee grounds or kitty litter, before discarding them in the regular trash. This precautionary measure aims to prevent accidental ingestion and potential contamination of water sources.

Being Ready for the Cold and Flu Season

Ensuring preparedness for the cold and flu season involves not only discarding expired medications but also replenishing essential medicines to promote overall health. It is vital to have access to medications that not only fall within the specified expiration date but also effectively alleviate symptoms.

According to Curtis, everyone should have either Tylenol or Advil products, such as acetaminophen or ibuprofen, on hand in case of fever. Additionally, nasal saline, available over the counter, can assist in maintaining nasal cleanliness. Curtis recommends keeping a cough suppressant, decongestant, or antihistamine for addressing a runny nose.

Garling-Nañez emphasizes the importance of identifying preferred remedies that have proven effective in the past and ensuring they are up-to-date. Beyond over-the-counter medications, various strategies can enhance preparedness for the cold and flu season.

Curtis highlights the significance of maintaining hand hygiene by regularly using hand sanitizer, especially when entering or leaving public places. Simple measures like staying home when sick and getting vaccinated against respiratory viruses contribute to effective prevention of seasonal illnesses.

Type 2 Diabetes Snacks

December 30, 2023

For individuals with diabetes, opting for snacks that promote blood sugar control is crucial. Discover the snacks that can be beneficial and those best avoided to effectively manage diabetes.

Type 2 diabetes, a persistent condition, arises when the body fails to effectively utilize insulin, a hormone crucial for facilitating glucose entry into cells. Glucose, a form of sugar derived from consumed food, is essential for energy production. However, when insulin fails to transport glucose into cells, it accumulates in the bloodstream, resulting in elevated blood glucose levels.

Given that glucose originates from dietary sources, individuals with type 2 diabetes must be vigilant about their diet, particularly their carbohydrate consumption. Carbohydrates undergo breakdown into glucose, causing a surge in blood sugar levels. This awareness extends beyond main meals to snack times. Selecting snacks rich in protein, fiber, and healthy fats is pivotal for managing blood sugar levels and curbing hunger between regular meals.

Best Snacks for Diabetes

When contemplating snacks, the association often leans towards high-sugar, carbohydrate-laden options. Nevertheless, there exists a plethora of diabetes-friendly snacks that can satiate your taste buds without causing a spike in your blood sugar levels.

Greek yogurt with berries

Unsweetened greek yogurt is an excellent snack for diabetes because it is high in protein and relatively low in carbohydrates.

One single-serve 5.5-ounce container of unsweetened, plain, nonfat Greek yogurt provides:

Calories: 92
Protein: 16.1g
Fat: 0.6g
Carbohydrates: 5.7g
Calcium: 173mg, 13% of the daily value

Enhancing your yogurt with a medley of blueberries, strawberries, or raspberries not only introduces natural sweetness but also brings the benefits of low sugar content and high fiber. Berries, being inherently low in sugar, make for a flavorful and nutritious addition. For instance, half a cup of fresh raspberries contains 4 grams of fiber, 7.3 grams of carbohydrates, and merely 2.7 grams of sugar (USDA, 2019).

Fiber plays a pivotal role in any diet, particularly for individuals managing diabetes. Its unique characteristic of being indigestible and non-absorbable prevents a spike in blood sugar, unlike some other carbohydrates. Beyond its impact on blood sugar, fiber contributes to improved digestion, offers protection against heart disease, and supports weight management (CDC, 2022).

Hard-boiled eggs

Hard-boiled eggs are a great high-protein snack for those with diabetes.

One large hard-boiled egg provides: (USDA, 2019)

Calories: 77.6
Protein: 6.3 g
Fat: 5.3g
Carbohydrates: 0.6g
Fiber: 0g

Eggs are also filling and can help reduce your overall daily calorie intake, which may lead to weight loss (Keogh, 2020). If you’re overweight, a modest weight loss of 5-10% of your body weight can improve your blood sugar control and decrease the need for glucose-lowering medications (ADA, 2015)(CDC, 2022).

Celery sticks and nut butter

Dipping celery sticks in nut butter, such as peanut butter, is another satisfying snack to keep you energized until your next meal. Celery sticks are naturally very low in calories and carbohydrates.

One cup of raw celery provides: (USDA, 2019)

Calories: 14.1
Protein: 0.7g
Fat: 0.2g
Carbohydrates: 3g
Fiber: 1.6g

Pairing celery sticks with one to two tablespoons of nut butter adds protein and healthy fats to your snack to curb hunger and promote blood sugar control.

One tablespoon of peanut butter provides: (USDA, 2019)

Calories: 94.4
Protein: 3.8g
Fat: 8g
Carbohydrates: 3.5g
Fiber: 1.1g

Popcorn

As long as it’s not served with butter or salt, popcorn is considered a good whole-grain snack for diabetes (Asif, 2014).

One cup of air-popped, unsalted popcorn provides: (USDA, 2019)

Calories: 30
Protein: 1g
Fat: 0.34g
Carbohydrates: 6.2g
Fiber: 1.2g

Popcorn is low in calories, which can support a healthy weight and overall management of type 2 diabetes. It also contains fiber, which can help you feel full and consume fewer calories throughout the day, also helping with weight management (MedlinePlus, 2015).

Because the majority of calories in popcorn come from carbohydrates, be sure to measure your portions and limit yourself to three cups, which provides around 18.6 grams of carbohydrates.

Raw vegetables with hummus

Hummus is a creamy spread made from mashed chickpeas. It contains complex carbohydrates, plant-based protein, fiber, and healthy fat.

Two tablespoons of hummus provide: (USDA, 2019)

Calories: 82.4
Protein: 2.5g
Fat: 5.8g
Carbohydrates: 5.1g
Fiber: 1.8g

Hummus has a low glycemic index, which means its carbohydrates take the body longer to digest and break down, causing a gradual rise in blood sugar. This means it is less likely to cause blood sugar spikes (Reister, 2020).

Hummus pairs perfectly with raw vegetables, including broccoli, carrots, and bell peppers, for a nutrient-rich, healthy snack for diabetes.

Handful of almonds

Almonds are an easy, nutrient-dense, on-the-go snack. Research shows that almonds and other tree nuts can improve blood sugar control for people with type 2 diabetes. Almonds are low in carbohydrates and high in magnesium and heart-healthy monounsaturated fats, which are thought to promote blood sugar control (Viguiliouk, 2014). They’re also a good source of other health-promoting nutrients, including fiber, protein, riboflavin, and vitamin E (Barreca, 2020).

One handful, or about 23 almonds, provides: (USDA, 2019)

Calories: 164
Protein: 6g
Fat: 14.1g
Carbohydrates: 6g
Fiber: 3.5g
Magnesium: 76.5mg, 18% of the daily value
Riboflavin: 0.32mg, 25% of the daily value
Vitamin E: 7.26mg, 48% of the daily value

Apple slices and peanut butter

Apple slices dipped in peanut butter is a quick and easy on-the-go snack for people with diabetes. Apples and other fruit are considered low glycemic index foods because of their fructose and fiber content. The natural sugar in apples can also satisfy a sweet tooth, curbing cravings (ADA).

One medium-sized, raw apple with the skin on provides: (USDA, 2019)

Calories: 94.6
Protein: 0.5g
Fat: 0.3g
Carbohydrates: 25.1g
Fiber: 4.4g

Paired with one tablespoon of peanut butter, you will have a diabetes-friendly snack that contains healthy fats, fiber, and protein to promote blood sugar control.

Tuna salad

Tuna salad is a high-protein, refreshing snack that can be made in just a few minutes by combining a can of tuna and one to two tablespoons of mayonnaise. You can also add other ingredients, such as bell peppers and celery, if you’d like.

One 5-ounce can of tuna provides: (USDA, 2019)

Calories: 121
Protein: 27g
Fat: 1.3g
Carbohydrates: 0.1g

Tuna is a good source of omega-3 fatty acids, which can reduce triglyceride levels (a type of fat in the blood), protect against strokes, and keep your heart healthy.(MedlinePlus, 2021).

You can eat tuna salad by itself or enjoy it with whole-grain crackers. Swap the mayonnaise for mashed avocado for an extra nutritional boost.

Avocado toast

Avocados are good for people with diabetes because they are low in carbohydrates yet high in fiber. They also provide a multitude of vitamins and minerals and are a good source of healthy fats.

One-half of an avocado provides: (USDA, 2019)

Calories: 160
Protein: 2g
Fat: 14.7g
Carbohydrates: 8.5g
Fiber: 6.7g

For a diabetes-friendly snack, mash half of an avocado and spread it on a piece of fresh, toasted whole-wheat bread. Sprinkle with sea salt and red pepper flakes.

Snacks to Avoid

You’ll want to limit your intake of processed foods, refined grains, and added sugar when snacking. These foods tend to raise your blood sugar faster than whole, minimally processed foods.

Snacks to limit include: (NIDDK, 2016)

Chips
Cookies
Candy
Sugary beverages
Ice cream
Sweetened yogurt
Salty foods
Fried foods
Fruit juice
Sweetened cereal
Canned fruit
Cereal bars

When you do have these snacks, you should do so less often and in smaller amounts (MedlinePlus).

When to Snack

Snacks play a multifaceted role—they can sustain you until your next main meal, prevent blood sugar dips, and provide fuel for physical activity.

Previously, the conventional wisdom held that individuals with type 2 diabetes should incorporate multiple daily snacks into their meal plans to stabilize blood sugar. However, this perspective has evolved, especially for those already maintaining three well-balanced meals each day (ADA, 2020).

Determining the necessity of a snack can be based on internal hunger cues and regular monitoring of blood sugar levels. If hunger strikes between meals, opting for a low-carbohydrate snack is advisable, such as those mentioned earlier.

While type 2 diabetes is commonly associated with elevated blood sugar, it’s crucial to acknowledge the potential for low blood sugar, especially for those using insulin or specific medications. In such cases, easily digestible foods containing around 15 grams of carbohydrates, like half a cup of juice, a tablespoon of honey, or glucose tablets, can be consumed. Monitor blood sugar levels, and if they remain low, repeat the 15-gram serving every 15 minutes until levels normalize. Subsequently, shift to a well-balanced snack or meal to maintain blood sugar within the target range (ADA).

Additionally, your healthcare provider might suggest having a snack before bedtime or during exercise to prevent blood sugar from dropping too low (MedlinePlus, 2022).

10 Medications You Should Never Mix With Coffee

December 29, 2023

If you’re like the majority of Americans, your day likely kicks off with a hot cup of coffee, often followed by a trip to the bathroom—a common consequence of caffeine consumption.

Research indicates that coffee has the potential to stimulate the stomach, influencing the speed at which food traverses the digestive system.1 However, beyond its impact on digestion, your morning coffee can also interact with the medications you might be taking, influencing the rate at which these drugs are absorbed into your bloodstream.

This implies that consuming coffee simultaneously with your medications could impact their efficacy. In 2020, a team of researchers conducted an extensive review of various medications and their interactions with coffee. Their findings highlighted that coffee “significantly affects the absorption, distribution, metabolism, and excretion of many drugs.”

It’s important to note that not all medications are susceptible to the effects of coffee. Continue reading to discover which medications should not be combined with coffee and what factors to consider.

Cold or Allergy Medication

Cold and allergy medications, commonly utilized by millions of individuals, frequently incorporate central nervous system stimulants such as pseudoephedrine.5 Since coffee is also a stimulant, pairing your allergy medication with coffee may heighten symptoms like restlessness and disrupt sleep.

Certain allergy medications, such as fexofenadine, should be avoided in conjunction with coffee, as it has the potential to overstimulate the central nervous system, intensifying restlessness symptoms.6 It is advisable to consult your healthcare provider for guidance on combining coffee with cold or allergy medicine.

Thyroid Medicine

If you’re dealing with hypothyroidism, a condition where your thyroid gland, resembling a butterfly-shaped structure at the front of your neck, fails to produce an adequate amount of thyroid hormone, various symptoms such as weight gain, dry skin, joint pain, hair loss, and irregular menstrual periods may manifest.

In the management of this condition, many individuals are prescribed levothyroxine or other thyroid medications to restore hormonal balance. Research indicates that consuming coffee concurrently with your thyroid medication can diminish the absorption of the medicine, potentially diminishing its effectiveness. This isn’t a minor impact; reports from patient cases suggest that coffee may reduce the absorption of thyroid medicine by more than half.

Alzheimer’s Medicine

Alzheimer’s disease ranks as the seventh leading cause of death in the United States, predominantly impacting individuals aged 65 and older. This neurodegenerative disorder hampers cognitive function, leading to challenges in thinking, remembering, and performing daily activities. Numerous Americans grapple with Alzheimer’s disease and often rely on medications such as donepezil, rivastigmine, and galantamine for its management.

Caffeine, present in coffee, can influence Alzheimer’s medication. The caffeine’s impact on the blood-brain barrier can tighten it, potentially diminishing the drug’s passage to the brain. Alzheimer’s medications function by safeguarding the neurotransmitter acetylcholine, and excessive coffee consumption has demonstrated the potential to compromise this protective effect.

Diabetes Medication

Combining your coffee with sugar or milk may result in a surge in blood sugar levels, impacting the effectiveness of your diabetes medication. Moreover, research indicates that caffeine could exacerbate symptoms for individuals with diabetes.

A study published by the American Diabetes Association suggests that the consumption of caffeinated beverages, such as coffee, may elevate insulin and blood sugar levels. While the study was limited in size, prompting the need for more research, the researchers cautioned that excessive caffeine intake could pose challenges in blood sugar management and potentially heighten the risk of diabetes-related complications.

In the United States and other Western nations, diabetes and prediabetes are prevalent health issues. The Centers for Disease Control and Prevention (CDC) reports that over 37 million Americans have diabetes, with nearly 100 million having prediabetes. Given the high prevalence, it’s common for millions of people to rely on diabetes medications as part of their daily routine.

Asthma Medication

Asthma, a chronic condition affecting the lungs, involves inflammation and irritation of the airways, leading to symptoms such as difficulty breathing, coughing, wheezing, and chest tightness. Millions of Americans, encompassing both adults and children, grapple with asthma and often rely on medications for its management.

During asthma exacerbations, many individuals turn to bronchodilators like aminophylline or theophylline. These medications function by relaxing the airways, facilitating easier breathing, but they are accompanied by potential side effects such as headaches, restlessness, stomach pain, and irritability. The consumption of coffee or other beverages high in caffeine can elevate the risk of experiencing these side effects. Furthermore, coffee may diminish the absorption and effectiveness of the medication within the body.

Osteoporosis Medication

Osteoporosis, a condition characterized by thin and fragile bones, significantly heightens the risk of bone fractures. This widespread ailment impacts millions of individuals, with women—particularly those postmenopausal—being most susceptible.

To combat osteoporosis, medications like risedronate or ibandronate are commonly prescribed. However, taking these drugs concurrently with coffee is discouraged, as it can diminish their effectiveness. Optimal absorption of these medications is achieved when taken on an empty stomach, preferably before consuming any food or beverages, with only plain water used to swallow the pill. Drinking coffee alongside these medications can curtail their efficacy by over half.

Antidepressants

Antidepressant medications have become a prevalent aspect of daily life, with one in 10 teens and adults relying on them, according to the CDC. They are particularly widespread among adults in their twenties and thirties, addressing depression, a mood disorder impacting both emotions and functionality.

Coffee consumption can influence the way your body processes antidepressant medications. Specific drugs such as fluvoxamine, amitriptyline, escitalopram, and imipramine may undergo altered metabolism when taken simultaneously with coffee, particularly in substantial amounts. The absorption of these medications can be diminished by coffee, potentially reducing their effectiveness.

Of note, studies highlight that fluvoxamine, in particular, can intensify the typical side effects of caffeine, leading to symptoms like insomnia and heart palpitations. It is advisable to separate the intake of medication from coffee consumption to optimize the therapeutic effects.

Blood Pressure Medicine

Hypertension, or high blood pressure, affects tens of millions of Americans, posing an increased risk of heart disease and stroke. Given its often asymptomatic nature, effective management is crucial.

Individuals with hypertension frequently rely on blood pressure medications, such as verapamil or propranolol, which function by reducing heart rate, thereby easing the heart’s workload in pumping blood to all body cells.

However, consuming coffee concurrently with blood pressure medications like felodipine may hinder optimal drug absorption, potentially diminishing its effectiveness. Consult with your healthcare provider to determine the best timing for your medication and your morning coffee.

Antipsychotic Medicine

Antipsychotic medications play a crucial role in managing conditions such as schizophrenia, mania, major depressive disorder, and various mental health issues, with nearly four million Americans relying on them annually. These medications exert their effects by either inhibiting specific neurotransmitters or blocking receptors in the brain.

Psychosis-treating medications encompass phenothiazine, clozapine, haloperidol, and olanzapine. Consuming coffee alongside these medications may lead to reduced absorption, impacting their effectiveness. Research indicates that coffee can alter the metabolism or breakdown of many of these medications in the body. To maximize the therapeutic benefits, it is advisable to take these medications with water rather than coffee.

Melatonin

Melatonin, a natural hormone produced by the body, plays a crucial role in inducing sleepiness as evening approaches, responding to the decreasing sunlight that signals to the brain it’s time to rest. In supplement form, available over-the-counter (OTC), melatonin is commonly used to aid sleep.

In contrast, coffee acts as a stimulant, promoting alertness and wakefulness. The caffeine in coffee opposes the function of melatonin, making it challenging to fall asleep. Concurrently consuming coffee with melatonin may interfere with the hormone’s production, potentially diminishing its effectiveness, as these contrasting substances might counteract each other.

When to Consult a Healthcare Professional

If you are prescribed any of these medications, particularly if they are to be taken in the morning, consider postponing your first cup of coffee.

For individuals taking multiple medications, it’s advisable to discuss with your healthcare provider the optimal way to coordinate your medication schedule with your coffee consumption. If you encounter any undesirable side effects such as restlessness, jitteriness, or insomnia, consult your healthcare provider for guidance on finding a solution.

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