By Dr. Marie Andersson

Part 2 of a 3-part series on vitality

In Part 1, we covered the fats that build and repair every cell membrane in your body. But even the healthiest membrane can’t do its job if it’s constantly fighting an uphill battle, and for a lot of us, that uphill battle is the medicine cabinet. This issue is about the other side of vitality: what happens when the body carries more pharmaceutical load than it was built to handle, and how your daily choices can quietly turn genes on or off without changing a single letter of your DNA.

None of this is an argument against medication. Some drugs are lifesaving, plain and simple. But there’s a real difference between using a medication as a bridge back to health and using it as a permanent patch over a problem that was never actually addressed. This issue is about understanding that difference, and about the deeper layer underneath it, called epigenetics, that determines which of your genes actually get switched on.

The Polypharmacy Problem

Let’s start with a number that might surprise you.

Living a long life is wonderful, if you’re actually healthy while you’re living it. But living a long life while needing multiple pharmaceuticals and not feeling well has become commonplace in our society. The average US senior citizen (age 65 and older) takes 4 to 5 prescription drugs daily, and about 9 out of 10 older adults rely on at least one prescription medication.

This high volume of medication use has a name: polypharmacy. A few statistics put it in perspective:

• The 5-Drug Threshold: more than 40% of older adults take 5 or more prescription medications concurrently.
• High-Volume Usage: nearly 20% of seniors take 10 or more prescription drugs chronically.
• Annual Prescriptions: seniors aged 65–69 fill an average of 15 prescriptions per year, a number that climbs to 18 for those in their early 80s.

Here’s the vitality connection: each of those medications gets metabolized by the same liver and kidneys, competing for the same detox pathways, and several common drug classes deplete nutrients your cells depend on for energy and hormone production along the way. Statins can deplete CoQ10; metformin can deplete B12; diuretics can deplete magnesium and potassium. Stack enough medications on top of each other, and that cumulative burden often shows up as fatigue, brain fog, or hormonal imbalance, the very things vitality is supposed to protect.

Understanding Black Box Warnings

Some of those prescriptions carry a warning most people never actually read.

Have you ever heard of a Black Box Warning? Do you read the package insert on the prescription drugs you take? A drug receives a Black Box Warning (officially called a boxed warning) when the FDA determines it carries a risk of serious, life-threatening, or permanently disabling side effects. It’s the strictest warning label the FDA can require without pulling the drug from the market entirely. A few things typically have to be true for the FDA to issue one:

• Evidence of Severe Harm: substantial clinical data, real-world observation, or, in its absence, significant animal toxicity links the drug to major adverse reactions, such as fatality, severe injury, or hospitalization.
• Emergence of New Data: this evidence can come from the original clinical trials or emerge after approval, through the FDA’s Adverse Event Reporting System (FAERS), once thousands of people have used the drug in the real world.
• Inadequate Risk Management: the warning is typically issued when standard labeling, advisory letters, or patient monitoring guidelines aren’t enough on their own to prevent the dangerous outcomes.
• Risk vs. Benefit Imbalance: the FDA requires the warning so that both doctors and patients stay hyper-aware of the specific hazard and can weigh it deliberately against the drug’s potential benefits.

Medication vs. Root-Cause Healing

But most medications never carry a warning that dramatic, so does that mean they’re completely safe?

Let’s say your medication doesn’t have a Black Box Warning. Did you know there’s no algorithm or program that can definitively tell you whether the medications you take in combination will harm you, especially once you’re taking more than two at once?

In my clinical experience, if a patient over 50 comes to see me on no medication at all, I’m genuinely surprised. What frightens me more is that I now commonly see multiple medications in patients under 50, even in young adults and children.

We can do better than that. I’m not saying all drugs are bad; there’s a time and place for pharmaceutical help, and it can be lifesaving. But if you need medication today, does that mean you should be on it for the rest of your life? Doesn’t it make more sense to take it as needed while you work on correcting whatever’s actually wrong, so that eventually you don’t need it anymore? This is where Part 1 comes back in: repairing the cell membrane and metabolic function that got you here in the first place is what root-cause work actually looks like, not just managing symptoms indefinitely.

In practice, that means asking why the problem showed up in the first place, whether it’s a nutrient deficiency, an inflamed cell membrane, a toxin exposure, or ongoing stress, and addressing that directly instead of only managing the symptom with a prescription indefinitely.

It’s Not Just Genetics: How Epigenetics Works

But root-cause work goes even deeper than diet and cell membranes. It reaches all the way down to which of your genes are actually switched on.

Have you been told that your condition is genetic, that you have it because your mom or dad had it? What does that actually mean?

There are multiple factors involved in how a disease gets expressed. Your hardware, the DNA you were born with, is essentially static; for a gene to actually mutate, something fairly extreme has to happen to it. Your software is your epigenetics: your lifestyle, environment, diet, stress, and toxin exposure. Think of it like a computer that stops working properly. It’s rarely the hardware that’s broken; it’s usually a change in the software.

We only actively express less than 2% of our DNA. The rest are non-coding genes that are supposed to stay switched off. Epigenetics is what flips those switches, and turning on a gene that should have stayed off is exactly what epigenetic expression means.

When your genes are exposed to toxins, the expression of those genes can change and switch on a disease process. The exposure doesn’t even have to cause a mutation in the DNA to matter; it can simply shift a cell’s behavior, for example nudging an immune cell to run more “pro-inflammatory” than “regulatory.” We’ll dig into exactly where those toxin exposures come from, and what you can do about them, in Part 3.

Recognizing what’s driving your genes to misbehave is the first step toward changing it. That’s the second pillar of vitality: knowing the difference between managing symptoms and addressing root cause, and seeing that your daily choices shape your own gene expression. Toxin exposure, one of the biggest levers you have, is next.

Have Questions About Your Medications or Epigenetic Health?

If you’d like to talk through your current medication list, understand whether a root-cause approach could reduce your reliance on any of them, or learn more about epigenetic factors affecting your health, we’d love to help. Contact us to get started.

As always, do not stop or change any medication without first talking to your prescribing doctor.

Next up in this series: Part 3 will cover toxin exposure, endocrine disruptors, and the daily lifestyle habits that support lasting vitality.

Note: This content is intended for informational purposes. Always consult a qualified healthcare professional before making changes to your health management plan.