We do not always rush to the doctor when we have certain health problems, often seeking advice from friends and relatives. They are happy to advise what exactly helped them and in what situations. Some recommend doctors, others recommend drugs and therapies, including those that are not scientifically proven to be effective.
The argument “it helped me” for many turns out to be decisive, after which we ourselves are ready to try even the strangest treatment, because it turned out to be useful to someone. But the reality is that what works for some people may not work at all for others.
Even if you do not take into account the methods of alternative medicine, drugs with proven effectiveness will affect different people in different ways. And there are several explanations for this.
The person is already taking some medication
In the event that a person is undergoing therapy, other medicines may not be suitable for him. They may simply not work against the background of taking others, or they may have an undesirable effect.
For example, antidepressants belonging to the class of selective serotonin reuptake inhibitors are categorically incompatible with non-steroidal anti-inflammatory drugs that are used for pain and fever. Taking them together can cause severe internal bleeding. A similar effect can be expected while taking anticoagulants and aspirin.
A person’s weight is abnormal
The dosage of the drug, as a rule, depends on the weight of the patient, and therefore, if you do not take this parameter into account, but simply take “half a tablet” on the advice of a colleague, you can get another, completely unexpected effect instead of the expected one.
So, for a person with a very large weight, the medicine may not work at all, and for someone who weighs little, there is a risk of overdose and all the side effects associated with it.
The body may react differently to medications
A huge number of genes are responsible for the work of our body, each of which can contain point mutations – polymorphisms. Some polymorphisms can affect how our body interacts with drugs: they may bind less well to the target to be acted upon, destroy drugs before they even begin to act, or, conversely, interfere with their metabolism, which causes drugs to begin circulate longer in the blood. In this case, the chances of side effects seriously increase.
Some polymorphisms can be identified during genetic testing, but in reality, such tests are not carried out so often.
Another reason why the drug will not work as advertised is the influence of intestinal bacteria, the so-called microbiome. A 2019 study showed that some gut micro-organisms can inhibit the effects of drugs, while others, on the contrary, activate them.
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The body develops an inflammatory process
Any inflammatory process in the body affects the work of cytochrome P450, an enzyme that is involved in the process of drug metabolism.
Cytochrome P450 is synthesized by liver cells, which, with the progression of the inflammatory reaction, is also involved in the production of cytokines and interferons involved in the development of the immune response. More resources are spent on the synthesis of these substances than on cytochrome P450, which is needed to destroy drugs. Drugs continue to circulate in the blood for longer than they should, causing overdose and side effects.
A common tactic is to reduce the dosage of drugs prescribed against the background of inflammation, and increase it after the inflammatory reaction has been stopped.
The cure just won’t work
There may simply be no receptors on the surface of the cells for which the drug is intended to bind, or there will be too few such receptors – often this is due to genetic characteristics. In this case, even a properly selected dose will be practically useless, since the drug simply cannot bind to target cells.
In addition, it is possible that a colleague or acquaintance will advise a medicine that is not at all intended to deal with the problem that caused this or that symptom. For example, the widespread practice of drinking antibiotics for viral diseases, including influenza and coronavirus, does not cause any improvement in the condition, because drugs of this type fight only bacterial infections.
By the way, the consequences of self-administration of treatment can be much larger than just an untreated disease. So, in 2015, WHO experts called the appointment of antibiotics without consulting a doctor, simply on the advice of friends and acquaintances, one of the reasons for the widespread bacterial resistance to antibiotics.
In Russia, by the way, only 56% of respondents took antibiotics as prescribed by a doctor – and this turned out to be one of the lowest rates among all respondents. Such tactics have already led to the fact that it has become more difficult to treat bacterial infections, and some of them have become completely resistant to absolutely all existing antibiotics.
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