Dr. Brian Lum is a certified functional medicine practitioner who has spent more than a decade specializing in chronic and complex illnesses. In our practice, new patients who are extremely sensitive to medications or supplements are the norm rather than the exception.
This sensitivity can include 'paradoxical reactions' which is when a supplement or medication causes an opposite reaction than what the patient was expecting.
Often, patients arrive in our care because these reactions are downplayed in hospitals or they are told "its all in their head."
When patients take an anxiety medication that causes a panic attack or take an herbal supplement that causes chest pain and a terrible feeling of impending doom - often, we can find the reason behind these seemingly strange reactions.
Functional medicine is ideal for treating chronic illness and unusual symptoms because it uses specialized testing to pinpoint causes and high-grade supplementation to restore health.
Specificity matters in the diagnosis and treatment of illness. It often makes the difference between a full recovery and years of wasted time and unnecessary suffering.
Paradoxical Reactions/Contrary Reactions to Medications
Many patients try to self-treat when they first experience new symptoms. For example, if they have anxiety, they may try lemon balm, magnesium, calming teas, or different CBD oils before trying pharmaceutical medications.
In some people, each of these may cause an unexpected reaction. An example would be if a person who took an anti-anxiety medication had a paradoxical reaction of increased anxiety or a panic attack.[1]
A paradoxical reaction like this can last for minutes, hours, or days or precipitate a new pattern and cause anxiety to be heightened for a longer period of time. [2}
Reasons for Contrary or Paradoxical Reactions
1. Different Processing Times
People detoxify drugs at different speeds based on environmental, behavioral, and genetic factors, as well as the health of underlying organ systems. These factors can affect an individual's detoxification rate.
Previous infections can also directly affect organ function and cause a medication to be processed more slowly. [3]
If this rate is affected, whether due to your natural predisposition or a recent illness, this could cause an anxiety medication to have a frighteningly strong effect or a pain medication to cause additional pain.
Genetic testing can be done to determine whether there is a genetic component to your reactions and assess what medications (including anesthetics) would be safer options for you in the future.
Processing times also vary considerably for those with food allergies and sensitivities and those with compromised gastrointestinal tracts.
2. Your Taking the Wrong Medication/Supplement
Sometimes, patients start self-medicating based on their own research or because of something they heard worked well for someone else. Frequently, this can make underlying symptoms worse. Even when taking a prescribed medication, unusual reactions are not uncommon.
As many doctors can attest, there are some medications or interventions that look great on paper and perform well in studies but simply do not work as expected.
This could be due to the genetic composition of the patient population used in the medical study, the sample size, the research parameters, or even the form of the medication or supplement used in the study.
Additionally, there is usually an order of operations in which underlying conditions are treated to achieve the desired improvement (some infections are higher priority, an impaired digestive tract may be preventing you from absorbing nutrients, etc).
3. You're Taking the Wrong Form
By form, I mean that even if a patient has a simple vitamin deficiency and takes the wrong form of that vitamin, it will not necessarily absorb as it should, and it could cause unintended symptoms.
Magnesium Malate, Magnesium Citrate, Magnesium Oxide, Magnesium Glycinate, and Magnesium Threonate are all "Magnesium," but they are used for different things, and your body will respond differently to each of them. [4]
Similarly, the potency of Olive Leaf Extract, a powerful herbal supplement, can vary by form and by the strength of your digestive system. [5]
Many liquid forms of Olive Leaf Extract are sold in alcohol bases. Unfortunately, alcohol-based extracts can be difficult for a person with a compromised digestive tract or an underlying condition to process.
In this case, a liquid capsule or a tea may achieve the desired effect.
How your herbal supplements are processed matters. Just like a diet based on processed food will make you very sick because it is largely devoid of nutrients, a supplement that has been highly processed or is very old will lack the medicinal components you need.
3. Your Taking Too Much of your Medication/Supplement
Different cultures have different ideas when it comes to medication. Doctors are warned in medical school that while a British person will take half of the medication you prescribe, an American will take twice as much because they assume "more is better."
When a patient is very sick, they are tempted to take more of whatever they are taking because they need something "strong enough" to get them better from such "strong" symptoms. This, however, is very rarely how the body heals.
I have found that relatively gentle treatments actually produce the most dramatic improvements in the most sensitive patients and those who have been sick for the longest time.
4. You Need to Treat the Underlying Problem
Often, a medication or supplement does not work as intended because your internal biological equilibrium is off balance.
An underlying viral or bacterial infection can cause paradoxical reactions. [6] These infections can be tested for, and once the infection is gone, medication tolerance often improves.
Paradoxical reactions can also be caused by excess inflammation from an underlying condition (like diabetes), the aftermath of an infection (like COVID-19, malaria, or influenza), or even from environmental toxins like mold.
Even medications and supplements designed to reduce inflammation often target the wrong kind of inflammation and can have no effect on paradoxical reactions.
For instance, many cases of anxiety are not due to some kind of neurological imbalance or an incapacity to handle stressors but an overwhelming amount of nerve inflammation.
This inflammation can cause a patient to hyper-react to a wide variety of medications and supplements and to situational variables like loud noises and large crowds.
A lack of good quality sleep, a compromised digestive symptom, and the presence of migraines or chronic pain can all be incredibly intense to an inflamed person.
Many patients mention that they used to be able to handle any kind of medicine but can't seem to handle anything now - this is indicative of a change in their internal environment.
Often, the solution is relatively simple - a corrected vitamin deficiency or the removal of a food allergen. Even when the solution requires a more lengthy multi-stage process, a full recovery is common in our practice.
Functional Medicine for Paradoxical Reactions
Usually, if you are experiencing paradoxical reactions, you are experiencing other symptoms as well.
You will not find a step-by-step guide to quickly relieving decades-long symptoms or the "one supplement that will solve all your problems" in these articles.
This is because conditions that took years to form require a specific and targeted approach to untangle. While quick recoveries can occur, they are rarely because of "quick fixes."
A patient can find relief after years of life-altering symptoms, but it requires an informed, holistic approach that incorporates long appointments, targeted treatments, and specific testing.
Dr. Lum offers functional medicine consultations for patients around the world.
If you would like to schedule a free 15-minute consultation to ask questions about becoming a patient, click the link below.
Written by Stephanie Lum and Dr. Brian Lum
Disclaimer: If you think that you may have a medical emergency, call your doctor or 911 immediately. No action or inaction should be taken based solely on the contents of this information. Nor should you ever delay seeking medical advice or treatment due to the information contained on this Website. The information on this Website is not intended to diagnose, treat, cure, or prevent any disease or medical condition. The information discussed is not intended to replace the advice of your healthcare provider. Reliance on the information provided by this Website, Dr. Brian Lum, or Functional Healthcare Institute is solely at your own risk.
Bibliography
[1] Fentanyl/nitrous oxide: Paradoxical anxiety and bradycardia: 2 case reports. 2017. Reactions Weekly(1661) (Jul 22): 136, http://search.proquest.com.ezp-prod1.hul.harvard.edu/scholarly-journals/fentanyl-nitrous-oxide-paradoxical-anxiety/docview/1977189835/se-2 (accessed May 18, 2023).
[2] Kirkpatrick, Daniel, Tyler Smith, Mitchell Kerfeld, Taylor Ramsdell, Hasnain Sadiq, and Arun Sharma. 2016. “Paradoxical Reaction to Alprazolam in an Elderly Woman with a History of Anxiety, Mood Disorders, and Hypothyroidism.” Case Reports in Psychiatry 2016: 6748947–5. https://doi.org/10.1155/2016/6748947.
[3]Alqahtani, Saleh A, and Jörn M Schattenberg. 2020. “Liver Injury in COVID-19: The Current Evidence.” United European Gastroenterology Journal 8 (5): 509–19. https://doi.org/10.1177/2050640620924157.
[4] Pardo, Marta R., Elena Garicano Vilar, Ismael San Mauro Martín, and María Alicia Camina Martín. 2021. “Bioavailability of Magnesium Food Supplements: A Systematic Review.” Nutrition (Burbank, Los Angeles County, Calif.) 89: 111294–111294. https://doi.org/10.1016/j.nut.2021.111294.
[5] Martín-Vertedor, Daniel, María Garrido, José Antonio Pariente, Javier Espino, and Jonathan Delgado-Adámez. 2016. “Bioavailability of Bioactive Molecules from Olive Leaf Extracts and Its Functional Value.” Phytotherapy Research 30 (7): 1172–79. https://doi.org/10.1002/ptr.5625.
[6] Frimpong, Michael, Bernadette Agbavor, Mabel Sarpong Duah, Aloysius Loglo, Francisca N. Sarpong, Justice Boakye-Appiah, Kabiru M. Abass, et al. 2019. “Paradoxical Reactions in Buruli Ulcer after Initiation of Antibiotic Therapy: Relationship to Bacterial Load.” PLoS Neglected Tropical Diseases 13 (8): e0007689–e0007689. https://doi.org/10.1371/journal.pntd.0007689.
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