Paradoxical Reactions: Why Medicine and Supplements Can Cause Opposite Reactions
I am a certified functional medicine practitioner who has spent more than a decade specializing in chronic and complex illnesses. In my 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 my 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 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 symptom. An example would be if a person who took an anti-anxiety medication had an paradoxical reaction of increased anxiety.[1]
A paradoxical reaction 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.
There is genetic testing that can be done to find out if there is a genetic component to your symptoms and what medications (and anesthetic) would be safer options for you in the future.
Processing times also vary considerably for those with food allergies and sensitivities.
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.
As many other 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 study, the sample size, the research methods or even the form of the medication or supplement used in the study.
Additionally, there is usually an order in which underlying conditions are treated to achieve the desired improvement (some infections are higher priority, an impaired digestive tract may be preventing you absorbing nutrients, etc).
3. Your Taking the Wrong Form
By form, I mean that even if a patient has a simple vitamin deficiency and they take 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 base, 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 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 be lacking 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 "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. This, however, is very rarely how the body heals.
I have found that the most sensitive patients and those who have been sick for the longest time, actually have the most dramatic improvements with relatively gentle treatments.
4. You Need to Treat the Underlying Problem
Often, the reason that a medication or supplement is not working as intended is because your internal biological equilibrium is off balance.
Paradoxical reactions can be caused by an underlying viral or bacterial infection. [6] An underlying infection is something that can be tested for and, once the infection is gone, medication tolerance can improve.
Paradoxical reactions can be also be caused by excess inflammation caused by 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 had been able to handle any kind of medicine before 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, I very often see a full recovery.
Functional Medicine for Paradoxical Reactions
Usually, if you are experiencing paradoxical reactions, you are experiencing other symptoms or conditions as well.
In these articles, you will not find a step-by-step guide to relieving decades long symptoms nor the "one supplement that will solve all your problems."
Conditions that took years to form take a specific and targeted approach to untangle. There can be quick recoveries but there are rarely "quick fixes."
A patient can find relief after years of life-altering symptoms, but it requires an informed, holistic approach which incorporates long appointments, targeted treatments and specific testing.
I offer functional medicine consultations for patients around the world.
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If you would like to schedule a free 15 minute consultation with me to ask direct questions about becoming a patient click the link below.
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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.