Diary of a Student Nutritionist - Week 1 - Nutritional Pharmacology

Updated: Dec 15, 2021

Nutritional Pharmacology

This was a really interesting week learning about the main pharmaceutical drugs we might see in clinic and why it is important to know about them as a nutritionist.

It was firstly interesting to know what the drugs are prescribed for and that sometimes they are prescribed not for their main known purpose but for other things you might not have thought about. I have therefore learnt not to assume I know when I see a client is on a drug that they have a certain condition and instead need to listen to what they have to say first.

Secondly, it was interesting to learn about polypharmacy where a client might be taking a drug to manage a symptom but in doing so leads to other symptoms which they then take another drug to reduce this. Sometimes this can cascade to multiple drugs over a number of years not through anyone's fault but as a nutritionist, you can spend more time with your clients and really have the chance to look at the bigger picture, before redirecting clients back to their doctor when necessary.

One anecdote that was shared with us that sounds to be quite common is that clients will come to see a nutritionist with gut problems such as irritation, food intolerances, diarrhoea, constipation etc and when the nutritionist creates a timeline of events they can see that around the time the symptom started they began taking a certain medication. This is when once again a nutritionist will redirect their client back to their doctor to have a review.

Thirdly, we learnt about pharmacokinetics (the movement of drugs within the body) and pharmacodynamics (how the drugs interact with the body to exert their effect). Again something I had no idea a nutritionist would need to know about before I started the training. Understanding how a drug works, where it is absorbed, where it goes, how it is broken down how it is used and how it leaves the body once it is done is so interesting, it makes you realise quite how clever the scientists are who are making these drugs.

It is really important to know about pharmacokinetics and dynamics as you do not want to negatively influence a drugs ability to do its job. For example, putting in slippery elm to line the intestines is not a good idea if a drug is absorbed through the intestinal walls, adding pomegranate can inhibit the breakdown of certain drugs in the liver or using a certain supplement that exerts the same effects as the drug creating an overdose type situation.

Where a drug is excreted is also a really interesting topic area as a drug might leave through the bowels and therefore as a nutritionist you can support this system and therefore support the additional load on the body. Or a drug might be excreted through the kidneys and therefore need some additional support.

Finally, we learnt about what nutrients can be depleted when a client is taking certain drugs and therefore which nutrient levels might need checking and supporting. It is also important to know what drugs a client has used in the past to be able to see if there are any links to how they are feeling today, such as antibiotics and gut health or statins and energy levels. Until I did the course I didn't really know the importance of being asked 'so what drugs have you taken previously'. I also didn't know just how powerful over the counter drugs could be, especially those that you could just pick up at the supermarket. Many seem harmless but they are actually pretty powerful, should be treated with respect and used properly.

This week has really opened my eyes to the world of pharmacology and just how careful a nutritionist needs to be when making recommendations. I now have the BNF close to hand with all the up-to-date drug information and will do my research to make sure my clients remain safe with any recommendations I make. I also know just how incredible it can be if doctors as nutritionists work side by side to support people with their health-giving them a great variety of tools to work with.

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