When Medicines Multiply: Garth’s Story of Polypharmacy and the Power of De-Prescribing

When most people think of medicine, they imagine it as the answer to their health problems.  And often it is, especially in emergencies.  But in chronic illness, the story can look very different.  Too often, one prescription leads to another, then another, until the very medicines meant to help become part of the problem.  This cycle, called ‘polypharmacy’, is what happened to Garth.

His story shows how treating symptoms with drugs can snowball into dependency, and how addressing root causes with lifestyle medicine can turn things around.

From a Rugby Injury to a Medicine Cabinet

Garth was once a talented rugby player, set for a professional career until a knee injury in his twenties changed everything. The injury left him with chronic pain, and to cope, he started taking anti-inflammatories and painkillers daily.

At first, that seemed reasonable. But over time:

• The NSAIDs damaged his stomach lining, leading to an ulcer.
• To protect his stomach, he was prescribed a proton pump inhibitor (PPI).
• With pain limiting his movement, he became sedentary, gained weight, and developed high blood pressure.
• His doctor prescribed amlodipine, which caused swollen feet.
• To counter that, he was given a diuretic.

And the spiral continued. The diuretic tipped his blood chemistry out of balance — raising uric acid, worsening blood sugar control, and pushing his cholesterol up. Suddenly, he was also taking allopurinol, metformin, and a statin.

By now, Garth had gone from a fit young athlete to a man weighed down by medications and their side effects. He felt constantly tired, depressed, and heavy in his own body. The decline in mood and sexual health led to two more prescriptions: an antidepressant and erectile dysfunction medication.

What began with pain relief had mushroomed into 12+ medications and a shelf of supplements and yet Garth was still unwell.

The Medication Cascade

Here’s how the cycle of prescribing unfolded for Garth:

Medication	Why it was prescribed	Common side-effects
NSAIDs (anti-inflammatories)	Chronic knee pain	Stomach ulcers, kidney strain, high blood pressure
Painkillers	Chronic pain	Constipation, drowsiness, dependency
Proton Pump Inhibitor (antacid)	Stomach damage from NSAIDs	Nutrient deficiencies (B12, magnesium), rebound acid, bone loss
Amlodipine	High blood pressure	Swollen feet, flushing, headaches
Diuretic	Swelling from amlodipine	Gout, low potassium, diabetes risk, raised cholesterol
Allopurinol	High uric acid	Rash, liver irritation
Metformin	High blood sugar	Nausea, diarrhea, B12 deficiency
Statin	High cholesterol	Muscle aches, liver effects, fatigue
Antidepressant	Low mood	Weight gain, fatigue, sexual dysfunction
Erectile dysfunction drug	Erectile dysfunction	Headaches, flushing, dizziness

Each new drug was meant to help, but in reality it created more problems… A cascade where the patient ends up treating the side effects of the treatments themselves.

Changing Direction: Looking for the Root Cause

When Garth came to see me, he was exhausted, physically and emotionally.  Instead of adding more medicines, we asked:

What is the root cause of all of this?

The answer was clear:  His knee injury had triggered a chain reaction of pain, inactivity, weight gain, and inflammation. If we could reverse those, perhaps the drugs wouldn’t be needed at all.

So, together, we set out on a new plan:

• Nutrition: A low-carb, Mediterranean-style diet (<100 g carbs/day) to reduce inflammation, improve metabolism, and support weight loss.
• Exercise: Slow, controlled strength training to build muscle, protect his joints, and boost his metabolism.
• Monitoring: Careful follow-up so that medications could be reduced safely as his health improved.

The Power of De-Prescribing

This is where the magic happened.  As Garth’s body healed, we began de-prescribing:  Intentionally removing drugs that were no longer necessary.

First, the statin, metformin, and allopurinol… Gone once his cholesterol, blood sugar, and uric acid levels normalised. With them went the fatigue, digestive upset, and muscle aches.

Then the amlodipine and diuretic.  No longer needed as his blood pressure stabilised with weight loss and exercise. The swollen feet and gout risk disappeared.

Next, the NSAIDs and painkillers were phased out as his knee pain came under control through strength training and weight reduction. Without them, he didn’t need the acid-blocking PPI anymore, and his digestion improved naturally.

Finally, the antidepressant and erectile dysfunction medication were unnecessary once his energy, confidence, and sex drive returned.

Step by step, the medicines fell away.  With each one, not only did a side effect vanish, but Garth felt more like himself again.

A New Chapter

Within months, Garth had lost nearly 20 kilograms, rebuilt his strength, and regained his energy.  He was no longer a man defined by his prescriptions but someone actively in control of his health.

Most importantly, his pill burden dropped from over a dozen to almost none. The supplements he once relied on became optional, not essential.  His quality of life skyrocketed.

The Lesson

Garth’s story highlights two very different approaches:

• The mainstream path: Symptom → drug → side effect → more drugs.
• The lifestyle medicine path: Find the root cause, support the body to heal, and de-prescribe as health improves.

Mainstream medicine saved his life in moments, but lifestyle medicine gave it back to him.

For Garth, the miracle wasn’t a new pill, it was the realisation that by addressing his lifestyle, he could reverse the cascade, step off the treadmill of prescriptions, and feel truly well again.

And that, perhaps, is the most powerful medicine of all.