Chronotherapy – how the body clock influences the efficiency of medicines – would be the key to making sure we get the best out of our pills, from heartburn medication to chemotherapy and even aspirin
More than 30 million of us take medication every day. For some it is a single pill, but for others it is a number – some taken with food, some without.
One fifth of Britons over 70 take no less than seven pills a day.
And with instruction lists as long as your arm, exactly what time of day you should take each can be confusing. But now an intriguing field of scientific research can offer a solution.
Chronotherapy – how the body clock influences the efficiency of medicines – would be the key to making sure we get the best from our pills, from heartburn medication to chemotherapy and even aspirin.
A new Dutch study found that taking blood thinners such as aspirin overnight instead of the morning could reduce your risk of heart disease and stroke by half.
"We have clocks in our bodies that control most physiological processes," says Dr. Robert Dallmann, assistant professor of molecular clocks at Warwick University Medical School. "They determine when we are active, when we rest and how we metabolize drugs. As a result, some medications are best given at night and others during the day. & # 39;
So when is the right time to take your pills?
HAVE BLOOD PRESSURE PILLS AT NIGHT TIME
The tablet: Blood pressure medicines called ACE inhibitors such as enalapril and lisinopril and other medicines called beta blockers such as atenolol and bisoprolol.
How they work: Both types of medication reduce the pressure of blood flow through the circulatory system by relaxing and dilating blood vessels.
Time to take them: Patients who take blood pressure tablets before bedtime see a more pronounced decrease than those who take them in the morning, according to studies. Dr. Dallman says: "Blood pressure peaks & # 39; early in the morning to prepare the body for waking. But if you take the medication just before bedtime, they are released into the bloodstream at night & prevent a morning peak. & # 39;
The most common treatments for heartburn or acid reflux work by limiting the amount of acid produced by the stomach. Heartburn is naturally higher between about 7 p.m. and midnight, so if you take the pills in the evening, the peaks will stop to the point that they return to the food pipe – creating the uncomfortable burning sensation. (File photo)
HARTBURN DRUGS ARE BEST AT 6:00 PM
The tablet: Acid indigestion drugs, called proton pump inhibitors, such as omeprazole and H2 inhibitors, such as Zantac.
How they work: The most common treatments for heartburn or acid reflux work by limiting the amount of acid produced by the stomach.
Time to take them: Heartburn is naturally higher between about 7 p.m. and midnight, so if you take the pills in the evening, the level stops to the point that they return to the food pipe – causing the uncomfortable burning sensation.
A recent study found that three-quarters of patients taking PPIs experienced prolonged relief after taking them at 6 p.m., compared to less than half before noon. A report by scientists at Berkeley University in California found a similar effect with the H2 blocker, cimetidine. And don't wait until after dinner. Because the problem is often worse during eating, the scientists discovered that patients reported less discomfort when the medicine was taken before supper.
NO PARACETAMOL FOR BREAKFAST
The tablet: Paracetamol, also called paracetamol.
How they work: The drug reduces the production of chemicals that make nerve endings sensitive. So although the cause of the pain remains, we can feel it less.
Time to take them: Paracetamol is processed by the liver in the body. But the drug can be more toxic if it is taken in the morning. "Our levels of an enzyme called NAPQI in the liver are highest in the morning, and paracetamol raises this level," Dr. Dellman. "If this enzyme accumulates, it can cause considerable damage.
"So it's best to take it & # 39; in the evening when the levels are naturally low."
This theory has been demonstrated in various mouse studies by researchers from the University of Wisconsin. & # 39; If you give paracetamol to mice when they are the most & # 39; When they are awake, their levels of NAPQI are much higher over a 24-hour period compared to when they rest, "says Dr. Dallman.
An overdose of acetaminophen is, according to The British Liver Trust, the cause of almost a third of liver transplants in the UK.
STOP HEART ATTACKS WITH A BED TIME PILL
The tablet: Blood thinners or anticoagulants such as warfarin.
How they work: Taken to prevent heart attacks and strokes by diluting the blood to prevent potentially fatal blood clots in the arteries that feed the heart and brain.
Time to take them: If you fold the pills just before going to sleep, the "perfect storm" that causes the most heart attacks and strokes can occur between 6 AM and noon.
Dr. Dallam says: "We produce most of our large blood cells, called platelets, & # 39; at night.
"This makes our blood thick and sticky, so by the morning it is at its best, making it much more likely to coagulate.
"In addition to this, just like the heartbeat, blood pressure peaks just before you get up and you prepare your body for waking up. So you have thicker blood that is passed through the arteries with greater force. & # 39;
Taking medication to prevent stroke and heart attacks at night prevents this chain reaction.
Most patients with rheumatoid arthritis experience that their pain and stiffness is much worse in the morning, allowing them to take their pills that can take hours to provide relief. But taking them before bedtime can be more effective. (File photo)
NIGHT ARTHRITIS PILLS FIGHT MORNING PAIN
The tablet: Anti-inflammatory drugs such as ibuprofen and naproxen, used for pain caused by rheumatoid arthritis and diseases that are thought to be caused by the immune system that affects the joints.
How they work: One of the most common treatments for pain relief, this drug stops the production of enzymes that cause a cascade of inflammation in the joints and cause pain.
Time to take them: Most patients with rheumatoid arthritis experience that their pain and stiffness is much worse in the morning, allowing them to take their pills that can take hours to provide relief. But taking them before bedtime can be more effective.
A review at the University of Genoa concluded that patients who took anti-inflammatory drugs just before bedtime had less pain and stiffness in the morning than those they had taken when they woke up.
The overreaction of the immune system that causes the disease, and release of inflammatory enzymes, accelerates overnight and builds up into the early hours.
By administering medication overnight, the pills are gradually released into the bloodstream, blocking the increase in inflammatory substances.
A series of studies in the 1980s showed that some non-steroidal anti-inflammatory drugs, such as ibuprofen or naproxen, can be most effective when taken about eight hours before the most acute pain.
Ever wondered why …
… certain scents make you feel emotionally?
Scents influence mood and behavior in different ways as a result of a process called associative learning.
This is one through which one item is psychologically associated with another due to previous experiences. The linked item evokes the same emotions and thoughts as felt in the original situation.
For example, a perfume worn by a partner on a first date can evoke an emotional response, such as feelings of romance.
The nerves and structures involved in scent are directly connected to those nerves that process emotion and learning in the brain.
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