While I’m not a big fan of prescription drugs, mainly because of what I see as the problems of overprescribing and drug side effects, when I read an article about PFAS and pharmaceuticals, that got my attention!
PFAS is shorthand for what are commonly called “forever chemicals.”
So, when you think about PFAS, what comes to mind? Nonstick cookware,
water-resistant clothing, stain-resistant carpets, food packaging, or perhaps
contaminated drinking water?
But prescription drugs? Uh?
I recently came across research showing that fluorinated chemicals
are used in a surprisingly large number of pharmaceutical drugs, and
that some fluorinated pharmaceuticals can actually fall under certain
scientific definitions of PFAS. Fluorinated chemicals are also used in parts of
the pharmaceutical manufacturing process.
So...I decided to take a closer look at what the research actually says.
First...What Exactly Is PFAS?
PFAS stands for per- and polyfluoroalkyl substances. They are a large family
of man-made chemicals that have been widely used because they resist heat,
water, oil, and chemical breakdown.
That can be a benefit, but it can also be a problem. Many PFAS are extremely
persistent in the environment, which is why they are often called “forever
chemicals.”
Research has associated exposure to certain PFAS with health concerns
including increased cholesterol, changes in immune response, changes in liver
enzymes, pregnancy-induced hypertension and preeclampsia, reduced birth weight,
and certain cancers. However, these effects vary considerably depending on the
specific PFAS chemical, the amount of exposure, and how long someone was
exposed.
Here's Where It Gets Interesting
Fluorine is used extensively in modern drug design. Adding fluorine to a
drug molecule can change the way that drug behaves in the body, including its
metabolic stability, absorption, and other pharmacological properties.
In fact, roughly 20% of commercialized medications contain fluorine.
Some familiar examples include:
·
Statins: Atorvastatin,
Rosuvastatin
·
Antidepressants: Fluoxetine,
Escitalopram
·
Acid Reflux / PPIs:
Pantoprazole
·
NSAIDs & Anti-inflammatories:
Celecoxib
·
Steroids: Fluticasone
So...does that mean all of these drugs are “forever chemicals”?
It turns out the answer is no. A drug containing fluorine
is not automatically a PFAS.
And this is where things get really interesting. Researchers examined 360
fluorinated pharmaceuticals using nine different definitions of PFAS and found
that the definitions classified anywhere from 1% to 100% of those drugs as
PFAS. In other words, how you define PFAS makes a huge difference.
So, we shouldn't simply see the letter “F” in a chemical formula and
immediately jump to the conclusion that we are taking a dangerous forever
chemical.
At this point, I’d be looking at the specific drug, its known side effects,
and exactly what chemicals are actually in the formulation.
But Should You Be Worried?
I wouldn't panic, but I also wouldn't ignore the issue.
PFAS exposure in our environment is a legitimate health concern, but
research on environmental PFAS contamination cannot automatically be applied to
every fluorinated prescription drug you take. The fact that a molecule contains
fluorine doesn't tell us by itself whether that particular drug presents the
same risks associated with environmental PFAS exposure.
And many fluorinated medications serve important medical purposes. I
certainly would not recommend stopping a prescription simply because it
contains a fluorine atom. Doing so could create a much bigger and more
immediate health problem than the exposure you are trying to avoid.
Instead, I think the smarter approach is to find out exactly what you're
taking and whether a reasonable alternative exists.
Here's What You Can Do
If you want to take a proactive look at your medications, here is a
practical step-by-step approach.
1. Check Your Labels: Look up your medication on DailyMed,
the National Library of Medicine's database of drug labeling, and review both
the active and inactive ingredients. You can also check the FDA's Inactive
Ingredient Database, which is updated quarterly.
2. Ask Your Pharmacist a Specific Question: Instead of
simply asking, “Does this drug contain fluorine?” ask, “Does this
particular manufacturer and formulation contain any ingredients that meet a
current scientific definition of PFAS?” That's a much more targeted
question.
3. Explore Formulation Differences: Two manufacturers can
make the same medication using different inactive ingredients, such as fillers,
coatings, or binders. So, if an inactive ingredient is the concern, another
manufacturer or formulation may provide an alternative.
4. Talk With Your Doctor: If the active drug itself is the
source of your concern, ask your doctor whether another medication could treat
the same condition without that particular chemical structure. But remember, never
stop or switch a prescription medication on your own!
My Take
Looking at natural health and wellness research over the years has taught me
that sometimes the biggest problem isn't the information we receive. It's the oversimplification
of that information!
PFAS are a legitimate concern, and I think it makes complete sense to reduce
unnecessary exposure where we reasonably can. But when it comes to prescription
medications, we shouldn't throw the baby out with the bathwater.
A fluorinated drug isn't automatically a dangerous “forever chemical,” just
as the presence of PFAS in a particular product doesn't automatically tell us
what the actual health risk is. We need to look at the specific chemical, the
amount of exposure, and the available research.
So...know what you're taking. Check the active ingredients, check the
inactive ingredients, review the known side effects, and talk with your
pharmacist and doctor about whether a medically appropriate alternative is
available.
The goal isn't to eliminate every single molecule containing fluorine from
your life. The goal is to reduce unnecessary chemical exposure and
unnecessary side effects while still getting the medical treatment you need.
And I think that's a pretty reasonable goal!
______________________________________
References
·
Agency for Toxic Substances and Disease Registry
(ATSDR). “How PFAS Impacts Your Health.”
·
Hammel, S. C., Webster, T. F., Gurney, R., &
Heiger-Bernays, W. (2022). “Implications of PFAS definitions using fluorinated
pharmaceuticals.” iScience, 25(4), 104020.
·
“Chemistry and Pharmacology of Fluorinated Drugs
Approved by the FDA (2016–2022).” PMC.
·
“Contribution of Organofluorine Compounds to
Pharmaceuticals.” PMC.
·
U.S. Food and Drug Administration. “Inactive
Ingredient Database.”
·
DailyMed. U.S. National Library of Medicine.