Polypharmacy

In the world of pharmaceuticals (and the various medical fields that prescribe them), "polypharmacy" refers to the use of several drugs simultaneously—some fields and practitioners reserve this term for patients taking five or more medications, while others apply it more broadly and flexibly.

Historically, polypharmacy has been most common in people who suffer from several chronic (or otherwise long-term) conditions, which is sometimes referred to as "multimorbidity."

Folks with two or more chronic illnesses (or other conditions that necessitate or incentivize treatment) may thus end up with several bottles of pills, a few self-injections, and several in-office treatments blended into their schedule, which stresses healthcare systems (that's a lot of medication for one person to consume, which depletes supplies and occupies healthcare workers' time, attention, and energy) while also potentially straining the patient's system.

The trouble is that all medications and treatments have associated risks, ranging from a minor, increased strain on organs (one's liver being forced to process and sieve medication from one's body, for instance) to potential allergic reactions (barely noticeable and annoying, all the way up to significant and possibly dangerous).

Those risks are amplified with each new treatment or medication used along the first, because of their isolated risks, and because they can interact with the first medication in different and unpredictable ways.

When you get to five different pills or shots or whatever else, that's a few dozen different potential one-to-one interactions, alongside all the possible interactions that can arise when three or more substances interact; there are just a boggling number of variables at play, and countless potential, additional consequences could result from any given drug cocktail.

At a certain scale of input, it's borderline impossible to map out all the possible side effects a person might experience as a patient taking a necessary-seeming handful of medications.

What's more, the side effects from these interactions are sometimes misdiagnosed as new symptoms, not side effects, which can lead to what's called a “prescribing cascade”: the prescription of more drugs that are meant to address a theorized underlying problem, even though that problem is actually the consequence of the drugs already being taken.

Many healthcare systems (especially in wealthy countries) are oriented around treating symptoms rather than preventative medicine, which increases the likelihood of this sort of scenario (the US healthcare system in particular leans heavily on medicating after the fact, rather than preventing the issues that might eventually necessitate medication).

The largely unregulated supplement industry can also play a role here, as the consumption of too much selenium, for instance, can lead to selenium toxicity, which can cause fingernail discoloration and brittleness, hair loss, irritability, persistently bad breath, and an overall sick, nauseas, vomity feeling.

Those sorts of symptoms can then kick-off a prescribing cascade, even if the patient experiencing them isn't taking a slew of formally prescribed medications: the doctor has no way of knowing what they're taking if they're not told by the patient, and just like with actual meds, combinations of such supplements can trigger a cascade of health issues that can be tricky for doctor or patient to untangle—even if the dosages of the supplements, themselves, are tolerable and don’t cause any unwanted side effects.