Growing up with type 1 diabetes, one of the sticking points (pun intended!) was always that it couldn’t be managed with oral medication. Nope– “Shots, shots, shots!” it was, and not in a fun, drinky way. And then in 2005, I graduated to an insulin pump, but that’s just a more mechanically complex syringe. Treatment, for me, is about blood and tissue and infusion.
So it’s a little disorienting to find myself popping handfuls of pills every day now that I’ve entered adulthood. Granted, most of them are over-the-counter vitamins, but still– I count nine caps a day:
- Synthroid (for autoimmune thyroiditis)
- Estrogen (to keep hormone levels in balance)
- A salt cap (my blood pressure runs low, and this seems to help)
- A multivitamin (from GNC; two pills, each of which is pretty big as is, so I’m glad it’s not combined into one)
- A Vitamin D/Calcium supplement (from Costco; two pills, to meet the 1000mg/day bone health recommendation from my doctor)
- Fish oil supplement (from Costco; I hate taking this one, because I can taste the fish oil)
- Low-dose aspirin (from CVS, a sugar-free, safe for diabetics version)
Looking at this list, I get slightly worried. Should I be taking so many vitamins? Doesn’t that seem like maybe it could have unforeseen negative effects? Is it too much? Should I go all natural?
Then my more rational side kicks in and reasons, well, everything I eat and breathe all day is full of synthetic everything; these vitamins and medications were carefully selected (I read reviews and Consumer Reports, and I read the FDA statement on lead content in women’s vitamins), so really the question is not nothing versus a set of supplements, but rather tons of engineered input versus some additional engineered input that is specially selected to be helpful. But, still. Nine pills a day? That’s weird, right?
The aspirin is the most recent addition. I feel like I’m young to begin worrying about cardiovascular health and cancer, but, then again, I’m a diabetic, and I seem to aim for high-intensity life rather than carefree, stress-free living, so heart disease and cancer are real risks. And the scientific pendulum has swung back in favor of daily low-dose aspirin as a “We don’t understand why it works, but it seems to help,” long term preventative for cancer (see, for example, the recent piece in Science Magazine on the controversy over aspirin).
However, if we don’t really understand the mechanism behind things like aspirin, but we theorize that somehow over the long term they have measurable effects that we think right now are positive, then it is easy to imagine that over the long term these seemingly innocuous pills could be having measurable negative consequences as well. How can I know? To paraphrase Milan Kundera, if I only live once, I cannot test both scenarios– taking these vitamins every day versus not, all else being equal. I can read studies and consider the aggregate statistics, but without understanding how exactly they work, I can only guess what the exact effect will be on me, for my body. Maybe taking Vitamin D will make me 1% less likely to get a bone fracture down the line. But maybe the molecular formulation of the capsules interacts with some errant cells lodged in my bones somewhere, and day after day helps those cells get stronger, and actually I’m 1% more likely to get bone cancer in sixty years.
And then I pause this stream of thought and I consider: sixty years! Think of how far we have come, that I, a diabetic, think nothing of forecasting my life sixty years out.
Besides, statistically speaking, my worrying about the outcomes of taking so many pills is more likely to cause long term damage than just taking the pills.
Put more poetically (and to make up for the fact that I began this post with a reference to LMFAO), consider the passage from one of my most favorite books, Kundera’s Unbearable Lightness of Being:
“There is no means of testing which decision is better, because there is no basis for comparison. We live everything as it comes, without warning, like an actor going on cold. And what can life be worth if the first rehearsal for life is life itself? That is why life is always like a sketch. No, ‘sketch’ is not quite the word, because a sketch is an outline of something, the groundwork for a picture, whereas the sketch that is our life is a sketch for nothing, an outline with no picture.
Einmal ist keinmal, says Tomas to himself. What happens but once, says the German adage, might as well not have happened at all. If we have only one life to live, we might as well not have lived at all.”
Which brings me to the most reasonable conclusion I see possible: que sera, sera. And with that, it’s 78F and sunny in October in San Diego, so I’m going to go outside and enjoy that– the threat of skin cancer be damned!