I am sure that we all know someone who has 2 grocery bags full of medications that they take and have very little clue what each of them does.  This has a name as I learned a few weeks ago.  It is called the cascading effect. 

I will use a condition that I am familiar with and that is a thyroid condition.  Those of us who have had the thyroid gland removed by ablation or by surgery are then prescribed a drug which is used to replace the thyroxin that our thyroid gland no longer produces.

OK, so everything is great and no need to pursue this any further.  Hold on now, remember that all medications have side effects.  One of the side effects of Synthroid or Levothroid, or whatever replacement therapy that the doctor prescribes for you is that it removes calcium from the system.  Your endocrinologist may then prescribe a calcium supplement to replace the calcium that is being depleted from your system.

A close watch should be kept on the balance of calcium through blood tests.  These blood tests are usually administered simultaneously with the check on hormone levels to determine the dosage of calcium along with the dosage of the replacement therapy.

The depletion of calcium will probably also be monitored by bone density exams, and you may be prescribed a drug that enhances the uptake of calcium and promotes the reconstitution of calcium in the bones.

The example that I have provided is one which demonstrates the responsible cascade of drugs due to the treatment of a condition.

The problem comes when the doctors do not communicate, or the patient does not communicate, and one doctor is not aware of the medication prescribed by another physician.  It is important that you have a list of all medications that you take including supplements.  This list should be shared with all your care team so that unnecessary cascading does not take place.

Remember that we are the number 1 person responsible for our health.  We need to take an active role in the prescribing process as well.