Why they're prescribed: Antibiotics are used to treat health conditions caused by bacteria, including ear and skin infections, urinary tract infections, food poisoning, pneumonia, meningitis and other serious illnesses. They're also used to treat or prevent infections that can complicate surgery or other medical procedures.
Commonly prescribed antibiotics include amoxicillin (various brand names), azithromycin (Zithromax), ciprofloxacin (Cipro) and levofloxacin (Levaquin).
How they can cause fatigue: Researchers have long known that some people who take antibiotics experience feelings of tiredness and extreme fatigue, but it's still not clear exactly why. Read the safety and prescribing information for sulfamethoxazole/trimethroprim (Bactrim DS), for example, and you'll see "unusual tiredness or weakness" listed as a potential side effect. Similarly, the package insert for cephalexin (Keflex, Keftabs, Panixine, Biocef, Zartan) lists fatigue as a potential side effect.
Alternatives: I believe, as do many doctors and other health care professionals, that antibiotics are grossly overprescribed. If you have a minor bacterial infection, ask your physician if an antibiotic is really needed and if a natural alternative might the trick. Studies show that garlic, for example, fights bacterial infections and helps to prevent the spread of pathogens. But consultation with a health professional is essential, as garlic can interfere with blood thinners, nonsteroidal anti-inflammatory drugs (NSAIDs) and other medications.
Why they're prescribed: Diuretics (sometimes called water pills) are used to treat high blood pressure, glaucoma, edema and other conditions.
How they can cause fatigue: Diuretics can interfere with the balance of electrolytes — the major ones being sodium, potassium and chloride — in your body. Electrolyte imbalances can cause serious health problems, including extreme fatigue, muscle weakness and achy joints, bones and muscles (along with many other symptoms not related to fatigue).
Alternatives: Talk with your doctor or other health care provider about cutting back on your use of salt, exercising more and limiting your fluid intake.
Ask the Pharmacist is written by Armon B. Neel Jr., PharmD, CGP, in collaboration with journalist Bill Hogan. They are coauthors of Are Your Prescriptions Killing You?, which was published last year by Atria Books.
Information contained in the Ask the Pharmacist column by Dr. Armon B. Neel Jr. is intended to help individuals and their families become more informed about medication usage and interactions, and be better health care consumers. Any advice or information provided should not be followed in lieu of a personal consultation with a trained medical professional.