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The effects of chronic disease medications on thermoregulation

chronic diseases

The treatment of chronic diseases with medication can inadvertently disrupt the body’s ability to regulate its temperature efficiently, posing significant challenges for individuals, particularly the elderly, during hot weather. A review conducted by a team of researchers from various institutions in Singapore sheds light on the potential repercussions of medications on thermoregulation in patients dealing with conditions such as cancer, cardiovascular diseases, neurodegenerative diseases, and diabetes.

Uncovering the Link Between Medications and Thermoregulation

The research, led by Associate Professor Jason Lee from the Human Potential Translational Research Programme at the Yong Loo Lin School of Medicine, National University of Singapore (NUS Medicine), involved an extensive examination of relevant scientific literature. This comprehensive review, presented in Pharmacological Reviews under the title “Effects of Medications on Heat Loss Capacity in Chronic Disease Patients: Health Implications Amidst Global Warming,” delved into the associations between medications and their influence on thermoregulation.

The Findings and Their Health Implications

The study brought to light that medications employed for treating prevalent chronic conditions, such as blood thinners, blood pressure medications, drugs for Parkinson’s disease, and Alzheimer’s disease, and some chemotherapy drugs, can hinder the body’s ability to cope with hot weather. This interference often manifests as a reduced capacity to sweat or increased blood flow to the skin.

Lead author Jericho Wee, a second-year Ph.D. candidate from the Human Potential Translational Research Programme, emphasized the significance of this research in the context of rising global temperatures due to climate change.

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He noted that the growing elderly population, many of whom manage multiple chronic conditions with various medications, faces an increased risk of heat-related illnesses and dehydration. Understanding how each medication impacts thermoregulation in the face of warmer climates is crucial for predicting potential health outcomes, particularly when multiple medications are administered simultaneously.

The study sought to bridge a gap by presenting evidence within the context of high ambient temperatures and its impact on individuals with chronic diseases reliant on long-term medication. Senior author Assoc Prof Jason Lee underscored the importance of investigating altered thermoregulation mechanisms in individuals with diabetes and other cardiometabolic conditions to prevent heat-induced issues.

Given the rapidly aging populations and rising temperatures in places like Singapore, the need for transdisciplinary research efforts in this field is apparent. The goal is to refine medication prescription guidelines to safeguard the health of those who require these medications, even in hot weather.

Assoc Prof Melvin Leow, co-author of the review and Senior Consultant Endocrinologist at Tan Tock Seng Hospital emphasized that physicians often overlook the potential adverse effects of certain medications on the body’s thermoregulatory control mechanisms. This oversight is especially critical as individuals with chronic diseases and older adults possess reduced thermoregulatory capacity, making them vulnerable to heat-related health complications. Collaborative efforts between scientists and doctors across various medical disciplines are essential in this area of research.

Key Findings by Chronic Diseases Category

Cancer: Patients receiving specific cancer medications may experience symptoms like hot flushes, inappropriate sweat responses, and increased core temperature, negatively affecting their quality of life. While exercise and improved fitness levels can mitigate hot flashes and enhance thermoregulatory responses, chemotherapy, and medications may limit patients’ exercise capabilities, hindering their recovery.

Cardiovascular Disease: Individuals with cardiovascular diseases, including coronary heart disease, stroke, and heart failure, face higher vulnerability to heat exposure. Medications like anti-platelets, beta-blockers, and others can impact core temperature, skin blood flow, and sweat responses, potentially leading to heat stroke.

Diabetes: Insulin, used to manage Type 1 diabetes, may impair heat regulation and increase metabolic heat production, which can be dangerous when excess heat cannot be dissipated. For those with Type 2 diabetes using metformin, gastrointestinal side effects like diarrhea and nausea can lead to dehydration, particularly in older patients.

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Neurocognitive Diseases: Patients with neuropsychiatric diseases like Parkinson’s and Alzheimer’s experience thermoregulatory dysfunction due to internal imbalances. Medications to manage these conditions can alter thermoregulation and sweat responses, making patients susceptible to hyperthermia and hypothermia.

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Concluding Thoughts

This research underscores the need for a more comprehensive understanding of how medications used to treat chronic diseases impact the body’s ability to regulate temperature. With the elderly population growing and climate change driving higher temperatures, it is crucial to refine medication guidelines to ensure the safety and well-being of patients, even in hot weather conditions.