This Is When You Should Take Your Meds

Owls can't rotate their heads 360 degrees...

But the early English believed that they could... and that an owl would turn its head all the way around to watch you until it strangled itself. Some cultures even believed that death would soon come for you if you were sick in bed and heard an owl screech. (And it turns out owls can only turn their heads 270 degrees.)

This folklore probably came from the fact that these creatures are nocturnal, and death was also associated with nighttime. And the term "night owl" likely started getting used to describe folks who preferred the twilight hours in the mid-1800s.

Today, scientists think genetics plays a big part in dictating if you're a morning person or a night owl. This is called your chronotype – the times within a 24-hour cycle your body prefers to be asleep and awake.

It works with the 24-hour "clock" in your brain that conducts your sleep/wake cycle, or circadian rhythm.

Your body undergoes cyclical biochemical and hormonal changes throughout the day, creating varying environments for a med to act. So the time of the day you take your medication can affect how well the med might work, along with how well you might tolerate the med to minimize side effects.

Recently, research has shown that one widely taken drug might work best according to your chronotype...

Nearly half of all American adults have high blood pressure, or hypertension. Worse, a 2020 JAMA study showed that high-blood-pressure awareness, which had been on the rise for 15 years, was starting to decline. That's not great news. After all, hypertension is called "the silent killer" for a reason – it can be taking place without producing any red-flag symptoms.

But for those who know they have hypertension, it's estimated that roughly 76% take some kind of medication for it.

As for making sure your little pill does its job to the fullest, a recent study suggests that it could boil down to whether you're a night owl or a morning lark.

Your blood pressure is naturally lower while you're asleep and higher when you're awake and alert... though maybe not if you're battling hypertension and on the older side. Studies have found that some types of hypertension meds do a better job of reining things in if you take them at night. Examples include amlodipine and angiotensin-converting-enzyme ("ACE") inhibitors.

But according to recent research, whether your hypertension meds work better if taken in the morning versus the evening can vary by your chronotype...

Published this month in the Lancet, a U.K. study followed 5,358 hypertensive folks – half took their medication in the evening and the other half in the morning.

Researchers used a questionnaire to determine which chronotype each patient had. They also looked at whether the participants became hospitalized for heart attack or stroke (both nonfatal).

The results showed that the larks who took their meds in the morning and the owls who took their meds at night had a lower chance of ending up in the hospital for a heart attack. Interestingly, the chronotype and medication type wasn't associated with stroke hospitalization.

More research is needed for other medications and whether they work best by chronotype. But for now, let's go over some other common medications and the optimal time in the day to take them...

  • Thyroid and osteoporosis drugs work best on an empty stomach. So they might be more suited to the mornings. Otherwise, make sure to take that pill at least an hour before eating, say, dinner, or two hours after that meal.
  • Diuretics (or "water pills") help maintain a healthy blood pressure in folks with hypertension or heart failure by making you urinate. So you'll want to avoid taking these too close to bedtime or else you might find yourself blearily getting up out of bed to use the toilet.
  • Steroid drugs like prednisolone are best in the morning. That's because our "stress hormone" cortisol levels tend to be highest in the mornings. So popping your med with breakfast means you'll be more in sync with your body's natural levels.
  • Once-daily antihistamines for allergies might work better if you take it at night. These meds usually take almost half a day to reach peak levels in your bloodstream. That way, you'll be armed when you wake up in the morning which is when symptoms tend to be the worst.

One last important note: these aren't hard and fast rules. That is, they might not be applicable to all drugs. So make sure you check with your prescribing doctor and/or pharmacist if you're thinking about changing up when you pop that pill or if you take multiple medications.

And whether it's a "rise and shine" or a before-sleep nightcap, make sure you stay consistent.

In my upcoming issue of Retirement Millionaire – publishing next Wednesday – I detail the dangers of a common medication most folks should never take. Make sure you're already subscribed so you don't miss it. Click here to get started with Retirement Millionaire today.

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Here's to our health, wealth, and a great retirement,

Dr. David Eifrig and the Health & Wealth Bulletin Research Team
June 6, 2024