Dr. Linda J. Dobberstein, DC, Board Certified in Clinical Nutrition
- Common medications like pain relievers, antibiotics, PPIs, and statins may disrupt the gut microbiome and intestinal health.
- Gut health changes have been linked to inflammation, brain fog, mental health issues, and neurological diseases.
- A whole-food diet, reduced processed foods, and mindful medication use may help protect gut and brain health.
Have you ever questioned how your medication might affect your gut health? Perhaps you have noticed some rumbling, diarrhea, constipation, or feeling queasy and pass it off to something that you ate or recent stress. Perhaps you have noticed brain fog, feeling less mentally sharp, or some depression.
Research has identified common medications—often used without concern—that affect the gut microbiome, intestinal barrier, and brain health. America continues to be a nation of pill poppers but may tragically be unaware of long-term consequences with common place medications. We must become cognizant of risks, proactively protect our health, and share knowledge with others.
Most Common Prescription and OTC Use
A recent study published in JAMA Network Open February 2026 surveyed 21,000 U.S. adults and their prescription and/or OTC medications use. The three most common medications used were acetaminophen, ibuprofen, and aspirin, which is the same trend from 25 years ago.
Other popular medications in descending order of use included naproxen, atorvastatin, lisinopril, levothyroxine, diphendydramine, omeprazole, amlodipine, metformin, caffeine, cetirizine, hydrochlorothiazide, losartan, metoprolol, loratadine, rosuvastatin, fluticasone, and sertraline.
Multiple Medication Use Expected for Decades
The report showed that an estimated nearly 65% of U.S. adults take at least one prescription medication annually. The Centers for Medicare and Medicaid Services estimated prescription drug costs exceeded $463 billion and OTC medication sales were $44.3 billion in 2024. Additional statistics showed that there were 6.1 billion prescriptions given in 2018 which increased to 6.7 billion in 2022 for an estimated U.S. population of 332.5 million in 2022.
Data from the 1996–2019 Medical Expenditure Panel Surveys, the Human Mortality Database, and the National Center for Health Statistics shows that newborns in 2019 could be expected to take prescription drugs for half of their lifetime. Furthermore, adults aged 65 and older have the highest rate of multiple medication use, with as many as 42% of individuals using five or more medications daily.
Medication Classes That Change the Gut
In recent years, researchers have delved into the impact of medications on gut health. Thus far, 19 of 41 classes of medications have been shown to interfere with the gut microbiome causing dysbiosis. These effects increase the risk and contribute to the likelihood of intestinal permeability causing other adverse health changes throughout the body.
Gut disturbing drug classes identified currently include:
• antibiotics
• antidepressants
• antidiabetics Metformin/GLP-1, sulfonylureas
• antifungals
• antiparasitic
• antipsychotics
• antivirals
• acetaminophen
• chemo drugs
• immunosuppressants
• laxatives
• NSAIDs (e.g. ibuprofen, aspirin, etc.)
• polyethylene glycol
• PPI proton pump inhibitors/antacids
• statins (cholesterol lowering medications)
• steroids
Gut dysbiosis and increased intestinal permeability linked with the most commonly used drugs include acetaminophen, ibuprofen, aspirin, naproxen, atorvastatin, omeprazole, metformin, amlodipine, hydrochlorothiazide (HCTZ), and rosuvastatin.
Gut Dysbiosis Linked with Neuroinflammation and Disease
Gut dysbiosis challenges brain health leading to neurotransmitter imbalances, oxidative stress, and neuroinflammation. These physiological changes underlie the development of anxiety, depression, autism and autism spectrum disorders, schizophrenia, bipolar disorder, Parkinson's disease, dementia, multiple sclerosis, and epilepsy because of immune and neuroinflammation, neurotransmitter metabolism changes and accumulation of amyloid beta plaques and tau proteins.
Gut Bacteria Translocation to Brain
Recent cutting-edge research showed that the Western diet, known to cause increased intestinal permeability, opens the door for gut-brain changes. In animal studies, researchers found low levels of gut bacteria moved across the gut barrier, traveled along the vagus nerve and into the brain.
We know that changes of the gut microbiome can influence the onset and progression of Alzheimer's disease and other disorders. This raises further concerns for individuals with medication use and the Western Diet of greater permeability effects and nutritional deficits. What is it doing to the health of the American public or globally?
Triple Increase Forecasted for Alzheimer’s Disease
More than 50 million people globally are currently affected by Alzheimer’s disease (AD). By 2050, in less than 25 years, an estimated 152.8 million people will have AD9 causing untold costs for the individual, caregivers, families, and society.
The integrity of your gut microbiome and its systemic effects to overall health is invaluable. Unfortunately, and with great concern, millions of individuals are using medications, consume the Western diet, and have other factors that interfere with gastrointestinal health putting them at risk of serious consequences.
As a consumer of these medications, you must review and critically evaluate the benefits versus the risk of long-term drug use and brain health. The findings and implications of current research are very compelling that common medications change the gut microbiome, lead to increased intestinal permeability and change the neuroimmune-inflammatory dynamics of brain health.
Time for Reflection and Change
Take a moment to reflect on these drug usage statistics, the volume of common medications used in the general population, and the changes induced into the gut microbiome affecting intestinal barrier integrity and brain health. How are you doing? How about the older adults in your life who frequently have used ibuprofen, aspirin, PPIs, and statins?
Have you noticed changes in cognitive health, needed multiple joint replacements, or had multiple serious medical diseases or felt chronically unwell? How about your kids and grandchildren’s use of acetaminophen and antibiotics and their current health concerns? Do they now struggle with eczema, ADD/ADHD, mental health, obesity, or even autoimmune disorders in their youth or as young adults?
Whether you have a diagnosis or experience chronic brain fog, pesky “senior moments”, behavioral outbursts, or mental health decline, these symptoms are your body’s way of letting you know that things are not working well. The gut-brain axis, the gut microbiome, the integrity of the gut intestinal barriers etc. need support and protection. Our bodies can cope with things for a period, but health gradually erodes. Symptoms are a way of showing that your body is overloaded, at risk, and in need of change.
A Healthy Diet Can Change the Outcome
The research on the translocation of gut bacteria to the brain caused by the Western diet showed that when a whole foods diet was reinstated, there were positive changes in gut microbiome, intestinal permeability and overall health!
Your daily diet is something you can change. Choose whole food at least 80-90% of the time. Avoid ultra-processed foods and reduce or avoid alcohol, added sugar, and other things that erode your gut health as outlined in the article How Stress, Diet, and Medications Disrupt Your Gut Health. You can do it!
Tell others and teach your children and grandchildren how to make healthier choices and be proactive. If you are on forever medications, please work with your prescribing practitioners for different choices or reductions whenever possible.
Your body and microbiomes depend on you for lifelong protection and nourishment. Medications are meant to change functions, but they do not replace good diet and lifestyle choices. Your health and the future of America depend on mindful, healthy choices.
Additional Resources
How Stress, Diet, and Medications Disrupt Your Gut Health
Repairing the Gut Barrier: Key Nutrients for Intestinal Integrity
NSAIDs Injure Gut Lining and Mitochondria
Proton Pump Inhibitors Lead to C Diff, SIBO, Dementia, and Heart Attacks
High-Dose Vitamin C Therapy Proven Effective
