The Hidden Truth About Drug Side Effects

Why "Uncommon" Doesn't Mean "Truly Rare"

Introduction

I was interviewed on Reality Check Radio this morning about how the ACC is letting down the people of New Zealand. I made the point that NZ, once the least medicated of the "developed" nations, is now among the most medicated, being eclipsed by a whisker by the USA. This reversal in NZ's health fortunes began around about 1980, and we now have a nation that is crippled by ill health. This medically-induced ill-health is at crisis point now, not helped by the experimental COVID mRNA wonder vaccines. Despite this, the remedies being offered are yet more drugs, more surgeries, more doctors, more screening - more billions spent on failed remedies. This is insanity on a massive scale.

Few people die today from old age. Instead, they die from a combination of malnutrition, medication side-effects, and neglect.

Uncovering the Reality of Under-Reporting

You hurry to go to your doctor and find the whole experience, even waiting, stressful. It's not surprising that your blood pressure is higher when the Practice Nurse takes it. Your doctor responds by recommending a drug or two such as Candersarten, a drug I come across often. When you ask about side effects, these are described as being few and rare, and you might be handed the patient information sheet here:

03102025140535-0001.pdf

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The Misleading Label of "Uncommon"

In the medical field, we often rely on clinical trials and regulatory reporting to categorise side effects as "common," "uncommon," or "rare." However, these classifications can be misleading, masking the harsh reality that many side effects are under-detected, under-attributed, or under-reported. Patients typically suffer in silence, and doctors may wrongly attribute new symptoms to ageing or other diseases. This causes official numbers that lag behind real-life experiences.

It is agreed that less than 10% of medication side effects are ever acknowledged, let alone officially recorded. Many sceptics think the reporting is nearer 1% than 10%. With certain classes of drugs that are caught up in ideology wars, such as vaccines, the reporting rate may be even lower.

In the case of vaccines, reporting their adverse effects may be seen as promoting vaccine-hesitancy. This can cost a doctor not only their job, but also their profession, so there is underreporting:

• https://www.garymoller.com/post/the-medical-mafia-strikes-again

• https://www.garymoller.com/post/the-medical-mafia-strikes-yet-again

Labelling any adverse event below 10% as "uncommon" is misleading. One in every twenty or one in every ten people is not "rare." In real-world practice, especially with older, sicker, and multi-medicated patients, these "uncommon" effects become more apparent over time. The longer a person is on one or more drugs, the more likely the side effects.

Candesartan: A Case Study

Let's examine candesartan, an angiotensin II receptor blocker (ARB), as our case study.

What is Candesartan Used For?

Candesartan, typically administered as the prodrug candesartan cilexetil, is primarily used for:

• Hypertension (high blood pressure)

• Heart failure in patients who cannot tolerate ACE inhibitors

• Renal protection/slowing kidney damage in patients with diabetic nephropathy or proteinuria

Candesartan blocks the angiotensin II type 1 receptor. This causes blood vessels to dilate, lower aldosterone production, and reduce water and sodium retention. This helps the heart and kidneys work better.

The Extensive List of Reported Side Effects

The list of side effects associated with candesartan is large. Compare what NZ doctors give their patients and what I have here of the reported adverse effects, grouped by how often they happen. Remember that there is gross underreporting of what is listed here.

Very Common/Common Side Effects

• Dizziness, light-headedness

• Headache

• Upper respiratory tract infection (e.g., cold symptoms, pharyngitis)

• Cough (less frequent than with ACE inhibitors)

• Back pain

• Fatigue, weakness, malaise

• Nasal congestion, rhinitis

• Sore throat

• Abdominal pain, gastrointestinal upset

• Nausea

• Diarrhoea

• Muscle cramps or muscle pain (myalgia)

• Elevated potassium (hyperkalemia)

• Altered renal function/creatinine increase

• Low blood pressure (hypotension, especially on standing)

• Edema (swelling of ankles, hands)

• Skin reaction/rash

Less Common/Uncommon Side Effects

• Palpitations, irregular heartbeat

• Dry mouth

• Increased thirst

• Constipation

• Severe dizziness, fainting

• Sleep disturbances, insomnia

• Reduced libido, erectile dysfunction

• Hair thinning/alopecia

• Tingling or numbness (paresthesia)

• Confusion, drowsiness, nervousness

• Skin sensitivity to sunlight

• Skin ulceration, peeling, severe reactions

• Depression, mood changes

• Anaemia

• Liver injury/hepatotoxicity

• Angioedema

• Acute kidney injury or worsening renal failure

• Hypersensitivity reactions

• Electrolyte disturbances

• Severe hypotension

• Foetal injury or death (pregnancy use)

Rare/Very Rare Side Effects

• Severe hepatic failure

• Severe allergic reactions

• Lupus-like syndrome

• Pancreatitis

• Exacerbation of asthma

• Vasculitis

• Neuropathy

• Psychiatric symptoms (mania, hallucinations)

• Glomerulonephritis

• Rhabdomyolysis

• Skin cancers or melanoma (possible association)

• Interstitial lung disease

• Neuromuscular disorders

The Issue of Under-Reporting

Despite the extensive list of side effects, the reality is that many more go unnoticed or uncredited. The reasons for this under-reporting include:

1. Short trial durations missing long-term adverse effects

2. Selective trial populations excluding frail/elderly patients

3. Under-reporting by both patients and doctors

4. Attribution bias, where symptoms are blamed on age or disease

5. Regulatory framing that labels events below 10% as "uncommon"

6. Lack of real-world data

7. Delays in post-marketing surveillance

Implications for Clinical Practice

As clinicians, when prescribing candesartan or any long-term medication, it's crucial to:

• Forewarn patients about realistic side effects

• Actively inquire about energy, balance, mood, and sexual health

• Start with low doses, proceed slowly, and monitor closely

• Balance the benefits against the burden on daily life

• Be prepared to switch or adjust treatment if necessary

Conclusions

1. The under-reporting of drug side effects in New Zealand is a significant issue that affects patient care and safety.

2. More drugs do not make people healthier. Our experience since the 1980s shows that few drugs make people healthier, instead, they make them sicker.

3. Understanding the true scope of potential side effects and actively monitoring patients, and prescribing alternatives like better nutrition, exercise, relaxation, and laughter, clinicians can provide better care.

4. It's essential to approach medication with a critical and informed perspective, recognising that "uncommon" does not mean "truly rare."

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Medical Disclaimer: This article is for educational and discussion purposes only. It does not substitute for professional medical advice. Always consult a qualified health professional before changing or stopping any prescribed medication.