27 Jun I Can’t Swallow Pills

As a functional medicine physician, I see that people aren’t always getting the optimal levels of vitamins and minerals from their diets and can often benefit from taking supplemental nutrients. I am also often recommending herbs that are helpful for many conditions and assist the body in everything from inflammation, to balancing gut bacteria, and even controlling allergy symptoms. The most common preparations for most of these recommendations are tablet or capsule form. But surveys show that up to 40% of adults have some trouble with pill swallowing. So what to do if you are a person who has difficulty swallowing pills?

Do some people have a true inability to swallow pills?

There are actual physical conditions that can make it difficult for some to swallow pills, otherwise known as dysphagia. These are usually disorders involving muscle control, such as muscular dystrophies, myopathies, and motor neuron disorders like ALS (amyotrophic lateral sclerosis). Achalasia, which results in a tensing of esophageal muscles, can eventually create difficulty swallowing. Scleroderma, which causes progressive thickening of tissues with decreases in elasticity can also result in difficulty swallowing. Trouble swallowing can also be a late effect of dementia or Parkinson’s Disease. Generally, these are progressive difficulties that worsen as the underlying disease process worsens. In some cases, swallowing can be a side effect of facial Botox treatments.

I’ve always had difficulty swallowing pills.

Usually when people have trouble swallowing supplements and medications, it’s due to anxiety, not an actual physical condition. Stress tends to make the gag reflex more pronounced, and some people can inadvertently “teach” themselves to gag with pills simply because they are anxious about it. Once a person is convinced that they cannot swallow pills, they have more anxiety just trying, and are hyper-focused on every sensation of swallowing that pill. The general rule is that if you can swallow food, you can swallow pills. But if a person has taught themselves to gag at the discomfort of a pill, what should they do?

You can teach yourself to swallow pills.

If your brain has taught itself to reject pills or capsules, you will have to teach yourself that you actually can swallow pills. One method that makes the process easier is to turn your head either to the right or to the left as you’re swallowing. This allows the back of the throat to open up a little so that it’s more comfortable as you swallow. If you take in too much liquid in your mouth, it can make it more difficult to swallow pills.  It may cause the pill to swirl around the mouth rather than be positioned at the back of the throat. Just drinking as one would normally drink is enough to get a pill or capsule down. Some people like to tilt their head back and wiggle it a little just before they swallow, kind of like a bird drinking water. This helps place the tablet or capsule at the back of the throat so it doesn’t float back into the mouth.

What can I do if I’m too anxious about the whole thing?

If you find that your gag reflex is too strong or that your anxiety is preventing you from even trying to swallow a pill, you may have too much activation of your stress response or not enough activation of your relaxation response. Daily exercises to improve the tone of the Vagus nerve could be helpful in these cases. Do these once a day:

1. Take a full glass of water
2. Start with one mouthful and gargle forcefully until it becomes uncomfortable or you start to get a tear in your eye
3. Spit out that mouthful
4. Take another mouthful and gargle forcefully as before, spitting it out once you reach the point of discomfort or a tear in your eye.
5. Continue this way until you have worked your way through the entire glass of water.

These exercises will help balance your gag reflex as well as fire the Vagus nerve centers to encourage your body to have better balance of your autonomic nervous system.

Madeleine M Castellanos, MD is a practitioner of functional medicine – working with people to identify the root cause of their symptoms and helping them to reverse the process of illness through diet, nutrition, and lifestyle optimization. She also integrates the physical with the mental and spiritual aspect of health and teaches people how to use these together for their best quality of life. In her private practice, she does body composition analysis, can recommend nutritional and toxic element testing, and hormone evaluation. For more information, or to book an appointment, please call 917-454-8444.

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