The first nationwide study of human drugs in fish tissue is completed. Researchers found that fish caught near wastewater treatment plants serving five major US cities contained pharmaceutical residues, including medications used to treat high cholesterol, allergies, high blood pressure, bipolar disorder, and depression.

At the same time, a study from Environmental Health Perspectives reported that certain pesticide mixtures in fish are more toxic than the “sum of their individual components” might have predicted. In a kind of negative synergy, phthalates in combination have shown greater effect on testosterone, for example, than small amounts of each, which may show little or no effect.

Polypharmacy is the practice of administering several different medicines concurrently for the treatment of the same disease. But with very few exceptions, research has not been done on the safety of combining multiple medications, which allopathic physicians routinely prescribe to treat chronic disease. Allopathic medicine frequently points to the lack of double-blind clinical studies for integrative therapies, yet in nearly 100% of the cases when multiple medications are prescribed for a patient, no double-blind clinical studies have been done either. We simply don’t know what raising a generation of children on increasingly frequent mixtures of medications might mean for their health, or that of future generations.

The commonsense approach would be to err on the side of caution. Dietary changes, increased physical activity, time-honored remedies that include herbs and homeopathic remedies, and rest—these should always be our first-line approaches. Only when lifestyle changes are not enough should one consider the higher-tech and higher-risk approaches of medications and procedures.