Is Your Medicine Causing A Nutrient Deficiency?

August 2019

Common Drug Interactions with Critical Vitamins and Minerals

Many types of common prescription drugs, such as statins, diabetes drugs, antibiotics, proton-pump inhibitors, birth control pills, corticosteroids, and diuretics affect micronutrient levels in the body, some of them significantly so. Many of these drugs are prescribed to treat common conditions, such as acid reflux or heartburn, or prevent pregnancy, and so many underestimate how powerful the drugs are and how much impact they can have on absorption and utilization of vitamins and minerals in the body. They can reduce absorption, increase excretion of nutrients, impair digestion, or affect the storage of nutrients. This causes the depletion of vitamins, minerals and electrolytes, such as iron, cobalt, chromium, copper, iodine, manganese, selenium, zinc and molybdenum as well as vitamins A, C, B, D, and E.

Antidepressants have been shown to lead to deficits in B6, B12, B2, melatonin, folate, selenium, zinc, and L-Glutathione. Conversely, supplemental B vitamins has been shown to enhance the efficiency of antidepressants. Statins lower cholesterol, but also lower the coenzyme Q10 (CoQ10) and decrease vitamin D levels. Antibiotics, often over-prescribed, can potentially deplete the body of vitamin K, thiamin, B6, B12, potassium, Niacin, vitamin C and especially essential probiotics. For this reason, it is recommended that you begin taking a probiotic before beginning antibiotic treatment.

Diabetes drugs can lower blood levels of vitamin B12 and folic acid by reducing their uptake from the gastrointestinal tract. Proton-pump inhibitors (PPIs), commonly prescribed to treat acid-reflux and heartburn, deplete the body of vitamin B12, vitamin C, calcium, and vitamin D. Birth control pills, taken by many women, can deplete the body of folic acid, vitamins B2, B6, B12, vitamin C, E and the minerals magnesium, selenium. They also elevate levels of Vitamin K, copper, and iron. Over the longer term, this can lead to health problems.

Corticosteroids, prescribed for inflammatory conditions, such as rheumatoid arthritis, Crohn’s Disease, and chronic-obstructive pulmonary diseases, cause the body to excrete calcium, leading to calcium deficiencies for patients who take them. They also deplete the body of magnesium, copper, selenium, and zinc.

Diuretics, used to treat high blood pressure, glaucoma and edema, can deplete the minerals magnesium, sodium, potassium and zinc. While these are only a few of the most commonly prescribed drugs, many other prescription drugs can deplete your body of micronutrients and it’s important to research or talk to your doctor if you’re taking a prescription drug in order to determine what dietary supplements you may need. Be aware, many doctors may not be aware of the impact a drug may have on micronutrient levels but most will be receptive to a discussion if you come prepared with research.

A Closer Look at Drug / Nutrient Interactions

Many drugs and supplements can reduce absorption, causing depletion of vitamins, minerals and electrolytes. Doctors may fail to notify their patients of this possibility as micronutrient deficiency is not considered a side-effect. Micronutrients, which include elements like iron, cobalt, chromium, copper, iodine, manganese, selenium, zinc and molybdenum as well as vitamins, such as vitamin A, C, B, D, and E, are essential for many functions of the body.

Prescription drugs may influence micronutrient levels in the body through a number of different ways. While some drug may suppress or increase a patient’s appetite or craving, causing the patient to consume less or more of various micronutrients, other drugs are direct micronutrient agonists or antagonists, which means that they inhibit or enhance the absorption of certain micronutrients. Some drugs have similar metabolic pathways to certain micronutrients that may result in vitamin depletion. Certain medications can also increase excretion of nutrients, can impair digestion, or affect the storage of nutrients. When considering how prescription drugs can affect nutrition status, it is also important to factor in the duration of the therapy and the underlying nutritional status of the patient before the start of therapy.

Antidepressants

13 percent of Americans take antidepressants, such as Prozac, Paxil, Zoloft, which can all influence your micronutrient levels. They can reduce your appetite thereby decreasing the amount of macro and micro nutrients you consume. Antidepressants can also cause insulin resistance or metabolic syndrome, which can result in blood sugar swings, causing patients to crave simple carbohydrates, such as sugar, bread and pasta, which lack many micronutrients.

They also affect micronutrient levels by increasing the number of neurotransmitters in the brain. The brain must rapidly break down stores of neurotransmitters to compensate with the neurotransmitter overload. Then in order to build back these stores of neurotransmitters, the brain needs to increase the amount of nutrients it needs. Antidepressants can lead to deficits in B6, B12, B2, melatonin, and folate. Supplemental B vitamins has been shown to enhance the efficiency of antidepressants and reduce the concentration of homocysteine, an amino acid that can increase the risk of heart attacks and strokes in high concentrations.[1] Antidepressants have been shown to reduce melatonin levels and should be supplemented with melatonin for better sleep and recovery. Additionally, they can deplete the body of selenium, zinc, and L-Glutathione, an amino acid critical for immune function and controlling inflammation.

Statins

Statins, such as Lovastatin and Pravastatin, are used to lower cholesterol levels and are often used to treat cardiovascular disease and stroke. Statins inhibit HMG-CoA reductase pathway, an enzyme involved in cholesterol synthesis, which results in lowering of cholesterol, but also of lowering the coenzyme Q10 (CoQ10). As a result, statins can cause cause CoQ10 deficiency. CoQ10 is a micronutrient that plays a role in cellular respiration and ATP (energy) generation in the brain, liver, bones, and the cardiovascular system. It also plays an important role in preventing heart disease and cancer. Therefore, those taking statins should consider a CoQ10 supplement or consuming more organ meats, which are high in CoQ10. Statins also raise vitamin D levels. By lowering cholesterol, a precursor to vitamin D, statins paradoxically cause vitamin D levels to increase.[2] So people who are taking a statin and taking a vitamin D supplement should monitor their blood levels.

Antibiotics

Antibiotics can reduce or block the absorption of important nutrients, especially essential minerals, in the gastrointestinal tract. This happens because the antibiotics bind to them before they’re able to be absorbed into the bloodstream. Research has demonstrated that antibiotics tend to block or decrease the absorption of calcium, magnesium, iron, and zinc in the GI tract.[3] They also deplete nutrients by increasing metabolic activities of cells, which increases the amount of nutrients needed to execute these activities. Nutrients are used up and must be replaced by food or supplements. Antibiotics have been linked to vitamin K, thiamin, B6, B12, potassium, Niacin, and vitamin C deficiencies. By eliminating the body of harmful bacteria, they also rid the body of helpful bacteria, which can disrupt the gut flora and deprive the body of essential probiotics, including Lactobacillus acidophilus (L. acidophilus) and Bifidobacterium bifidum (B. bifidum). Fortunately, antibiotics should not be used for a long period of time.[4, 5]

Diabetes drugs

Diabetes drugs like Diabinese, Tolinase, and Metformin, improve the body’s sensitivity to insulin, but as a result lower blood levels of vitamin B12 and folic acid by reducing their uptake from the gastrointestinal tract.[6] Diabetes drugs reduce the intrinsic factor, which is a glycoprotein produced by the cells of the stomach that is needed to absorb B12 by the small intestine.[7, 8, 9]

Proton-pump inhibitors

Proton-pump inhibitors (PPI), such as Nexium, Prevacid, and Prilosec, are commonly prescribed to treat acid-reflux and heartburn. PPI prevent the production of gastric acid, but as a result end up preventing the release and utilization of vitamin B12 from food as well as reduce the bioavailability of dietary vitamin C. Additionally, by reducing the production of gastric acid, which plays an important role in the uptake of calcium, PPI reduces the absorption of calcium, which in turn can disrupt vitamin D metabolism and reduce the uptake of iron from food. One study found that people over age 50 who take the drugs for more than one year have a 44 percent increased risk of breaking a hip. Higher doses taken for longer periods of time significantly increase the risk.[10]

Oral Contraceptives/Hormone Replacement Therapy

More than 10 million women use birth control pills in the country and these drugs can deprive the body of nutrients, which could cause serious deficiencies over time. Hormone replacement therapy (HRT) uses the same hormones as birth control pills as therefore causes the same types of deficiencies. Studies have shown birth control pills can deplete the body of folic acid, vitamins B2, B6, B12, vitamin C and E and the minerals magnesium, selenium and and elevate levels of Vitamin K, copper, and iron.[11, 12] Additionally, approximately 80% of all women using OCs for 6 or more months experience abnormal tryptophan absorption, which is an amino acid necessary for niacin and serotonin production, which helps stabilize mood.[13, 14] As oral contraceptives actually increase the levels of Vitamin K, copper, and iron, it’s important to not take an iron supplement if you are on birth control as too much iron can be harmful.

Diuretics

Thiazide diuretics, such as Diuril and Microzide, are used to treat high blood pressure, glaucoma and edema. They work by increasing the amount of salt and water that a patient execrates, and as a result can deplete you of minerals, such as magnesium, sodium, potassium and zinc. One study found those who use thiazide diuretics were eleven times more likely to have hypokalemia, low potassium.[15] Thiazide diuretics also decrease magnesium and zinc levels.

Arthritis and Other Inflammatory & Autoimmune Diseases

Corticosteroids, like prednisone, and hydrocortisone, are often prescribed for inflammatory conditions, such as rheumatoid arthritis, Crohn’s Disease, and chronic-obstructive pulmonary disease (COPD), as well as autoimmune illnesses, such as bronchial asthma and atopic dermatitis. Corticosteroids are vitamin D antagonists and Vitamin D is necessary for you body to properly absorb calcium. As a result, these drugs cause the body to excrete calcium, leading to calcium deficiencies for patients who take them. They also deplete the body of magnesium, copper, selenium, vitamin B12, and zinc.[16-26]

References:
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