ARE YOUR PRESCRIPTION MEDICATIONS CAUSING NUTRIENT DEFICIENCIES?

ARE YOUR PRESCRIPTION MEDICATIONS CAUSING NUTRIENT DEFICIENCIES?

We all know that prescription medications can come with side effects, but did you know that many of the common drugs on the market also cause nutrient depletion?[1] 

Drug-induced nutrient depletion is an often overlooked issue that your prescribing doctor may not tell you about. In fact, many of the side effects that come with medications are due, in part, to the impact they have on the nutrients your body needs to thrive.

In this article, we'll highlight some of the most common drugs out there and detail which nutrients they may be robbing from your body.

Commonly Prescribed Drugs That May Be Stealing Your Nutrients

#1 Statins

Statins are cholesterol-lowering drugs that go by several different names, including: 

Crestor®, Lipitor®, Lescol®, Mevacor®, and others.

These drugs work by inhibiting an enzyme called HMG CoA reductase, which is involved in the synthesis of cholesterol but also plays a key role in the synthesis of Coenzyme Q10 (CoQ10).

CoQ10 is a vital nutrient in converting food into energy. It's also a powerful antioxidant, protecting your cell membranes from oxidative stress. Your cells use CoQ10 for growth and maintenance, and research shows that healthy levels of CoQ10 are necessary for optimal heart health, metabolic health, and physical performance.[2]

In addition to CoQ10, statin drugs may also deplete fat-soluble vitamins such as vitamin A, vitamin D, vitamin E, and vitamin K, which are responsible for a range of activities, including antioxidant, immunity, vision, cell division, and much more. 

#2 Diabetes Medication (Oral Hypoglycemics) 

Diabetes medications assist your body in utilizing glucose by helping to restore your cells' response to insulin. 

Drugs that fall under this class include Avandia®, Diabeta®, Glucophage® (Metformin), Prandin®, and others. 

Although the exact mechanism is not understood, these drugs may deplete levels of vitamin B12 and folate (also known as folic acid). It's believed that glucose-lowering drugs may interfere with calcium-dependent membrane activity that's responsible for the absorption of B12 and folate.[3][4]

Vitamin B12 is responsible for a range of activities in your body related to the nervous system, and it acts as a methyl donor for 100s of reactions.[5]

Folate is needed to create healthy red blood cells and is critical during periods of growth and development.[6]

#3 Antacids And Proton Pump Inhibitors 

Antacids and proton pump inhibitors (PPIs) are used to neutralize or decrease the acid secretion in your stomach. PPIs work by blocking acid transporter pumps that send acid into your stomach, while antacids work by directly neutralizing existing acid in your stomach. 

These medicines can be found over the counter or as perspectives. Some common names for these types of medications include:

Nexium®, Pepcid®, Prevacid®, Prilosec®, and Tagamet® (among others). 

The problem with these types of medications is that stomach acid plays a key role in breaking down your food (particularly protein), allowing the nutrients within your food to be liberated and absorbed into circulation. When you use PPIs and antacids, you may unknowingly interfere with nutrient absorption by over-neutralizing your acids. 

Some nutrient deficiencies that are common with the use of these medications include magnesium and B vitamins (particularly B12).[7,8] 

As mentioned, B12 is vital for the function of your central nervous system. Magnesium is a mineral that acts as a cofactor for over 300 enzyme systems in your body, covering a range of activities, including muscle and nerve function, blood glucose control, protein synthesis, blood pressure regulation, and much more.[9]

#4 Birth Control Pills (Oral Contraceptives)

Oral contraceptives are synthetic or semi-synthetic analogs of estrogen or progesterone that are used to prevent pregnancy by either inhibiting ovulation, thickening the cervical mucus, or diminishing the activity of the endometrium. 

Common oral contraceptives include Yasmin®, Yaz®, Microgynon®, Kariva®, and Azurette®, among others.  

Due to increased estrogen levels in the blood, birth control has been shown to deplete magnesium levels.[10] Furthermore, it appears that birth control may deplete B vitamins such as B12, B6, and folate, likely due to shifts in hormones, but an exact mechanism has not been nailed down.[11,12] 

Vitamin B6 (also known as Pyridoxal 5' phosphate or PLP) plays a crucial role in brain development, as well as maintaining the health of your immune and nervous system.[13] 

#5 Blood Pressure Medication (Anti-Hypertensives)

Blood pressure medications are often used to prevent cardiovascular disease. 

Two common types of blood pressure medications include ACE inhibitors and calcium channel blockers. ACE inhibitors work by preventing an enzyme in your body from producing angiotensin II, a substance that narrows blood vessels. Thus, these medications prevent the restriction of blood vessels and allow for a natural flow of blood.[14]

Common ACE inhibitors include Capoten® (Captopril) and Vasotec® (Enalapril). Some ACE inhibitors can bind to the mineral zinc, causing a gradual depletion of this nutrient. 

Zinc plays a crucial role in the maintenance of your immune system, protein, and DNA synthesis, wound healing, as well as cell signaling and division.[15]

Calcium channel blockers work by preventing calcium from entering the cells of the heart and arteries. Calcium causes the heart to contract; therefore, by blocking its action, calcium channel blockers allow blood vessels to stay relaxed and open.[16]

Common calcium channel blockers include Norvasc®, Cardiazem®, Tiazac®, and Plendil®. 

Although more research is required, some evidence suggests these drugs can deplete potassium levels. Potassium is vital for the maintenance of fluid levels inside your cells, as well as muscle contraction and the maintenance of healthy blood pressure.[17]

Another class of blood pressure lowering medication is diuretics, which can lower blood pressure by clearing excess water from your body. One type of diuretic, known as Thiazide diuretics, works directly on your kidney by increasing urine flow and may cause depletion of magnesium, potassium, and zinc. 

#6 Antidepressants 

There are several classes of antidepressants, the most popular being serotonin reuptake inhibitors (SSRIs). SSRIs work by inhibiting the reuptake of serotonin, increasing levels of this neurotransmitter in your brain. 

Common SSRIs include Celexa®, Lexapro®, Paxil®, Prozac®, Zoloft®, and others.

SSRIs have been shown to deplete vitamin D by affecting the uptake and metabolism of this nutrient. Vitamin D is crucial for bone health, as well as calcium homeostasis and immunity.[18]

Research also suggests that SSRIs may interfere with folate levels, but the exact mechanism is not clear.[19]

Takeaway

This list highlights just a handful of the most common medications out there, but there are many more nutrient-depleting drugs to be aware of. In fact, it would be wise to look at your medicine cabinet to see what other culprits you may be taking on a regular basis.

There are many cases where prescription drugs can help to turn around a disease process and potentially even save lives. Unfortunately, the side effects that come with these medications can sometimes cause more issues than they're worth.

While short-term use typically doesn't cause a problem, long-term use of these common medications can create serious nutrient deficiencies — even when taken at a low dose.

Taking the appropriate supplements can help you combat nutrient depletion, but there's no one size fits all. That's why it's important that you talk with your healthcare provider about which supplements you need and at what dose. 

Citations

  1. https://www.aafp.org/dam/AAFP/documents/about_us/sponsored_resources/Nature%20Made%20Handout.pdf
  2. https://www.mayoclinic.org/drugs-supplements-coenzyme-q10/art-20362602
  3. Chapman, L. E., A. L. Darling, and J. E. Brown. "Association between metformin and vitamin B12 deficiency in patients with type 2 diabetes: A systematic review and meta-analysis." Diabetes & metabolism 42.5 (2016): 316-327.
  4. Xu, Lijuan, et al. "Adverse effect of metformin therapy on serum vitamin B12 and folate: short-term treatment causes disadvantages?." Medical hypotheses 81.2 (2013): 149-151.
  5. https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/
  6. https://ods.od.nih.gov/factsheets/folate-HealthProfessional/
  7. William, Jeffrey H., and John Danziger. "Proton-pump inhibitor-induced hypomagnesemia: Current research and proposed mechanisms." World journal of nephrology 5.2 (2016): 152.
  8. Cagle, Stephen, and Steve Song. "Does long-term use of proton pump inhibitors cause B12 deficiency?." Evidence-Based Practice 22.5 (2019): 23-24.
  9. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
  10. Blum, M., et al. "Oral contraceptive lowers serum magnesium." Harefuah 121.10 (1991): 363-364.
  11. Veninga, Karen Smit. "Effects of oral contraceptives on vitamins B6, B12, C, and folacin." Journal of Nurse-Midwifery 29.6 (1984): 386-390.
  12. Berenson, Abbey B., and Mahbubur Rahman. "Effect of hormonal contraceptives on vitamin B12 level and the association of the latter with bone mineral density." Contraception 86.5 (2012): 481-487.
  13. https://ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional/
  14. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/ace-inhibitors/art-20047480#:~:text=ACE%20inhibitors%20prevent%20an%20enzyme,hormones%20that%20raise%20blood%20pressure
  15. https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/
  16. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/calcium-channel-blockers/art-20047605#:~:text=Calcium%20channel%20blockers%20are%20medications,vessels%20to%20relax%20and%20open
  17. https://ods.od.nih.gov/factsheets/potassium-HealthProfessional/
  18. https://ods.od.nih.gov/factsheets/vitamind-healthprofessional/#:~:text=Together%20with%20calcium%2C%20vitamin%20D,metabolism%20%5B1%2D3%5D
  19. Mohn, Emily S., et al. "Evidence of drug–nutrient interactions with chronic use of commonly prescribed medications: An update." Pharmaceutics 10.1 (2018): 36.


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