The Secret of Drugs & Nutrient Depletion:

 

Drug-induced nutrient depletion occurs when the medications we take for our chronic health conditions block the absorption, storage, metabolism, or synthesis of essential nutrients in the body. When nutrients are blocked or depleted over time, health problems will develop.

Antacids:

This category includes medications such as Pepcid, Tagamet, magnesium & aluminum containing antacids (such as Gaviscon, Maalox, Mylanta):

• Dexlansoprazole (Dexilant)
• Esomeprazole (Nexium)
• Lansoprazole (Prevacid)
• Omeprazole (Prilosec and another with sodium bicarbonate, Zegerid)
• Pantoprazole (Protonix)
• Rabeprazole (Aciphex)

Antacids work by neutralizing stomach acid or by inhibiting the release of a digestive enzyme (like pepcin). Unfortunately, stomach acid is necessary to release vitamins from food, and when you decrease or stop the production of it, you absorb fewer vitamins. These medications can cause deficiencies in the following nutrients:

• Vitamin B12
• Folic Acid
• Vitamin D
• Calcium
• Iron
• Zinc

Most common of these is deficiencies is B12. Vitamin B12 deficiency can cause anemia, depression, tiredness, and weakness. When choosing a B12 supplement, you want to look exclusively for the methylated form Methylcobalamin. Dosages range from 1 to 5mgs and it can be taken twice daily if needed. I recommend taking it in the morning and around noon. Vitamin B12 provides energy, so never take it too close to bedtime. Vitamin B12 is also “water soluble” meaning that you cannot overdose on it since the body automatically eliminates any excess through urine.

NSAIDs

This group includes medications such as Motrin, Aleve, Advil, Anaprox, Dolobid, Feldene, and Naprosyn. These are all known to cause folic acid deficiency due to a decrease in the body’s ability to absorb folate from the intestine. Folic acid deficiency can cause birth defects, anemia, and a higher risk of cardiovascular disease. Also in this group is aspirin and other salicylates. Long term use of aspirin is linked to deficiency in the following nutrients:

• Vitamin C
• Calcium
• Folic Acid
• Iron
• Vitamin B5 (Pantothenic Acid)

Aspirin can cause the body to expel more Vitamin C in urine than normal and Vitamin C is essential for a healthy immune response. Calcium is necessary for bone, heart & dental health. Iron prevents anemia, weakness, fatigue, hair loss, and brittle nails. Vitamin B5 helps with fatigue and listlessness.

Now let’s address anti-depressants, antibiotics, cholesterol lowering drugs, and diabetic drugs.  I would like to stress that I am NOT advocating that you stop taking any medication that your doctor has prescribed, only letting you know that you may require additional amounts of these nutrients to stay healthy while on that medication.

Anti-depressants

Anti-depressants include Prozac, Effexor, Lexapro, Wellbutrin, and many more.  With long-term use of anti-depressants, you are going to deplete two things:  Coenzyme Q10 (CoQ10) and Vitamin B2 (Riboflavin).  You can get some CoQ10 from your diet, but most patients require a supplement form.  Natural sources are red meat, oily fish, and some nuts.  Vitamin B2 (Riboflavin) is found in foods such as beef liver, lamb, mushrooms, spinach, and almonds. You can also find B2 as a supplement alone or in a B-Complex.

Antibiotics

Antibiotics include medications such as Gentamycin, Neomycin, Streptomycin, Cephalosporins, Penicillins, and Tetracyclines.  Most antibiotics are used only for a short amount of time.  However, some patients are put on long-term antibiotic therapies.  This long-term use can lead to depletion of:

• B Vitamins
• Vitamin K
• Calcium
• Magnesium
• Iron
• Zinc

You can increase intake of these vitamins and minerals through a healthy diet, but some patients will need to incorporate a high-quality multivitamin daily.  No matter what choice you make for vitamin repletion, EVERYONE will require a high-dose probiotic to recolonize the bacteria in the gastrointestinal tract. 

Cholesterol Drugs:

Drugs in this category are collectively called “statins” and include names like: Lipitor, Crestor, Zocor, and others.  They too deplete Coenzyme Q10.  Low energy is a common complaint from patients on statins and this can be partially due to depleted CoQ10.  Seek a high-quality CoQ10 supplement to fight this fatigue. They will also trigger muscle pain. Depletions of CoQ10, Vitamin D, Vitamin K and Selenium is attributed to statin therapy.

Diabetic Drugs:

Metformin and Sulfonylurea drugs are used to manage Type 2 Diabetes.  Metformin being the oldest and most common drug in this category, depletes Coenzyme Q10, Vitamin B12, and Folic Acid.  All three of these directly affect energy levels, cardiovascular health, and the immune system.  Since most patients continue with long-term Metformin therapy, I recommend repletion with high-quality supplements for these nutrients.  When purchasing your supplements, be sure that your Vitamin B12 and Folic Acid are in the active/bioavailable form.  Look for “methylcobalamin” for B12 and “5-methyltetrahydrofolic acid” for Folic Acid.

Do you want to know if you are nutrient depleted?  We offer Micronutrient Testing,  D and B12 Testing, Organic Acids Testing and Food Allergies testing. These tests looks at your nutritional status from a cellular level checking vitamins and minerals such as: B Vitamins, Vitamin K, Vitamin D, Selenium, Coenzyme Q10, Copper, and many more.  Test results come with repletion suggestions for foods or supplements and the appropriate dosing.

What is Organic Acids Testing?

The Organic Acids Test (OAT) offers a comprehensive metabolic snapshot of your overall health with 76 markers.  It provides an accurate evaluation of intestinal yeast and bacteria. Abnormally high levels of these microorganisms can cause or worsen behavior disorders, hyperactivity, movement disorders, fatigue and immune function. Many people with chronic illnesses and neurological disorders often excrete several abnormal organic acids in their urine. The cause of these high levels could include oral antibiotic use, high sugar diets, immune deficiencies, acquired infections, as well as genetic factors.

Please note that all supplements are available at our office location at 12443 San Jose Blvd Suite 403- Jacksonville Florida, 32259

References:

1. Mohn ES, Kern HJ, Saltzman E, Mitmesser SH, McKay DL. Evidence of Drug-Nutrient Interactions with Chronic Use of Commonly Prescribed Medications:  An Update. Pharmaceutics. 2018 Mar 20;10(1):36. doi: 10.3390/pharmaceutics10010036. PMID: 29558445; PMCID: PMC5874849.