Medications and Nutritional Deficiencies

MedicationNutritionJacquie Eubanks RN BSN

We’ve all seen the happy, healthy looking people in numerous television pharmaceutical commercials, which often conclude with a rushed but pleasantly presented list of side effects. We acknowledge that certain medications are necessary to save lives, prevent or fight disease, and manage chronic conditions, yet we tend to accept or ignore the side effect warnings. While the best defense against poor health is a healthy lifestyle, that includes good nutrition, regular physical activity, and stress management, the side effects of prescription and OTC medications may also require scrutiny and management.

When a pharmaceutical protocol is recommended, it pays to do some research to fully understand the side effects. There may be an equally good medication with fewer side effects, and lifestyle interventions may help to reduce the amount of time medication is necessary. Medications that can rob your body of the vital nutrients essential to health can lead to a host of deficiency-related side effects. While nutrient deficiency may pale in comparison to the seriousness of the disease or other significant side effects, drug-induced nutrient depletion can undermine your quality of life and lead to poor health or illness.

Per the CDC, almost 50% of Americans take at least one prescription drug daily, 23% take three or more, and 12% take five or more, equating to 2.8 billion drugs prescribed by physicians annually. The therapeutic classes most frequently prescribed are antihyperlipidemic agents, analgesics, antidiabetic agents and antidepressants. Add to that the 329 million drugs ordered or provided during outpatient hospital visits, the over 297 million ordered or provided during hospital emergency room visits, and the 81% who take OTC medication as a first line of defense, and one can quickly surmise that with our reliance upon medications, drug-induced nutrient depletion is far more common than has been acknowledged.

Side effects of a medication’s interference with the body’s ability to synthesize nutrients and digest, absorb, and utilize certain nutrients from dietary sources may not be immediately revealed. Nutrient deficiencies are best determined by laboratory testing. Physical symptoms can include muscle cramping or weakness, fatigue, irregular heartbeat, tingling in the hands and feet, hair loss, intestinal problems, liver dysfunction, impaired immune response, bone loss, and more.

Examples of medications and the related nutritional deficiencies include:

-Proton pump inhibitors (PPIs) used to reduce heartburn and acid reflux can inhibit the production of CoQ10, a potent antioxidant necessary for cellular energy production. PPIs can also cause low calcium and magnesium levels and interfere with B12 absorption. The long-term consequences of PPI use include increased risk of calcium and magnesium malabsorption, clostridium difficile infections and pneumonia. Long-term use is defined as greater than 14 days, the maximum recommended therapy for OTC products.

-Statin drugs used to lower cholesterol levels can increase your need for, or interfere with, the activity of CoQ10, beta-carotene, folic acid, iron and vitamins A, B12, D, E, and K. Side effect symptoms include muscle pain and weakness, liver inflammation, increased blood sugar levels, confusion and memory loss.

-Beta-blockers are used to treat angina and elevated blood pressure, prevent migraines, and reduce the odds of further complications in those who have had a heart attack. Taking this medicine can deplete your body of, or increase your need for, CoQ10 and melatonin. Melatonin, a neurohormone that helps regulate reproductive hormones and maintains the body’s circadian rhythm, has cardioprotective properties, including anti-inflammatory and antioxidant effects. Melatonin should only be supplemented under the supervision of a knowledgeable healthcare professional.

-Corticosteroids are used to reduce the signs and symptoms of inflammatory conditions, such as asthma and arthritis, and to suppress the immune response in autoimmune conditions. Because these medications affect the entire body, they can have significant side effects, including high blood pressure, fluid retention, high blood sugar, cataracts, and glaucoma, as well as osteoporosis resulting from impaired calcium absorption. In addition, steroid therapy can interfere with the normal absorption and utilization of potassium, sodium, protein and vitamins C and D.

-Oral contraceptives have been shown to depress levels of vitamins B2, B6, B12 and C, as well as niacin, folacin, magnesium and zinc, while elevating levels of vitamin K, copper and iron, and negatively affecting tryptophan metabolism.

Those taking long-term prescription medications should check in with their healthcare provider to address any negative side effects. As ample and balanced stores of essential nutrients are the foundation of good health, truly preventive medicine focuses on ensuring the optimum intake of nutrients vital to every cellular process. Micronutrient testing can identify vitamin, mineral, fatty acid, antioxidant, amino acid and metabolite deficiencies. Armed with information, a healthy diet, and proper supplementation, one can avoid or minimize the health harming side effects of medication-related nutrient depletion, thereby resulting in a positive effect on disease risk management, optimal wellness, and healthy aging.

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References:
Nutrient-Drug Interactions. http://www.merckmanuals.com/professional/nutritional-disorders/nutrition-general-considerations/nutrient-drug-interactions
A Practical Guide to Avoiding Drug-Induced Nutrient Depletion. http://circleofdocs.com/a-practical-guide-to-avoiding-drug-induced-nutrient-depletion/
Pharmaceutical Malnutrition: the Downside of Drugs. http://www.drjondunn.com/newsletters/2007-07Downsideofdrugs.html
Drug Influences on Nutrient Levels and Depletion. http://naturaldatabase.therapeuticresearch.com/ce/ceCourse.aspx?pc=08-40&cec=0&pm=5&AspxAutoDetectCookieSupport=1
Statistics on OTC Use. https://www.chpa.org/MarketStats.aspx
Therapeutic Drug Use. https://www.cdc.gov/nchs/fastats/drug-use-therapeutic.htm
Nutritional effects of oral contraceptive use: a review. https://www.ncbi.nlm.nih.gov/pubmed/7001015
Statin Side Effects: Weigh the benefits and risks. http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/statin-side-effects/art-20046013
Prednisone and other corticosteroids. http://www.mayoclinic.org/steroids/art-20045692
Melatonin. http://www.umm.edu/health/medical/altmed/supplement/melatonin
Steroids and Nutrition. https://www.nationaljewish.org/health-insights/healthy-eating/steroids

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