Correcting pharmaceutical-induced nutritional deficiencies Many patients suffer from an almost completely ignored epidemic of drug-induced nutrient depletions that can cause severe health problems. A large number of pharmaceutical side-effects are the direct result of these drug-induced nutrient deficiencies. In other words, a pharmaceutical medicine 'robs' you of one or more nutrients or other helpful substances, and this lack of nutrients causes additional side-effects. In a sense the medicine acts as an 'anti-vitamin' pill, taking away the substances you need for good health. Thus, nutrient depletion caused by the medicines, rather than the medicines themselves, is often directly responsible for many of the side-effects associated with pharmaceuticals. Among the most common medicines linked to nutrient depletion are oral contraceptives, cholesterol-lowering statins, and antibiotics. These and many other over-the-counter and prescription medications can interfere with your body's ability to digest, absorb, synthesise, or make use of certain nutrients, leading to nutrient deficiency-related 'side-effects'. A pharmaceutical medicine 'robs' you of one or more nutrients or other helpful substances, and this lack of nutrients causes additional side-effects. The only solution to averting pharmaceutical-induced nutritional deficiencies is to replace the depleted nutrients through nutritional supplements, dietary sources, or both. This chart summarises some commonly prescribed medicines, along with the vitamins, minerals, and other nutraceuticals they are most likely to deplete. It is important to supplement with these nutrients if you are on any of these medicines. Pharmaceutical Medicine ACE inhibitors (eg. Benazepril, Captopril, Enalapril, Fosinopril, Lisinopril, Moexipril, Perindopril, Erbumine, Quinapril, Ramipril, Spirapril, Trandolapril),
Deficiency caused: Zinc Alendronate (including all bisphosphonates)
Deficiency caused: Calcium Antacids (Aluminium salts)
Deficiency caused: Copper & Zinc, Magnesium & Calcium, Iron Antacids (Calcium salts)
Deficiency caused: Copper & Zinc, Magnesium & Calcium, Iron Antacids (Magnesium salts)
Deficiency caused: Copper & Zinc, Magnesium & Calcium, Iron Antibiotics: AMINOGLYCOSIDES (eg. Gentamicin, Neomycin, Tobramycin)
Deficiency caused: Calcium & Magnesium, Iron, Lactobacillus (Probiotics), Vitamin K, Vitamins A & B12 Antibiotics: CEPHALOSPORINS (eg. Cefaclor, Cefprozil, Cefuroxime, Loracarbef)
Deficiency caused: Lactobacillus (Probiotics) also... MACROLIDES (eg. Erythromycin, Azithromycin, Clarithromycin) also
PENICILLINS (eg. Amoxicillin, Ampicillin, Flucloxacillin, Pivampicillin)
Deficiency caused: Vitamins B2, B12, Folic Acid, Biotin also... QUINOLONES (eg. Ciprofloxacin, Gatifloxacin, Levofloxacin, Lomefloxacin, Moxifloxacin, Nalidixic Acid, Norfloxacin, Ofloxacin, Sparfloxacin, Travafloxacin)
Deficiency caused: Vitamin K also...
SULFA DRUGS (eg. Co-Trimoxazole, Sulfamethoxazole, Trimethaprim) - also TETRACYCLINES (eg. Tetracycline, Doxycycline, Minocycline). Antibiotic: ISONIAZID (anti-TB medication)
Deficiency caused: Calcium & Vitamin D, Lactobacillus (Probiotics), Vitamins B3, B6, E, Vitamin K Anti-inflammatories: NSAIDs (eg. Diclofenac, Etodolac, Fenoprofen, Ibuprofen, Indomethacin, Ketoprofen, Mefanamic acid, Melofenamate, Nabumetone, Naproxen, Oxaprozin, Piroxicam, Sulindac, Tolmetin)
Deficiency caused: Iron & Folic Acid, Zinc, Melatonin Anti-retrovirals: REVERSE TRANSCRIPTASE INHIBITORS (eg. Lamivudine (3TC), Didanosine (ddl) , Zalcitabine (ddC), Stavudine (d4T), Ribavirin, Zidovudine (AZT), Abacavir (ABC), Emtricitabine (FTC), Tenofovir, Adefovir, Efavirenz, Nevirapine, Delavirdine)
Deficiency caused: Copper & Zinc Aspirin
Deficiency caused: Iron, Folic Acid & Vitamin C Barbiturates (eg. Phenobarbital)
Deficiency caused: Calcium & Vitamin D, Folic Acid & Vitamib B12 Betablockers (eg. Acebutolol, Atenolol, Betaxolol, Bisoprolol, Carteolol, Celiprolol, Esmolol, Labetalol, Levobetaxolol, Levobunolol, Metipranolol, Metoprolol, Nadolol, Penbutolol, Pindolol, Propranolol, Sotalol, Timolol)
Deficiency caused: Melatonin Birth Control Pill (oestrogen/progestin combination) mono/bi & triphasic (eg. Ethinyl estradiol, Desogestrel, Levonorgestrel, Norethindrone, Norgestimate)
Deficiency caused: Magnesium, Zinc, Vitamins B2, B6, B12, C & Folic Acid Carbemazepine
Deficiency caused: Folic Acid Cholestyramine & Colestipol (bile sequestrants)
Deficiency caused: Vitamins A,D,E,B12 & Folic Acid & Betacarotene, Vitamin K Clonidine
Deficiency caused: Co-enzyme Q10 Corticosteroids (eg. Prednisone, Prednisolone, Hydrocortisone, Beclometasone, Dexamethasone, Triamcinolone)
Deficiency caused: Calcium & Magnesium, DHEA, Protein, Vitamins C,D,B6,B12, Folic Acid, Selenium & Zinc, Melatonin Digoxin
Deficiency caused: Magnesium, Vitamin B1 Diuretics (loop) (eg. Bumetanide, Ethacrynic Acid, Furosemide, Torsemide) Deficiency caused: Calcium & Magnesium (however, if this type of diuretic is COMBINED with a potassium-sparing diuretic, then a magnesium deficiency will NOT occur. A calcium deficiency IS still likely though) Deficiency caused: Potassium (however, if this type of diuretic is COMBINED with a potassium-sparing diuretic, then a potassium deficiency will NOT occur. Vitamins B1, B6 & C Diuretics (potassium sparing) (eg. Amiloride, Triamterene, Sopironolactone)
Deficiency caused: Calcium, Folic Acid
Diuretics (Thiazide type) (eg. Chlorothiazide, Hydrochlorothiazide, Indapamide, Methyclothiazide, Metolazonel)
Deficiency caused: Co-enzyme Q10 Deficiency caused: Potassium (however, of this type of diuretic is COMBINED with a potassium-sparing diuretic, or an ACE inhibitor, then a potassium deficiency will NOT occur). Deficiency caused: Magnesium (however, if this type of diuretic is COMBINED with a potassium-sparing diuretic, then a magnesium deficiency will NOT occur. Deficiency caused: Zinc (however, if this type of diuretic is COMBINED with a potassium-sparing diuretic, then a zinc deficiency will NOT occur. Fibrate type cholesterol-reducing medications (eg. Bezafibrate, Ciprofibrate, Clofibrate, Gemfibrozil, Fenofibrate)
Deficiency caused: Co-Enzyme Q10, Vitamin E Histamine H2 blockers (eg. Cimetadine, Ranitidine, Famotidine, Nizatidine)
Deficiency caused: Calcium & Vitamin D, Iron, Vitamin B12 & Folic Acid, Zinc Hydralazine
Deficiency caused: Co-enzyme Q10, Magnesium, Vitamin B6 Metformin
Deficiency caused: Folic Acid & Vitamin B12 Paracetamol
Deficiency caused: Glutathione, Selenium Phenytoin
Deficiency caused: Calcium & Vitamin D, Vitamin B1, Folic Acid & Biotin Proton pump inhibitors (eg. Lansoprazole, Omeprazole)
Deficiency caused: Vitamin B12 Psychotropics:
Phenothiazines (eg. Chlorpromazine, Fluphenazine, Mesoridazine, Perphenazine, Prochlorperazine, Thioridazine, Trifluoperazine)
Deficiency caused: Co-enzyme Q10 also... Thioxanthenes (eg. Chlorprothixene, Flupenthixol, Thiothixene, Zuclopenthixol)
Deficiency caused: Vitamin B2 Sodium bicarbonate
Deficiency caused: Magnesium, Folic Acid Sulfasalazine
Deficiency caused: Folic Acid SSRI antidepressants (eg. Fluoxetine, Sertraline, Paroxetine, Citalopram, Escitalopram, Fluvoxamine)
Deficiency caused: Melatonin, Protein Statins (HMG-CoA reductase inhibitors) (eg. Atorvastatin, Fluvastatin, Lovastatin, Provastatin, Simvastatin, Posuvastatin)
Deficiency caused: Co-enzyme Q10 Sulfonylureas antidiabetic medication (eg. Acetohexamide, Chlorpropamide, Gliclazide, Glipizide, Glybenclamide, Glyburide, Tolazamide, Tolbutamide)
Deficiency caused: Co-enzyme Q10 Theophylline & derivatives (eg. Theophylline, Aminophylline
Deficiency caused: Vitamin B6 Tricyclic antidepressants (eg. Amitriptyline, Amoxapine, Clomipramine, Desipramine, Doxepin, Imipramine, Noriptyline, Protriptyline, Trimipramine)
Deficiency caused: Co-enzume Q10, Vitamin B2 Valproic Acid & derivatives
Deficiency caused: L-Carnitine, Copper, Zinc & Selenium, Folic Acid CONSEQUENCES OF NUTRIENT DEPLETIONS Beta-Carotene. This nutrient is converted to vitamin A by the body. Therefore deficiency symptoms are the same as those of vitamin A. The earliest symptom is reduced night vision. Prolonged deficiency leads to more advanced changes in eye tissue. Other potential signs of mild to moderate deficiency include rough, dry skin, loss of appetite, loss of hair lustre, brittle nails, joint pain, and possibly increased susceptibility to infection. Biotin. Low levels of biotin are associated with changes in skin colour, inflammation of the skin, hair loss, muscle pain, anaemia, loss of appetite, depression, insomnia, and elevated cholesterol levels. Calcium. Osteoporosis (bone loss) is the primary disease associated with long-term calcium deficiency. It may be associated with bone pain and spinal deformity. Depleted levels can also cause muscle cramps, irregular heartbeat, and depression. Carnitine (L-Carnitine). Deficiency is associated with anaemia, fatigue, increased blood levels of ammonia, lethargy, unexplained stupor, and heart irregularities. Co-Enzyme Q10. A deficiency of the anti-oxidant co-enzyme Q10 may be associated with long-term conditions including heart disease and high blood pressure. Symptoms of deficiency include gingivitis, and weakened immune function. Copper. Signs and symptoms of long-term depletion of copper include anaemia, changes in the structure and appearance of hair, heart damage, growth retardation, impaired bone formation, osteoporosis (bone loss), and emphysema (lung disease) Folic Acid. Low levels of folic acid have been linked to anaemia, elevated homocysteine, heart disease, increased cancer risk, and birth defects. Iron. Depleted levels of iron may lead to anaemia and weakened immune function. In the event of anaemia, symptoms include dizziness, fatigue, shortness of breath, pale skin colour, and possible irregular heartbeat. Lactobacillus. Reducing the number of probiotic organisms in the gastrointestinal tract may decrease the body's ability to resist infections and diseases. Symptoms of deficiency include gas, abdominal distress, diarrhoea, immune complaints, allergies, aggravation of auto-immune diseases, and yeast infections. Magnesium. Magnesium deficiency affects calcium and vitamin D levels in the body and may be associated with muscle cramps, heart irregularities, insomnia, high blood pressure, diabetes, and osteoporosis (bone loss). Melatonin. Reduced levels of melatonin in the body have been associated with sleep disturbances and accelerated brain ageing (through oxidative damage). Potassium. Symptoms of potassium deficiency include loss of appetite, nausea, drowsiness, feelings of apprehension, excessive thirst, irrational behaviour, fatigue, muscle pain and weakness (usually of the lower limbs), severe cases may lead to irregular heartbeat. Protein. Protein deficiencies are characterised by weakened immune status, including increased susceptibility to infection, impaired wound healing, muscle and weight loss, growth retardation, and deterioration in skin and hair condition. Selenium. Selenium deficiency may be associated with muscular, digestive, and heart disorders; long-term deficiency may be associated with increased risk of developing certain chronic illnesses such as cancer, diabetes, or liver disease. Vitamin A (Retinol). The earliest symptom of deficiency of this nutrient is reduced night vision. Prolonged deficiency leads to more advanced changes in eye tissue. Other potential signs of mild to moderate deficiency include rough, dry skin, loss of appetite, loss of hair lustre, brittle nails, joint pain, and possible increased susceptibility to infection. Vitamin B1 (Thiamine). ymptoms of depleted levels of thiamine include weakness, fatigue, anorexia, constipation, memory loss, confusion, and depression. Deficiency may lead to beri-beri, a condition characterised by inflammation of nerves, heart irregularities, and fluid retention. Vitamin B2 (Riboflavin). ymptoms of vitamin B2 deficiency may include cracks at the corners of the mouth, inflammation of the skin, growth retardation, and impaired wound healing. Vitamin B3 (Niacin or Niacinamide). Because this nutrient plays a key role in many metabolic processes, low levels may impair the breakdown and use of starches, fats, and proteins. Symptoms of deficiency may occur within 1-2 months. Severely low levels of niacin or niacinamide cause pellagra, a condition characterised by inflammation of the skin, mental depression, abdominal pain and diarrhoea. Vitamin B6 (Pyridoxine). Symptoms of vitamin B6 deficiency may include weakness, nervousness, insomnia, mental confusion, irritability, and anaemia. Long-term low levels of this nutrient may also increase the risk of heart disease as well as colon and prostate cancers. Vitamin B12. It can take years to develop complications associated with long-term depletion of this nutrient. Irritability, weakness, numbness, anaemia, loss of appetite, headache, personality changes, and confusion are some of the signs and symptoms associated with vitamin B12 depletion. Low levels of this vitamin may also be associated with an increased risk of colon cancer, heart disease, brain disorders, and birth defects. Vitamin C. Vitamin C deficiency may include bruising, fever, anaemia, emotional changes, swollen and bleeding gums, fatigue, lethargy, jaundice (yellowing of the skin and eyes), increase susceptibility to infections, slow wound healing, and swelling of the lower limbs. Very rarely severe deficiency leads to scurvy, a disorder that affects muscles and bones and is potentially fatal. Vitamin D. Vitamin D deficiency leads to abnormal bone formation (rickets) in children and softening of the bones (osteomalacia) in adults. Vitamin D deficiency interferes with calcium absorption, leading to deficiency of that nutrient with all of the associated symptoms (such as increased risk of fractures, osteoporosis (bone loss), and muscle weakness). Vitamin D deficiency is also associated with increased risk of cancer (especially breast cancer), and depression. Vitamin E. Vitamin E deficiency negatively affects muscle tissue, red blood cells, and the nervous and reproductive systems. Over the long-term, depleted levels of this nutrient may also be associated with cancer, heart disease, and altered immune function. Vitamin K. The major symptom of vitamin K deficiency is an inability of the blood to clot properly, which may lead to excessive bleeding and a tendency to bruise easily. A deficiency of this vitamin can also accelerate hardening of the arteries. Zinc. Signs and symptoms of zinc deficiency include loss of appetite or sense of taste, impaired immunity, growth retardation, skin changes, reduced hormonal production, decreased sex drive and increased susceptibility to infection. |
