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Medicine

Nutrient Depletion Caused by Drugs

Antiarrhythmic Agents:

Medications to keep your heart beating regularly Digoxin depletes calcium, magnesium, phosphorus, and B1. Phenytoin, which is used for ventricular arrhythmia, as well as grand mal, simple partial and complex partial seizures, depletes the body of biotin, calcium, folic acid, thiamin, B12, vitamin D, and vitamin K.

Antihypertensives:

Medication to lower your blood pressure Beta blockers (used for hypertension, angina, and arrhythmia) deplete coenzyme Q10. ACE inhibitors (benazepril, captopril, enalapril, fosinopril, lisinopril), collectively deplete the body of zinc. Hydrochlorothiazide and triamterene deplete the body of B6, folic acid, and calcium.

Antilipemic Agents:

Medications to lower your cholesterol Cholestyramine resin and colestipol deplete the body of beta-carotene, folic acid, vitamin A, B12, vitamin D, folic acid, vitamin E, vitamin K, calcium, iron, magnesium, phosphorus, and zinc. Statin drugs (atorvastatin, cerivastatin, fluvastatin, lovastatin, simvastatin) deplete the body of coenzyme Q10.

Antidiabetic Agents:

Medications to lower high blood sugar metformin (glucophage), acetohexamide (dymelor), glyburide (diabeta, glynase, prestab, micronase), tolazaminde (tolinase), tolbutamide (orinase), as a group deplete coenzyme Q10, with desipramine also depleting the body of B12. Since diabetes is a cardiovascular disease risk factor, the depletion of these nutrients places the individual at increased risk, because of the fact that coenzyme Q10 and B12 contribute to proper cardiovascular health.

Antibiotics:

Medications to fight infections Besides destroying beneficial gut bacteria that aid digestion, protect against infection, and synthesize certain nutrients, tetracyclines (achromycin, sumycin, tetracap, panmycin), penicillins, cephalosporins, fluoroquinolones, and sulfonamides, deplete the body of B1, B2, B3, B6, B12, biotin, inositol, vitamin K, iron, and magnesium.

Antidepressants:

Medications to help with depression or anxiety Amoxapine (asendin), desipramine (norpramin), nortriptyline (aventyl hydrochloride), protriptyline (vivactil), amitriptyline (elavil), clomipramine (anafranil), doxepin (adapin), and imipramine (tofranil) deplete the body of coenzyme Q10 and B2.

Anti-inflammatory Agents:

Medications to fight swelling and inflammation The nonsteroidal anti- inflammatory drugs diclofenac, diflunisal, etodolac, fenoprofen, ibuprofen, ketoprofen, mefenamic acid, nabumetone, naproxen, and piroxicam all deplete the body of folic acid.

Estrogen Medications:

To prevent the change of life in women or lessen the symptoms (conjugated and esterified): Premarin, estratab, and menest, deplete the body of B6, magnesium, and zinc.

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Top 10 Nutrient Depleting Drugs

Atorvastatin (Lipitor) Cholesterol Lowering Medication:

In a double-blind trial, individuals with high cholesterol who were treated with lovastatin or pravastatin (drugs related to atorvastatin) for 18 weeks had a significant reduction in blood levels of coenzyme Q10 (CoQ10). One study found that supplementation with 100 mg of CoQ10 prevented declines in CoQ10 levels when taken with simvastatin (another HMG-CoA reductase inhibitor drug). Many doctors recommend that people taking HMG-CoA reductase inhibitor drugs such as atorvastatin also supplement with approximately 100 mg CoQ10 per day, although lower amounts, such as 10– 30 mg per day, might conceivably be effective in preventing the decline in CoQ10 levels.

Azithromycin (Z-Pack) 3 or 5 day commonly prescribed antibiotic:

Several cases of excessive bleeding have been reported in people who take antibiotics. This side effect may be the result of reduced vitamin K activity and/or reduced vitamin K production by bacteria in the colon. One study showed that people who had taken broad-spectrum antibiotics had lower liver concentrations of vitamin K2 (menaquinone), though vitamin K1 (phylloquinone) levels remained normal. Several antibiotics appear to exert a strong effect on vitamin K activity, while others may not have any effect. Therefore, one should refer to a specific antibiotic for information on whether it interacts with vitamin K. Doctors of natural medicine sometimes recommend vitamin K supplementation to people taking antibiotics. Additional research is needed to determine whether the amount of vitamin K1 found in some multivitamins is sufficient to prevent antibiotic- induced bleeding. Moreover, most multivitamins do not contain vitamin K.

Estrogens (Combined) Female Hormone Replacement:

A small preliminary trial found most women taking conjugated estrogens therapy without a progestin to have lower levels or a deficiency of vitamin B6.7 Numerous studies have found negative effects of oral contraceptives (OCs) on vitamin B6 status, although some studies suggest that vitamin B6 deficiency does not occur when low-dose OCs are used.11 While OCs contain different forms of estrogen than conjugated estrogens, there is a possibility of a similar problem when any form of estrogen is supplemented, but more research is needed.

Inhaled Corticosteroids (Popular Inhalers and Nasal Sprasy) Prescribed for asthma and seasonal allergies: Some are now even available without prescription like Flonase!

Most of an inhaled dose of beclomethasone is actually swallowed, which may lead to reduced absorption of calcium. Health practitioners may recommend calcium supplementation to individuals using beclomethasone inhalers. Dehydroepiandrosterone (DHEA) A group of women with asthma who had been taking inhaled beclomethasone were shown to have low levels of DHEA compared to women with asthma who were not taking beclomethasone. The authors speculated that this effect may partially explain how corticosteroids can cause osteoporosis.

However, more research is needed to confirm these suspicions and to evaluate whether supplemental DHEA is beneficial to patients taking inhaled corticosteroids.

Lansoprazole (Prevacid) Reduces acid in your stomach prescribed for heartburn and reflux:

Omeprazole, a drug closely related to lansoprazole, taken for seven days led to a near- total loss of stomach acid in healthy people and interfered with the absorption of a single administration of 120 mg of beta-carotene. It is unknown whether repeated administration of beta-carotene would overcome this problem or if absorption of carotenoids from food would be impaired. Persons taking omeprazole and related acid-blocking drugs for long periods may want to have carotenoid blood levels checked, eat plenty of fruits and vegetables, and consider supplementing with carotenoids. Folic acid is needed by the body to utilize vitamin B12.
Antacids, including lansoprazole, inhibit folic acid absorption. People taking antacids are advised to supplement with folic acid. Omeprazole, a drug closely related to lansoprazole, has interfered with the absorption of vitamin B12 from food (though not supplements) in some, but not all, studies. This interaction has not yet been reported with lansoprazole. However, a fall in vitamin B12 status may result from decreased stomach acid caused by acid blocking drugs, including lansoprazole.

Omeprazole (Prilosec) Reduces acid in your stomach used for heartburn and reflux. Can be bought without a prescription!:

Folic acid is needed by the body to utilize vitamin B12.

Antacids, including omeprazole, inhibit folic acid absorption. People taking antacids are advised to supplement with folic acid. 2) Omeprazole interferes with the absorption of vitamin B12 from food (though not from supplements) in some but not all studies. A true deficiency state, resulting in vitamin B12-deficiency anemia, has only been reported in one case. The fall in vitamin B12 status may result from the decrease in stomach acid required for vitamin B12 absorption from food caused by the drug. This problem may possibly be averted by drinking acidic juices when eating foods containing vitamin B12. However, all people taking omeprazole need to either supplement with vitamin B12 or have their vitamin B12 status checked on a yearly basis. Even relatively small amounts of vitamin B12 such as 10–50 mcg per day, are likely to protect against drug induced vitamin depletion.

Oral Corticosteroids (are used to provide relief for inflamed areas of the body. They lessen swelling, redness, itching, and allergic reactions):

Calcium, Chromium, Magnesium, Melatonin, Potassium, Selenium, Vitamin B6, Vitamin D.

Pravastatin (Pravahvol) Cholesterol Lowering Medication:

In double-blind trials, treatment with pravastatin and other HMG-CoA reductase inhibitors has resulted in depleted blood levels of coenzyme Q10 (CoQ10). Supplementation with 90–100 mg CoQ10 per day has been shown to prevent reductions in blood levels of CoQ10 due to simvastatin, another drug in the same category as pravastatin. However, some investigators have questioned whether it is worthwhile or necessary for individuals taking HMG-CoA reductase inhibitors to supplement with CoQ10.5 Until more is known, people taking pravastatin should ask a doctor about supplementation with 30–100 mg CoQ10 per day.

Risperidone (Risperdal) A medication to treat certain types of mental illness:

Vitamin B6, Vitamin E

Simvastatin (Zocor) Cholesterol Lowering Medication:

Co Enzyme Q 10