Are the Drugs You Take Making You Lose Essential Vitamins and Minerals?

In another article, (Are the drugs you take making you lose essential nutrients?), I described the general problem of drugs depleting essential nutrients and how so many people are unaware that they may be at risk. In this article, I’ll get more detailed about specific drugs—what nutrients they deplete and what you can do about it.

There can be problems with prescription drugs….AND over-the-counter drugs. It seems that people have gotten so used to taking all sorts of medicines, the assumption is that they are perfectly safe.

Now, as I say to my patients, I am not against drugs…I’m against the mis-use of drugs. It would be foolish not to recognize the benefits – to the individual and to humanity as a whole—of antibiotics, pain relievers, asthma drugs and various drugs for different life-threatening conditions. But, I think it’s worth asking yourself:

• Do you REALLY need that stomach -acid lowering drug or is it wiser to eat better?
• Do you REALLY need that pain reliever for a mild headache or might you be better off taking some time to relax?
• Do you REALLY need that diet pill, or could you eat more vegetables and exercise more?

I am definitely not suggesting you stop taking your prescribed medications—that is a decision for you and your doctor, but please talk to your health care professional to determine if that particular medication at that dosage is necessary and if so, do you need to supplement with the nutrients that medication may deplete!

So, what are the most commonly prescribed medications?

Some of the most commonly prescribed classes of drugs include antacids, anti-depressants, blood pressure medications, stimulants, statins to control cholesterol, anti-anxiety drugs, anti-asthma drugs, pain relievers, sleep aids, anti-inflammatories and drugs to control blood sugar. The most common over-the-counter drugs are pain relievers, fever reducers, antacids and cold medications.

Specific Drugs and the Nutrients They Deplete

Antacids

Drugs such as famotidine (Pepcid), cimetidine (Tagamet), ranitidine (Zantac) deplete vitamin B12 primarily, with some depletion of calcium, folic acid, iron, zinc and possibly chromium.

B12 deficiency can cause anemia, gastrointestinal and neurological symptoms. Other problems can occur, especially if the B12 deficiency is coupled with folic acid deficiency.

Lansoprazole (Prevacid) and Omeprazole (Prilosec) can severely deplete magnesium. They also deplete vitamin B12 and other minerals.

Magnesium deficiency is rather common and the symptoms are not always easy to distinguish from other conditions. Signs of early magnesium deficiency include nausea, vomiting, loss of appetite, fatigue, and weakness. Later signs may include numbness, tingling, muscle contractions and cramps and seizures. There may also be personality changes and heart problems.

If you take any of these drugs, talk to your doctor about supplementing with B vitamins and minerals—especially magnesium!

Cholesterol lowering drugs

These are the commonly used statins—these drugs interfere with a step in cholesterol synthesis—the problem is that they also interfere with the synthesis of other important substances.

Cerivastatin (Baycol), fluvastatin (Lescol), atorvastatin (Lipitor), lovastatin (Mevacor) and simvastatin (Zocor) all deplete a substance called CoQ10.

CoQ10 is very important –it is found in all mitochondria and therefore in every cell of your body—remember hearing about mitochondria being the “powerhouse of the cell”? Well, without CoQ10, the mitochondria are powerhouses which have been shut down! CoQ10 deficiencies can result in serious neurologic and muscular conditions (there is even a condition called statin myopathy caused by the statins!)

Other cholesterol lowering drugs are colestipol (Colestid) and cholestyramine (Questran). They interfere with cholesterol absorption and are known to deplete particularly the fat soluble vitamins A, D, E and K.

Talk to your doctor about supplementing with CoQ10 or vitamins A,D, E and K if you are on a statin or other cholesterol lowering drug.

Oral contraceptives or hormone replacement therapy (HRT)

Birth control and hormone replacement therapy both deplete essential nutrients such as vitamins B2, B6, folic acid and B12 as well as vitamin C and the minerals magnesium and zinc. In addition, levels of vitamin K, iron and copper are increased.

Vitamin K is involved in blood clotting mechanisms and bone metabolism. The effects of increased levels of vitamin K are not well understood, but it may have something to do with the increased risk of clots associated with oral contraceptives and some forms of HRT.

Elevated copper levels can lead to liver and kidney damage.

Iron overload is better understood. Moderate levels of iron overload can cause stomach irritation, nausea, vomiting, diarrhea, or constipation. There is also a potential for liver and kidney damage.

Diuretics (water pills)

These include HCTZ (Hydrochlorothiazide), Lozol (indapamide) and Zaroxolyn (metolazone).

These can deplete potassium, sodium, zinc and magnesium.

Now, one of the points of this treatment IS to deplete sodium, but we do need some sodium for health. Potassium loss is one of the main nutrient losses associated with diuretics—you can talk to your doctor about potassium-sparing diuretics like amiloride and spironolactone, or supplementing with potassium.

Blood Pressure Lowering Medications

The ACE inhibitors (such as captopril, enalopril, lisinoril and benezepril) can deplete zinc levels.

Zinc depletion can decrease your immune system, slow down wound healing and cause smell and taste disturbances. Zinc deficiency can also cause problems with blood sugar regulation and depression, among other things.

The beta- blockers, including propranolol, carvedilol, atenolol and timolol, can deplete CoQ10 and melatonin.

CoQ10 is a critical cofactor in energy production and is in every cell of your body. Melatonin is the “sleep hormone”—well, you can see what might happen if melatonin is depleted!

Medications to control blood sugar

Metformin (Glucophage) can deplete CoQ10 and the B-vitamins folic acid, vitamin B1 (thiamine) and vitamin B12.

Folic acid and B12 deficiencies can lead to birth defects, anemias and heart disease. Thiamine deficiency can be related to neurological problems.

Pain relievers

Naproxyn, Indomethacin, celecoxib and ibuprofen can all deplete folic acid.

Acetaminophen can deplete glutathione—one of the body’s most effective natural anti-oxidants.

So if you have chronic pain and are using any of these pain-relievers, make sure you talk to your doctor about supplements, particularly B-vitamins such as folic acid and anti-oxidants like vitamin C, vitamin E and others (some examples include grape seed extract, resveretrol, astaxanthin, acai etc) to make up for the lost glutathione. (Glutathione supplements are not very well-absorbed by mouth).

Anti-anxiety medications

Medications such as diazepam (Valium), clonazepam (Klonopin) and lorazepam (Ativan) can cause major depletion of calcium and may cause vitamin K depletion.

Talk to your physician especially about the potential need for calcium supplementation.

Corticosteroids

Corticosteroids are used in a variety of conditions, but are used often in asthma patients. Beclomethasone, budenoside and dexamethosone can deplete calcium, chromium, magnesium and vitamin D.¹ In fact, inhaled magnesium sulfate is a treatment for an acute asthma attack!

Proton pump inhibitors

Proton pump inhibitors (PPIs) are a class of drugs primarily used to treat acid-related disorders in the stomach. These disorders can include gastroesophageal reflux disease (GERD), stomach and duodenal ulcers, and Zollinger-Ellison syndrome.

Prolonged use of PPIs can lead to decreased absorption of certain nutrients, notably calcium, magnesium, vitamin B12, and iron.

Beta-Blockers

Beta-blockers, also known as beta-adrenergic blocking agents, are a class of drugs primarily used to treat cardiovascular conditions. They block the effects of epinephrine (adrenaline) and other stress hormones on the heart and blood vessels, which results in a decrease in heart rate, blood pressure, and strain on the heart.

Beta-blockers can reduce the levels of CoQ10 in the body. CoQ10 is a vital component of the energy production system of cells and has antioxidant properties. Reduced levels can lead to fatigue, muscle weakness, and soreness. Also, some beta-blockers may interfere with melatonin production, which can affect sleep patterns. Melatonin is a hormone responsible for regulating the sleep-wake cycle.

Antipsychotics

Antipsychotics, also known as neuroleptics, are a class of medications primarily used to manage and treat symptoms of psychosis, including delusions, hallucinations, and thought disorders, most commonly seen in conditions like schizophrenia and bipolar disorder. They can also be used in the treatment of severe depression, aggressive behavior, and Tourette's syndrome.

Chronic use of antipsychotics, especially if it results in reduced sun exposure due to lifestyle changes or sedation, can lead to decreased vitamin D levels. Some antipsychotic medications have been associated with lower folate levels, which is crucial for DNA synthesis and repair, and neurotransmitter formation.

Finally

Again, it is strongly recommend you speak to your physician about the possibility of nutrient depletion with any prescription medications—we are constantly learning more and more, and these examples are given just to give you a basic idea of the scope of the situation. The “fix” is very often quite easy —many times, it is simply a matter of adding the depleted nutrient back! And if that simple fix can save you from immune, neurological, bone, respiratory, cardiac, bleeding and other health problems down the line….well, YOU decide if it’s worth it!