"For every dollar we spend on prescription drugs, we spend a dollar to fix a complication. Understanding how nutritional supplements affect these drugs could make them safer and more effective."
-- Mehmet Oz, M.D., Professor of Surgery at Columbia University and author of bestsellers "YOU: The Owner's Manual" and "YOU: On A Diet"
A little known but potentially life-saving fact is that common medications deplete vital nutrients essential to your health. Here's a practical guide to avoid drug-induced nutrient depletion, and even replace your medications with natural supplements.
We have been called a pill-popping society, and statistics bear this out. Nearly 50 percent of American adults take at least one prescription drug, and 20 percent take three or more. In a survey(1), more than half of those over 65 and 30 percent of people 45 to 65 used at least three prescription drugs in a one-month period. With our increasing reliance on medications comes nutrient depletion, a problem we can't ignore. Every medication, including over-the-counter drugs, will drain the body of specific nutrients. On top of this, most Americans are already suffering from nutrient depletion. In fact, many of the conditions we see in everyday practice may actually be related to this deficiency.
The good news is that with the right supplements, you can avoid depletion side effects, and even better, you may be able to control and prevent chronic diseases, such as diabetes, cardiovascular disease and osteoporosis.
A Common Scenario
I have seen case after case of patients who have experienced nutrient loss from taking prescribed medications. Too often, neither the patients nor their doctors were aware that the cause of symptoms was the medications themselves.
For example, a 57-year-old retired schoolteacher, Kathy, was being treated by her internist with three medications: the thiazide diuretic, Diuril, for high blood pressure; Fosamax for osteoporosis; and the beta-blocker, Tenormin, for heart palpitations.
She was referred to me, an integrative psychiatrist, because she suffered from fatigue, anxiety, depression and insomnia. I couldn't find an obvious psychological explanation for these symptoms, except perhaps for the stress of her physical illnesses.
The likeliest cause of her symptoms was the drugs themselves. So, rather than adding an antidepressant, an anti-anxiety pill or sleeping agent, I checked the known nutrient depletions associated with these medications. Lab results confirmed that Kathy was deficient in three essential minerals: magnesium, potassium and zinc.
Any one of her three medications could deplete potassium and magnesium, causing arrhythmias, hypertension, fatigue and depression. The diuretic also could be depleting zinc. Her internist agreed that he would continue to oversee her medications while I supervised her nutritional regimen.
Daily doses of magnesium, zinc and potassium, in addition to a high-potency multivitamin, resolved Kathy's "psychiatric" symptoms. Once her mineral levels were restored, her energy and mood were back to normal. She was not only spared the burden of an additional medication, but was able to lower the doses of the three she was taking.
I see cases similar to Kathy's more frequently than I'd like. Physicians will often tell these patients that their symptoms are "part of the illness" or "just signs that they're getting older." They then prescribe an additional drug or two for the side effects, further compounding the problem.
To understand the role of medications in nutrient depletion, we must first understand the variety of nutrient-depleting mechanisms in pharmacy.
Many drugs, such as the stimulants Ritalin (methylphenidate) and Adderall, are prescribed for attention deficit disorder. These can reduce appetite. This, in turn, decreases the intake of beneficial nutrients. Some antidepressants also tend to have this appetite-reducing effect.
On the flip side, a drug can reduce nutritional status by increasing the desire for unhealthy foods, such as refined carbohydrates. Many of the neuroleptics (antipsychotic drugs) and some antidepressants cause insulin resistance or metabolic syndrome, with resulting blood sugar swings. Patients then crave simple carbohydrates, such as sugar, bread and pasta. Steroid drugs, including those given by an inhaler, can create similar issues as well.
Certain medications reduce the absorption of nutrients. In passing through the gastrointestinal tract, drugs often bind to specific nutrients before they're absorbed into the bloodstream. The antibiotic, tetracycline, for example, can block absorption by binding with minerals such as calcium, magnesium, iron and zinc in the GI tract.
Weight loss drugs and cholesterol lowering medicines similarly bind to fats, preventing them from being absorbed. Drugs that treat acid reflux or heartburn raise the pH environment of the upper GI tract, which reduces absorption of needed vitamins and minerals. This is especially problematic among the elderly, who often are already low in stomach acid.
Nutrients are essential to the metabolic activities of every cell in the body. They're used up in the process and need to be replaced by new nutrients in food or supplements. Some drugs deplete nutrients by speeding up this metabolic rate. These drugs include antibiotics (including penicillin and gentamicin) and steroids, such as prednisone and the gout medication, colchicine.
Other drugs block the nutrients' effects or production at the cellular level. In addition to the intended effect on enzymes or receptors, medications can influence enzymes or receptors that help process essential nutrients. For example, widely prescribed statin drugs block the activity of HMG-CoA, an enzyme that's required to manufacture cholesterol in the body. This action also depletes the body of coenzyme Q10, which requires HMG-CoA for its production. This has a serious negative impact on muscle and heart health.
Drugs also can increase the loss of nutrients through the urinary system. Any drug that does this can drain the body's levels of water-soluble nutrients, including B vitamins and minerals, such as magnesium and potassium. The major offenders are medications to treat hypertension, particularly the diuretics that reduce blood pressure by increasing the volume of water flushed out of the body.
Drug-induced nutrient depletion is far more common than we think. In evaluating patients' symptoms, doctors must assess whether symptoms are due to the illness, to side effects of the drugs or to drug-induced nutrient depletion. Considering the inadequate nutrition of most people, we must remember that the illness itself may be due, in part, to nutrient deficiency. To cover all bases, it is easiest to provide baseline coverage: a daily high potency multivitamin mineral formula, CoQ10 (200 mg), omega-3 fatty acids (2 grams) and additional vitamin D and probiotics, especially if you've taken antibiotics.
The bottom line: As physicians, we must look more deeply and determine underlying causes to determine whether drugs are harming patients, and what we can do to reverse these effects. As a consumer, be aware of these drug-nutrient depletions, and do what you can to avoid taking medications whenever you can, using natural products instead.
1. Centers for Disease Control and Statistics. Health United States 2006. Accessed via www.cdc.gov/nchs/data/hus/hus06.pdf#093.
I will also continue this theme in subsequent blogs, discussing various categories of medications, their nutrient depletions, and natural, healthier substitutes.
A more complete article can be found at Total Health Magazine, p. 40 ff.
For more information, see my book, Supplement Your Prescription: What Your Doctor Doesn't Know About Nutrition available at my website, www.cassmd.com.
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