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Do you know what nutrients your medications are depleting?

A  GUIDE TO Drug-Induced Nutrient Depletion

Drug induced Nutrient depletion is widespread.

Physicians often tell their patients that symptoms arising from nutrient depletion are simply “part of the illness” or just signs that they’re “getting older.” To make matters worse, physicians frequently try to address the symptoms arising from drug-induced nutrient depletion by prescribing even more drugs, further compounding the problem.

To understand the role various medications play in causing nutrient depletion, we must first look at the variety of nutrient-depleting mechanisms in pharmacology. It is also important to note that the fourth leading cause of death in the US, according to the CDC(1) , is “taken as Prescribed” drugs and this does not include complications arising from nutrient depletion.

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, some drugs can deplete nutritional status by increasing the desire for unhealthy foods, such as refined carbohydrates. Many of the neuroleptics (anti-psychotic drugs) and some antidepressants cause insulin resistance or metabolic syndrome, with results in 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 specific nutrients in the gastrointestinal tract by binding to them 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. (2)

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 nutrient’s 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 co-enzyme Q10 or COQ10-ubliquinol, 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. Drugs that promote this reaction 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.

Common Nutrient Robbers

The bottom line here is, we need to be aware of drugs that are nutrient robbers. The following provides some of the major drug categories:

Anti-Hypertensives

The ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) (2) concluded that thiazide-type diuretics are better than ACE inhibitors and calcium-channel blockers at preventing heart attacks in high-risk people. Physicians often prescribe potassium to offset the well-known potassium depletion associated with this prescription.

However, these diuretics are also known to deplete other minerals, such as magnesium, sodium, potassium and zinc, which are seldom specifically supplemented. One study found hypokalemia (low potassium) in 8.5 percent of people treated with thiazide diuretics and hyponatremia (low sodium) in 13.7 percent in the same patient population. (2,3) This indicates the importance of testing levels, and not simply restricting sodium.

Thiazide diuretics also decrease magnesium in approximately 20 percent of patients (4) and can significantly decrease serum zinc. (5) Loop diuretics deplete potassium, magnesium, calcium, zinc, pyridoxine, thiamine and ascorbic acid.

One study showed that thiamine deficiency was found in 98 percent of patients with congestive heart failure who took 80 mg of furosemide daily, and in 57 percent of patients who took just 40 mg daily. This shows a dose relationship. Furosemide also increases excretion of ascorbic acid and pyridoxine. (6)Vitamin C and B-6 

For these patients, consider the following daily supplements: calcium , magnesium, potassium vitamins C B1 , B6 in a transdermal application methylcobalamin B-12 with 10 essential vitamins patch and a D3 patch.

Beta Blockers

Beta blockers are among the oldest classes of antihypertensive drugs. They lower blood pressure by reducing the effects of catecholamines, thereby reducing the force and speed of the heartbeat. Beta-adrenergic blockers deplete CoQ10 by interfering with the production of this essential enzyme for energy production. (7) This lack of CoQ10 is particularly dangerous, considering that the target condition is cardiovascular disease. Since the heart is particularly rich in CoQ10-hungry mitochondria, the energy factory of the cell, the end result can be heart failure. To offset this negative side effect you can take CoQ10, via transderrmal patch to counter malabsorption.

These drugs also reduce production of melatonin (N-acetyl-5-methoxytryptamine). Produced from serotonin at night in the pineal gland by stimulating adrenergic beta1- and alpha1-receptors, this neuro-hormone regulates circadian rhythm and promotes sound sleep. By blocking beta receptors, these drugs may inhibit the release of the enzyme serotonin-N-acetyltransferase, which is necessary for the synthesis of melatonin, resulting in sleep disturbance. (8) Take a melatonin patch at bedtime to counter this effect.

Cholesterol-Lowering Drugs

Statin drugs are the most widely prescribed medicines for lowering cholesterol. In fact, Lipitor (atorvastatin) is the best-selling drug on the planet. However, physicians need to address a serious risk. Statins deplete the body of CoQ10 with the following potential side effects: heart failure, muscle pain and weakness, irritability, mood swings, depression and impotence. (9-11) The last few side effects may also be due to lack of cholesterol, which is needed for brain cell and hormone production.

Therefore, people on statins should take CoQ10-ubiquinol via TNDS-(Transdermal Nutrient Delivery System) to counter this potentially fatal depletion.

While no specific recommendations from the pharmaceutical industry exist, one pharmaceutical statin manufacturer observed the depletion effect in early research. This manufacturer holds a patent on a combination statin and CoQ10. Sadly, the patents have never been activated, nor have any warnings been provided by the U.S. pharmaceutical industry.

Health Canada, on the other hand, which is the federal department responsible for helping Canadians maintain and improve their health, requires that manufacturers of statin drugs include warnings on patient safety information sheets about the potential for myopathies and impaired cardiac function. Degradation in the production of IF (Intrinsic factor) in the GI can lead to malabsorption syndrome because IF binds with vitamins and nutrients to escort through the mesenteric vein of the terminal ilium and into our bloodstream. Specifically cobalamin B-12 ( see Fig. Below) The rate of death attributed to heart disease has doubled since the release of statin drugs.

Acid Blockers

Antacids, histamine-2 receptor antagonists (H2 blockers) and proton-pump inhibitors (PPIs) are commonly prescribed for treating heartburn, gastro-esophageal reflux disease (GERD) and peptic ulcers. Numerous studies indicate that these drugs cause several nutrient deficiencies.

For example, aluminum antacids (Maalox, Mylanta and Gaviscon) and calcium carbonate (Caltrate, Dicarbosil, Rolaids, Titralac and Tums) act by buffering or neutralizing the acid pH of the stomach. Unfortunately, this reduction of stomach acid impairs the breakdown of the ingested food into its component nutrients.

Both PPI and H2 blockers significantly increase the risk of vitamin B12 deficiency in elderly patients. B12 requires adequate gastric acid for absorption. This population is already prone to deficiency in intrinsic factor, necessary for B12 absorption. (12) This lack of stomach acid also decreases the absorption of folic acid, iron and zinc. (13,14) H2 blockers (Tagamet, Pepcid, Axid and Zantac) decrease acid secretion by blocking histamine.

Proton pump inhibitors (PPIs, Prilosec, HK-20), the most potent of acid-reducing medications, are increasingly popular. They reduce stomach acid production by up to 99 percent by decreasing the action of proton pumps, which are part of the stomach lining’s acid-making machinery. This, however, can strongly interfere with nutrient absorption.

One study showed that high doses of PPIs, used for a year or more, could make people 2.5 more times susceptible to hip fracture than control subjects. Lower doses decreased the risk factor to 1.5 times that of nonusers. The longer these drugs are used, the higher the fracture risk. This heightened risk of osteoporosis is probably due to the drastic drop in calcium and vitamin D absorption that occurs with these drugs. Some experts believe the drugs themselves may hamper the body’s ability to build new bone. (15)

For anyone taking acid-reducing medication, I recommend daily intake of vitamin D3 transdermal patch.

Oral Hypoglycemics

Metformin (Glucophage, Glucophage XR and Glucovance) enhances the action of insulin in cases of insulin resistance, allowing glucose to enter the cells. This reduces elevated blood sugar. A study published in the Archives of Internal Medicine showed that diabetics on metformin had B12 levels that were less than half those of control subjects. The longer the drug had been used and the higher the dose, the greater the drop in B12. (16)

In people with Type 2 diabetes who take metformin therapy, serum folic acid levels decrease 7 percent and vitamin B12 levels decrease by 14 percent. (17) B12 and folic acid depletion also increases homocysteine levels. In addition, metformin may deplete CoQ10, thereby increasing heart disease risk. To reduce these effects, patients should

take vitamin B12 , folic acid and CoQ10 and the B-12 patch.

Psychotropic Medications

For antidepressants to work optimally, an ongoing supply of the B vitamins must be available as co-factors to help manufacture the needed neurotransmitters, such as serotonin and dopamine. (18,19) So, while these drugs may not directly deplete B vitamins, patients on these medications should ensure they get enough of these vitamins. In addition, be aware that lithium carbonate, used for treating bipolar illness, depletes folic acid (take 800 mcg) and inositol (take 500 mg bid)Methylcobalamin is the bio-available form of B-12 that the human body uses.Use transdermal applications for higher efficacy.

Antibiotics

Antibiotics deplete biotin, inositol, vitamins B1, B2, B3, B5, B6, B12 and vitamin K. Additionally, fluoroquinolones and all floxacins (including ciprofloxacin or “Cipro”) deplete calcium and iron. Tetracyclines (suffix, -cycline) deplete calcium and magnesium. Trimethoprim-containing antibiotics (brand names Trimpex, Proloprim or Primsol) deplete folic acid. Penicillins (suffix, -cillin) deplete potassium. Aminoglycosides, such as gentamicin, cause imbalances of magnesium, calcium and potassium. (20) In fact, one study showed that gentamicin causes increased excretion of calcium by 5 percent and magnesium by 8.4 percent. (21)

When you take antibiotics, consider a B-12 transdermal patch along with it.

Antibiotics can disrupt the natural bacteria flora in the digestive system, killing “good” bacteria, including Lactobacillus acidophilus (L. acidophilus) and Bifidobacterium bifidum (B. bifidum). These are probiotics or bacteria that normally live in and on the human body, concentrated mostly in the digestive and genital/urinary systems. Choose a supplement that contains at least 1 billion live organisms per daily dose.The danger of candida( a yeast fungus) sharply increases with antibiotics. Antibiotics can disrupt the natural bacteria flora in the digestive system, killing “good” bacteria, including Lactobacillus acidophilus (L. acidophilus) and Bifidobacterium bifidum (B. bifidum). These are probiotics or bacteria that normally live in and on the human body, concentrated mostly in the digestive and genital/urinary systems. Choose a supplement that contains at least 1 billion live organisms per daily dose. Taking capric acid a MCT found in coconut oil has been proven to kill candida albican-yeast. It is recommended that you consult with functional medicine nutritionist or well coach.

Physiological

The millions of sufferers of IBS/Crohn’s disease and Ulcerative Colitis have nutrient absorption problems. Coupled with those who have undergone gastrectomy/vagotomy and you find a population that needs alternative supplementation approaching epidemic proportions.

Alternative Therapy

Transdermal Nutrient Delivery System-TNDS- provides a superior delivery system for those who oral supplementation is problematic. TNDS delivers a higher efficacy and is more patient compliant than pills and more economical than injections. High quality organic foods in a smoothie mix also provide easily absorbed nutrients that are clinically proven to increase optimal health.

Summary

Drug-induced nutrient depletion is far more common than has been acknowledged. In evaluating patients’ symptoms, doctors must assess whether symptoms are due to the illness, to the side effects of the drugs, or to drug-induced nutrient depletion. Considering the inadequate nutritional status of the majority of the population, we must remember that the illness itself may be due, in part, to nutrient deficiency. For insurance, it is easiest to provide baseline coverage: a daily nutrient dense organic food mix of super foods in a raw state by cold extraction to a powder. These foods are easy to absorb and still maintain the enzymes and glucosinolates critical for cellular health and specifically to fight cancers. “Nutritionists don't always study nutrients in cruciferous vegetables called glucosinolates — but they should! From a chemistry point of view, glucosinolates are sugar-based molecules that contain a modified form of sugar (glucose) together with sulfur and nitrogen. Glucosinolates aren't found exclusively in cruciferous vegetables, but they are overwhelmingly absent from most other food groups. Over 100 different glucosinolates have been identified in cruciferous vegetables, and all of the glucosinolates studied to date have been shown to have anti-cancer properties."

The bottom line: Physicians must look more deeply and determine underlying causes to analyze whether drugs are harming patients – and what we can do to reverse these effects. As health care professionals, be aware of these drug-nutrient depletions, and do what you can to educate and provide alternatives and/or premium grade supplements. Personally avoid taking medications whenever you can, using natural products instead.(over 600 studies have identified ITCs-isothiocyanates-) and supplementing through the skin bypassing the hepatic pathway.

References
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