Could your medications be causing a nutrient deficiency?

Concerns over side effects whether taking a prescribed or over-the-counter medication are very common.  Asking questions of your doctor or pharmacist or taking the time to read the inserts that accompany a medication are always good practice in order to be aware of possible side effects you might experience.

But have you ever considered that a medication you’re taking could lead to a nutritional deficiency? This lesser known side effect is often overlooked and one even doctors may forget to advise you of. Generally, if you are taking a medication for a short period of time, the chance of developing a nutrient deficiency is unlikely. However, long-term use is a different story. Not all medications have the ability to lower nutrient stores or interfere with them, but there are certain medications that can and do, especially when taken for quite some time.

How would you know if you have a nutrient deficiency?

Signs of nutrient deficiencies are often not recognized by the general public.  And even if it is discovered you have one, taking a supplement of the nutrient you are deficient in may not be the answer in curing the problem. Often the best fix is to switch to another medication if possible, and to be counseled by a registered dietitian on rich food sources of whatever nutrient you may be deficient in.  Here are some examples of symptoms of certain nutrient deficiencies and what nutrient it might be indicating you are low in:

·      Muscle cramps, irregular heartbeat, mood changes  - it might be a magnesium deficiency

·      Muscle weakness, irregular heartbeat, tiredness, constipation – it might be a potassium deficiency

·      Weakness, numbness, tingling in hands and feet – it might be a vitamin B6 deficiency

·      Low red blood cells, tingling sensation, pale skin, lightheadedness, weakness, numbness, neurological and cognitive disorders  – it might be a vitamin B12 deficiency

·      Low red blood cells, fatigue, pale skin, tender tongue – it might be a folic acid deficiency

·      Weakened bones or bone loss – it might be a vitamin D and calcium deficiency

·      Weakened immune system, taste or smell changes, rash, hair loss, diarrhea – it might be a zinc deficiency

What common medications are known to cause nutrient deficiencies?

There are several commonly prescribed medications that if taken long-term, can raise the risk of person using them to develop a nutrient deficiency.  However, never stop taking a medication prescribed to you – discuss your concerns with your prescribing physician on their opinion and advice to reduce your chance of developing a nutritional deficiency.

Here are some examples of commonly prescribed medications that may cause a nutritional deficiency:

·      Metformin – This oral diabetes medication is very commonly prescribed to help control blood sugar levels. It can also, if taken long-term, interfere with the absorption of vitamin B12, increasing the risk of a vitamin B12 deficiency in patients who have been on them for a long duration of time. Every patient on Metformin, should have their vitamin B12 levels checked after one year and every three years thereafter, unless the person is a vegan or has a history of bariatric surgery, then it should be done more frequently. All patients on Metformin should discuss with the doctor of any concerns of a vitamin B12 deficiency. Metformin may also reduce levels of folic acid, necessary to produce and maintain new cells and prevents changes to DNA that may lead to cancer.

 

·      Zantac, Tagamet, Prilosec, Prevacid and Protonix – These medications are considered acid-lowering drugs (proton pump inhibitors and H2-receptor antagonists) commonly used to treat conditions associated with excess stomach acid production like gastroesophageal reflux (GERD), stomach ulcers, and indigestion. They also can inhibit the absorption of vitamin B12. Stomach acid is required to release B12 from food so it can be absorbed but these medications lower stomach acid production that may reduce the amount of B12 available for absorption. Over time, this could lead to a B12 deficiency.

 

·      Statins – Prescribed to lower cholesterol, statins such as Simvistatin, Pravstatin, Lipitor, or Crestor, may inhibit the production of coenzyme Q10 (CoQ10) which plays a role in preserving the energy supplies of our cells.

 

·      High blood pressure medications such as diuretics – Diuretics lower blood pressure mainly by causing the kidneys to excrete more sodium and water, which reduce fluid volume throughout the body and helps widen blood vessels. Diuretics commonly prescribed for lowering blood pressure are ACE inhibitors such as lisinopril, angiotensin receptor blockers such as losartan, beta blockers, and calcium channel blockers such as amlodipine. While each of these medications do a good job for lowering blood pressure, they also may deplete magnesium, potassium, and calcium, all important minerals performing various functions in the body.

 

·      Levodopa and Carbidopa (Sinemet) – These medications are commonly used for treating Parkinson’s disease.  When taken long-term, they could reduce the levels of vitamin B6, vitamin B12, and folic acid.

 

Anyone who has been taking a medication long-term and believes they are experiencing signs or symptoms of a nutrient deficiency should report them to their doctor as soon as possible.  The sooner it is found, the better chance it can be treated successfully with few lasting issues.

David B. Samadi, MD, Urologic Oncology Expert and Robotic Surgeon located at 485 Madison Avenue on the 21st floor, New York, NY – 212-365-5000.  Follow Dr. Samadi at www.samadimd.com,  www.prostatecancer911.com, and www.roboticoncology.com.