Modern medicine is incredible. When used appropriately, surgeries, procedures and drugs can do everything from relieve pain to save our lives. I’m often in awe of the knowledge we’ve gained about how the body works and what can be done when it stops working quite as well as it could. In fact, I’m all for taking full advantage of what the medical system offers us… again, when it’s appropriate. The problem is when we don’t realize (usually because we aren’t told) what unintended side effects may occur as a result.
Let me give you an example…
One of the biggest shocks I got during my nutrition studies was when I found out that the birth control pill depletes multiple vitamins and minerals from the body. The main ones depleted are vitamin B6, folic acid and magnesium, but there is evidence it can also cause a deficiency in thiamin (B1), riboflavin (B2), niacin (B3), vitamin B12, vitamin C, selenium and zinc.
When I learned this lovely little fact, I had been taking the birth control pill for ~15 years, oblivious to the potential negative impacts this common medicine could have on my body. About the time that I was learning about this nutrient depleting capability, my doctor tested my B12 level and it came back really low. I didn’t have any symptoms associated with B12 deficiency, like anemia, depression, tiredness or weakness, so I honestly don’t know why he tested me. But I’m glad he did because a deficiency of B12 carries an increased risk of cardiovascular disease!
In addition to my B12 being ridiculously low (the doc literally said, “I’ve never seen a level this low in an American”), my folate levels were below optimal and I had previously had a chiropractor tell me that she thought my magnesium levels were low. Unfortunately, many nutrient levels are difficult to ascertain in a routine blood test, so I didn’t know what other deficiencies there might be. And while I acknowledge that there are other causes for B12, folate and magnesium deficiencies, the Pill certainly wasn’t helping my situation, if it wasn’t the primary cause.
As it turns out, lots of very common medications cause all sorts of nutrient deficiencies. The mechanism by which these deficiencies are caused varies. The drug may block the nutrient from being absorbed in the digestive tract, increase the rate at which it is excreted from the body before the body has a chance to use it, or use the nutrient as part of its own metabolism so there is an increased need for the nutrient. No matter the mechanism, the end result is the same: the drugs might be helping us on one hand and harming us on the other.
Although this sounds scary, it’s typically not a life threatening situation. Rather, I want you to be aware so that you can discuss this with your doctor and take the appropriate steps to protect yourself from these potential problems. That might mean finding another way to fix the root cause of the problem so that you can eventually go off the drug or changing your food and supplement routine to ensure you don’t end up in a deficient state while you still need the medication. Of course, you should not stop taking your medication without first consulting your doctor or other healthcare practitioner.
With all of that in mind, here are some common drug categories and the nutrient deficiencies they can cause…
- Acid suppressing drugs / antacids / ulcer medications: folic acid, vitamin B12, vitamin D, calcium, magnesium, iron, zinc
- Antibiotics: thiamin (B1), riboflavin (B2), vitamin B6, folic acid, vitamin B12, vitamin K, calcium, magnesium, potassium, iron, zinc
- Antidepressants: riboflavin (B2), folic acid, coenzyme Q10
- Antihypertensives / blood pressure reducing medications: thiamin (B1), vitamin B6, folic acid, vitamin C, calcium, magnesium, potassium, sodium, zinc, coenzyme Q10
- Antiinflammatories (including steroids, NSAIDs, aspirin): pantothenic acid (B5), vitamin B6, folic acid, vitamin B12, vitamin C, vitamin D, calcium, magnesium, selenium, chromium, iron, zinc
- Cholesterol lowering drugs (statins): selenium, zinc, coenzyme Q10
- Diabetic drugs / oral hypoglycemics: folic acid, vitamin B12, coenzyme Q10
- Hormone replacement / oral contraceptives: thiamin (B1), riboflavin (B2), niacin (B3), vitamin B6, folic acid, vitamin B12, magnesium, selenium, zinc
* Note: The specific type of drug in each category will determine which nutrients are depleted.
While there’s no hard and fast rule for if or when these deficiencies will show up, it is likely that these shortages get worse the longer the medicine is used. For me, it’s quite possible that the B12 deficiency was somewhat new or it’s possible it had been around for awhile. There’s no way to know since I wasn’t tested before.
As well, it is worth noting that the body’s number one job is to keep us alive. So, if we aren’t getting enough nutrients for all of our needs, the body will preferentially use what’s available for the most critical tasks first. This is called the Triage Theory of Optimal Nutrition by Dr. Bruce Ames. Unfortunately, if we don’t increase our intake or stop the “thing” that is depleting the nutrient, eventually there won’t be enough for those critical activities and that’s when we really get into trouble. By the way, this means you may not have symptoms of a deficiency (just like me), but it could still be there and could cause you problems down the road.
Now that you know your medication could be depleting nutrients from your body, here are some steps you can take to protect yourself:
- Use the free website MyTavin to figure out which nutrients your medications could be depleting. (You can even enter multiple medications at one time to get a complete list.)
- Talk to your doctor or other healthcare practitioner (like me!) about using food and lifestyle changes to improve your condition, with the intention of getting off your medication some day. From autoimmune disease to acid reflux to migraines to infertility, there are many conditions that can be helped or completely relieved through food and lifestyle changes.
- Work with a qualified practitioner (like me!) to adjust your food and supplement routine to ensure you are getting enough of the necessary nutrients, while you are still taking the medication. Depending on the practitioner, he/she may talk to you about doing a blood test to determine your micronutrient levels. This is not a routine blood test and is not available in all states, but I want you to be aware of it because it can provide hard data about the deficiencies you have.
As I said at the beginning, modern medicine is an incredible thing and I am all for it being used in an effective way to help us live better, healthier lives. At the same time, we need to be aware of the potential pitfalls (including nutrient deficiencies) that come with taking prescription and over-the-counter drugs so that we can take the necessary steps to counteract the negative effects.
Now that you know, you have one more piece of the very complex puzzle that allows you to feed your intention to thrive.
Footnote: I didn’t learn any of this while getting my master’s degree in nutrition, because that would make far too much sense. Rather, I learned it during my continuing education courses in the area of functional and integrative nutrition. So, if your doctor or dietitian or other healthcare provider isn’t warning you about these problems, it may simply be because they don’t know!
— Allen S. Dietary Supplements. IFMNT Mentor Training Series: Level II. Fall 2015.
— Cass H. A Practical Guide to Avoiding Drug-Induced Nutrient Depletion. Nutrition Review. December 11, 2016. Accessed on March 21, 2017.
— Doherty J. Nutrition Triage. Accessed on March 21, 2017.
— Morrow K. Dietary Supplements: Science, Art, Practice and Principles. Integrative and Functional Nutrition Academy – Track 1, Module 6. Winter 2016.