The Nutrient Robbers

Prescription drugs are designed to heal, but some can deplete your body of
vital vitamins and minerals. Learn how supplementation can aid
in your nutritional self-defense.

By Lisa James

May 2006

Unless you’re a hermit, you know at least one person who takes at least one prescription—45% of all Americans do, according to the National Center for Health Statistics. Even smart, nutrition-savvy individuals (like you!) sometimes find themselves at the pharmacy getting any one of the roughly 13,000 drugs on the market, and no one can say that many haven’t been helped by medications.

Unfortunately, many other people learn—the hard way—that prescribed drugs can bring more grief than relief. As we noted in our March 2005 story “Can We Really Trust Prescription Drugs?” 1.5 million people wind up in hospitals each year because of adverse drug reactions and 100,000 of them die. Some drugs like Vioxx (rofecoxib), a type of pain reliever, have been pulled from the market because of potentially life-threatening side effects.

Drugs make people sick for many reasons: wrong dosages, patients who don’t follow (or can’t understand) directions, poor monitoring by doctors. But it never occurred to researchers that medications might interfere with how the body uses nutrients—specifically micronutrients like vitamins and minerals that are needed in small-but-crucial amounts.

Fortunately, a small but growing number of practitioners are paying attention now. “Many side effects—nausea, liver damage, fatigue, dry mouth—are secondary to nutrient robbery,” says Frederic Vagnini, MD, director of the Heart, Diabetes and Weight Loss Centers of New York and co-author (with Barry Fox) of The Side Effects Bible (Broadway Books). He explains that drugs can deplete nutrients by interfering with enzymatic reactions and by affecting the liver, the body’s main drug-processing plant. This nutrient loss is aggravated by the fact that many folks are already walking around with low-level deficiencies. “Even in healthy people you would be surprised to see subclinical depletions of things like zinc and vitamin C,” Vagnini says.

Another factor that contributes to what Vagnini calls “the over-drugging of America” is when doctors counter one medication’s side effects with yet another: “That pill’s making you constipated/weak/nauseous? Here, take this.” Pretty soon an individual is taking a whole pile of pills, each of which is washing out different nutrients. This can be especially hazardous for older people, since the body’s ability to handle drugs may decline with age.

Nutrient thieves can be found lurking in all sorts of pill bottles. Take Prozac (fluoxetine), the most famous member of an antidepressant drug class known as the selective serotonin reuptake inhibitors (SSRIs). “Millions of people are on antidepressants like Prozac,” Vagnini says. “These drugs will deplete B vitamins. Prozac is also well-known for depleting melatonin, a hormone that helps you sleep.”

Taking Drug Effects to Heart

At the heart of the drug-nutrient connection is the heart itself, that muscular pump whose woes remain the leading cause of death in the US. For example, the statin drugs (Lipitor, Zocor, etc.) used to fight high cholesterol, a factor in heart disease, are taken by millions. “One of the side effects is that they deplete the body of CoQ10, which incidentally is required for heart function,” says Vagnini, a heart surgeon who has also written 30 Minutes a Day to a Healthy Heart (Reader’s Digest). “It’s a potent antioxidant that helps protect LDL cholesterol from oxidation (a type of rancidity that makes LDL more likely to clog arteries). It is also useful for people suffering from fatigue. That’s a blatant nutrient deficiency that most doctors are not aware of; most doctors are not even aware of CoQ10.”

The heart is also affected by medications meant to deal with other problems. The most famous is Vioxx, an anti-inflammatory agent linked to an increase in heart attack risk. “One of the things that NSAIDs (a class of pain relievers) like Vioxx do is deplete folic acid,” explains Vagnini. “An under-recognized problem are the cardiovascular dangers related to elevated levels of homocysteine, and one of the key nutrients in limiting homocysteine is folic acid.”

Although Vagnini uses drug therapy with his own patients, the prescription pad isn’t always his weapon of choice. “Doctors are practicing what I call reactive medicine—if you have joint pain you get this drug, if you have high cholesterol you get that drug,” he says. “I’m a firm believer in diet and exercise as a potent therapeutic option.” That option also makes it less likely a person will have to take nutrient-robbing medications down the road: “I have patients well into their 70s and 80s who take no drugs.”

Of course, as healthcare consumers—and human beings who want to live energetic, pain-free lives—we can’t just point fingers at the white-coat crowd. “No one’s eating seven fruits and vegetables a day,” notes Vagnini. “The population wants the easy way out; they want to take Lipitor and eat bacon cheeseburgers.” So be aware of what nutrients prescription meds and other burglars may be pilfering from your body—and find a practitioner who can help you create your very own nutritional anti-theft system.

 

Installing a Nutritional Security System

While nearly all nutrients are prone to drug depletion, some are more vulnerable than others. This chart lists several important nutrients and some of the prescription medications that may hijack each one. Space considerations do not allow us to show all possible interactions; for a much more complete list, we strongly suggest you check out The Side Effects Bible by Frederic Vagnini, MD, and Barry Fox, PhD (Broadway Books).

Nutrient: Calcium
Depleted By (Examples)/Used For: Diuretics (Bumex, Demadex, Diuril, Lasix)/excess fluid, high blood pressure (BP); Fosamax/bone building; steroids* (Cortef, Cortone)/inflammation
Nutrient Sources: Dairy, broccoli, Chinese cabbage, kale
*The steroid group also includes some allergy meds like Flonase and Nasonex

Nutrient: CoQ10
Depleted By (Examples)/Used For: Statins (Lipitor, Lescol, Mevacor, Pravachol, Zocor)/high cholesterol; newer sulfonylureas (Amaryl, DiaBeta, Glucotrol)/type 2 diabetes
Nutrient Sources: Mackerel, organ meats, sardines

Nutrient: Folic Acid
Depleted By (Examples)/Used For: Bile acid sequestrants (Questran, Welchol)/high cholesterol; Celebrex/pain relief; Glucophage/type 2 diabetes
Nutrient Sources: Beans, broccoli, leafy greens, oranges, peas, whole grains

Nutrient: Magnesium
Depleted By (Examples)/Used For: Diuretics/excess fluid, high BP; Fosamax/bone building; steroids/inflammation
Nutrient Sources: Beans, leafy greens, lean meat, nuts, seafood, whole grains

Nutrient: Potassium
Depleted By (Examples)/Used For: Diuretics/excess fluid, high BP; Levodopa/Parkinson’s disease; steroids/inflammation
Nutrient Sources: Avocados, bananas, brown rice, dates, garlic, nuts, spinach

Nutrient: Vitamin A
Depleted By (Examples)/Used For: Bile acid sequestrants/high cholesterol; steroids/inflammation; Xenical (also affects vitamins D and E)/fat blocking
Nutrient Sources: Dairy, fish, liver

Nutrient: Vitamin B1
Depleted By (Examples)/Used For: Antibiotics**/infection; diuretics/excess fluid, high BP
Nutrient Sources: Nuts, whole grains
**Many nutrients, especially the B vitamins, are depleted by various classes of antibiotics.

Nutrient: Vitamin B2
Depleted By (Examples)/Used For: Elavil/migraines
Nutrient Sources: Broccoli, dairy, lean meat, whole grains

Nutrient: Vitamin B6
Depleted By (Examples)/Used For: Bile acid sequestrants/high cholesterol; steroids/inflammation
Nutrient Sources: Bananas, fish, leafy greens, potatoes

Nutrient: Vitamin C
Depleted By (Examples)/Used For: Diuretics/excess fluid, high BP; steroids/inflammation
Nutrient Sources: Broccoli, citrus, potatoes, strawberries, tomatoes

Nutrient: Vitamin D
Depleted By (Examples)/Used For: Barbiturate sedatives (Butisol, phenobarbital)/anxiety, insomnia (phenobarbital also used for epilepsy); bile acid sequestrants/high cholesterol; steroids/inflammation
Nutrient Sources: Fortified dairy, fatty fish, sunlight exposure

Nutrient: Zinc
Depleted By (Examples)/Used For: Acid fighters (Pepcid, Prilosec, Tagamet, Zantac)/chronic heartburn, ulcers; diuretics/excess fluid, high BP; steroids/inflammation
Nutrient Sources: Lean meats, seafood

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