Are you suffering from a lack of energy?  Depression? Memory loss or brain fog? Joint pain and muscle aches? Palpitations? Digestive problems? Chronic pain?  Headaches? While these conditions seem unrelated, they may all result from the medications you’re taking! 

Although prescription and over-the-counter (OTC) drugs can have beneficial and even life-saving effects, millions of Americans suffer from an almost completely ignored epidemic of drug-induced nutrient depletion (DIND) that can cause serious health problems.  Most people, including healthcare professionals, are completely unaware of the dangerous side effects these medications create in depleting vital nutrients.In fact, it’s estimated that up to 30 percent of pharmaceutical side effects are the result of drug-induced nutrient depletion.  Drugscan deplete the body’s natural stores of vitamins, minerals, and enzymes. While some of theseside effectsmay be merely unpleasant, others can be life-threatening and can increase the risk of developing other chronic illnesses.

What drugs cause nutrient depletion?

More than 1,000 of the most commonly prescribed prescription drugs and many OTC medications depletethe body of specific vital nutrients.  These include the following kinds of drugs:

• cholesterol-lowering statins
• anti-acid/heartburn
• antidiabetic
• antihypertensive
• anti-inflammatory
• anticonvulsants
• oral contraceptives and hormone replacement therapy
• antibiotics

Who is at risk for drug-induced nutrient depletion?

Most Americans already fall short on their dietary intake of important vitamins and minerals because they regularly eat nutritionally deficient meals, filled with empty calories from high sugar and processed foods, especially fast foods.  In fact, a recent study, “What America’s Missing: a 2011 Report on the Nation’s Nutrient Gap,” revealed that 90 percent of Americans are nutrient deficient.  Another nutritional survey reported that 80 percent of Americansfail to consume the recommended daily allowance (RDA) for one or more of the essential nutrients on a daily basis. For example, 73 percent of those surveyedwerenot getting enough zinc in their diets, 65 percent were deficient in calcium, 62 percent were low in magnesium, 56 percent in vitamin A, and 54 percent in vitamin B6.If these alreadynutritionally deficient people take medications, thedrugs will further starve their bodies of essential nutrients. And that willincrease their likelihood of developing additional health problems and chronic illnesses, including heart disease, high blood pressure, diabetes, osteoporosis, anemia, and neurologic symptoms. 

How many people are at risk of developing drug-induced nutrient depletion?

More Americans than ever are taking prescription drugs; this trendwill continue, along with the increased incidence of chronic illnesses in adults and now even in children, especially obesity, diabetes, gastrointestinal problems, depression and asthma.  More than half of all American adults regularly take at least one prescription drug, and one fifth take four or more.  One of four children and teenagers is also on a medication for a chronic illness.

Many of the conditions we as physicians see in our everyday practice may actually be related to nutrient depletion.  Unfortunately, many physicians try to address the symptoms arising from drug-induced nutrient depletion by prescribing even more drugs, compounding the problem. Therefore, millions of Americans are already suffering from DIND — or at a very high risk of developing it.  That depletion has thepotential to create more health problems, leading to more medications, further exacerbating nutritional deficiencies.  What a vicious cycle!

Does your doctor know about drug-induced nutrient depletion?

Drug-induced nutrient depletion is a topic that physicians and other healthcare practitioners should be aware of, but most know very little about it.  Unfortunately, the subject is rarely part of medical school curricula, so most doctors are unlikely to instruct their patients to supplement the prescriptions they give them.  Despite hundreds of scientific studies on DIND that haveappeared in medical journals for decades, throughout the world, most of this information has not been publicized to health professionals or the general public. Fortunately, all this research has been organized and reported in The Drug-Induced Nutrient Depletion Handbook by Ross Pelton, R.Ph., and James Lavelle, R.Ph.  More recent books emphasizing DIND are Supplement Your Prescription: What Your Doctor Doesn’t Know About Nutrition by Hyla Cass, M.D., and Drug Muggers: Which Medications Are Robbing Your Body of Essential Nutrients —And Natural Ways to Restore Them,by Suzy Cohen, R.Ph.

How do drugs cause nutrient depletion?

Drug-induced nutrient depletion can occur through several mechanisms. Some drugs interfere with the absorption of nutrients, while others may lead to increased excretion. Some drugs may block the action or production of certain nutrients within the cells. Eventually, these nutritional deficiencies can become significant, causing severe side effects, especially when the medications are taken for long periods.  Well-known mechanisms are:

1. Absorption – Drugs can change the environment in the gastrointestinal tract in a way that reduces the absorption of needed vitamins and minerals that are in food.  For example, anti-acid/heartburn medications decrease the acidic environment in the gut, decreasing calcium absorption that requires an acidic environment for optimal absorption.  People who take an acid suppressor can have reduced calcium absorption, leading to risks of osteoporosis and skeletal fractures.

2. Excretion – Some drugs can increase the rate at which the body breaks down a nutrient or eliminates it through the kidneys.  Diuretics increase fluid and electrolyte loss through the urine, causing depletion of water-soluble nutrients, including vitamin B, magnesium, and potassium, leading to muscle spasm, cramping, palpitation, and headaches.

3. Metabolism – Drugs can change how the body utilizes certain nutrients or change biochemical pathways involved in the formation of a nutrient. Statin drugs inhibit the pathway of cholesterol production; at the same time, they inhibit the production of coenzyme Q10, which is vital for cellular energy and heart health, causing increased fatigue, muscle aches, or even heart failure. 

What can you do to avoid drug-induced nutrient depletion?

Every person who takes or gives prescription drugs needs to know about drug-induced nutrient depletion.  The only solution to averting drug-induced nutritional deficiencies is to replace the depleted nutrients through nutritional supplements, dietary sources, or both.  If you are one of the many Americans who find yourself needing to takemedications on a long-term basis, then you must supplement the essential nutrients that they steal. Taking a natural supplement along with the medication will replenish the essential vitamins and minerals that are lost.  Supplements will not only minimize or prevent unwanted side effects caused by the drug, but also increase the effectiveness and compliance of the medication.

What’s the bottom line?

Drug-induced nutrient depletion is a serious issue — and it’s not one that’s likely to go away, with so many people taking prescription or OTC medications. Patients need to be aware that these medications can lead to severe nutrient deficiencies. And physicians, in evaluating patients’ symptoms,need to assess whether those symptoms are due to the illness, to the side effects of the drugs or to nutrient depletions caused by a medication. With appropriate nutritional supplementation, we can controlor at least minimize those side effects andprevent longer-term health complications associated with DIND. It’s our chance tolive a longer and healthier life!

Theresa Luu, M.D., a cardiothoracic surgeon, earned a neurobiology degree from the University of Pennsylvania and attended medical school at Emory University, where she completed extensive training and served aschief resident.Through her research in integrative and nutritional medicine and now through the clinical studies she’s conducting, she has come to realize the importance of nutritional support for her cardiac patients, both preoperatively and postoperatively, and has seen improved outcomes. She has also led the clinical formulation of the first multivitamin linedeveloped to address drug-induced nutrient depletion (Replenish multivitamins). For more information, visit ReplenishVitamins.com.

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