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Cholesterol treatment drug Lipitor gets poured and counted at a drug store in Toronto in this file photo. (Deborah Baic)
Cholesterol treatment drug Lipitor gets poured and counted at a drug store in Toronto in this file photo. (Deborah Baic)

Is your medication depleting your nutrient reserve? Add to ...

They make you feel better, fight infection and help prevent or delay chronic disease. But many of the medications Canadians take may also be draining important vitamins and minerals from your body.

What’s more, drug-induced nutrient drains can be compounded if you take multiple drugs, if your diet is less than stellar, or if you take certain drugs – especially at higher doses – for a prolonged period of time. Medications can disrupt nutrient status in a few ways.

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Some interfere with nutrient absorption, others enhance nutrient excretion and still others impede the body’s ability to synthesize nutrients or convert them to useable forms.

While hundreds of drugs can impact nutrient levels in the body, only a handful cause a meaningful depletion over time that requires taking a supplement.

For others, it’s prudent to boost your intake through food. The key is knowing which medications can be problematic and how to fortify your diet or, in some cases, supplement your intake.

This list gives an overview of key nutrients impacted by common medications. As always, consult your doctor, health-care provider or pharmacist for advice on supplementing safely.

ACID-REFLUX DRUGS

What they do:

Such drugs as Losec, Tecta and Zantac allow ulcers in the esophagus, stomach and duodenum (upper small intestine) to heal by blocking the enzyme in the wall of the stomach that produces acid.

What they deplete:

Vitamin B12

Why it’s important:

B12 makes red blood cells, keeps nerves healthy and helps make DNA, the genetic material of all cells. Adequate B12 is also linked to protection from dementia, heart attack and stroke.

Best food sources:

Animal foods including fish, poultry, lean meat, dairy, eggs, fortified plant-based beverages (soy, rice, almond, oat, coconut milks), fortified soy products.

Do you need a supplement? Since B12 requires adequate stomach acid to be absorbed from food, a multivitamin or B complex supplement is recommended for people taking acid-reducing drugs long-term.

 

METFORMIN

What it does:

Such medications as Glucophage and Glumetza control elevated blood sugar by helping the body use insulin properly and decreasing the amount of sugar the liver makes and that your intestinal tract absorbs.

What it depletes:

Vitamin B12 (see acid-reflux drugs, above, for more info)

Do you need a supplement?

Older adults, vegetarians and people taking metformin for three years or longer are at risk for B12 deficiency. A multivitamin or B complex can prevent low levels. A B12 supplement, 1,000 to 2,000 micrograms per day, can correct a deficiency.

 

ANTIBIOTICS

What they do:

Treat infections by destroying or slowing down the growth of harmful bacteria.

What they deplete:

Antibiotics also kill off the “friendly” probiotic bacteria and yeast in the gut.

Why they’re important:

Probiotic bacteria help keep the intestinal tract healthy, produce vitamins and strengthen the immune system.

Best food sources:

Kefir, yogurt, miso soup, sauerkraut, kombucha tea (fermented tea).

Do you need a supplement?

If taking an antibiotic for five days or longer, or if you have had antibiotic-associated diarrhea in the past, take a probiotic supplement containing acidophilus and bifidobacteria once or twice daily with meals; continue for a week after therapy.

Some experts also recommend taking a yeast called Saccharomyces boulardii to prevent and treat diarrhea caused by antibiotics. Feed these friendly bacteria on a daily basis with foods called prebiotics. They include whole grains, bananas, onions, leeks, garlic, asparagus, artichokes and soybeans.

 

DIURETICS

What they do:

Medications such as HydroDiuril and Lasix lower blood pressure and reduce the workload of the heart by acting on your kidneys to produce more urine and remove excess salt.

What they deplete:

Potassium, magnesium

Why they’re important:

Potassium helps maintain normal fluid balance, nerve function, muscle control and blood pressure. Magnesium regulates many body processes including protein synthesis, energy production, muscle and nerve function, as well as blood sugar and blood pressure control.

Best food sources:

Potassium: bananas, cantaloupe, honeydew, acorn squash, baked potato (with skin), prunes, cooked leafy greens, lima beans, yogurt, milk. Magnesium: black beans, chickpeas, lentils, kidney beans, soybeans, tofu, edamame, spinach, Swiss chard, halibut, almonds, cashews, sunflower seeds, yogurt, wheat germ.

Do you need a supplement?

In some cases, doctors will prescribe a potassium supplement to prevent depletion. To prevent magnesium loss, a supplement of magnesium citrate, 200 to 300 mg once or twice daily, can be used.

 

STATINS

What they do:

Crestor and Lipitor lower blood cholesterol by blocking the liver’s production of cholesterol; also has anti-inflammatory effects.

What it depletes:

Coenzyme Q10 (CoQ10), a compound primarily made in the body; only a little comes from food.

Why it’s important:

CoQ10 is essential for producing energy in cells and is a powerful antioxidant. It may also be useful in lowering blood pressure and treating heart failure. Some, but not all, studies suggest CoQ10 can improve muscle pain caused by statins.

Best food sources:

Meat, poultry, oily fish, canola oil, nuts

Do you need to supplement?

It’s unclear if CoQ10 provides

a health benefit to people taking statins, however, 30 to 100 mg per day may be used to

help maintain body stores. For statin-induced muscle symptoms, 100 to 200 mg per day has been used. CoQ10 is considered very safe for most people. Since CoQ10 can lower blood pressure, use with caution if taking anti-hypertensive medication.

Leslie Beck, a registered dietitian, is based at the Medisys clinic in Toronto. She can be seen every Thursday at noon on CTV News Channel's Direct; lesliebeck.com.

Follow on Twitter: @lesliebeckrd

 

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