DIND

Based on a 2018 CDC report, more than half of the adults in the United States had at least one diagnosed chronic condition (such as arthritis, cancer, diabetes, etc. In addition, more than 25% if adults had multiple chronic conditions. Most chronic conditions result from a complex interaction of imbalances in lifestyle, nutrient status, genetic predisposition, and environmental factors. This points to the significance of lifestyle interventions in preventing and managing chronic diseases. However, this is often not as readily implemented and medications often become the primary tool for management. As we see a rise in chronic conditions, we continue to see an increase in the use of multiple medications for disease management in an individual patient.

As a result of polypharmacy and medications being used in early treatment of diseases, medication/drug induced nutrient depletion poses a potential challenge to health professionals. Drug induced nutrient depletion (DIND) occurs with specific medications which potentially disrupt nutrient levels with prolonged use. Nutrient depletion is multifactorial, and can be influenced by genetics, stress, as well as variations in diet and activity level in an individual. However, certain medications can enhance these imbalances as a result of their actions on cellular levels. In some cases, these nutrient depletions can enhance progression of other conditions and play a role in future symptoms. As we discuss the role of medications in depleting specific nutrients, it is important to keep in mind that this is not an indication to stop taking a specific medication, but rather a reminder to monitor and fortify nutrient status through diet, and supplementation as needed. It is always recommended to discuss your medications with your health team and the potential for nutrient depletion, along with measures to minimize its impacts. We will highlight some of the more commonly prescribed medications and their impact on nutrient levels below. This chart serves as an example of some of the common potential nutrient depletions.

Drug CategoryDrug ExamplesPotential Nutrients Depleted
AntacidsOmeprazole, pantoprazole, ranitidineMagnesium, iron, calcium,
vitamin B12
Cholesterol lowering medicationsAtorvastatin, simvastatin, pravastatin, etcCoenzyme Q10, vitamin D
Diabetic medicationsMetforminVitamin B12
Atenolol, metoprololCoenzyme Q10
Blood pressure lowering
medications
Glipizide, glyburideCoenzyme Q10
Lisinopril, enalaprilZinc
HormonesOral contraceptivesVitamin B6, magnesium, zinc
Hormone replacement therapyVitamin B6, folate
Anti-inflammatory medicationsPrednisone, dexamethasoneCalcium, vitamin D

As we continue to learn more about the impact of pharmaceutical medications on nutrient composition in an individual, we see patterns which indicate depletion of nutrients which are all vital on a cellular level. Many of these nutrients are important players in energy production, enzyme activity, detoxification and many more fundamental processes. As a result, depletion of certain vital nutrients impacts overall function and wellbeing of that individual. Many of these nutrients are also involved in how our genes are expressed and can potentially contribute to disease development as a secondary consequence of medication regimens, in susceptible people. Taking a personalized approach to lifestyle modalities for healing allows for identifying and addressing specific needs to help you achieve your personal best health.

References:

  • https://www.cdc.gov/pcd/issues/2020/20_0130.htm
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