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 Category | Drug Examples | Potential Nutrients Depleted |
| Antacids | Omeprazole, pantoprazole, ranitidine | Magnesium, iron, calcium, vitamin B12 |
| Cholesterol lowering medications | Atorvastatin, simvastatin, pravastatin, etc | Coenzyme Q10, vitamin D |
| Diabetic medications | Metformin | Vitamin B12 |
| Atenolol, metoprolol | Coenzyme Q10 | |
| Blood pressure lowering medications | Glipizide, glyburide | Coenzyme Q10 |
| Lisinopril, enalapril | Zinc | |
| Hormones | Oral contraceptives | Vitamin B6, magnesium, zinc |
| Hormone replacement therapy | Vitamin B6, folate | |
| Anti-inflammatory medications | Prednisone, dexamethasone | Calcium, 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
- Raghupathi W, Raghupathi V. An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach. Int J Environ Res Public Health. 2018 Mar 1;15(3):431. doi: 10.3390/ijerph15030431. PMID: 29494555; PMCID: PMC5876976.
- Kushner RF, Sorensen KW. Lifestyle medicine: the future of chronic disease management. Curr Opin Endocrinol Diabetes Obes. 2013 Oct;20(5):389-95. doi: 10.1097/01.med.0000433056.76699.5d. PMID: 23974765.
- LaValle JB. Hidden disruptions in metabolic syndrome: drug-induced nutrient depletion as a pathway to accelerated pathophysiology of metabolic syndrome. Altern Ther Health Med. 2006 Mar-Apr;12(2):26-31; quiz 32-3. PMID: 16541994.
- Felípez L, Sentongo TA. Drug-induced nutrient deficiencies. Pediatr Clin North Am. 2009 Oct;56(5):1211-24. doi: 10.1016/j.pcl.2009.06.004. PMID: 19931072.
