Are Your Medications Causing Poor Nutrition?

By Natalie Collier, MScN

The human body gives us subtle (and sometimes not-so-subtle) clues when it is missing key nutrients. Symptoms of nutrient deficiencies can vary by vitamin and/or mineral and may include fatigue, weakness, anxiety, depression, weight changes and much more. When mysterious symptoms start popping up, we often forget to check in our medicine cabinets for the cause.

Prescription medications are often helpful and necessary for symptom management and treatment of certain conditions. However, prescription medications can contribute to nutrient depletions sometimes overlooked by the prescribing physician. While taking a prescription medication it’s important to know what nutrient depletions may result with your prescription medication use so you can up your intake of certain dietary nutrients and supplement during medication use.  

Below we are highlighting common nutrient deficiencies along with medications that may contribute to nutrient depletions and some simple solutions for upping your intake.

IRON

Iron is the most common nutrient deficiency worldwide and one of the most common deficiencies in the United States. Women and children are the most vulnerable to iron deficiency. Symptoms of iron deficiency may include nail discoloration and/or brittle nails, coldness in hands and feet, irregular heartbeat, headache, fatigue and dizziness.

Medications that may cause iron depletion:

• Acid Blockers such as Protonix and Zantac
• Antacids such as calcium carbonate and sodium bicarbonate
• Antibiotics such as Tetracycline
• Anti-inflammatory drugs such as ibuprofen
• Aspirin

Other Considerations: Alcohol use, caffeine use, low stomach acid, and malabsorption (Celiac, Crohn’s Disease or IBS) may contribute to iron deficiency.

Foods/Supplements to include: Include grass-fed beef, lamb, pasture-raised chicken, nuts, seeds, beets and greens. Vitamin C will also help your body absorb iron so be sure to include lots of fresh produce in the diet. Supplement with an herbal iron, food-based iron or glycinate form of iron, when needed. 

IODINE

Iodine is an essential nutrient that helps our bodies produce thyroid hormones and regulates growth and development. Table (iodized) salt is used worldwide to prevent deficiencies in iodine. Iodine deficiency is the most preventable cause of mental retardation in newborns. Worldwide iodine deficiency is the most common cause of an enlarged thyroid (goiter). Symptoms of iodine deficiency include weight gain, thyroid imbalances, low energy, depression, and cognitive decline.

Medications that may contribute to iodine deficiency:

• SSRIs such as Escitalopram (Lexapro)
• Fluticasone/Salmeterol (Advair)

Other Considerations: It should be noted that both high and low iodine can impact thyroid levels in a negative way.

Foods/Supplements to include: Include foods such as pasture-raised eggs, fatty fish (such as tuna, salmon and sardines) and/or shellfish (like shrimp and scallops). Sea vegetables are a wonderful vegetarian source of iodine. Supplement with a professional-grade multivitamin that contains iodine such as Neuro Nutrients 2. 

VITAMIN D

Vitamin D is the sunshine vitamin so naturally levels decline for most individuals during winter months. Recent research has shown that Vitamin D functions as a hormone so maintaining optimal Vitamin D levels is important for hormone health. Vitamin D deficiency can cause a variety of symptoms such as depression, anxiety, fatigue, weakness, low immunity, hormone imbalances and weight gain.

Medications that may contribute to Vitamin D deficiency:

• Acid Blockers such as Protonix and Zantac
• Antibiotics such as Amoxicillin (Amoxil)
• Corticosteroids such as Budesonide (Rhinocort) and Dexamethasone (Decadron)
• Statins

Other Considerations: Lack of sunlight, malabsorption (Celiac, Crohn’s Disease or IBS) and alcohol use can contribute to Vitamin D deficiency.

Foods/Supplements to include: Include egg yolks, fatty fish (think salmon, sardines and tuna), mushrooms in the diet. If levels of Vitamin D are low, it is recommended to include Vitamin D supplementation. The correct dosage of Vitamin D will depend on your level of deficiency. 

VITAMIN B12

Vitamin B12 is a unique vitamin because it the only vitamin that requires intrinsic factor for absorption. Intrinsic factor naturally declines as we age making B12 deficiency more common in elder populations. A Tufts University study of 3000 adults founds that nearly 40% had levels of B12 low enough to cause neurological symptoms. Symptoms of B12 deficiency include fatigue, weakness, nail discoloration, easy bruising, neurological symptoms and mouth and tongue sores. Symptoms of B vitamin deficiency may include weakness, heart palpitations, pale skin, constipation, diarrhea, nerve problems, vision loss, and depression.

Medications that may contribute to Vitamin B12 deficiency:

• Acid Blockers (PPIs) such as Esomeprazole (Nexium)
• Antacids such as calcium carbonate and sodium bicarbonate
• Antibiotics such as Amoxicillin (Amoxil)
• Ciprofloxacin (Cipro)
• Diabetes Medications such as Metformin
• Birth Control/Oral Contraceptives containing Estradiol such as Activella, Climara, Estraderm and/or Menostar

Other considerations: Low stomach acid, alcohol use, and H.pylori infections may contribute to B12 deficiency.

Foods/Supplements to include: Include grass-fed beef, fatty fish (think salmon, sardines, or tuna), eggs, and fortified nutritional yeast. Supplement the diet with a methylated B complex (that includes methylated B12). If deficiency is severe talk to your healthcare provider about B12 shots. 

MAGNESIUM

Magnesium is a relaxing mineral and one of the most common mineral deficiencies. Our food supply used to be naturally rich in magnesium, but soil has become depleted overtime. Symptoms of magnesium deficiency may include migraines, insomnia, anxiety, muscle twitches, cramps and tremors.     

Medications that may contribute to Magnesium deficiency:

• Acid Blockers such as Esomeprazole (Nexium) and Ranitidine (Zantac)
• Antacids such as calcium carbonate and sodium bicarbonate
• Antiviral Agents such as Delavirdine (Rescriptor)
• Blood Pressure Drugs such as Valsartan (Diovan)

Other considerations: Alcohol use, caffeine use and calcium supplementation may contribute to magnesium deficiency.

Foods/Supplements to include: Include leafy greens, black beans, dark chocolate, almonds, bananas and avocados. Supplement with a good-quality magnesium supplement. 

ZINC

Zinc is a foundational mineral that is known for its role in immune function. Symptoms of zinc deficiency can include acne, eczema, diarrhea, hair loss, psychological disorders and poor appetite.

Medications that may contribute to Zinc deficiency:

• Acid Blockers such as Esomeprazole (Nexium) and Ranitidine (Zantac)
• Antacids such as calcium carbonate and sodium bicarbonate
• Blood Pressure Drugs such as Lisinopril (Prinivil, Zestril)
• Birth Control/Oral Contraceptives containing Estradiol such as Activella, Climara, Estraderm and/or Menostar
• Corticosteroids such as Budesonide (Rhinocort) and Dexamethasone (Decadron)

Other considerations: Alcohol use, coffee use, and malabsorption (Celiac, Crohn’s Disease or IBS) may contribute to zinc deficiency.

Foods/Supplements to include: Include pumpkin seeds, sesame seeds, lentils, cashews, garbanzo beans, turkey and quinoa. Supplement with a professional-grade multivitamin that contains zinc and/or a zinc supplement with balanced copper.

If you have questions or concerns regarding your medications and how they may be affecting your nutrition, contact a Wellnicity Clinician Today!