The Down Side to Prescription Drugs – What You May Not Know

Many people taking prescription or OTC meds are willing to risk some mild side effects to feel better. Package inserts, drug info sites on the Internet, pharmacists, and the prescribing practitioner can be helpful in providing information about side effects. However, one potentially damaging side effect you are rarely told about is the negative effect of medications on nutrient levels. Drugs can interfere with the absorption of nutrients or inappropriately increase excretion. Keep in mind that vitamins and minerals play a major role in hundreds and hundreds of chemical reactions in the body vital for life.

The concern is not just about preventing vitamin deficiency diseases, but the possibility that low levels of nutrients can prevent the body from functioning in an optimal manner, eventually causing another illness. Since many drugs are taken long term, especially for chronic illness, the nutrient deficit can have deleterious consequences. Yet, how often do we hear from health experts that as long as you eat a “balanced” diet you can get what you need from food? Some health authorities even say that taking a multivitamin/mineral isn’t necessary. I believe they are wrong on both counts, especially if you take medications. Have you ever had a doctor prescribe medication and address the potential for nutrient depletion? I haven’t.

Since numerous drug categories can deplete nutrients, in the interest of time, I will focus only on meds that are usually prescribed for conditions most commonly related to obesity. These include metabolic syndrome and diabetes, high cholesterol, hypertension, GERD, cardiovascular disease and arthritis.

Prescription Drugs Can Cause Metabolic Syndrome/Diabetes

One of the most common oral medications for pre-diabetes or type 2 diabetes is Metformin. It causes depletion of B12, folic acid and CoQ10 all of which are needed for a healthy heart. Remember that heart disease is a complication of diabetes. Painful neuropathies and anemia can result from low levels of B12. Sulfonylurea meds used for diabetes such as Glyburide, Glipizide, Amaryl and others in this group deplete CoenzymeQ10.

Prescription Drugs Can Cause High Cholesterol

Statins are one of the most commonly prescribed medications in the US. It is well known to pharmaceutical companies that statins blocks the synthesis of an important nutrient, CoenzymeQ10. Without CoQ10 in the mitochondrial membrane of the cell, there is an inability to convert energy from carbs or fats to the ATP that fuels cells, including heart muscle. Since the heart requires a continuous supply of energy, imagine the problem if CoQ 10 is not sufficient. Yet there are still many doctors who won’t or don’t order this nutrient for their patients on a statin. Further, statins are recommended for any patient with the diagnosis of diabetes, regardless of their lipid levels, exposing many more people to potential damage due to these drugs. At the Atkins Center a minimum of 100 mg of CoQ10 was given if a patient presented on statins or if they had taken them in the past. Note that since the onset of the frequent use of statins there is an increase in the incidence of congestive heart failure. The heart muscle is simply unable to stay strong and pump effectively.

Note that in the case of congestive heart failure more than 100 mg of CoQ10 is needed. The heart is not the only organ that can suffer from a lack of CoQ10. Symptoms can occur body wide.

Prescription Drugs Can Cause GERD (gastroesophageal reflux disorder)

One of the most common complications of obesity responds very quickly to carb restriction even before there is significant fat loss. Yet in our drug culture many people would rather take meds every day for months, or years, to avoid symptoms of heartburn caused by the backup of stomach acid or bile into the esophagus. Drugs for GERD were meant to be used in the short term. Not for years. We know that osteoporosis and fractures are a side effect of long term use. These drugs block the absorption of a number of nutrients needed for healthy bone. The drugs associated with GERD treatment are the older H2 inhibitors such as Pepcid, Tagamet and Zantac. The newer proton pump inhibitors (PPIs) are Prilosec, Prevacid, Nexium, Protonix and Aciphex and carry the same side effects.
Often people take antacids for relief. Using them occasionally is not the concern, but multiple daily dosing can deplete the body of a number of nutrients such as vitamin D, calcium, chromium, iron, magnesium, zinc and others.

Acid blockers can have a negative effect on the prostate and insulin production as well as wound healing and immune function due to a lack of zinc. Anemia can result from a lack of iron.
The loss of magnesium from PPI use over 1 year is serious. Among other risks from low magnesium levels is the chance of a dangerous cardiac irregularity. The FDA has warned that some people are unable to normalize their magnesium levels even with supplementation and must stop the drug.

Prescription Drugs Can Cause Arthritis

Some wear and tear on joints is common, especially as we age, but for obese people the damage and stress is accelerated by carrying increased body fat. Because of the chronic nature of pain, inflammation, and loss of mobility in joints, many meds for arthritis are taken long term. Whether OTC or by prescription, side effects are common, including negative effects on important nutrients. Aspirin depletes folic acid, vitamin C, iron, zinc, and potassium. Loss of nutrients can cause anemia. Acetaminophen (Tylenol) depletes CoQ10 and glutathione, an important anti-oxidant. Non-steroidal anti-inflammatory drugs (NSAID) such as Ibuprofen, Naproxen, etc. deplete folic acid.

Prescription Drugs Can Cause High Blood Pressure

Many overweight people have high insulin levels that increase blood pressure. Additionally, a high carb diet leads to increased salt retention, water retention, and higher blood pressure. Losing excess body fat is a tried and true strategy to normalize blood pressure and insulin levels, especially if you are controlling carbs. Excess water retention improves with carb restriction, often negating the need for diuretics to control blood pressure. This is a far better strategy than years of numerous drugs for blood pressure control.

There are several types of diuretic drugs used to control blood pressure. They can all deplete nutrients. Thiazide diuretics such as hydrochlorothiazide, Diuril, Hydrodiuril, etc. deplete calcium, magnesium, potassium, vitamin D, and CoQ10. Loop diuretics, such as Lasix, deplete vitamin C, some B vitamins such as B1 and B6 and minerals such as zinc, calcium, magnesium, and potassium. Potassium sparing diuretics, such as spirolactone and Dyazide, deplete calcium and magnesium but can lead to retention of potassium causing levels to rise too high.

Diuretics are often used in conjunction with other classes of drugs to control blood pressure. Ace inhibitors such as Lisinopril, Altace, Capoten, Prinivil, Zestril, Vasotec, and Accupril deplete zinc. Beta-blockers such as Toprol XL, Lopressor, Atenolol, Corgard, and Tenormin deplete chromium, CoQ10 and melatonin. Calcium channel blockers such as Norvasc, Procardia, and Plendil deplete vitamin D.

I hope this quick review will give you some insight into the potential harm long term use of medications can cause. Yes, popping a few pills for what ails us is easier than addressing the underlying cause of illness. However, there are serious consequences from this approach. Not only is the expense stressing our healthcare system, but in the long run people are often getting sicker rather than healthier. Since many chronic illness have a lifestyle component, addressing an unhealthy lifestyle will, in the long run, be worth the effort.

If you have no choice and must take a medication be sure to supplement appropriately with at least a good quality iron free multi-vitamin/mineral. (Use iron only if it has been prescribed for you.)
Note that a multivitamin may not be enough to replenish what is lost. Additional replacement may be needed.

More Low-Carb Articles by Jacqueline A. Eberstein, RN

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