Drug-Induced Depletions: Medications and Missing Micronutrients

Key takeaways:

• Many prescription medications can cause lower levels of specific micronutrients.
• Genetic variants can exacerbate the susceptibility to low micronutrient levels.
• Understanding where your susceptibility lies can help you to make better diet and supplement choices.
• Use this information to know what to test and what to increase in your diet/supplement.

Medications can decrease vitamin and nutrient levels

In the US, about 2/3 of the adult population regularly takes at least one prescription medication, with many taking multiple drugs.[ref] From blood pressure to acid reflux to diabetes, modern medicine has a drug to fix it, but these ‘fixes’ often come with unintended side effects.

One side effect is that many medications can block the absorption of micronutrients or can increase the depletion of specific vitamins or minerals.[ref] Genetic variants can also increase someone’s susceptibility to being low in a certain vitamin or micronutrient, and the nutrients consumed in the diet are also important.

When you consider medication use + genetics + diet/lifestyle information, it can help you know whether you may need more of a micronutrient.

How can you use this information?

Below, you’ll see medications along with studies showing which micronutrients may be affected. Logged-in members also see their genotypes for variants that influence the levels of those specific vitamins or minerals.

1. Look at the medications you’re taking and nutrients affected
2. Check your genetic variants related to that nutrient (Read the full article on the nutrient for more details)
3. Consider your diet, length of time on the medication, any supplements you already take
4. Decide if you should talk to your doctor, test your nutrient level, and/or add foods or supplements to restore your nutrient levels.

Caution: Don’t start or stop any supplement without discussing it with your prescribing physician, since some nutrients (like potassium with ARBs, or vitamin K with warfarin) have very important interactions with the way the drugs work. This article is for informational purposes only.

Jump to:

Metformin | PPIs | Statins | Oral Contraceptives | Corticosteroids | Blood Pressure | Beta-Blockers | Diuretics | Aspirin & Acetaminophen | Antibiotics | Antispychotics | Warfarin | Antidepressants

Metformin:

Metformin is a commonly prescribed medication for diabetes or PCOS.  It works by affecting the mitochondria and activating an enzyme called AMPK.

Depleted nutrients: Vitamin B12 and Vitamin B6

Vitamin B12: A meta-analysis of 17 studies showed that within 6 weeks to 3 months of use, there is an increased risk of low vitamin B12 in patients who are using metformin. The length of time on the drug also matters. A placebo-controlled trial showed that after 5 years, twice as many patients on metformin (19%) met the definition of low or borderline low B12 (> 298 pg/mL) compared to patients on a placebo.[ref][ref]

RDAs for Vitamins and Minerals:

Here’s a handy reference for the RDA and Upper daily limit (UL) for the vitamins and minerals covered in this article. Note that taking more than the upper daily limit on some vitamins and minerals can have negative effects, such as long-term high intake of zinc blocking copper absorption.

Related Articles and Topics:

Supplements with Genetic Connections

Phase I and Phase II Detoxification Pathways Explained

References: