The human body gives us subtle (and sometimes not-so-subtle) clues when it’s missing key nutrients. Symptoms of nutrient deficiencies can vary by vitamin and/or mineral and can include fatigue, weakness, anxiety, depression, weight changes and more. When mysterious symptoms begin to appear, we often forget to check our medicine cabinets for the cause.
Prescription medications are often helpful and necessary for symptom management and the treatment of certain conditions. However, prescription medications can contribute to nutrient depletion that is sometimes overlooked by the prescribing physician. When taking prescription medication, it is important to know what nutrient intakes may result from using your prescription medications so that you can increase your intake of certain dietary nutrients and supplements while using medications.
Below, we highlight common nutrient deficiencies as well as medications that can contribute to nutrient depletion and some simple solutions to increase your intake.
THE IRON
Iron is the most common nutrient deficiency in the world 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 fingernails, cold hands and feet, irregular heartbeat, headache, fatigue, and dizziness.
Drugs that can 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 consumption, caffeine consumption, low stomach acid, and malabsorption (celiac disease, Crohn’s disease, or IBS) can contribute to iron deficiency.
Foods/supplements to include : Include grass-fed beef, lamb, pasture-raised chicken, nuts, seeds, beets and green vegetables. Vitamin C will also help your body absorb iron, so be sure to include plenty of fresh produce in your diet. Supplement with plant-based iron, food-based iron, or a glycinate form of iron, if needed.
IODINE
Iodine is an essential nutrient that helps our body produce thyroid hormones and regulates growth and development. Table (iodized) salt is used worldwide to prevent iodine deficiency. Iodine deficiency is the most preventable cause of mental retardation in newborns. Iodine deficiency is the most common cause of an enlarged thyroid (goiter) worldwide. Symptoms of iodine deficiency include weight gain, thyroid imbalances, lack of energy, depression, and cognitive decline.
Drugs 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 negatively impact thyroid levels.
Foods/supplements to include: Include foods such as pasture-raised eggs, fatty fish (like 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 like Neuro Nutrients 2.
VITAMIN D
Vitamin D is the sunshine vitamin, so levels naturally decline for most individuals during the winter months. Recent research has shown that vitamin D works like a hormone, so maintaining optimal levels of vitamin D is important for hormonal health. Vitamin D deficiency can cause a variety of symptoms such as depression, anxiety, fatigue, weakness, low immunity, hormonal imbalances and weight gain.
Drugs 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 consumption can contribute to vitamin D deficiency.
Foods/Supplements to Include: Include egg yolks, fatty fish (think salmon, sardines, and tuna), and mushrooms in your diet. If vitamin D levels 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 is the only vitamin that requires an intrinsic factor for its absorption. Intrinsic factor naturally declines as we age, making vitamin B12 deficiency more common in older people. A Tufts University study of 3,000 adults found that almost 40% had B12 levels low enough to cause neurological symptoms. Symptoms of vitamin B12 deficiency include fatigue, weakness, nail discoloration, easy bruising, neurological symptoms, and mouth and tongue sores. Symptoms of vitamin B deficiency can include weakness, heart palpitations, pale skin, constipation, diarrhea, nerve problems, vision loss, and depression.
Drugs 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
- Oral contraceptives/contraceptives containing estradiol such as Activella, Climara, Estraderm and/or Menostar
Other Considerations:Low stomach acid, alcohol consumption, and H. pylori infections can contribute to vitamin 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 (which includes methylated B12). If the deficiency is severe, talk to your healthcare professional about vitamin B12 injections.
MAGNESIUM
Magnesium is a relaxing mineral and one of the most common mineral deficiencies. Our food supply was once naturally high in magnesium, but the soil has become depleted over time. Symptoms of magnesium deficiency can include migraines, insomnia, anxiety, muscle twitches, cramps and tremors.
Drugs 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 medications such as valsartan (Diovan)
Other Considerations: Alcohol consumption, caffeine consumption, and calcium supplementation can 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 fundamental mineral known for its role in immune function. Symptoms of zinc deficiency can include acne, eczema, diarrhea, hair loss, psychological disturbances and lack of appetite.
Drugs 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 medications such as lisinopril (Prinivil, Zestril)
- Oral contraceptives/contraceptives containing estradiol such as Activella, Climara, Estraderm and/or Menostar
- Corticosteroids such as budesonide (Rhinocort) and dexamethasone (Decadron)
Other Considerations: Alcohol consumption, coffee consumption, and malabsorption (celiac disease, Crohn’s disease, or IBS) can contribute to zinc deficiency.
Foods/supplements to include: Include pumpkin seeds, sesame seeds, lentils, cashews, chickpeas, turkey, and quinoa. Supplement with a professional-grade multivitamin that contains zinc and/or a zinc supplement with balanced copper.
If you have any questions or concerns about your medications and how they may affect your nutrition, contact a clinician today!