Nearly 50% of Americans age 20 years and older take at least one prescription medication. Often those medications come with a list of side effects. It goes without saying then, that a majority of Americans know what a side effect is, and nearly 4.5 million people seek medical attention because of adverse side effects. These side effects have been ingrained into our brains: nausea, headache, vomiting, dizziness, stomach upset, and many more. Occasionally, a patient can experience some side effects that are not listed on commercials or on the sides of pill bottles.

Indeed there are other side effects of some prescription drugs that often go undiagnosed and unfortunately often untreated due to nutrient depletion. Nutrients play a vital role in maintaining a healthy life, whether they are ingested entirely from a well-balanced diet or via various supplements. The human body needs several key vitamins and minerals in order for it to function normally. Depending on the specific nutrient, a deficiency can cause a person to experience symptoms like frequent sickness, decreased appetite, inability to sleep, and blood cell abnormalities. Without proper laboratory tests one would never know that certain symptoms could be related to medication-induced nutrient depletion. Here are a couple of examples of nutrient depletion caused by a very well-known and highly prescribed medication.

According to the CDC, more than 29 million Americans have diabetes, and 86 million more have prediabetes. ACP, or the American College of Physicians, recommends that metformin be added as the initial drug treatment when lifestyle modifications such as diet and exercise fail to improve blood sugar. This translates to a staggering amount of Americans currently or possibly taking metformin for type 2 diabetes, and the number is even higher if you take into account metformin’s off-label uses to treat Polycistic Ovary Syndrome and weight loss. Despite having many beneficial uses, metformin is perhaps the biggest culprit when it comes to nutrient depletion, this one drug alone can have negative effects on three different nutrients.

The first nutrient at risk for depletion from metformin is coenzyme Q10. This powerful antioxidant is found in nearly every cell in the human body and its primary responsibility is to convert food into energy. It is also believed to have beneficial heart-related effects. Under normal conditions, the human body will produce enough CoQ10 on its own, but supplementation may be required in the presence of metformin therapy. The second nutrient at risk for depletion from metformin is folate, also known as folic acid. Unlike CoQ10, folic acid is not produced naturally in the body, and therefore a person must include foods in their diet that contain high levels of it such as spinach and beans. It can also be taken in supplement form either by itself or in a multivitamin/multimineral form. Folic acid plays an important role in helping the body to make new proteins, form new red blood cells, and even help produce and repair DNA. Depletion of this nutrient can cause folate-deficiency anemia, which causes red blood cells to become abnormally large. This will cause a person to become extremely fatigued, and have persistent weakness and shortness of breath. The third and final nutrient at risk for depletion is vitamin B12. Like folic acid, vitamin B12 is not produced by the body and requires intake from foods that contain it naturally such as meat, dairy products, and OTC or prescription supplements. Similar to folic acid, vitamin B12 plays a role in red blood cell formation and DNA production, as well as fatty and amino acid metabolism. Depletion of this vitamin can lead to megaloblastic anemia, which like folate-deficiency anemia can cause a reduced number of red blood cells that are abnormally large, leading to fatigue, muscle weakness, loss of appetite, weight loss, and rapid heartbeat.

This is just a small glimpse of medication induced nutrient depletion. There are several other very common medications that also carry this risk: beta-blockers commonly used for hypertension and proton pump inhibitors used for acid reflux and available over the counter. If one doesn’t take the proper precautions, they can very quickly deplete the body of these extremely important nutrients, and not even know they are doing it! This is one of the reasons why it is hard to determine exactly how many people are experiencing drug-induced nutrient depletion. They simply do not know or report it! Unless blood work is performed routinely, a person can go years without knowing that they have a negative medication effect occurring. While this can affect a person of any age, it is safe to assume that the Medicare population is more at risk since they are more likely to be taking at least one medication. Considering pharmacists are the most involved health care professionals in handling a patient’s medication, they are at the forefront of ensuring medication safety. iMedicare is proud to introduce our Nutrient Depletion Opportunity, a proactive approach to identifying patients taking a nutrient depleting medication and recommending the appropriate supplement to ensure they provide their body with the essential nutrients needed to live out a happy and healthy life!