Pharmaceutical drugs are sometimes necessary, but often come at a price for your body. Make sure you’re not missing out on vital nutrients with our expert guide
Even with the healthiest lifestyle in the world, sometimes you still end up having to take medication from the doctor, especially as you get older. But did you know some everyday drugs can deplete vital nutrients, potentially leading to further problems down the line? Here’s what you need to know…
Drug: Antacids and heartburn medication As their name implies, antacids lower the level of acidity in your stomach, which can ease the pain of heartburn. “However,” says Dr Sarah Brewer, GP and medical director of Healthspan (healthspan.co.uk ), “reducing the amount of acid in the stomach also makes it harder for the body to absorb calcium, needed for healthy bones, among many other things, including non-haem iron, for carrying oxygen in red blood cells, magnesium, which is needed for over 300 enzymes in the body to work properly, zinc, for sex hormone balance and wound healing, and phosphorus, for energy production and healthy bones.
“On average, this lack of acid means that anything from 50 to 80 percent fewer vitamins and minerals are absorbed by the gut. With long-term use, this can have negative consequences such as thinning bones, iron-deficiency anaemia and poor wound healing. Absorption of energyboosting B group vitamins, especially vitamin B12, folate and vitamin C is also affected by acid-suppressing drugs.”
Solution
“If you need long-term acid suppressing medication, it’s important to follow a nutrient-rich diet,” says Dr Sarah. “Supplements can help, but lower levels will also be absorbed from these, so look for ones with boosted levels such as those designed for people aged 50+ which take reduced acid secretion into account. Taking vitamin C with iron supplements will help boost absorption. Also, talk to your doctor about the pros and cons of long-term use of acidsuppressing drugs.”
Drug: Statins
The most commonly prescribed medication in the UK, statins help to lower cholesterol levels by blocking a liver enzyme called HMG-CoA reductase.
“This enzyme is also used to produce co-enzyme Q10, a nutrient needed for energy production in cells,” says Dr Sarah. “Research has shown that taking a statin can halve your circulating levels of co-enzyme Q10 within just four weeks. Low levels of this nutrient have been linked with muscle weakness, aches and pains – something many people taking statins complain of.
“Statins also reduce your natural production of vitamin D3 in the skin. This can also contribute to muscle pain.”
Solution
“If you are taking a statin, consider taking vitamin D3 and co-enzyme Q10 supplements. I usually advise taking co-enzyme Q10 in the ‘body-ready’ form of ubiquinol (100mg).” Try Nature’s Best Ubiquinol, £29.95, naturesbest.co.uk
Drug: Metformin
“Taken for type 2 diabetes, metformin can deplete the body’s reserves of co-enzyme Q10, folic acid and vitamin B12,” says Dr Sarah. A B12 or folate deficiency can cause symptoms like extreme tiredness and lack of energy, breathlessness, feeling faint, headaches and pale skin, and extreme cases can cause memory, coordination and nervous system problems.
Solution
“Supplementing with these nutrients can be helpful. Calcium may also be useful.”
Drug: The pill
“Several studies, including a report from the World Health Organisation, have raised concerns about how oral contraceptive pills can lower a woman’s levels of folic acid, vitamins B2, B6, B12, vitamin C and E, plus magnesium, selenium and zinc,” says Dr Sarah. “Why the pill affects blood levels of vitamins and minerals is not fully understood, but may partly be due to fluid retention.
“The oestrogen and progestogens used in the pill are steroid hormones which have effects on the kidneys and the way salt and fluid balance is regulated. They tend to cause sodium and fluid retention, which can dilute the concentration of micronutrients in the blood. The pill may reduce absorption of vitamins such as folic acid and increase their excretion. This may lead to nutritional deficiencies – especially of folate or folic acid, the lack of which increases the risk of foetal abnormalities, which is a concern if pregnancy occurs while taking the pill or soon after stopping it. Lower vitamin B2 levels may explain the headaches that some women experience with the pill.”
Solution
“It’s important to follow a healthy, nutrientrich diet,” says Dr Sarah. “Aim for at least five portions of vegetables a day, including dark green leaves for folate. Nuts, seeds and wholegrains are good sources of vitamins and minerals, too.
“If you are planning a pregnancy at some stage in the future, a multivitamin and mineral is a good idea.”
Drug: Aspirin
“Popped by plenty of people every day for all manner of problems, this common painkiller can deplete the body of folic acid, iron, B12, vitamin C and zinc,” says Dr Sarah. “Most of us assume we take vitamin C to reduce tiredness and fatigue and to stave off illnesses such as colds and flu. But it actually has a very important role in digestion, too. The stomach lining stores a lot of the vitamin C we get from our diet – the concentration can be 25 times higher than the level found in our blood.
“This helps protect it from becoming inflamed by stomach acid and enzymes. This function of vitamin C also helps to prevent stomach ulcers and bleeding. But taking aspirin regularly – even small daily doses of mini-aspirin to reduce the risk of heart attack or stroke – can increase the risk of increase the risk of ulcers and bleeding.
“This is because it blocks the absorption of vitamin C into the body, therefore lowering the level of the protective vitamin in the stomach lining. Occasional use of aspirin, for example to treat a headache, is usually fine. But if it causes indigestion, aspirin might be affecting your stomach lining, and it is best to avoid it and seek medical advice.”
Solution
“If you are taking long-term aspirin consider taking a vitamin C supplement, too,” says Sarah. “A non-acidic form of vitamin C (the best-known is a type called ester-C) will reduce the risk of acid indigestion.”
Drug: Ace inhibitors
Often prescribed after a heart attack, these common blood pressure meds can sap zinc. “ACE inhibitors used to treat high blood pressure or heart failure can lead to a zinc deficiency, especially when used together with a diuretic (water tablets),” says Dr Sarah. “Lack of zinc can lead to changes in taste sensation and reduced immunity.”
Solution
“Taking a multivitamin and mineral supplement that includes zinc is a good idea,” says Dr Sarah.
Drug: Antidepressants
Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine deplete folate, also known as vitamin B9. Tricyclic drugs like amitriptyline deplete vitamin B2 and co-enzyme Q10.
Solution
“Take a good folate supplement,” says Dr Sarah. “Ginkgo biloba may help reduce the side effects of this medication. Taking B vitamins may be supportive for health, too.”
Do you need more magnesium?
Studies have found that, by the end of their childbearing years, as much as 80 percent of women have inadequate magnesium levels. “Magnesium is responsible for over 300 different actions within the body, meaning a deficiency can manifest itself in many ways,” says Keeley Berry, nutritional expert at BetterYou (betteryou.com)
“Early signs of deficiency include disturbed sleep, poor skin heath, nausea, vomiting, feeling weak, and as the deficiency progresses it can cause numbness, tingling and cramps in the muscles. Fatigue, anxiety and depression have also been linked to low levels of magnesium.
“Diuretics prescribed to lower blood pressure can deplete magnesium levels. Proton pump Inhibitors (PPIs) such as omeprazole can also cause magnesium levels to drop as absorption becomes inhibited by PPI use.
“Aspirin, a nonsteroidal anti-inflammatory drug (NSAIDs), can be antagonistic, also causing inhibitory effects. Magnesium is used to aid transport of calcium and potassium ions in and out of cells. If the balance of these electrolytes is lost, it can have a detrimental effect within the body particularly for the circulatory system, affecting heart rhythm.
“Consuming a calcium-rich diet or high dose supplements can also deplete levels of magnesium which can affect bone health. Magnesium is essential for the conversion of vitamin D into its active form, so the body can use it to absorb calcium. If calcium cannot be absorbed effectively into the bones, it can deposit in the artery walls and cause them to harden, meaning the body cannot respond effectively to blood pressure changes.” Try BetterYou Magnesium Skin Body Lotion, £9.95, betteryou.com
