Here's a final list of our three part series on common drugs that deplete your body of essential minerals, co enzymes, vitamins and similar nutrients. If you need to take one of these medications, make sure to supplement with the nutrients you are lo

Cardiovascular/antihypertensives

Angiotensin converting enzyme

(ACE) inhibitors and chlorthalidone;

decrease zinc levels (J Am Coll Nutr, 1998; 17: 75-8; S Afr Med J, 1982; 62: 373-5).

Clonidine, hydralazine hydrochloride and methyldopa;

all three inhibit one of two types of coenzyme Q10, which are important for the heart's bioenergetic function (Res Commun Pathol Pharmacol, 1975; 12: 533-40).

Hydralazine containing vasodilators;

can cause vitamin B6 deficiency (J Cardiovasc Pharmacol, 1990; 15: 150-6).

Cardiac glycosides;

decrease vitamin B1 (thiamine) levels (Eur J Pharmacol, 1998; 361: 151-5)

decrease levels of calcium, magnesium and phosphorus by increasing kidney excretion (J Clin Invest, 1965; 44: 1143).

Beta adrenoceptor blocking drugs (commonly known as beta blockers);

inhibit both of the coenzymes Q10 (succinoxidase and NADH oxidase) which are important for the heart's bioenergetic function significantly with propranolol, less so with metoprolol and hardly at all with timolol (Res Commun Pathol Pharmacol, 1975; 12: 533-40; Res Commun Chem Pathol Pharmacol, 1977; 17: 157-64).

Anticonvulsants

Carbamazepine;

decreases vitamin D levels (J Bone Miner Res, 1994; 9: 631-7).

Phenobarbital;

disturbs biotin (an organic acid considered part of the vitamin B complex) metabolism, leading to biotin depletion (Ann NY Acad Sci, 1985; 447: 297-313; J Paediatr Gastroenterol Nutr, 1998; 26: 245-50).

Barbiturates;

deplete both calcium and vitamin D (Quart J Med, 1986; 59: 569-77).

Carbamazepine, barbiturates and primidone;

all of these decrease folic acid levels (Clin Neuropharmacol, 1995; 18: 165-82; J Neurol Sci, 1977; 145: 109- 12).

Carbamazepine and primidone;

both inhibit transport of biotin in the intestine (Am J Clin Nutr, 1989; 49: 127-31).

Phenytoin;

depletes vitamin K (Clin Pharmacol Ther, 1983; 34: 529-32)

lowers vitamin D levels (J Bone Miner Res, 1994; 9: 631-7)

decreases both folic acid and vitamin B12 levels (S Afr Med J, 1973; 47: 2245-6)

increases excretion of and decreases intestinal absorption of calcium (Acta Physiol Latin Am, 1979; 29: 223-8)

disturbs biotin metabolism, leading to biotin depletion (J Paediatr Gastroenterol Nutr, 1998, 26: 245- 50).

Valproate (also known as valproic acid in the US);

inhibits carnitine biosynthesis (carnitine is an amino acid derivative, found in the liver and skeletal muscle, required for fatty acid oxidation) (Epilepsia, 1998; 39: 1216-25; Biochem Pharmacol, 1996, 52: 1429- 33).

Antimetabolites

Methotrexate (used in the treatment of childhood leukaemia, tumours, severe active rheumatoid arthritis and severe resistant psoriasis);

depletes folic acid (Br J Rheumatol, 1995; 34: 1172-4).

Penicillamine (used in the treatment of chronic active hepatitis, rheumatic disease, cystinuria and Wilson's disease);

inactivates vitamin B6 as well as decreases magnesium and zinc levels (J Am Coll Nutr, 1982; 1: 207- 14; Acta Derm Venereol, 1984; 64: 424-7).

It may well be that, in one or two cases, the nutrient decrease plays a significant part in the effectiveness of the drug. In this case, supplementing won't always correct the known depletion effectively.

Poor diet, exposure to high stress, a demanding occupation, the effects of pollution and the like will always aggravate the situation, and these factors should also be taken into account.

Harald Gaier

Harald Gaier is a registered osteopath, naturopath and homoeopath

(c) 2001 Harald Gaier