Prolonged intake of some drugs can lead to important vitamin and mineral deficiencies, reducing absorption and / or increasing the loss of essential micronutrients.
The following are the most well-known cause / effect relationships between the assumption of certain drugs and vitamin / mineral deficiencies, remembering that it is the physician's sole task to establish whether or not to support the drug with a specific vitamin or mineral supplement (yes remember, for example, that in some cases this practice could compromise the absorption or the effectiveness of the drug itself).
- ANTIBIOTICS (penicillin, cephalosporin, tetracycline etc.): alter and destroy the intestinal bacterial flora, including the indispensable strains for the synthesis of some vitamins, such as folic acid and vitamin K. In the long run they can cause hemorrhagic syndromes due to deficiency for lack of synthesis of vitamin K.
- DIURETICS: used above all for the treatment of arterial hypertension, increases the losses of vitamins (group B, especially B1, and vitamin C) and minerals (above all potassium, magnesium and calcium)
- RELAXATION: they mainly inhibit the absorption of fat-soluble vitamins
- SEQUENT RESINS BILE ACIDS: used against hypercholesterolemia, can reduce the absorption of fat-soluble vitamins
- FIBRATES: used against high cholesterol, they can reduce the availability of B vitamins (B12, B6, B3) and folate; the latter are also important to compensate for the increase in homocysteine levels induced by fibrates
- STATINES: used against high cholesterol, they can promote vitamin D deficiency and coenzyme Q10
- ANTIACIDES, H2 ANTAGONISTS AND INHIBITORS OF THE PROTONIC PUMP: they help to solve problems such as gastritis, reflux and peptic ulcers, reducing the acidity of the gastric contents; however, for the same reason they can reduce the absorption of vitamin B12, Beta-carotene, Vitamin D and folic acid, in addition to that of minerals such as calcium, iron and zinc.
- ANTI-DISCUSSION PILL AND TOS (menopausal hormone replacement therapy): they can reduce the plasma levels of B vitamins, Vitamin C and Folic Acid, in addition to that of important minerals such as magnesium, selenium and zinc, and some amino acids (tryptophan and tyrosine ).
- ASPIRIN AND ANTIREHUMATIC (non-steroidal corticosteroids and anti-inflammatory drugs): in the long run they cause a significant reduction in vitamin C (especially aspirin) in white blood cells and blood platelets (which participate in the coagulation process), with consequent risks of bleeding. They can also reduce the availability of Vitamin B12 and folic acid
- CHEMOTHERAPIES (antimitotic, antitumor): some of these act by inhibiting the transformation of folic acid into its active form, blocking a fundamental process for cell replication. The result is a reduction in vitamin levels in the body.
- ANTITUBERCULARS (eg isoniazid): they cause deficiencies of vitamin B6 in tuberculosis patients, already undernourished, with consequent neurological disorders of the polyneuritic type, or vitamin PP deficiencies that induce depressive-type neuropsychic disorders.
- ANTIDIABETICS (biguanides, metformin, and sulfonylureas): can cause a deficiency of vitamin B12, coenzyme Q10 and folic acid; some sulfonylureas (glipizide, acetoesamide, glyburide and tolazamide) inhibit enzymes necessary for the synthesis of an important antioxidant, coenzyme Q10. Chlorpropramide and tolbutamide are two sulfonylureas that do not interfere with coenzyme Q10. Metformin (biguanide) also reduces the levels of coenzyme Q10 in the body, in addition to those of Vitamin B12 and folic acid.
- ANTICONVULSIVANTS prescribed in cases of epilepsy (eg diphenylhydantoin): in the long term they may be associated with blood damage due to folic acid deficiency and bone damage due to vitamin D deficiency.
- ANTIDEPRESSANTS (selective serotonin reuptake inhibitors): in the long run, they can promote the onset of melatonin deficiencies and B vitamins.
| Some drugs that cause Vitamin Deficiencies (Merk Manual) | |
| Drug | Vitamins |
| Alcohol | Folate, Thiamine (B1) and Vitamin B6 |
| Antacids | Vitamin B12 |
| Antibiotics, such as isoniazid, tetracycline, and associations Trimethoprim-Sulfamethoxazole | Group B vitamins, Folate, Vitamin K |
| Anticoagulants, such as warfarin | Vitamin E, Vitamin K |
| Anticonvulsants, such as phenytoin, primidone and phenobarbital | Biotin (Vitamin H), Folate, Vitamin B6, Vitamin D, Vitamin K |
| Antipsychotics | Riboflavin (B2), Vitamin D |
| Barbiturates, such as phenobarbital | Folate, Riboflavin (B2), Vitamin D |
| Chemotherapists such as methotrexate | folate |
| cholestyramine | Vitamin A, Vitamin D, Vitamin E, Vitamin K |
| Corticosteroids | Vitamin C, Vitamin D |
| cycloserine | Vitamin B6 |
| hydralazine | Vitamin B6 |
| Levodopa | Vitamin B6 |
| Mineral oil, ex. Paraffin (long term use) | Vitamin A, Vitamin D, Vitamin E, Vitamin K |
| Metformin | Folate, Vitamin B12 |
| Nitric oxide (repeated exposure) | Vitamin B12 |
| Oral contraceptives | Folate, Thiamine, Vitamin B6 |
| Penicillamine | Vitamin B6 |
| phenothiazines | Riboflavin |
| primidone | Folate, Vitamin D |
| Rifampin | Vitamin D, Vitamin K |
| sulfasalazine | folate |
| Thiazide diuretics | Riboflavin |
| Triamterene | folate |
| Tricyclic antidepressants, such as amitriptyline and imipramine | Riboflavin |
