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DRUGS DEPLETE NUTRIENTS

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DRUGS NUTRIENT DEPLETED POSSIBLE MECHANISM WHAT THE NUTRIENT IS REQUIRED FOR
(Includes some representative U.S. and Canadian Brand Names.)
ANALGESICS/ANTI-INFLAMMATORIES
Acetaminophen (Tylenol) Glutathione Acetaminophen depletes endogenous glutathione. Glutathione is the Master Anti-oxidant; major chelator; required for both red and white cell development; regulates hormones; regulates Nitric Oxide; transports amino acids; protects the mitochondria; etcNote:Glutathione supplements cannot be absorbed at a cellular level.Protandim will turn on the mRNA tools to make glutathione and other supplements provide the nutrients required by the cell to produce glutathione and/or the glutathione complex
Aspirin, other salicylates Folic Acid Decreases protein binding and serum levels. Folic acid may be redistributed as opposed to lost. Red blood appear to maintain normal levels.
Iron Mucosal damage in the gastrointestinal tract causing bleeding and may cause chronic blood loss. Iron is utilized in many ways in the body, i.e., the heme proteins: hemoglobin (blood) myoglobin (muscle) and cytochrome P450 (large and diverse family of enzymes involved in drgu metabolism, oxidation, and involved in almost 75% of metabolic reactions.)Deplete iron results in iron based anemia, interference with vital functions, morbidity and death.
Vitamin C Increases urinary excretion. Controversial as to whether it causes vitamin C deficiency.Vitamin C is involved in a number of roles:anit-oxidant; enzyme cofactor (helper molecule); production of collagens, neurotransmitters, natural anti-histamine
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Diclofenac (Voltaren), Etodolac (Lodine), Fenoprofen (Nalfon), Flurbiprofen (Ansaid), Ibuprofen (AdvilMotrin, etc), Indomethacin (Indocin), Ketoprofen (OrudisOruvail), Ketorolac (Toradol), Meclofenamate, Mefenamic Acid (Ponstel), Meloxicam (Mobic), Nabumetone (Relafen), Naproxen (Anaprox,NaprosynNaprelan), Oxaprozin (Daypro), Piroxicam (Feldene), Sulindac (Clinoril), Tolmetin (Tolectin) Iron Mucosal damage and GI bleeding, even if asymptomatic, can cause chronic blood loss. Iron is utilized in many ways in the body, i.e., the heme proteins: hemoglobin (blood) myoglobin (muscle) and cytochrome P450 (large and diverse family of enzymes involved in drgu metabolism, oxidation, and involved in almost 75% of metabolic reactions.)Deplete iron results in iron based anemia, interference with vital functions, morbidity and death.
Folic Acid Folate-dependent enzymes are inhibited by some NSAIDs. The clinical significance of this is not known.
ANTI-INFECTIVES
     ANTIBIOTICS
Antibiotics – General: Biotin aka Vitamin H aka Vitamin B7 Destruction of normal intestinal microflora may lead to decreased production of various B vitamins and vitamin K. Vitamin B7 is a coenzyme and is involved in the production of fatty acides, amino acids and glucogenesis required to produce the fuel for the cells, ATP.
Cephalosporins, Fluoroquinolones, Isoniazid, Macrolides, Penicillins, Sulfonamides, Tetracyclines, Trimethoprim/Sulfamethoxazole Vitamin B12 aka adenosylcobalamin aka Vitamin B12 aka adenosylcobalamin aka Dibencozide Possible interferece with vitamin K-dependent clotting factor production. Vitamin K-dependent clotting factor production deficiency may cause significant issues with people having other risk factors due to low vitamin K levels. Vitamin B12 is required for normal functioning in the brain and the nervous system
Pantothenic Acid (B5) required to produce the cell fuel – ATP; thus causing irritability, fatigue, apathy; impairment in acetylcholine production & therefore issues psychologically/neurologically; muscle cramps
Pyridoxine (B6) involved in nutrient metabolism; neurotransmitter & histamine production and hemoglobin production and DNA
Riboflavin (B2) Vitamin B2 is required to make the fuel for every cell – ATP; cracked and red lips; inflammation of the lining of the mouth and tongue; mouth ulcers; sore throat; dry and scaling skin; itchy and watery eyes; irone deficiency anemia
Thiamine (B1) Vitamin B1 is required to make the fuel for every cell – ATP; required for neural functioning; and for the nervous system; optic neuropathy;
Vitamin B12 Vitamin B12 is required for normal functioning in the brain and the nervous system
Vitamin K Required for blood coagulation
Folic Acid Disruption of normal intestinal microflora effects folic acid absorption and may reduce production. Also inhibits conversion of folic acid to its active form. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
Aminoglycosides: (means protein (amino) attached to a glycoside (sugar). Amikacin (Amikin), Gentamicin (Garamycin), Kanamycin (Kantrex), Netilmicin (Netromycin), Streptomycin, Tobramycin (Nebcin)Note: the ones that end with mycin are derived from the bacteria:Streptomyces genus, see http://en.wikipedia.org/wiki/Aminoglycosides Magnesium Increased urinary excretion which may be associated with drug-induced kidney damage. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Potassium Potassium plays a key part in nerve transmission; depletion results in various cardiac functions; plays a key role in the water balance between cells; prevents muscle contraction.Deficiency symptoms may include: muscle weakness, ECG abnormalities, decreased reflex response; respiratory paralysis, and high alkalinity in the blood
Cefditoren Pivoxil (Spectracef) Acetyl-L-Carnitine can cause carnitine deficiency – an amino acid combination of lysine and methionine Carnitine is required to transport fatty acids (the long chain acyl group) into the mitochondrial matrix to make ATP (the fuel for the cells). Also required for the constant turn over required to maintain bone mass. Also acts as an anti-oxidant. Carnitine is required to transport fatty acids (the long chain acyl group) into the mitochondrial matrix to make ATP (the fuel for the cells). Also required for the constant turn over required to maintain bone mass. Also acts as an anti-oxidant……..Some research shows thatL-Carnitine supplements help to reduce need for medication required for angina
L-Carnitine
Propionyl-L-Carnitine
Chloramphenicol (Chloromycetin) Niacin and Niacinamide (different forms of Vitamin B3) May interfere with the functions of Vitamin B3 Vitamin B3 is used to increase HDL cholesterol; is a neuroprotector and is involved in anti-inflammatory processes.Deficiency is associated with diarrhea, dermatitis and dementias; lesions in the lower neck; hyperpigmentation, thickening of the skin, inflammation of tongue and mouth, digestive issues, amnesia, delirium
Fluoroquinolones: Ciprofloxacin (Cipro), Enoxacin (Penetrex), Gatifloxacin (Tequin), Levofloxacin (Levaquin), Lomefloxacin (Maxaquin), Moxifloxacin (Avelox), Norfloxacin (Noroxin), Ofloxacin (Floxin), Sparfloxacin (Zagam), Trovafloxacin (Trovan) Calcium, Biotin, B1, B2, B3, B6, B12 Formation of insoluble complexes (prevents absorption of both nutrient and fluoroquinolone). diarrhea that is watery or bloody; sei-zures; confu-sion; halluci-nations; unu-sual thoughts or behavior; dizziness, fainting, fast or pounding heartbeat, sudden pain or swelling near joints; easy bruising or bleeding; urinating less; numbness, burning, pain, tingling in hands or feet; pale or yel-lowed skin; dark coloured urine; fever; weakness; fe-ver; sore throat; head-ache with blis-tering; peeling red skin rash; any skin rash; nausea, vom-iting, stomach pain; constipation; feeling restless or anxious; headache; dizziness; muscle pain, insomnia.Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Iron Iron is utilized in many ways in the body, i.e., the heme proteins: hemoglobin (blood) myoglobin (muscle) and cytochrome P450 (large and diverse family of enzymes involved in drgu metabolism, oxidation, and involved in almost 75% of metabolic reactions.)Deplete iron results in iron based anemia, interference with vital functions, morbidity and death.
Magnesium Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Zinc Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver;
Neomycin (Mycifradin) Beta-Carotene Reduced absorption. Required for normal functioning in the brain and the nervous system; and most well known is that of vision (translation of light into vision); also involved in the skin processes; acts as an anti-oxidant. Deficiences thus include visual issues; also skin issues; and it effects the development of various fetal tissues
Vitamin B12 aka adenosylcobalamin aka Dibencozide Vitamin B12 is required for normal functioning in the brain and the nervous system
Vitamin A Vitamin A is required for a number of functions:growth & development; good vision (important for both low-light and colour vision); good immune system functioning; and acts as a hormone-like growth factor for epitheial cells (cells that line cavities and surfaces, i.e., gut, skin, lungs, etc in the body, and glands)
Pivampicillin (Pondocillin) Acetyl-L-Carnitine Chronic use of pivampicillin can induce carnitine deficiency. It is a prodrug that releases pivalic acid and are known for depleting levels of carnitine which is required for: transport of fatty acids and as such plays a role in the krebs cycle and the production of the fuel ATP
L-Carnitine
Propionyl-L-Carnitine
Penicillins (sodium-containing): Carbenicillin (Geocillin), Mezlocillin (Mezlin), Penicillin G sodium (Pfizerpen), Piperacillin (Pipracil), Ticarcillin (Ticar) Potassium A large sodium load is presented to the kidneys, resulting in sodium reabsorption and potassium excretion. fever, sore throat, head-ache, peeling or red skin rashes, nau-sea, stomach pain, low fe-ver, loss of appetite, dark urine, clay coloured stools, jaun-dice, watery or bloody di-arrhea, fever, chills, body aches, easy bruising or bleeding, less urination, agi-tation, confu-sion,seizure, nausea, vom-iting, vaginal itching or dis-charge, swol-len, black or hairy tongue, white patches in your mouth or throat
Sulfadiazine Acetyl-L-carnitine Not known. Carnitine is an amino acid required for the transport of fatty acids into the mitochondria to produce fuel – cellular ATP
L-carnitine
Proprionyl-L-carnitine
Tetracyclines: Tetracycline (Achromycin VPanmycin,RobitetRobicapsSumycin,TelineTetracapTetracyn,Tetralan), Demeclocycline (Declomycin), Doxycycline (Bio-TabDoryxDoxy Caps,DoxychelDoxychel Hyclate,MonodoxPeriostatVibra-TabsVibramycin), Minocycline (DynacinVectrin), Oxytetracycline (Terramycin,Uri-Tet) Calcium Formation of insoluble complexes prevents absorption of both nutrient and tetracycline. Required for heart function; for bone metabolism; healthy teeth; neurotransmitter release; muscle contraction;
Iron Iron is utilized in many ways in the body, i.e., the heme proteins: hemoglobin (blood) myoglobin (muscle) and cytochrome P450 (large and diverse family of enzymes involved in drgu metabolism, oxidation, and involved in almost 75% of metabolic reactions.)Deplete iron results in iron based anemia, interference with vital functions, morbidity and death.
Magnesium Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Zinc Doxycycline does not reduce zinc absorption. Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver;
Potassium Increased renal excretion associated with nephropathy. Required for neuron and nerve function; plays a role in balancing the fluids in / out of the cell; important in muscle contraction; deficiencies can cause vomiting, diarrhea, muscle weakness, decreased reflex responses, cardiac arrhythmia
Rifampin (Rifadin, Rimactane,Rofact)
Amphotericin B (Abelcet,AmBisomeAmphocin,AmphotecFungizone) Magnesium Increased urinary excretion, associated with drug-induced renal damage. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc Can cause renal dysfunction.
Potassium Potassium plays a key part in nerve transmission; depletion results in various cardiac functions; plays a key role in the water balance between cells; prevents muscle contraction.Deficiency symptoms may include: muscle weakness, ECG abnormalities, decreased reflex response; respiratory paralysis, and high alkalinity in the blood
Fluconazole (Diflucan) Potassium Increased urinary excretion, associated with drug-induced renal damage. Potassium levels can be reduced, especially in people with abnormal renal function
     ANTIMALARIALS
Pyrimethamine (Daraprim) Folic Acid Folate antagonism. Pyrimethamine binds to dihydrofolate reductase thus reducing the capacity to convert folic acid to its active form Folic acid aka Vitamin M aka Vitamin B9 is essential for many body functions from production of and repair of DNA to healthy red blood formation
Anemia, depression, diarrhea, confusion,
Yet folic acid antagonizes the therapeutic effects of pyrimethamine.
Acetyl-L-carnitine Not known. Carnitine is required to transport fatty acids (the long chain acyl group) into the mitochondrial matrix to make ATP (the fuel for the cells). Also required for the constant turn over required to maintain bone mass. Also acts as an anti-oxidant.
L-carnitine
Proprionyl-L-carnitine
Quinacrine Riboflavin (B2) Can interfere with conversion to the active form flavin adenine dinubleotide (FAD). Vitamin B2 is required to make the fuel for every cell – ATP; cracked and red lips; inflammation of the lining of the mouth and tongue; mouth ulcers; sore throat; dry and scaling skin; itchy and watery eyes; irone deficiency anemia
     ANTIPROTAZOALS
Pentamidine (NebuPent,PentacarinatPentam 300) Folic Acid Weak folate antagonist, preventing conversion of folic acid to its active form. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
Magnesium Increased urinary excretion, associated with drug-induced renal damage. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
     ANTIRETROVIRALS
Adefovir Acetyl-L-carnitine Increased urinary excretion of L-carnitine. Carnitine is required to transport fatty acids (the long chain acyl group) into the mitochondrial matrix to make ATP (the fuel for the cells). Also required for the constant turn over required to maintain bone mass. Alsoacts as an anti-oxidant.
L-carnitine
Proprionyl-L-carnitine
Zidovudine (AZT, Combivir,Retrovir) Copper Some HIV patients taking zidovudine have subnormal copper and vitamin B12 levels. The mechanism is unknown. Copper is a key component for the respiratory enzyme: Cytochrome c oxidase; copper works with iron to reduce oxygen; also a component of the anti-oxidant SOD (Superoxide dismutase); and is also found in the liver, muscle and bone. Deficiencies can cause anemia like Symptoms: neutropenia, bone abnormalities, hypterthyroidism; and abnormalities in blood glucose and cholesterol levels.
Vitamin B12 aka adenosylcobalamin aka Dibencozide Vitamin B12 is required for normal functioning in the brain and the nervous system
Zinc Zinc supplements may reduce AIDS-related opportunistic infections, but have also been linked to increased mortality; Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver;
Acetyl-L-carnitine Zidovudine interferes with mitochondrial transport of L-carnitine into muscle cells. Low L-carnitine blood levels are found in some people with HIV infection. Zidovudine can exacerbate this. Lower muscle carnitine levels is linked to symptoms of myopathy.
L-carnitine
Proprionyl-L-carnitine
     ANTITUBERCULOSIS AGENTS
Aminosalicylic Acid (Para-aminosalicylic Acid, Paser) Folic Acid Inhibits absorption in the gastrointestinal tract. May worsen folic acid deficiency associated with tuberculosis.
Iron Reduced gastrointestinal absorption. Iron is utilized in many ways in the body, i.e., the heme proteins: hemoglobin (blood) myoglobin (muscle) and cytochrome P450 (large and diverse family of enzymes involved in drgu metabolism, oxidation, and involved in almost 75% of metabolic reactions.)Deplete iron results in iron based anemia, interference with vital functions, morbidity and death.
Vitamin B12 aka adenosylcobalamin aka Dibencozide Reduced gastrointestinal absorption. Vitamin B12 is required for normal functioning in the brain and the nervous system
Cycloserine (Seromycin) Folic Acid Possibly reduces absorption or increases metabolism. Rare cases of megaloblastic anemia reported, but usually with other factors contributing to folate deficiency.
Niacin and Niacinamide Interference with conversion of tryptophan to niacin. Vitamin B3 is used to increase HDL cholesterol; is a neuroprotector and is involved in anti-inflammatory processes.Deficiency is associated with diarrhea, dermatitis and dementias; lesions in the lower neck; hyperpigmentation, thickening of the skin, inflammation of tongue and mouth, digestive issues, amnesia, delirium
Pyridoxine (B6) Inactivates pyridoxal-5′-phosphate, increasing pyridoxine requirements. Deficiency can contribute to the neurotoxicity and seizures associated with cycloserine. Vitamin B6 is involved in nutrient metabolism; neurotransmitter & histamine production and hemoglobin production and DNA
Ethambutol (Myambutol) Copper Ethambutol and its metabolite chelate copper and zinc in the gastrointestinal tract and decrease their absorption. Copper is a key component for the respiratory enzyme: Cytochrome c oxidase; copper works with iron to reduce oxygen; also a component of the anti-oxidant SOD (Superoxide dismutase); and is also found in the liver, muscle and bone. Deficiencies can cause anemia like Symptoms: neutropenia, bone abnormalities, hypterthyroidism; and abnormalities in blood glucose and cholesterol levels.
Zinc Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver;
Zinc deficiency may contribute to visual dysfunction associated with higher doses of ethambutol. Monitor visual function.
Ethionamide (Trecator-SC) Niacin and Niacinamide Ethionamide has structural similarities to niacinamide and may interfere with its activity. Vitamin B3 is used to increase HDL cholesterol; is a neuroprotector and is involved in anti-inflammatory processes.Deficiency is associated with diarrhea, dermatitis and dementias; lesions in the lower neck; hyperpigmentation, thickening of the skin, inflammation of tongue and mouth, digestive issues, amnesia, delirium
Isoniazid (INH, Laniazid) Pyridoxine (B6) Interferes with pyridoxine metabolism. Vitamin B6 is involved in nutrient metabolism; neurotransmitter & histamine production and hemoglobin production and DNA
Niacin and Niacinamide Isoniazid inhibits the conversion of tryptophan to niacin. It also has structural similarities to niacinamide and may interfere with its activity. Vitamin B3 is used to increase HDL cholesterol; is a neuroprotector and is involved in anti-inflammatory processes.Deficiency is associated with diarrhea, dermatitis and dementias; lesions in the lower neck; hyperpigmentation, thickening of the skin, inflammation of tongue and mouth, digestive issues, amnesia, delirium
Pyrazinamide Niacin and Niacinamide Pyrazinamide has structural similarities to niacinamide and may interfere with its activity. Vitamin B3 is used to increase HDL cholesterol; is a neuroprotector and is involved in anti-inflammatory processes.Deficiency is associated with diarrhea, dermatitis and dementias; lesions in the lower neck; hyperpigmentation, thickening of the skin, inflammation of tongue and mouth, digestive issues, amnesia, delirium
Rifampin (RifadinRimactane,Rofact) Vitamin D Increased hepatic metabolism of vitamin D due to enzyme induction. Vitamin D is required for cholesterol; transport of calcium; cardiovascular action; bone health; prevention of cancer; immune health; healhy DNA
Vitamin K Possibly decreased gastrointestinal absorption, destruction of vitamin K-producing bacteria, and interference with regeneration of vitamin K from inactive metabolite. Required for blood coagulation
     ANTIVIRALS
Foscarnet (Foscavir) Magnesium Chelation and increased excretion. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
ANTI-CANCER DRUGS
Aldesleukin (Interleukin-2, IL-2,Proleukin) Magnesium Intracellular shift of magnesium. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Amifostine (Ethyol) Magnesium Increased urinary excretion. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Busulfan Vitamin E High doses of chemotherapy seems to reduce levels of vitamin E. Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
Cisplatin (Platinol-AQ), Carboplatin (Paraplatin) Acetyl-L-carnitine Increased urinary excretion of L-carnitine. It is a prodrug that releases pivalic acid and are known for depleting levels of carnitine which is required for: transport of fatty acids and as such plays a role in the krebs cycle and the production of the fuel ATP
L-carnitine
Proprionyl-L-carnitine
Magnesium Increased urinary excretion probably associated with drug-induced renal damage. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc. Hypomagnesemia worsens with repeated courses of treatment, and is more severe with cisplatin than carboplatin. Monitor magnesium levels and give supplements as necessary.
Potassium Renal tubular damage caused by cisplatin increases loss of electrolytes including potassium. Potassium plays a key part in nerve transmission; depletion results in various cardiac functions; plays a key role in the water balance between cells; prevents muscle contraction.Deficiency symptoms may include: muscle weakness, ECG abnormalities, decreased reflex response; respiratory paralysis, and high alkalinity in the blood
Vitamin E High doses of chemotherapy seems to reduce levels of vitamin E. Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
Zinc Increased urinary excretion. Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver.Some research shows that zinc return to normal within 48 hours after a given dose
Cyclophosphamide (Cytoxan,Neosar) Vitamin E High doses of chemotherapy seems to reduce levels of vitamin E. Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
Cytosine Arabinoside (Cytosar-U) Vitamin E High doses of chemotherapy seems to reduce levels of vitamin E. Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
Dexrazoxane (Zinecard) Zinc Chelation of metal ions including zinc, leading to increased urinary excretion. Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver;
Doxorubicin (Adriamycin,RubexDoxil) Riboflavin (B2) Formation of inactive complexes, interference with binding and conversion to active form, increased renal excretion. Vitamin B2 is required to make the fuel for every cell – ATP; cracked and red lips; inflammation of the lining of the mouth and tongue; mouth ulcers; sore throat; dry and scaling skin; itchy and watery eyes; irone deficiency anemia
Vitamin E High doses of chemotherapy seems to reduce levels of vitamin E. Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
Etoposide (Etopophos,VePesidToposar) Vitamin E High doses of chemotherapy seems to reduce levels of vitamin E. Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
Ifosamide (Ifex) Acetyl-L-carnitine Increased urinary excretion of L-carnitine. It is a prodrug that releases pivalic acid and are known for depleting levels of carnitine which is required for: transport of fatty acids and as such plays a role in the krebs cycle and the production of the fuel ATP
L-carnitine
Proprionyl-L-carnitine
Fluorouracil (5-FU, Adrucil) Niacin and Niacinamide Interference with conversion of tryptophan to niacin. Vitamin B3 is used to increase HDL cholesterol; is a neuroprotector and is involved in anti-inflammatory processes.Deficiency is associated with diarrhea, dermatitis and dementias; lesions in the lower neck; hyperpigmentation, thickening of the skin, inflammation of tongue and mouth, digestive issues, amnesia, delirium
Thiamine (B1) Might interfere with the activation of thiamine, or increase its breakdown. Vitamin B1 is required to make the fuel for every cell – ATP; required for neural functioning; and for the nervous system; optic neuropathy;
Vitamin E High doses of chemotherapy may reduce levels of vitamin E. Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
Mercaptopurine (6-MP,Purinethol) Niacin and Niacinamide Interferes with conversion of niacin to nicotinamide adenine dinucleotide (NAD), due to structural similarities to adenine. Vitamin B3 is used to increase HDL cholesterol; is a neuroprotector and is involved in anti-inflammatory processes.Deficiency is associated with diarrhea, dermatitis and dementias; lesions in the lower neck; hyperpigmentation, thickening of the skin, inflammation of tongue and mouth, digestive issues, amnesia, delirium
Methotrexate (Rheumatrex) Vitamin E High doses of chemotherapy seems to reduce levels of vitamin E. Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
Folic Acid Folate antagonist, preventing conversion of folic acid to its active form. Yet, Folic acid supplements can interfere with the actions of methotrexate.
Thiotepa (Thioplex) Vitamin E High doses of chemotherapy seems to reduce levels of vitamin E. Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
ANTI-DIABETES AGENTS
Insulin Magnesium May increase loss of magnesium in the urine. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc. Decreased absorption and osmotic diuresis may also contribute to low magnesium levels in diabetic patients.
Metformin (Glucophage) Folic Acid Malabsorption of dietary vitamin B12 and possibly folic acid. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
Vitamin B12 aka adenosylcobalamin aka Dibencozide Vitamin B12 aka adenosylcobalamin aka Dibencozide
Thiamine (B1) Theoretically, metformin might reduce thiamine activity. Vitamin B1 is required to make the fuel for every cell – ATP; required for neural functioning; and for the nervous system; optic neuropathy;
ANTIGOUT/ANTIRHEUMATIC
Azathioprine (Imuran) Niacin and Niacinamide Azathioprine is metabolized to 6-mercaptopurine which may inhibit conversion of niacin to its active form, nicotinamide adenine dinucleotide. Vitamin B3 is used to increase HDL cholesterol; is a neuroprotector and is involved in anti-inflammatory processes.Deficiency is associated with diarrhea, dermatitis and dementias; lesions in the lower neck; hyperpigmentation, thickening of the skin, inflammation of tongue and mouth, digestive issues, amnesia, delirium
Colchicine Beta-Carotene Disruption of intestinal mucosal function by colchicine can reduce absorption. Required for normal functioning in the brain and the nervous system; and most well known is that of vision (translation of light into vision); also involved in the skin processes; acts as an anti-oxidant. Deficiences thus include visual issues; also skin issues; and it effects the development of various fetal tissues
Vitamin B12 aka adenosylcobalamin aka Dibencozide Disruption of intestinal mucosal function by colchicine can reduce absorption. Vitamin B12 is required for normal functioning in the brain and the nervous system
Methotrexate (Rheumatrex) Folic Acid Folate antagonism. Binds to dihydrofolate reductase, preventing conversion of folic acid to its active form. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
People taking methotrexate for cancer should avoid folic acid supplements unless recommended by their oncologist, since they may interfere with the anticancer effects.
Penicillamine (Cuprimine,Depen) Copper Chelation in the GI tract, decreasing absorption of these minerals. Copper is a key component for the respiratory enzyme: Cytochrome c oxidase; copper works with iron to reduce oxygen; also a component of the anti-oxidant SOD (Superoxide dismutase); and is also found in the liver, muscle and bone. Deficiencies can cause anemia like Symptoms: neutropenia, bone abnormalities, hypterthyroidism; and abnormalities in blood glucose and cholesterol levels.
Iron Iron is utilized in many ways in the body, i.e., the heme proteins: hemoglobin (blood) myoglobin (muscle) and cytochrome P450 (large and diverse family of enzymes involved in drgu metabolism, oxidation, and involved in almost 75% of metabolic reactions.)Deplete iron results in iron based anemia, interference with vital functions, morbidity and death.
Magnesium Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Pyridoxine (B6) Inhibition of pyridoxine activity, possibly by forming an inactive complex with pyridoxal-5′-phosphate. Vitamin B6 is involved in nutrient metabolism; neurotransmitter & histamine production and hemoglobin production and DNA
Zinc Chelation of zinc which can increase urinary zinc excretion, but can also increase GI absorption of zinc. Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver; however the actions of both elimination and GI uptake may cancel each other out
CARDIOVASCULAR
     ANTIHYPERTENSIVES
Hydralazine (Apresoline) Pyridoxine (B6) Formation of an inactive complex with pyridoxal-5′-phosphate, and increased excretion. Vitamin B6 is involved in nutrient metabolism; neurotransmitter & histamine production and hemoglobin production and DNA
Captopril (Capoten) Zinc Binding of zinc, leading to increased urinary elimination. Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver;
     CARDIAC GLYCOSIDES
Digoxin (LanoxicapsLanoxin) Magnesium Reduced reabsorption of magnesium in the renal tube, leading to magnesium excretion. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
     CHOLESTEROL-REDUCING DRUGS
HMG CoA Reductase Inhibitors (“Statins”): Coenzyme Q10 Blocking of synthesis of mevalonic acid, which is a precursor of coenzyme Q10. CoQ10 is hugely important to every cell of the body as it is the limiting factor in making the fuel, ATP; thus deficiency can impact on every function in the body; it also plays a role as an anti-oxidant
Atorvastatin (Lipitor)
Fluvastatin (Lescol)
Lovastatin (Mevacor)
Pravastatin (Pravachol)
Rosuvastatin (Crestor)
Simvastatin (Zocor)
Bile Acid Sequestrants: Beta-Carotene Reduced absorption of fat and fat-soluble vitamins. Reduced plasma lipids may reduce the amount of beta carotene and vitamins A and E carried in the blood. Required for normal functioning in the brain and the nervous system; and most well known is that of vision (translation of light into vision); also involved in the skin processes; acts as an anti-oxidant. Deficiences thus include visual issues; also skin issues; and it effects the development of various fetal tissues
Cholestyramine (LoCHOLEST,PrevaliteQuestran) Vitamin A Vitamin A is required for a number of functions:growth & development; good vision (important for both low-light and colour vision); good immune system functioning; and acts as a hormone-like growth factor for epitheial cells (cells that line cavities and surfaces, i.e., gut, skin, lungs, etc in the body, and glands)
Colestipol (Colestid) Vitamin E Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
Vitamin K Required for blood coagulation
Folic Acid Reduced absorption. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
Iron Reduced absorption. Iron is utilized in many ways in the body, i.e., the heme proteins: hemoglobin (blood) myoglobin (muscle) and cytochrome P450 (large and diverse family of enzymes involved in drgu metabolism, oxidation, and involved in almost 75% of metabolic reactions.)Deplete iron results in iron based anemia, interference with vital functions, morbidity and death.
Vitamin B12 aka adenosylcobalamin aka Dibencozide Reduced absorption due to binding of intrinsic factor and vitamin B12-intrinsic factor complexes. Vitamin B12 is required for normal functioning in the brain and the nervous system
Calcium Reduced absorption of vitamin D, which in turn reduces calcium absorption. Required for heart function; for bone metabolism; healthy teeth; neurotransmitter release; muscle contraction;
Vitamin D Vitamin D is required for cholesterol; transport of calcium; cardiovascular action; bone health; prevention of cancer; immune health; healhy DNA
Magnesium Possibly reduced absorption and increased urinary magnesium excretion. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Phosphate Salts Cholestyramine can bind phosphate in the gut and reduce its absorption. see Magnesium, Potassium and Calcium
Colestipol can bind phosphate in the gut and reduce its absorption. see Magnesium, Potassium and Calcium
Gemfibrozil (Lopid) Vitamin E Mechanism unknown. Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
Loop Diuretics: Calcium Increased urinary excretion. Electrolyte disturbances more likely with higher doses. Hypokalemia and hypomagnesemia occur most commonly. May need to use potassium and/or magnesium supplements, or add a potassium-sparing diuretic (which will also spare magnesium).Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Bumetanide (BumexBurinex), Magnesium Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Ethacrynic acid (Edecrin), Potassium Potassium plays a key part in nerve transmission; depletion results in various cardiac functions; plays a key role in the water balance between cells; prevents muscle contraction.Deficiency symptoms may include: muscle weakness, ECG abnormalities, decreased reflex response; respiratory paralysis, and high alkalinity in the blood
Furosemide (Lasix), Folic Acid Possibly increased urinary excretion. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
Torsemide (Demadex) Pyridoxine Increased urinary excretion pyridoxine. IMajor issues for people with chronic renal failure increases urinary excretion of pyridoxine.Vitamin B6 is involved in nutrient metabolism; neurotransmitter & histamine production and hemoglobin production and DNA
Thiamine (B1) Increased thiamine excretion due to increased urinary flow. Vitamin B1 is required to make the fuel for every cell – ATP; required for neural functioning; and for the nervous system; optic neuropathy;
Vitamin C Increased urinary losses of vitamin C, probably due to increased water excretion. Vitamin C is involved in a number of roles:anit-oxidant; enzyme cofactor (helper molecule); production of collagens, neurotransmitters, natural anti-histamine
Thiazide and Thiazide Derivatives: Magnesium Increased urinary excretion. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Bendroflumethiazide (Naturetin), Potassium Potassium plays a key part in nerve transmission; depletion results in various cardiac functions; plays a key role in the water balance between cells; prevents muscle contraction.Deficiency symptoms may include: muscle weakness, ECG abnormalities, decreased reflex response; respiratory paralysis, and high alkalinity in the blood
Benzthiazide (Exna), Zinc Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver; deficiencies also comprimises white blood cells (immune system)
Chlorothiazide (Diuril), zinc Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver; deficiencies also comprimises white blood cells (immune system)
Chlorthalidone (Hygroton,Thalitone), zinc Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver; deficiencies also comprimises white blood cells (immune system)
Magnesium Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Potassium Potassium is required in brain & neuron function; preventing muscle contraction; deficiency can result in: vomiting, diarrhea, increased urination; muscle weakness, ECG abnormalities; decreased reflex response; respiratory and cardiac issues
Hydrochlorothiazide (Esidrix,HydrodiurilOretic), potassium Potassium is required in brain & neuron function; preventing muscle contraction; deficiency can result in: vomiting, diarrhea, increased urination; muscle weakness, ECG abnormalities; decreased reflex response; respiratory and cardiac issues
Magnesium Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
zinc Monitor for: thirst, lethargy, confusion, weakness, drowsiness, muscle cramps, scanty production of urine, abnormal heart rhythm, seizures, nausea and vomiting.
Iron Iron is utilized in many ways in the body, i.e., the heme proteins: hemoglobin (blood) myoglobin (muscle) and cytochrome P450 (large and diverse family of enzymes involved in drgu metabolism, oxidation, and involved in almost 75% of metabolic reactions.)Deplete iron results in iron based anemia, interference with vital functions, morbidity and death.
Hydroflumethiazide (Diucardin,Saluron), zinc Monitor for: thirst, lethargy, confusion, weakness, drowsiness, muscle cramps, scanty production of urine, abnormal heart rhythm, seizures, nausea and vomiting.
Sodium Sodium regulates blood volume, blood pressure; and water balance
Potassium Potassium is required in brain & neuron function; preventing muscle contraction; deficiency can result in: vomiting, diarrhea, increased urination; muscle weakness, ECG abnormalities; decreased reflex response; respiratory and cardiac issues
Indapamide (LozideLozol), Potassium Potassium is required in brain & neuron function; preventing muscle contraction; deficiency can result in: vomiting, diarrhea, increased urination; muscle weakness, ECG abnormalities; decreased reflex response; respiratory and cardiac issues
Methyclothiazide (Aquatensen,Enduron), Potassium Potassium is required in brain & neuron function; preventing muscle contraction; deficiency can result in: vomiting, diarrhea, increased urination; muscle weakness, ECG abnormalities; decreased reflex response; respiratory and cardiac issues
Metolazone (Mykrox,Zaroxolyn), Iron
Magnesium Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Potassium Potassium is required in brain & neuron function; preventing muscle contraction; deficiency can result in: vomiting, diarrhea, increased urination; muscle weakness, ECG abnormalities; decreased reflex response; respiratory and cardiac issues
Polythiazide (Renese), Magnesium Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Quinethazone (Hydromox), Folic Acid Possibly increased urinary excretion. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
Trichlormethiazide (Diurese,MetahydrinNaqua) Thiamine (B1) Increased thiamine excretion due to increased urinary flow. Vitamin B1 is required to make the fuel for every cell – ATP; required for neural functioning; and for the nervous system; optic neuropathy;
Triamterene (Dyrenium) Folic Acid Reduced absorption of folic acid and reduced conversion to the active form. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
CENTRAL NERVOUS SYSTEM
     ANTICONVULSANTS
Carbamazepine (AtretolEpitol,Tegretol) Biotin Competitive inhibition of absorption, increased breakdown, and decreased renal tubular reabsorption. Vitamin B7 is a coenzyme and is involved in the production of fatty acides, amino acids and glucogenesis required to produce the fuel for the cells, ATP.
Acetyl-L-Carnitine Possibly increased metabolism or decreased synthesis. It is a prodrug that releases pivalic acid and are known for depleting levels of carnitine which is required for: transport of fatty acids and as such plays a role in the krebs cycle and the production of the fuel ATP
L-Carnitine
Propionyl-L-Carnitine
Folic Acid Decreased intestinal absorption and induction of hepatic microsomal enzymes leading to increased folic acid metabolism. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
Calcium Increases the rate of vitamin D metabolism leading to decreased levels of various forms of vitamin D. Decreased vitamin D levels reduce calcium absorption. Required for heart function; for bone metabolism; healthy teeth; neurotransmitter release; muscle contraction;
Vitamin D Vitamin D is required for cholesterol; transport of calcium; cardiovascular action; bone health; prevention of cancer; immune health; healhy DNA
Vitamin K Induction of liver enzymes may increase vitamin K metabolism, producing a significant decrease in vitamin K levels in neonates, who haven’t built up stores of the vitamin. Required for blood coagulation.Increases risk of neonatal intracranial hemorrhage. Monitor for both mother and infant.
Vitamin E Children taking carbamazepine seem to have lower vitamin E levels compared to children not receiving carbamazepine. Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
Phenytoin (Dilantin), Biotin Competitive inhibition of absorption, increased breakdown, and decreased renal tubular reabsorption. Vitamin B7 is a coenzyme and is involved in the production of fatty acides, amino acids and glucogenesis required to produce the fuel for the cells, ATP.
Fosphenytoin (Cerebyx) Folic Acid Reduced absorption, increased metabolism, and increased demand for folate as a coenzyme for induced hepatic enzymes. Folic acid supplements may reduce phenytoin side effects, but can also reduce phenytoin serum levels and may independently worsen seizure control. Advise patients to consult a physician before starting folic acid supplements.
Acetyl-L-Carnitine Possibly increased metabolism or decreased synthesis. It is a prodrug that releases pivalic acid and are known for depleting levels of carnitine which is required for: transport of fatty acids and as such plays a role in the krebs cycle and the production of the fuel ATP
L-carnitine
Propionyl-L-Carnitine
Niacin/Niacinamide Mechanism unknown. Vitamin B3 is used to increase HDL cholesterol; is a neuroprotector and is involved in anti-inflammatory processes.Deficiency is associated with diarrhea, dermatitis and dementias; lesions in the lower neck; hyperpigmentation, thickening of the skin, inflammation of tongue and mouth, digestive issues, amnesia, delirium
Thiamine (B1) Mechanism unknown. Vitamin B1 is required to make the fuel for every cell – ATP; required for neural functioning; and for the nervous system; optic neuropathy;
Vitamin B12 aka adenosylcobalamin aka Dibencozide Reduces absorption of vitamin B12. This may exacerbate the megaloblastic anemia associated with phenytoin, which is primarily caused by folate deficiency. Encourage patients to maintain adequate dietary vitamin B12 intake. Monitor vitamin B12 and folate if symptoms of anemia develop.7843,10502-5
Vitamin B12 Vitamin B12 is required for normal functioning in the brain and the nervous system
Calcium Increases the rate of vitamin D metabolism leading to decreased levels of various forms of vitamin D. Phenytoin may also increase the renal excretion of vitamin D metabolites. Decreased vitamin D levels reduce calcium absorption. Required for heart function; for bone metabolism; healthy teeth; neurotransmitter release; muscle contraction;
Vitamin D Vitamin D is required for cholesterol; transport of calcium; cardiovascular action; bone health; prevention of cancer; immune health; healhy DNA
Vitamin E Children taking phenytoin seem to have lower vitamin E levels compared to children not receiving phenytoin. Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
Vitamin K Induction of liver enzymes may increase vitamin K metabolism, producing a significant decrease in vitamin K levels in neonates who haven’t built up stores of the vitamin. REquired for blood coagulation.Increased risk of neonatal intracranial hemorrhage. Monitor both pregnant mother and infant.
Zinc May chelate zinc and could reduce absorption. Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver;
Phenobarbital (Luminal,Solfoton) Biotin Competitive inhibition of absorption, increased breakdown, and decreased renal tubular reabsorption. Vitamin B7 is a coenzyme and is involved in the production of fatty acides, amino acids and glucogenesis required to produce the fuel for the cells, ATP.
Primidone (Mysoline) Folic Acid Reduced absorption, increased metabolism, and increased demand for folate as a coenzyme for induced hepatic enzymes. Reduced folic acid levels are associated with phenobarbital or primidone treatment & mayoccasionally lead to megaloblastic anemia, and may contribute to neurological side effects and mental changes. However, folic acid supplements can worsen seizure control. Advise patients to consult a physician before starting folic acid supplements.4427,4530,4536,9333,9354-9
Dibecozide Reduced absorption Encourage patients to maintain adequate dietary vitamin B12 intake. Monitor vitamin B12 status if symptoms of anemia develop.7843,10502-5
Vitamin B12 Vitamin B12 is required for normal functioning in the brain and the nervous system
Acetyl-L-Carnitine Possibly increased metabolism or decreased synthesis. It is a prodrug that releases pivalic acid and are known for depleting levels of carnitine which is required for: transport of fatty acids and as such plays a role in the krebs cycle and the production of the fuel ATP
L-Carnitine
Propionyl-L-Carnitine
Vitamin E Children taking phenobarbital seem to have lower vitamin E levels compared to children not receiving phenobarbital. Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
Calcium Increased rate of vitamin D metabolism leading to decreased levels of various forms of vitamin D and reduced calcium absorption. Required for heart function; for bone metabolism; healthy teeth; neurotransmitter release; muscle contraction;
Vitamin D Vitamin D is required for cholesterol; transport of calcium; cardiovascular action; bone health; prevention of cancer; immune health; healhy DNA
Vitamin K Induction of liver enzymes may increase vitamin K metabolism, producing a significant decrease in vitamin K levels in neonates, who haven’t built up stores of the vitamin. Required for blood coagulation .Increased risk of neonatal intracranial hemorrhage. Monitor both pregnant mother and infant.
Valproic Acid (Depakene,Depakote) Folic Acid Mechanism unknown. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
Acetyl-L-Carnitine Possibly increased metabolism or decreased synthesis. It is a prodrug that releases pivalic acid and are known for depleting levels of carnitine which is required for: transport of fatty acids and as such plays a role in the krebs cycle and the production of the fuel ATP
L-Carnitine
Propionyl-L-Carnitine
Niacin and Niacinamide Mechanism unknown. Vitamin B3 is used to increase HDL cholesterol; is a neuroprotector and is involved in anti-inflammatory processes.Deficiency is associated with diarrhea, dermatitis and dementias; lesions in the lower neck; hyperpigmentation, thickening of the skin, inflammation of tongue and mouth, digestive issues, amnesia, delirium
Zinc May bind with zinc, possibly reducing serum and tissue levels. Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver;
     Dopamine agonists
Levodopa (L-DOPALarodopa,Dopar) Potassium Increased urinary potassium losses occur in some people treated with levodopa. The mechanism isn’t clear, but the effect doesn’t occur when a peripheral decarboxylase inhibitor, such as carbidopa, is used with levodopa (as inSinemet). Potassium plays a key part in nerve transmission; depletion results in various cardiac functions; plays a key role in the water balance between cells; prevents muscle contraction.Deficiency symptoms may include: muscle weakness, ECG abnormalities, decreased reflex response; respiratory paralysis, and high alkalinity in the blood
Levodopa / Cabidopa (Sinemet) Niacin and Niacinamide Carbidopa may reduce conversion of tryptophan to niacin. Vitamin B3 is used to increase HDL cholesterol; is a neuroprotector and is involved in anti-inflammatory processes.Deficiency is associated with diarrhea, dermatitis and dementias; lesions in the lower neck; hyperpigmentation, thickening of the skin, inflammation of tongue and mouth, digestive issues, amnesia, delirium
Chlorpromazine (Thorazine) Riboflavin (B2) Interference with conversion to active form, and increased renal excretion. Vitamin B2 is required to make the fuel for every cell – ATP; cracked and red lips; inflammation of the lining of the mouth and tongue; mouth ulcers; sore throat; dry and scaling skin; itchy and watery eyes; irone deficiency anemia
Gastrointestinals
     Antacids
Aluminum Salts (Amphojel,AlternajelBasaljel, etc), Magnesium Salts (Mag-OxMilk of Magnesia, etc), Calcium Aluminum salts bind phosphate in the gastrointestinal tract. This reduces phosphate levels, which induces movement of calcium from bones into the blood, increasing urinary calcium excretion. see Magnesium, Potassium and Calcium
Phosphate Salts High serum magnesium levels can increase urinary calcium excretion. see Magnesium, Potassium and Calcium
Chromium Antacids may reduce chromium absorption from the gastrointestinal tract. Chromium required blood glucose & fat metabolism
Folic Acid Increased intestinal pH produced by antacids may reduce folic acid absorption. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
Iron Iron is utilized in many ways in the body, i.e., the heme proteins: hemoglobin (blood) myoglobin (muscle) and cytochrome P450 (large and diverse family of enzymes involved in drgu metabolism, oxidation, and involved in almost 75% of metabolic reactions.)Deplete iron results in iron based anemia, interference with vital functions, morbidity and death. Iron is utilized in many ways in the body, i.e., the heme proteins: hemoglobin (blood) myoglobin (muscle) and cytochrome P450 (large and diverse family of enzymes involved in drgu metabolism, oxidation, and involved in almost 75% of metabolic reactions.)Deplete iron results in iron based anemia, interference with vital functions, morbidity and death.
     GI ANTI-INFLAMMATORIES
Sulfasalazine (Azulfidine,Salazopyrin) Folic Acid Competitive inhibition of folate absorption, and interference with breakdown of dietary folate to its absrobable form. Hemolysis caused by sulfasalazine can increase folate requirements for red blood cell formation. Decreased folate levels are associated with prolonged sulfasalazine therapy, especially in doses above 2 grams/day. This may lead to megaloblastic anemia, hyperhomocysteinemia, and an increased risk of colon cancer in people with ulcerative colitis. Recommend that patients increase their dietary folate intake if possible, or take a supplement, especially if they have other risk factors for folate deficiency.
     HISTAMINE-2 BLOCKERS
H-2 Blockers: Calcium Absorption of some calcium supplements, especially the carbonate salt, is decreased by increased gastric pH. Required for heart function; for bone metabolism; healthy teeth; neurotransmitter release; muscle contraction;
Cimetidine (Tagamet), Chromium Increased pH may cause formation of less soluble chromium salts, reducing absorption. Chromium required blood glucose & fat metabolism
Famotidine (Pepcid), Folic Acid Reduced absorption due to increased pH. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
Nizatidine (Axid), Iron Iron is utilized in many ways in the body, i.e., the heme proteins: hemoglobin (blood) myoglobin (muscle) and cytochrome P450 (large and diverse family of enzymes involved in drgu metabolism, oxidation, and involved in almost 75% of metabolic reactions.)Deplete iron results in iron based anemia, interference with vital functions, morbidity and death. Iron is utilized in many ways in the body, i.e., the heme proteins: hemoglobin (blood) myoglobin (muscle) and cytochrome P450 (large and diverse family of enzymes involved in drgu metabolism, oxidation, and involved in almost 75% of metabolic reactions.)Deplete iron results in iron based anemia, interference with vital functions, morbidity and death.
Ranitidine (Zantac) Vitamin B12 aka adenosylcobalamin aka Dibencozide Decreased gastric acid reduces cleavage of protein-bound dietary vitamin B12, reducing the amount available for absorption. Vitamin B12 is required for normal functioning in the brain and the nervous systemVitamin B12 is required for normal functioning in the brain and the nervous system
Zinc Inhibition of gastric acid secretion might reduce absorption of zinc. Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver;
     LAXATIVES
Mineral Oil Beta-Carotene Decreases gastrointestinal absorption. Occassional use of mineral oil is unlikely to cause deficiency. Advise patients to avoid large doses or regular use of mineral oil.4454,4495-6
Calcium Required for heart function; for bone metabolism; healthy teeth; neurotransmitter release; muscle contraction;
Vitamin A Vitamin A is required for a number of functions:growth & development; good vision (important for both low-light and colour vision); good immune system functioning; and acts as a hormone-like growth factor for epitheial cells (cells that line cavities and surfaces, i.e., gut, skin, lungs, etc in the body, and glands)
Vitamin D Vitamin D is required for cholesterol; transport of calcium; cardiovascular action; bone health; prevention of cancer; immune health; healhy DNA
Vitamin E Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
Vitamin K Required for blood coagulation
Phosphate Salts Mineral oil reduces absorption of vitamin D, which acts to increase phosphate absorption in the gastrointestinal tract and reabsorption in the kidney tubules. see Magnesium, Potassium and Calcium
Sodium Phosphates Magnesium Increased loss of electrolytes from gastrointestinal tract. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
(Fleet Phospho-Soda) Potassium Potassium plays a key part in nerve transmission; depletion results in various cardiac functions; plays a key role in the water balance between cells; prevents muscle contraction.Deficiency symptoms may include: muscle weakness, ECG abnormalities, decreased reflex response; respiratory paralysis, and high alkalinity in the blood
Stimulant Laxatives: Senna (SenexonSenolaxSenokot,Senna-GenSenokotxtra,Black-DraughtGentlaxDr. Caldwell SennaFletcher’s CastoriaDosalax), Potassium Increases gastrointestinal losses. Excessive use of stimulant laxatives may result in hypokalemia. Limit to short-term use of recommended doses. Hypokalemia has been reported in patients undergoing short-term bowel-cleansing regimens. Use with caution in patients who have other risk factors for hypokalemia.4411-2,4425
Bisacodyl Tablets (Bisacodyl,UnisertsBisco-LaxCorrectol,DulcagenDulcolaxFeen-a-mintFleet Laxative) Calcium Decreases gastrointestinal absorption. Required for heart function; for bone metabolism; healthy teeth; neurotransmitter release; muscle contraction;
Vitamin D Vitamin D is required for cholesterol; transport of calcium; cardiovascular action; bone health; prevention of cancer; immune health; healhy DNA
     PANCREATIC ENZYMES
Pancreatin (Donnazyme,Pancrezyme) Folic Acid Reduced absorption due to formation of complexes in the gastrointestinal tract. Supplements may be needed with prolonged pancreatic enzyme therapy. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
Pancrelipase (CotazymCreon,PancreaseUltraseViokase) Iron
     PROTON PUMP INHIBITORS
Proton Pump Inhibitors: Lansoprazole (Prevacid), Omeprazole (LosecPrilosec), Rabeprazole (Aciphex), Pantoprazole (Pantoloc,Protonix) Beta-Carotene Increased gastric pH may decrease absorption of beta carotene. Required for normal functioning in the brain and the nervous system; and most well known is that of vision (translation of light into vision); also involved in the skin processes; acts as an anti-oxidant. Deficiences thus include visual issues; also skin issues; and it effects the development of various fetal tissues
Calcium Absorption of some calcium supplements, especially the carbonate salt, is decreased by increased gastric pH. Required for heart function; for bone metabolism; healthy teeth; neurotransmitter release; muscle contraction;
Chromium Increased pH may cause formation of less soluble chromium salts, reducing absorption. Chromium required blood glucose & fat metabolism
Folic Acid Increased pH could reduce folate absorption. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
Iron Reduced iron absorption from the gastrointestinal tract due to lack of acid. Iron is utilized in many ways in the body, i.e., the heme proteins: hemoglobin (blood) myoglobin (muscle) and cytochrome P450 (large and diverse family of enzymes involved in drgu metabolism, oxidation, and involved in almost 75% of metabolic reactions.)Deplete iron results in iron based anemia, interference with vital functions, morbidity and death.
Vitamin B12 aka adenosylcobalamin aka Dibencozide Decreased gastric acid reduces cleavage of protein-bound dietary vitamin B12, reducing the amount available for absorption. Vitamin B12 is required for normal functioning in the brain and the nervous system
Vitamin C Preliminary data suggests omeprazole reduces vitamin C levels, possibly due to increased destruction of vitamin C at higher gastric pH levels. Vitamin C is involved in a number of roles:anit-oxidant; enzyme cofactor (helper molecule); production of collagens, neurotransmitters, natural anti-histamine
Zinc Each 40 mg vial of pantoprazole IV contains 1 mg EDTA which can chelate zinc. Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver;
Inhibition of gastric acid secretion might reduce absorption of zinc.
     MISCELLANEOUS
Sucralfate Phosphate Salts Sucralfate has phosphate binding properties and reduces phosphate absorption. see Magnesium, Potassium, Phosphate salts
HORMONES
Corticosteroids [Glucocorticoids]: Calcium Increased renal calcium excretion and decreased intestinal calcium absorption. This depletion of calcium creates a greater need for vitamin D, to improve calcium absorption. Required for heart function; for bone metabolism; healthy teeth; neurotransmitter release; muscle contraction;
Short-acting Vitamin D Vitamin D is required for cholesterol; transport of calcium; cardiovascular action; bone health; prevention of cancer; immune health; healhy DNA
Cortisone (Cortone), Hydrocortisone [Cortisol] (CortefHydrocortone Chromium Increases renal excretion of chromium. Chromium required blood glucose & fat metabolism
Intermediate-acting Folic Acid Patients with multiple sclerosis treated with methylprednisolone seem to have decreased serum folate levels. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
Prednisone (Deltasone,MeticortenOrasonePanasol-S), Prednisolone (Delta-Cortef,PrelonePediapred), Triamcinolone (Aristocort,AtoloneKenacort), Methylprednisolone (Medrol Magnesium Drug-induced bone loss releases magnesium from bone and increases urinary excretion. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Long-acting Potassium Corticosteroids cause sodium retention, resulting in compensatory renal potassium excretion. Potassium plays a key part in nerve transmission; depletion results in various cardiac functions; plays a key role in the water balance between cells; prevents muscle contraction.Deficiency symptoms may include: muscle weakness, ECG abnormalities, decreased reflex response; respiratory paralysis, and high alkalinity in the blood
Dexamethasone (Decadron,DexamethDexone), Betamethasone (Celestone) Strontium Might increase urinary excretion of strontium. The clinical significance of this is not known.11405
Zinc Shift of zinc from the blood into the tissues and possibly increased loss in the urine. Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver;
Estrogens: Folic Acid Possibly reduced absorption, increased excretion, increased protein binding and induction of liver enzymes which use folate. Folic acid is synthesized by intestinal microflora which are destoyed by the anti-biotics. Prolonged high-doses of trimethoprim may cause megaloblastic anemia (caused by inhibition of the DNA synthesis in red blood production)
(AloraCenestinClimara,EstinylEstraceEstraderm,EstratabFemPatchMenest,OgenPremarinPremphase,PremproVivelle Magnesium Shift from plasma to tissues. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Pyridoxine (B6) Interference with pyridoxine metabolism. Vitamin B6 is involved in nutrient metabolism; neurotransmitter & histamine production and hemoglobin production and DNA
Estrogen-containing Oral Contraceptives Riboflavin (B2) Possibly reduced absorption or interference with conversion to active form. Vitamin B2 is required to make the fuel for every cell – ATP; cracked and red lips; inflammation of the lining of the mouth and tongue; mouth ulcers; sore throat; dry and scaling skin; itchy and watery eyes; irone deficiency anemia
Thiamine (B1) Small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase, suggesting mild thiamine deficiency. Vitamin B1 is required to make the fuel for every cell – ATP; required for neural functioning; and for the nervous system; optic neuropathy;
Vitamin A Estrogens stimulate production of retinol binding protein, increasing the amount of vitamin A removed from liver storage and carried in blood. Vitamin A is required for a number of functions:growth & development; good vision (important for both low-light and colour vision); good immune system functioning; and acts as a hormone-like growth factor for epitheial cells (cells that line cavities and surfaces, i.e., gut, skin, lungs, etc in the body, and glands)
Vitamin B12 aka adenosylcobalamin aka Dibencozide Reduced protein binding, leading to increased tissue uptake. Vitamin B12 is required for normal functioning in the brain and the nervous system
Vitamin C May reduce absorption, increase breakdown, or increase vitamin C requirements to prevent oxidation of estrogens. Vitamin C is involved in a number of roles:anit-oxidant; enzyme cofactor (helper molecule); production of collagens, neurotransmitters, natural anti-histamine
Zinc Decreases in serum albumin may reduce the amount of zinc carried in the blood. There may also be increased use and uptake of zinc by the tissues due to anabolic effects. Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver;
Thyroid hormones: Calcium Increased bone turnover may lead to increased urinary calcium losses. Required for heart function; for bone metabolism; healthy teeth; neurotransmitter release; muscle contraction;
Levothyroxine (Levothroid,LevoxylSynthroidThyro-Tabs,Unithroid
Thyroid desiccated (Armour Thyroid
Liothyronine sodium (Cytomel)
Teriparatide (Forteo) Phosphate Salts Teriparatide increases urinary phosphate excretion and decreases serum phosphate similarly to human parathyroid hormone. see Magnesium, Potassium, Calcium
RESPIRATORY
Beta-2-Agonists: Magnesium Intracellular shift of magnesium and potassium. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc. May contribute to arrhythmias, especially at high doses and in people with other risk factors. Monitor electrolyte levels during acute use of high doses (e.g., in preterm labor or acute asthma attacks), and in people with other risk factors.
Albuterol (salbutamol, Proventil,Ventolin), Bitolterol (Tornalate), Isoetharine, Levalbuterol (Xopenex), Metaproterenol (Alupent), Pirbuterol (Maxair), Salmeterol (Serevent), Terbutaline (Brethine) Potassium Potassium plays a key part in nerve transmission; depletion results in various cardiac functions; plays a key role in the water balance between cells; prevents muscle contraction.Deficiency symptoms may include: muscle weakness, ECG abnormalities, decreased reflex response; respiratory paralysis, and high alkalinity in the blood
Methylxanthines Potassium Possibly increased intracellular uptake. Potassium plays a key part in nerve transmission; depletion results in various cardiac functions; plays a key role in the water balance between cells; prevents muscle contraction.Deficiency symptoms may include: muscle weakness, ECG abnormalities, decreased reflex response; respiratory paralysis, and high alkalinity in the blood
Theophylline (SlobidTheo-24,Theo-DurTheolair
Aminophylline
Oxtriphylline (Choledyl SA
Diphylline (Lufyllin) Pyridoxine (B6) Inhibits conversion of pyridoxine to its active form. Vitamin B6 is involved in nutrient metabolism; neurotransmitter & histamine production and hemoglobin production and DNA
MISCELLANEOUS
Alcohol Glutathione Alcohol depletes endogenous glutathione. Glutathione is the Master Anti-oxidant; major chelator; required for both red and white cell development; regulates hormones; regulates Nitric Oxide; transports amino acids; protects the mitochondria; etcNote:Glutathione supplements cannot be absorbed at a cellular level.Protandim will turn on the mRNA tools to make glutathione and other supplements provide the nutrients required by the cell to produce glutathione and/or the glutathione complex
Cobalt Irradiation Vitamin B12 aka adenosylcobalamin aka Dibencozide Irradiation of the small bowel can decrease absorption of vitamin B12. Vitamin B12 is required for normal functioning in the brain and the nervous system
Cyclosporine (Neoral,Sandimmune) Magnesium Significant loss of magnesium in the urine, probably due to reduced tubular reabsorption and tubular damage. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc. Hypomagnesemia may contribute to seizures and neurotoxicity. Monitor serum magnesium levels closely.
Deferoxamine (Desferal) Zinc Dose-dependent increase in urinary zinc elimination. Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver;
Disulfiram (Antabuse) Zinc A metabolite of disulfiram chelates zinc, altering zinc absorption. Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver;
EDTA Zinc Chelation of metal ions, including zinc, leading to increased urinary excretion. Zinc is found in 100 enzymes; regulates cell apoptosis (cell death); important to the DNA & RNA; most zinc is found in the brain (regulates neural excitability), muscle, bones, kidney and liver;
Isotretinoin (AccutaneClaravis,Accutane RocheIsotrex) Acetyl-L-carnitine Not known. It is a prodrug that releases pivalic acid and are known for depleting levels of carnitine which is required for: transport of fatty acids and as such plays a role in the krebs cycle and the production of the fuel ATP
L-carnitine
Proprionyl-L-carnitine
Lanthanum Carbonate Phosphate Salts Lanthanum carbonate binds phosphate in the gut and reduce is absorption. see Magnesium, Potassium and Calcium
Nitrous oxide (N2O) Vitamin B12 aka adenosylcobalamin aka Dibencozide Inactivates the cobalamin form of vitamin B12. Nitric Oxide is important for vasodilation and thus blood pressure’. Deficiency symptoms may occur after a single dose of nitrous oxide in people with pre-existing, subclinical deficiency. Check vitamin B12 levels before using NO anesthesia in people with risk factors for vitamin B12 deficiency.
Orlistat (Xenical) Beta-Carotene Decreased absorption of fat soluble vitamins from the gastrointestinal tract. Required for normal functioning in the brain and the nervous system; and most well known is that of vision (translation of light into vision); also involved in the skin processes; acts as an anti-oxidant. Deficiences thus include visual issues; also skin issues; and it effects the development of various fetal tissues
Vitamin A Vitamin A is required for a number of functions:growth & development; good vision (important for both low-light and colour vision); good immune system functioning; and acts as a hormone-like growth factor for epitheial cells (cells that line cavities and surfaces, i.e., gut, skin, lungs, etc in the body, and glands)
Vitamin D Vitamin D is required for cholesterol; transport of calcium; cardiovascular action; bone health; prevention of cancer; immune health; healhy DNA
Vitamin E Vitamin E has many biological functions: anti-oxidant; enzyme activity(smooth muscle growth) ; DNA expression; neurological functions; cell signaling; inhibits platelet aggregation (clotting); prevents oxidation of lipids/fats/cholesterol;
Vitamin K Required for blood coagulation
Sevelamer Phosphate Salts Sevelamer binds phosphate in the gut by an ion exchange mechanism. see Magnesium, Potassium and Calcium
Sunscreens Vitamin D Frequent and extensive application of sunscreens can reduce vitamin D synthesis in the skin and plasma levels. Vitamin D is required for cholesterol; transport of calcium; cardiovascular action; bone health; prevention of cancer; immune health; healhy DNA
Tacrolimus (FK506, Prograf) Magnesium Reduced renal tubular reabsorption leads to increased excretion of magnesium. Hypomagnesemia occurs in a significant proportion of patients. Magnesium is required for over 380 different standard processes in every cell of the body.If magnesium is depleted than functions throughout the body can go down.Issues go from depression to renal/kidney dysfunction to energy production; to neurotransmitter production; sleep issues; etc
Footnote: Oral L-carnitine supplementation is strongly suggested for the following groups: patients with certain secondary carnitine deficiency syndromes; symptomatic VPA-associated hyperammonemia; multiple risk factors for VPA-associated hepatotoxicity; infants and young children taking VPA. An oral L-carnitine dosage of 100 mg/kg/day, up to a maximum of 2 g/day has been recommended.

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