America is a nation of pill poppers. Mayo Clinic presented a study in 2013 that showed that nearly 7 out of 10 Americans take prescription drugs. More than half take two drugs. Senior citizens, 65 and older, take on average 14 or more prescription drugs per year. This creates a major concern with multiple prescriptions creating negative drug interactions.

Drugs can be life-saving in many circumstances. When they are required and managed well, they provide a purpose. Many times, however, drugs create insidious nutrient depletions, and rob the body of precious nutrients. The nutrient depletions induced by the drug often causes further loss of health. This is especially concerning for our senior citizens who take multiple medications. They are often handed a prescription to deal with the side effects of another prescription. Many times, the side effects are a result of the nutrients depleted from marginal nutritional health to begin with. Here are some things that you need to be aware.

Nutrient Depletions Caused by Top 10 Drugs in 2014

This is list of the top ten drugs in 2014 per number of prescriptions written.
1. Synthroid, 22.6 million
2. Crestor, 22.5 million
3. Nexium, 18.6 million
4. Ventolin HFA, 17.5 million
5. Advair Diskus, 15.0 million
6. Diovan, 11.4 million
7. Lantus Solostar, 10.1 million
8. Cymbalta, 10.0 million
9. Vyvanse, 10.0 million
10. Lyrica, 9.6 million

These top ten prescribed medications have the potential to create problematic nutritional challenges for the body. Here are the known nutrients stripped out and robbed from the body by these drugs.

1. Synthroid (Levothyroxine). This thyroid medication interferes with calcium causing it to be lost in the urine.

2. Crestor or statin drugs (HMG CoA Reductase Inhibitors). This type of cholesterol medication depletes coenzyme Q10 and interferes with vitamin K2 and selenium.

3. Nexium. This is the popular purple pill used to block stomach acid causing heart burn or GERD. Nexium, a proton pump inhibitor, is a monkey wrench in the digestive track because it blocks stomach acid production, which is vital to digestion of food.  Proton pump inhibitors like Nexium are famous for depleting vitamin B12, folic acid, calcium, magnesium, but it also depletes iron, zinc, chromium, beta carotene and vitamin C. Anyone on long term use of Nexium is at risk. Other examples of common proton pump inhibitors include Prevacid, Omeprazole, and Protonix.

4. Ventolin HFA. This is also known as albuterol, a respiratory medication. Other common brand names include ProAir HFA, Proventil, Ventolin, and Proventil HFA. Albuterol is a short-acting, beta-adrenergic bronchodilator drug used for relief and prevention of bronchospasm or asthma. It is also used to prevent exercise-induced bronchospasm/asthma. This medication depletes calcium, magnesium, potassium and phosphate.

5. Advair. This respiratory drug is a combination of two active ingredients – salmeterol and fluticasone. Salmeterol is a type of long acting inhaler used for preventing exercise-induced bronchospasm or asthma. It is a beta agonist or long-acting, beta-adrenergic bronchodilator. Fluticasone is a type of corticosteroid used to treat inflammation of the lungs and bronchioles.

Salmeterol is a longer acting agent than albuterol/Ventolin HFA, but the nutrients depleted are the same. Salmeterol depletes calcium, magnesium, phosphate, and potassium.

6. Diovan or Valsartan. This angiotensin receptor blocker (ARB) is used to treat high blood pressure and heart failure. It depletes magnesium, potassium, and zinc. 

7. Lantus Solostar. This is a long-acting form of insulin. Lack of magnesium and calcium may cause poor response to insulin. The adrenal hormone DHEA that balances cortisol is depleted with insulin. Yet, another delicate hormonal balance tugged at with drug stress.

8. Cymbalta. Scientists have not discovered any drug-nutrient losses yet with this anti-depressant SNRI. Other types and classes of anti-depressant medications are known to deplete coenzyme Q10, Vitamin B2, B6, and melatonin.

9. Vyvanse (lisdexamfetamin demesylate) is a stimulant medication used to treat ADHD. Scientists have not discovered any drug-nutrient losses yet at this time.

10. Lyrica (pregabalin) is an anti-seizure medication that has a number of other uses. At this time, scientists have not identified any nutrients depleted by Lyrica.

Other popular medications

Here are some additional commonly used drugs that do have considerable impact and rob nutrients from the body. This is not an exhaustive list of medications, but provides a list of several medications that may commonly be found in a medicine cabinet. The longer the drugs are used the worse the risk and concern.

Pain Medications/Analgesics:
Acetaminophen/Tylenol: depletes glutathione. Glutathione is the master antioxidant for the whole body, but is especially important for liver function and detoxification. Acetaminophen is the most common drug-induced cause of liver damage in the US. Given the common use of Tylenol, coupled with at least 80,000 chemicals in the environment and rise of autoimmune disorders, it makes one wonder about the detoxification challenges, glutathione depletion, autoimmune issues since Tylenol has been on the market.

Aspirin is not immune to nutrient depletion. Aspirin depletes folic acid, iron, and vitamin C.

NSAIDs or Non-steroidal anti-inflammatory drugs (ibuprofen, ketoprofen, indomethacin, Naproxen, etc): deplete iron and folic acid in part due to the digestive irritation caused by the drug. While NSAIDs are certainly popular, their effect on the body can be serious. Steroid medications, oral or inhaled (Advair, etc), deplete calcium, vitamin D, chromium, folic acid, magnesium, strontium, DHEA, and zinc.

Antibiotics:
Antibotics in general deplete: vitamins B1, B2, B3, B5, B6, B12, folate, biotin, and vitamin K.  There are different classes or types of antibiotics which exhaust other nutrients. Here are three common classes of antibiotics.

• Aminoglycosides (Gentamicin, Streptomycin, etc) deplete magnesium and potassium.

• Fluoroquinolones (Cipro, Levaquin, Norfloxacin, etc) deplete calcium, iron, magnesium, and potassium.

• Tetracycline drugs deplete calcium, iron, magnesium, zinc, and potassium.

Diabetic medications:
The long acting insulin medication was listed above, but how about non-insulin blood sugar medications such as Metformin. Metformin is a popular diabetic medication that robs the body of coenzyme Q10, folic acid, vitamin B1, B6, and B12. These are just some of the nutrients specifically needed to manage blood sugar function in the body. This again creates a vicious cycle of robbing and depletion of the body.

Anti-Gout/Rheumatic:
Methotrexate used for some autoimmune disorders and cancer treatments depletes folic acid. It also causes poor conversion of folic acid into the active form – folate. This makes the activated form of folate essential to consume in dark green leafy vegetables or in supplement form. Colchicine is another medication used for gout or rheumatic concerns. It robs the body of beta carotene and vitamin B12. Think about the elderly who are on meds that deplete B12 and folic acid.

Cardiac medications:
Cardiac medications provide a wealth of drugs robbing the body. Here are just some of them beside the Crestor/Statins listed above. Blood pressure meds such as hydralazine depletes vitamin B6. Catopril depletes zinc. Cardiac glycosides (digoxin) deplete magnesium. Cholesterol reducing meds like bile acid sequestrants (cholestestyramine, Questran, etc): deplete beta carotene, vitamin A, vitamin E, and vitamin K.

Water Pills/Diuretics
Loop diuretics (Lasix, etc) deplete calcium, magnesium, potassium, folic acid, vitamin B1, B6, and C. Thiazide and Thiazide derivatives deplete: magnesium, potassium, zinc, folic acid, vitamin B1. Often the physician will prescribe potassium along with these types of drugs, but what about the other nutrients stripped out of the body? Magnesium, potassium, and vitamin B1 naturally manage fluid activity in the body.

Common GI Meds:
GI medications are another category that silently strips the body of essential nutrients. The popular commercials certainly do not expose these harmful effects, and make them seem perfectly harmless to use long term. Acid blocking medications of different types, such as antacids, (magnesium salts or aluminum salts) deplete calcium, phosphorus, chromium, folic acid and iron. H-2 Blockers (Tagamet, Pepcid, Zantac, etc) deplete calcium, chromium, folic acid, vitamin B12, and zinc. Proton pump Inhibitors (Prevacid, Omeprazole, Protonix) deplete beta carotene, calcium, chromium, folic acid, iron, Vitamin B12 and C, and zinc.

At the other end of the digestive tract, we have laxatives and enemas often used by seniors as bowel motility and function breaks down. Laxatives such as Mineral Oil deplete beta carotene, calcium, vitamin A, D, E, and K, and phosphate salts. Stimulant Laxatives (Senokot, Correctol, Dulcolax, etc) deplete potassium, calcium, and vitamin D. This can be especially problematic for some with the colonoscopy preparation solutions and mineral loss.

Hormones:
Steroid hormones were discussed earlier with the top 10 prescription drugs, but we cannot forget about other hormone prescriptions especially estrogen containing drugs. Estrogens (Estrace, FemPatch, Premarin, Prempro, etc) and Birth Control Pills that contain estrogen deplete folic acid, magnesium, vitamin B1, B2, B6, B12, vitamin A, C, and zinc.

Central Nervous System Drugs:
The three drugs listed in the top ten did not have known drug-nutrient depletions. There are, however, plenty of medications used for brain and mental health that do have known nutrient depletions. Rarely are these discussed when handed a prescription drug. Tricyclic Antidepressants (amytriptyline, Pamelor, etc) deplete coenzyme Q10 and vitamin B2.

SSRIs (Prozac, Zoloft, etc) deplete iodine, and MAOs deplete vitamin B6. Each nutrient is essential for energy production and mood stability, the very thing that the drugs are prescribed for.

Anti-seizure meds have several concerns and provide immense concerns for those with mitochondrial disorders or methylation defects that contribute to or cause the seizure disorders. Carbamazepine (Tegretol, etc) depletes biotin, acetyl-l carnitine, folic acid, calcium, vitamin D, E, and K. Phenytoin (Dilantin, etc.) reduces biotin, folic acid, acetyl l carnitine, vitamin B1, B12, D, E, K, calcium, and zinc. Valproic Acid (Depakote, etc) depletes folic acid, acetyl-l-carnitine, vitamin B3, and zinc. Lastly, anxiety meds (Xanax, Valium, etc) diminishes melatonin.

Weight Loss Drugs:
Xenical depletes beta carotene, vitamins A, D, E, and K.

The point of the article and known research is that it is fundamental to replenish what the drugs steal from the body. The majority of these nutrients are vital for maintaining energy, cognitive skills, memory, bone health, immune integrity, antioxidant status and simply vitality. Certainly there is a time and a place for properly prescribed medications.

Taking a quality multiple vitamin, multiple mineral, vitamin D, and coenzyme Q10 can go a long ways to stop this slippery dangerous slide that too many are on. If you have to be on a medication, work with your medical provider to take the drug in the smallest dose possible for the least amount of time. Replenish the lost nutrients as best as you can, otherwise this can lead to "new problems" and a downturn in health. Get rid of the other nutrient robbers in your life, i.e. white flour, white sugar, processed foods, alcohol, etc. and restore nutrients with a diet filled with colorful, well-balanced foods. Don’t let your health be robbed even further. Life has enough challenges as it is.