If you think it is just a small fraction of people taking prescription drugs for a long-term health condition, brace yourself! Most of the U.S. population is on some form of prescription drugs. In fact, a 2019 survey from the American Center for Health Statistics reveals that nearly 46% of the U.S. population used some prescription drugs in just the last 30 days[1].

Talk to anyone who's been taking medications for a long time and they'll have plenty to say - not only about the life-saving benefits - but also the frustrating side effects. Symptoms often include constipation, hives, rash, general weakness or fatigue, nausea, to name a few. While many of these noticeable side effects may be attributed to starting a new medication, ongoing symptoms are often a result of a bigger, lesser-known side effect – Nutrient Deficiency. 

Can long-term prescription medication induce a deficiency in critical nutrients? 

Yes! If you are considering if nutrient deficiencies due to prescription drugs are likely, you're right. It is a lesser-known, and the least talked about the side effect of chronic medication use. Unless you are someone that reads medical literature for work, you might not have even heard of drug-induced nutrient deficiencies.

That's because people often tend to confuse drug-induced nutrient deficiencies with deficits that arise due to malnourishment or poor diet. While deficiencies of nutrients are common, they differ by the cause of the condition. 

What is Drug-Induced Nutrient Deficiency?

Drug-induced nutrient deficiency is a type of drug and nutrient interaction that results in potential interference in the physiology over time. You got that? Me neither. Let's break it down:

We take prescription drugs to solve a health problem. Over time, many of those drugs can create new health problems by decreasing the level of a crucial vitamin or mineral in our bodies.

The severity of nutrient deficiency depends on the duration of the medication and the dosage needed for treatment. Short-term use of drugs can cause mild effects, which can be reversed after the medication is stopped. However, long-term use of medication can result in significant issues due to your body's low level of a vitamin or mineral, such as:

· Impact the way your body absorbs nutrients

· Deplete body stores of a nutrient

· Inhibit the body's ability to make specific nutrients

So, if you are someone over the age of 45, the likelihood of taking medications is high.

Because Americans are prone to and suffer many various cardiovascular conditions, we're taking a deeper look at cardiovascular medications.

Common cardiovascular drugs, their impact, and how to prevent potential nutrient deficiency

Medications for lowering your blood pressure or cholesterol, reducing your chance of blood clots, and decreasing your risk of stroke or heart attack are critical to sustaining your life. While there are risks for nutrient deficiency, you can do something about it by understanding how the medication impacts your body and creating the right plan.

Statins

• Atorvastatin (Lipitor)
• Fluvastatin (Lescol)
• Pravastatin (Lipostat)
• Rosuvastatin (Crestor)
• Simvastatin (Zocor)

Statins are commonly prescribed to manage cholesterol. Potential side effects of long-term statin use include edema, muscle pain, diarrhea, constipation, bone conditions, joint pains, headache, upper respiratory tract infections, abdominal pain, and constipation. The primary nutrient deficiency associated with statin use is Coenzyme Q10 (CoQ10). Since the body cannot make its own, CoenzymeQ10 supplementation is crucial and highly. Some statin drugs could also lead to deficiencies in vitamin D, calcium, and potassium.

Cardiac glycosides

• Digoxin (Lanoxicaps, Lanoxin, Digibind)
• Digitoxin (Crystodigin)

These drugs are prescribed to prevent heart failure and irregular heartbeats. Cardiac glycosides result in deficiencies of calcium, magnesium, thiamine (Vitamin B1), and phosphate. Studies show that cardiac glycosides could deplete magnesium levels in heart muscles leading to magnesium deficiency [2].

Beta-blockers

• Atenolol (Tenormin)
• Bisoprolol (Cardicor, Emcor)
• Carvedilol.
• Metoprolol (Betaloc, Lopresor)
• Nebivolol (Nebilet)
• Propranolol (Inderal)

Beta-blockers are used to lower blood pressure, slow down the heartbeat, and widen the arteries and veins to facilitate blood flow. Long-term use of beta-blockers is found to lower CoenzymeQ10 levels. As noted above, the body cannot make its own CoenzymeQ10, so supplementation is highly recommended.

Thiazide diuretics

• Microzide (Hydrochlorothiazide or HCTZ)
• Thalizone (Chlorthalidone)
• Enduron (methyclothiazide)

These drugs are used to lower high blood pressure, congestive heart failure, and to prevent fluid accumulation typical in kidney problems. Being a diuretic works by increasing urine production, which could lower the levels of micro minerals like magnesium and potassium.

Anticoagulants (Blood thinners)

• Warfarin
• Rivaroxaban (Xarelto) 
• Dabigatran (Pradaxa) 
• Apixaban (Eliquis)
• Edoxaban (Lixiana)

Blood thinners are prescribed to prevent clot formation and lower the risk of angina, heart attack, and heart problems. Blood thinners like aspirin, coumadin, and heparin can cause internal bleeding and cause iron loss. Iron deficiency leads to anemia characterized by dizziness and fatigue.

Ways to reduce side effects through nutritional supplements

Don't let nutrient deficiencies be the price you pay for effective drug therapy. If you are prescribed a medication for long-term use, be sure to ask your healthcare provider about possible side effects concerning nutrient deficiencies. Lack of awareness and prolonged use of prescription drugs are the two major risk factors for drug-induced nutrient deficiencies. You can avoid risk and unnecessary complications that may arise due to nutrient deficits by choosing suitable supplements. Some key points to remember when taking nutritional supplements:

· Never take dietary supplements at the same time you take the prescription medication.

· Make your diet a part of the solution to prevent nutrient deficits.

· Keep track of your nutritional status by monitoring your blood work under your provider's supervision.

· Always read the literature that comes with your medication and educate yourself about the effects of its long-term use.

· Check with your doctor if you can switch your prescription to reduce the risk of deficits.

A nutrient deficiency may not have apparent symptoms yet; it could be robbing you of vital minerals and vitamins. Your medications are, no doubt lifesaving and should never be discontinued without consulting your doctor. The best approach is to talk to your doctor about your concerns about deficiency when taking cardiovascular drugs and get started on a high-quality supplement. Appropriate use of dietary supplements could prevent deterioration of health and may bolster faster recovery. Besides taking dietary supplements adopting healthy food and lifestyle choices is crucial to improving your heart and overall well-being. 

We at CAMFormulas and Local Health Pharmacy are here to help you navigate your whole health picture, from prescriptions to supplements, so you can have the peace of mind and enjoyable lifestyle that your best health provides. To schedule a free consultation with our Pharmacy team today, connect with us via chat on the CAMFormulas homepage and click the message button in the lower right corner.

References

[1]https://www.bloomberg.com/news/articles/2019-05-08/nearly-one-in-two-americans-takes-prescription-drugs-survey

[2]https://pubmed.ncbi.nlm.nih.gov/6482510/