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| Anticonvulsant Medications |
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| Barbiturates |
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| Depletions |
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| Calcium |
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Osteoporosis (bone loss) is the primary disease associated
with long-term calcium deficiency; it may be associated with
bone pain and spinal deformity. Depleted levels can also cause
muscle cramps, irregular heartbeat, and depression.
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| Vitamin
B12 (Cobalamin) |
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Symptoms of vitamin B12 deficiency are rare
because it takes years to develop complications associated with
long-term depletion of this nutrient. Irritability,
weakness, numbness, anemia, loss of appetite, headache,
personality changes, and confusion are some of the signs and
symptoms associated with vitamin B12 depletion. Low
levels of this vitamin may also be associated with an increased
risk of colon cancer, heart disease, brain disorders, and birth
defects.
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| Vitamin
B9 (Folic Acid) |
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Low levels of folic acid have been linked to anemia, heart
disease, and birth defects.
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| Vitamin D |
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Vitamin D deficiency leads to abnormal bone formation
(rickets) in children and softening of the bones (osteomalacia)
in adults. Vitamin D deficiency interferes with calcium
absorption, leading to deficiency of that nutrient with all of
the associated symptoms (such as increased risk of fractures,
osteoporosis (bone loss), and muscle weakness). Because this
nutrient is fat-soluble, prolonged periods of deficiency are
required to produce these symptoms.
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| Editorial Note |
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The selected depletions information presented here identifies
some of the nutrients that may be depleted by certain
medications. The signs and symptoms associated with nutrient
deficiency may also indicate conditions other than nutrient
deficiency. If you are experiencing any of the signs or symptoms
mentioned, it does not necessarily mean that you are nutrient
deficient. Nutrient depletion depends upon a number of factors,
including your medical history, diet, and lifestyle as well as
the length of time you have been taking the medication. Please
consult your healthcare provider; he or she can best assess and
address your individual healthcare needs, and determine if you
are at risk for nutrient depletions from these medications as
well as others not listed here.
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| Supporting Research |
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Ames BN. Micronutrient deficiencies: A major cause of DNA
damage. Ann NY Acad Sci. 2000;889:87-106.
Berger W. Incidence of severe side effects during therapy
with sulfonylureas and biguanides. Horm Metab Res Suppl.
1985;15:111-115.
Carpentier JL, Bury J, Luyckx A, Lefebvre P. Vitamin B12 and
folic acid serum levels in diabetics under various therapeutic
regimens. Diabetes Metab. 1976;2(4):187-190.
Cashman K, Flynn A. Optimal nutrition: calcium, magnesium and
phosphorus. Proc Nutr Soc. 1999;58:477-487.
Covington T, ed. Nonprescription Drug Therapy Guiding
Patient Self-Care. St Louis, MO: Facts and Comparisons;
1999:467-545.
Holick MF, Krane SM, Potts JT. Calcium, phosphorus, and bone
metabolism: calcium-regulating hormones. In: Fauci AS, Braunwald
E, Isselbacher KJ, et al, eds. Harrison's Principles of
Internal Medicine. 14th ed. New York: McGraw-Hill
Companies Health Professional Division; 1998:2221-2222.
National Research Council. Recommended Dietary Allowances.
10th ed. Washington, DC: National Academy Press;
1989.
Potts JT. Diseases of the parathyroid gland and other hyper-
and hypocalcemic disorders. In: Fauci AS,Braunwald E,
Isselbacher KJ, et al, eds. Harrison's Principles of Internal
Medicine. 14th ed. New York: McGraw-Hill
Companies Health Professional Division; 1998:2241.
Rao DS. Perspective on assessment of vitamin D nutrition. J
Clin Densitom. 1999:2(4):457-464.
Reynolds, EH. et al. Anti-convulsant therapy, megaloblastic
hematopoiesis, and folic acid metabolism. Q JMed.1966;35:521-537.
Roe, DA. Drug-Induced Nutritional Deficiencies. Second
Edition. Westport, CT, Avi Publishing, p. 37, 57, 1985.
Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D
concentrations, and safety. Am J Clin Nutr.
1999;69:842-856.
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| Review Date: October 2000 |
Reviewed By: All depletions
monographs have been reviewed by a team of experts including
Derrick M. DeSilva, Jr., MD, Raritan Bay Medical Center, Perth
Amboy, NJ; Jacqueline A. Hart, MD, Department of Internal
Medicine, Newton-Wellesley Hospital, Harvard University and
Senior Medical Editor, A.D.A.M., Inc., Boston, MA; John Hinze,
PharmD, NMD, Woodbine, IA; Ruth Marlin, MD, Medical Director and
Director of Medical Education, Preventive Medicine Research
Institute, Sausalito, CA; Brian T Sanderoff, PD, BS in Pharmacy,
Clinical Assistant Professor, University of Maryland School of
Pharmacy; President, Your Prescription for Health, Owings Mills,
MD; Leonard Wisneski, MD, FACP, George Washington University,
Rockville, MD; Ira Zunin, MD, MPH, MBA, President and Chairman,
Hawaii State Consortium for Integrative Medicine, Honolulu, HI.
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Copyright © 2004 A.D.A.M., Inc
The publisher does not accept any
responsibility for the accuracy of the information or the
consequences arising from the application, use, or misuse of any
of the information contained herein, including any injury and/or
damage to any person or property as a matter of product
liability, negligence, or otherwise. No warranty, expressed or
implied, is made in regard to the contents of this material. No
claims or endorsements are made for any drugs or compounds
currently marketed or in investigative use. This material is not
intended as a guide to self-medication. The reader is advised to
discuss the information provided here with a doctor, pharmacist,
nurse, or other authorized healthcare practitioner and to check
product information (including package inserts) regarding
dosage, precautions, warnings, interactions, and
contraindications before administering any drug, herb, or
supplement discussed herein.
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