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| Cholesterol-Lowering
Medications |
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| Bile Acid
Sequestrants |
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 | Cholestyramine
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 | Colestipol
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| Depletions |
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| Beta-Carotene |
|
|
This nutrient is converted to vitamin A by the body,
therefore, deficiency symptoms are the same as those of
vitamin A. The earliest symptom is night blindness.
Prolonged deficiency leads to more advanced changes in
eye tissue. Other potential signs of mild to moderate
deficiency include rough, dry skin, loss of appetite,
loss of hair luster, brittle nails, joint pain, and
possibly increased susceptibility to infection.
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| Fat |
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Deficiency may lead to depletion of fat-soluble
vitamins (A, D, E, and K), eczema, and other skin
disorders. In children, fat deficiency could cause
growth retardation. Long-term deficiency could be
associated with many chronic illnesses. Fats are stored
in the body as fatty acids. There are three essential
fatty acids that the body cannot make and, therefore,
must get from dietary sources or supplements.
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| Iron |
|
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Depleted levels of iron may lead to anemia and
weakened immune function. In the event of anemia,
symptoms include dizziness, fatigue, shortness of
breath, pale skin color, and possibly irregular
heartbeat.
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| Vitamin
A (Retinol) |
|
|
The earliest symptom of deficiency of this nutrient
is night blindness. Prolonged deficiency leads to more
advanced changes in eye tissue. Other potential signs of
mild to moderate deficiency include rough, dry skin,
loss of appetite, loss of hair luster, brittle nails,
joint pain, and possibly increased susceptibility to
infection.
|

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| Vitamin
B9 (Folic Acid) |
|
|
Low levels of folic acid have been linked to anemia,
heart disease, and birth defects.
|

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| Vitamin
B12 (Cobalamin) |
|
|
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
D |
|
|
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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| Vitamin
E |
|
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While deficiency of this nutrient is uncommon, it
negatively affects muscle tissue, red blood cells,
nervous, and reproductive systems. Over the long-term,
depleted levels of this nutrient may also be associated
with cancer, heart disease, and altered immune function.
|

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| Vitamin
K |
|
|
The major symptom of vitamin K deficiency is an
inability of the blood to clot properly, which may lead
to excessive bleeding and a tendency to bruise easily.
|

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| Editorial
Note |
|
|
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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|
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| Supporting
Research |
|
|
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.
Covington T, ed. Nonprescription Drug Therapy
Guiding Patient Self-Care. St. Louis, Mo: Facts and
Comparisons; 1999: 467-545.
Fauci A. ed. et. al. Harrison's Principles of
Internal Medicine. Fourteenth Edition. New York, Mc-Graw-Hill
Companies Health Professional Division, 1998.
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.
International Life Sciences Institute, Present
Knowledge in Nutrition. Seventh Edition. Washington,
DC, ILSI Press, 1996.
Kirschmann G. and Kirschmann J. Nutrition Almanac.
Fourth Edition. McGraw-Hill, 1996.
National Research Council, Recommended Dietary
Allowances. Tenth Edition. Washington, DC, National
Academy Press, 1989.
Rao DS. Perspective on assessment of vitamin D
nutrition. J Clin Densitom. 1999:2(4):457-464.
Roe DA. Drug Induced Nutritional Deficiencies.
Second Edition. Westport, CT, Avi Publishing, pp.
158-159, 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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