Dietary Herbal Supplements for Nutritional Medicine Remedies

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Drug Nutrient Interactions

Americans spend millions of dollars on thousands of different prescription and non prescription (also called over the counter or OTC) drugs every year. The long term use of many of these medications can have serious nutritional consequences.

How can medications affect my nutritional status?

Medications can affect nutritional status in four ways:

Medications can increase or decrease appetite, which reduces vitamin and mineral intake or results in overconsumption of nutrient poor foods. Some medications produce side effects, such as nausea, heartburn, or an altered sense of taste, that affects appetite.

Medications can interfere with the absorption of nutrients, resulting in marginal vitamin and mineral deficiencies even when dietary intake is adequate. For example, some antibiotics reduce the absorption of vitamin B12, calcium, and iron. Other antibiotics reduce the production of normal bacteria in the digestive tract, which produce essential vitamins, such as vitamin K or biotin: consequently, this source of the vitamin is no longer available.

Medications can alter how the body uses or transports a nutrient or can entirely block the body's use of a vitamin or mineral. For example, oral contraceptives alter how the body uses vitamin B6.

Many medications increase vitamin and mineral excretion so nutrients are drained from the body faster than they are replaced. Diuretics, laxatives, and cathartics are examples of medications that increase the excretion of certain nutrients.

If I eat well, should I still worry about drug nutrient interactions?

Medication use might or might not affect a person, depending on several factors:

A person who is well nourished, with adequate amounts of vitamins and minerals stored in the body, and who has consumed a nutritious diet prior to and during illness probably is at low risk for developing a vitamin or mineral deficiency as a result of medication use.

For a person having no problems with digestion and absorption of food who must take a prescription or OTC drug for a short time, nutrient deficiencies are unlikely.

However progressive nutrient depletion is likely if dietary intake has been sub optimal, vitamin and mineral stores are low prior illness, or medication use is extended.

Who is most likely to be affected by a drug nutrient interaction?

Everyone should consume optimal amounts of all vitamins and minerals when taking perscription or OTC medications. However, some people are more susceptible to drug induced deficiencies.

Seniors are the greatest users of medications and are most likely to take those medications for extended periods of times. They also are most likely to use antacids, pain killers, cholesterol lowering medications, and high blood pressure medications, all of which alter vitamin and mineral status.

People who drink alcohol are at risk for vitamin or mineral deficiencies. Alcohol alters food and nutrient intake, reduces vitamin and mineral absorption, increases nutrient excretion, and affects how the body stores and uses many nutrients.

People with long term illness, such as heart disease, emotional problems, or arthritis, are likely to develop medication induced vitamin or mineral deficiencies. The dosage consumed also contributes to the potenial for nutrient deficiencies. High dose medication taken long term is more likely to cause vitamin and mineral deficiencies than a low dose taken for a short term.

People with increased nutrient needs or reduced food intake also are at risk for drug induced nutrient deficiencies. The added burden medication places on nutritional status can result in vitamin and mineral deficiencies.

What are the long term consequences of drug nutrient interactions?

Medication use can interfere with optimal nutritional status, which in turn can alter the course of disease, impede recovery, or increase the person's susceptibility to other disorders. Drug induced nutrient deficiencies develop gradually and often progress undectected until overt, and sometimes irreversible problemsdevelop.

How can i prevent a drug nutrient deficiency?

The best prevention is to consume a vitamin and mineral ruch diet that includes at least 5 to 9 servings of fresh fruits and vegetables, 6 to 11 servings of whole grains, 3 servings of low fat milk products, and servings of protein rich, extra lean meat, chicken, fish, or cooked dried beans and peas.

On those days when a person cannot follow these guildlines, a well balanced multiple vitamin and mineral supplement can fill in the nutritional gaps.

In addition, check the accompanying chart for specific vitamins and minerals affected by the most commonly prescribed medications.

Drug Nutrient Interaction Chart

The following categories of drugs and medications can affect one or more nutrients, either by reducing absorption, increasing excretion, or interfering with how the body uses the nutrient.

Medication/Drug Used

Nutrients Affected

Alcohol Vitamins A, D, E, K B1, B6, B12, C, Beta Carotene, Folic Acid, Calcium, Iron, Magnesium, Potassium, Selenium
Antacids such as magnesium or aluminum Vitamins B12, Folic Acid, Calcium, Copper
Iron, Magnesium, Phosphorus, Zinc
Sodium Bicarbonate
Folic Acid, Calcium, Iron
Antibiotics, such as tetracycline Vitamins B6, B12, Calcium, Magnesium, Zinc
Tuberculosis drugs
Vitamins D, E, B6, Niacin, Calcium
Vitamins A, K, B12, Calcium, Magnesium, Sodium, Iron, Potassium
Bactrim, Septra
Folic Acid
Anti Convulsants, such as phenobarbital Vitamin D, Folic Acid, Calcium
Phenytoin (Dilantin)
Vitamins D, B12, Folic Acid, Calcium
Anti Depressants, such as Elavil and Tofranil Vitamin B2
Anti epileptics, such as Dilantin Vitamin D, Vitamin B12
Anti-inflammatories, such as corticosteroids Vitamin D, Calcium, Potassium, Selenium, Zinc
Gout Medications
Vitamin B12, Beta Carotene, Potassium
Folic Acid
Vitamin C, Folic Acid, Amino Acids, Iron
Ibuprofen, naproxen
Folic Acid
Vitamin C, Folic Acid, Iron
Cholesterol lowering medications Vitamin A, D, E, K, B12
Bile Sequestrants, such as Questran or Colestipol
Beta Carotene, Folic Acid, Iron
Diuretics, such as hydralazine Vitamin B6
Loop Diuretics
Vitamin B6, Calcium, Magnesium, Potassium
Magnesium, Potassium, Sodium, Zinc
Folic Acid, Calcium
Diabetic medications, such as biguanides Vitamin B12
Female Hormones, such as Premarin or Estrace Vitamin B6, Folic Acid
Laxatives, such as mineral oil Vitamins A, D, E, K, Beta Carotene
Correctol, Exlax, Feen a Mint
Vitamin D, Calcium, Potassium
Oral Contraceptives Vitamin B6, B12, C, Folic Acid, Magnesium, Zinc
Tobacco Vitamins A, E, B6, C, Beta Carotene, Folic Acid, Zinc
Tranquilizers, such as thorazine Vitamin B12
Ulcers medications, such as H2 receptor antagonists Vitamins D, B12, Folic Acid, Iron, Zinc
Proton pump inhibitors
Vitamin B12
Axid, Pepcid, Tagamet, or Zantac
Vitamins D, B12, Folic Acid, Zinc
Other Medications
Vitamin K
Calcium, Magnesium
Vitamin B6
Copper, Zinc

Herbal Nutrient Interaction Chart

The following categories of herbs can affect one or more nutrients, perscription drugs, over the counter drugs, other herbs, and physical conditions. There are many ways herbs can affect the body. You should consult with a trained health professional before starting any herbal supplement.


May Interact With

Cascara Sagrada Bark Anti-arrhythmic drugs, thiazide diuretics, corticoadrenal steroids, licorice root
Cayenne Fruit Additional external heat
Devil's Claw Root Anti-Arrhythmic Drugs
Dong Quai Root Blood-thinning drugs
Echinacea Immuno-suppresive drugs
Eleuthero (Siberian Ginseng) Stimulants (including coffee), anti-psychotic drugs, hormone drugs
Evening Primrose Oil epileptogenic drugs (e.g. phenothiazines)
Garlic Cloves Anti-coagulant drugs (e.g. warfarin)
Ginger Rhizome Cardiac, anti-diabetic, or anti-coagulant therapy
Ginseng Root phenelzine
Goldenseal heparin
Gotu Kola hypoglycemic therapy, may increase serum-cholesterol concentrations
Kava Kava rhizome Alcohol, barbiturates, and psychopharmacological drugs
Licorice Root Thiazide diuretics (can lead to potassium loss, increasing sensitivity to digitalis glycosides)
St. John's Wort perscription antidepressants