As Naturopathic Doctors, we favour treating patients with dietary and lifestyle interventions first and turning to prescription drugs only when absolutely necessary. As powerful as diet and lifestyle are, though, there are cases in which drugs do play a role, or where they can serve as a powerful tool to transition to a healthier diet and lifestyle. In cases where pharmaceutical drugs are an appropriate option, I will do my best as a Naturopathic Doctor to educate my patients on the mechanisms by which their medications work, and what the implications are for micronutrient status. Far too many patients under the conventional medical approach are handed a prescription and sent on their way with no knowledge of how the drugs work and what the potential consequences and side-effects are.
One drug-nutrient interaction that is well recognized is the reduction in CoQ10 synthesis from statin drugs, such as the very commonly prescribed Lipitor.
This is but one class of drugs among a huge array of others. Antacids interfere with proper mineral absorption, which likely explains the noted association between use of proton pump inhibitors and increased risk for bone fracture. Because of impaired vitamin and mineral absorption, long-term antacid use has also been associated with increased risk for dementia. Among several other micronutrients, B12 is essential for healthy cognitive function, and antacids are known to impair B12 absorption. Metformin is another widely prescribed drug that may result in reduced B12 absorption, with deficiency even progressing to the point of potentially causing permanent neuropathy.
Another class of cholesterol-lowering medications, the bile acid sequestrants (e.g., cholestyramine, cholestipol), presents a different set of nutritional challenges. Owing to their role in increasing excretion and elimination of bile, these drugs reduce absorption of fat-soluble vitamins, that I collectively refer to by the pneumonic “ADEK”, which are vitamins A, D, E, and K, as well as beta-carotene and other fat-soluble nutrients.
Corticosteroids, which some patients might not be able to imagine life without, don’t just ameliorate pain. In addition to their well-known potential for inducing weight gain, oral corticosteroids also increase urinary excretion of vitamins C and B6, potassium, selenium and zinc.
Patients might be more motivated to make necessary diet and lifestyle changes if they were better informed of the potentially dangerous effects of long-term use of various drugs. Additionally, it may be helpful to note that in many cases, these issues are not “side effects,” but rather, are predictable results of the mechanisms by which the drugs work. For example, if proton pump inhibitors inhibit secretion of hydrochloric acid, there’s little reason to suspect these drugs wouldn’t impact mineral absorption.
In an ideal world, no one would need drugs at all, but there are certainly times when use is warranted and perhaps even essential. When it’s clinically appropriate for certain drugs to be used while a patient transitions to a healthier diet and lifestyle, they can be guided toward effective supplementation with a goal of minimizing the potential adverse effects of the drugs on nutrient absorption and/or retention.
At Core Health, our goal is to ensure we first do no harm, and to optimize our patients’ health in the best way possible. On many occasions, this means working with them to mitigate these “adverse events”. We have several lab tests, assessment tools, and a wealth of clinical experience to help you create an optimal nutrition and vitamin/nutraceutical regime to ensure you are living your most vibrant life possible! Come and see us for your own personal assessment and let us be your coach to wellness.
Dr. Brandy Strelec, ND has always had a passion for health, which led her to focus on assisting patients in their achievement of optimal health by assessing the physical, mental, emotional and spiritual aspect of health and addressing the underlying core of their health concerns. She develops individualized treatment plans and educates patients about their health while encouraging them to take an active role in their own health care.
As a licensed and registered Naturopathic Doctor, Dr. Strelec utilizes her strong background in Nutrition, Acupuncture & Traditional Chinese Medicine, Lifestyle counseling, Botanical Medicine, Homeopathy and Physical Medicine to assist her patients in attaining their treatment goals. She has a wealth of experience in dealing with hormone imbalances and digestive disorders. She has special interests in women’s health, chronic stress and fatigue-related issues, digestive health issues, heart disease, diabetes, pain management, fertility, and pediatrics. She has also designed specific programs dealing with weight management, detoxification, healthy aging and stress reduction. Brandy also brings her experience as a Bowen practitioner to add options for additional, individualized care for pain management.