COMMON DRUG NUTRIENT DEPLETIONS (DNDs) & INTERACTIONS (DNIs) DND – Use of certain medications may deplete key nutrients. DNI – Interactions with drugs and nutrients can affect drug effectiveness and nutrient absorption. ACID SUPPRESSING MEDICATIONS 2 1 ANTIBIOTICS1-3 & ANTACIDS1,3 DNDs DNIs DNDs DNIs

Potential and Goldenseal, Ginger, & Potential B (B1, Separate any minerals and B12 depletions with Green Tea may interact B2, B6, Folic Acid, B12) supplements use of H2 antagonists with and/or affect drug depletions. from antibiotics by at least and/or Proton Pump effectiveness. 2 hours. inhibitors.

3 BIRTH CONTROL 4 BLOOD PRESSURE MEDICATION1-5 (Oral Contraceptives)1,3 DNDs DNIs DNDs DNIs

Folic Acid, B6, and Alfalfa, Garlic, St. John’s CoQ10 (Beta blockers), Black Licorice, , Magnesium levels may Wort may interact with Potassium, and Milk Thistle, Niacin, St. be affected with and/or affect drug magnesium levels may be John’s Wort, and vitamin B6 medication use. effectiveness. affected (thiazide diuretics). may interact with and/or affect drug effectiveness. 5 BLOOD THINNING MEDICATION 6 CHOLESTEROL LOWERING MEDICATIONS (Anticoagulants)1 (Statins & Bile Acid Sequestrants)1-3 DNDs DNIs DNDs DNIs No major DNDs noted. CoQ10, Cranberry, Garlic, Statins may affect CoQ10; Garlic, Niacin, St. John’s Herbals, , and statins and bile acid Wort, , and vitamins E & K may interact sequestrants may affect may interact with and/or affect drug fat soluble vitamin with and/or affect drug effectiveness. (A,D,E,K) levels. effectiveness.

7 CORTICOSTEROIDS2,3 8 DIABETES MEDICATIONS (Metformin)1-3 DNDs DNIs DNDs DNIs Calcium and Magnesium Herbals, Licorice and Potential Folic Acid and Alfalfa, Aloe Vera, Alpha levels may be affected St. John’s Wort may vitamin B12 depletions. , CoQ10, with medication use. interact with and/or Chromium, Garlic, Green Tea, , Milk affect drug effectiveness. Thistle, Niacin, St. John’s Wort, and vitamin K1 may interact with and/or affect drug effectiveness. Sources* 1. US National Library of Medicine. Drugs, Herbs and Supplements. Internet: https://www.nlm.nih.gov/medlineplus/druginformation.html Accessed 28 April 2016. 2. Meletis CD & Zabriskie N. Common nutrient depletions caused by pharmaceuticals. Alt Comp Ther 2007;13(1):10-17. 3. Hyla Cass, M.D. A Practical Guide to Avoiding Drug-Induced Nutrient Depletion: http://nutritionreview.org/2013/04/practical-guide-avoiding-drug-induced-nutrient-depletion/ 4. Clayton,JA, Rodgers S, Blakey J. Thiazide diuretic prescription and electrolyte abnormalities in primary care. Br J Clin Pharmacol 2006 Jan;61:87-95. ©2016 Pharmavite LLC 5. Pak CY. Correction of thiazide-induced hypomagnesemia by potassium-magnesium citrate from review of prior trials. Clin Nephrol 2000;54:271-275. PID13168 *Additional references available upon request.