Nutrient Depletion

Sometimes eating a healthy diet that reaches the RDA for all nutrients isn’t quite enough.  This can be due to illness, genetics, digestive problems, periods of exceptionally physical activity such as training for a marathon, or the use of medications. 

For some, the requirement for specific nutrients is higher than the RDA.  We won’t cover this category as it is highly individual and requires a thorough medical and nutritional evaluation and monitoring.  

Today, the focus will be on situations where nutrients are being lost due to medical conditions and medication interaction.  If you find yourself resonating with the information found here, please do contact your medical team for guidance on how to address nutrient repletion and monitoring for effectiveness.  Also, don’t forget to review the article on evaluation of supplements prior to making any purchases!

Loss of nutrients - Image: firehose leaking water

Where Are All My Nutrients Going? 

Medical Issues: 

There are a few medical conditions that cause you to lose the nutrients you have eaten.  This is a brief introduction to some of the more common ones, but not an exhaustive review.  Make sure you discuss your own medical issues with your healthcare team. 

Many illnesses can result in an increased need for nutrients or loss of nutrients. Image - man in distress.

Alcohol: 

Chronic use of alcohol results in a loss of many different vitamins and minerals. (1)  Even moderate levels of alcohol consumption can be problematic for some people.  Moderate alcohol consumption is defined as up to seven drinks per week for women and up to 14 drinks per week for men.  This disparity is due to statistical differences in muscle mass, size, and metabolic activity.  If you are a smaller man without much muscle mass, consider reducing your intake to the moderate level for a woman. 

Nutrients of concern: 

• Fat soluble vitamins due to impaired fat digestion/absorption: A, D, E, K

• B vitamins

• Vitamin C

• Calcium

• Iron

• Magnesium

• Zinc

Blood Loss: 

Chronic blood loss results in a depletion of key nutrients needed for blood cell formation.  Sources of chronic blood loss include heavy menstrual periods and digestive ulcers or colon cancer.  Anyone with a demonstrated iron deficiency should be evaluated for occult (hidden) bleeding or volume of blood lost during menstruation. 

• Iron

• B12

• Folate

Kidney Disease: 

With chronic kidney disease, the body’s ability to maintain the balance of certain vitamins and minerals becomes compromised.  Also, certain vitamins and minerals can become toxically high quickly due to the kidney’s inability to filter out excesses. (2)  The nutrients that are commonly depleted in kidney disease include: 

• B vitamins

• Iron  

• Vitamin C

• Vitamin D

• Calcium

Chronic diarrhea/vomiting: 

Many nutrients are lost with chronic diarrhea or vomiting.  This includes medical issues ranging from Inflammatory Bowel Disease to eating disorders. (3)

• Electrolytes: sodium, potassium, chloride, calcium, bicarbonate 

• Water

• Calories

Diabetes: 

With elevated blood sugars in diabetes, increased urination results.  This increased urination is a pressure release valve allowing you to rid your body of excess sugar through the urine.  In addition to glucose (blood sugar), other nutrients are also lost in the urine. (4)

• Water

• Magnesium

• Zinc

• B12

• B6

• Folic acid

• Electrolytes

Many medications interfere with nutrient absorption, increase nutrient needs, or deplete nutrients. Image - many colorful pills

Medications: 

The list of medications that create nutritional depletions is vast and being added to as more information is revealed.  I will cover the top 10 most prescribed medications (5) below, but this again is not an exhaustive list.  To investigate nutrient depletion caused by your medications, I recommend using the website Mytavin.  Here you can enter all of your medications for evaluation after which the database will evaluate your list and give you a run-down of nutrients that may be depleted along with references to scientific studies with supporting evidence.  

Top 10 Most Prescribed Medications and the Nutrients They Deplete: 

Atorvastatin (Lipitor)

• Zinc

• Selenium

• CoQ10

• Omega-3 fatty acids

Lisinopril (Prinivil, Zestril)

• Zinc

Albuterol (Accuneb, Ventolin, Proair, Proventil)

• None known

Levothyroxine (Synthroid, Unithroid, Levoxyl, Levo-T, Euthyrox)

• None known

Amlodipine (Norvasc, Amvaz)

• None known

Gabapentin (Neurontin)

• B12

• Folic Acid

Omeprazol (Prilosec)

• B12

• Calcium

• Magnesium

• Zinc

• Folic acid

• Iron

• Probiotics

Metformin (Glucophage)

• B12

• Folic Acid

Losartan (Cozaar)

• zinc

Hydrocodone/Acetaminophen (Vicodin, Norco)

• Glutathione

Now that we know, we can do! Image - tiles spelling out the words: Pause, Breathe, Ponder, Choose, and Do

Applications: 

As you can see, there are many things that can complicate our nutritional needs.  Addressing health conditions and having them properly managed is one way we can work to meet our nutritional requirements.  Evaluating medications for nutrient depletion is another actionable step we can take to address our overall nutrition. 

I recommend you discuss your current health issues, medications, and supplement needs with your healthcare team.  If your doctor doesn’t have adequate information for you, consider asking for a referral to a nutritionist/dietitian for a deeper look into your unique situation and needs.  You can also print off a medication review through the mytavin website to discuss with your doctor.  

Image of orange sky with sun hanging low over hills.

Next Week: 

Next week we will look at nutrient deficiencies and the signs and symptoms that can arise when we aren’t getting enough of what we need.  You may be surprised to find that some of your troublesome symptoms may be much more connected to a nutrient deficiency rather than a medical condition in need of a pharmaceutical.  A trial of nutrient repletion (filling in the gaps) may be very helpful once you identify your status. 

To our health! 

References: 

1. National Institutes of Health, “Alcohol and Nutrition - Alcohol Alert No. 22-1993” Updated October 2000, https://pubs.niaaa.nih.gov/publications/aa22.htm Accessed 1/25/2021

2. National Kidney Foundation, “Vitamins and Minerals in Chronic Kidney Disease” Reviewed 5/31/2019, https://www.kidney.org/atoz/content/vitamineral Accessed 1/25/2021

3. Foulds Mathes, Wendy, “Nutritional Consequences of Bulimia Nervosa” Gurze - Salucore Eating Disorders Resource Catalogue 1/31/2017, https://www.edcatalogue.com/nutritional-consequences-bulimia-nervosa/,  Accessed 1/25/2021

4. Whitaker, Julian, “Nutrient Losses Cause Diabetic Complications”, Whitaker Wellness, https://whitakerwellness.com/health-concerns/diabetes-treatment/diabetic-nutrition/ Accessed 1/25/2021

5. GoodRx, “Top 10 Prescription Medications in the US August 2020” https://www.goodrx.com/drug-guide Accessed 1/25/2021

6. Mytavin, “Calculate your Risk” https://mytavin.com, Accessed 1/25/2021