Recognizing Drug-Induced Nutrient Depletion
in Chiropractic Practice

James B. LaValle, R.Ph., M.S., N.D., The American Chiropractor, vol. 32, no. 1,
January 2010, pages 26-26.

Dr. LaValle is both a pharmacist and a chiropractor. He presents the detrimental effects of drugs on nutritional status, which he describes as common and which often occur over time. He advocates an awareness of this type of problem, a drug-induced nutritional depletion, and he offers some guidelines in helping patients to recover from nutritional deficiency. 

Dr. LaValle’s discussion includes antacids, which includes proton pump inhibitors such as Prilosec, Prevacet, and Protonix, and notes that these medications can deplete vitamin B12 and folic acid levels. He also notes that H2 blocking drugs such as Tagamet and Zantac also can result in depletion of B12 and folate, in addition to vitamin D.  The H2 blocking drugs affect the absorption of minerals, including calcium, iron, and zinc. 

He notes that many people remain on these medications for years without the benefit of monitoring for vitamin D status or other symptoms.  He notes that studies have demonstrated  an increased risk of osteoporosis  with these medications.  Women are at greater risk for osteoporosis, but this problem also occurs in men. 

He notes that aspirin through competitive binding can cause folate and thiamine deficiency, aluminum-based antacids also through competitive binding can cause deficiencies in magnesium phosphates and potassium. 

Glucocorticoids through hyperexcretion through the kidneys can cause depletion of amino acids, ascorbic acid, magnesium, potassium, and zinc. 

Methotrexate through inhibition of coenzyme biosynthesis can cause a deficiency in B12. 

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