Drug induced nutrient depletions (DIND) refers to the nutrients that are depleted from our bodies as a result of the prescription and over-the-counter medications that we take every day. This will be a multi-part series in which I will focus on a different drug class each week. In previous weeks, we focused on the nutrients depleted from the use of antibiotics, oral contraceptives, and antihyperlipidemics. This week for part four, we will explore the nutrients that are depleted due to the use of over-the-counter pain-relieving agents.
People in the United States use many over-the-counter medications each year. In 2017, over-the-counter (OTC) medicine retail sales totaled around $34.3billion (1). Of that approximately $4.2 billion was spent on over-the-counter pain relievers (1). Pain relievers account for the category with the greatest spend. Pain relievers can deplete the following nutrients:
Aspirin: Folic Acid, Vitamin C, Iron, Potassium, Sodium, Zinc
Acetaminophen (Tylenol): Glutathione
Here are some guidelines on how much of the depleted nutrients you need each day as well as some good food sources.
How much you may need per day if you use a supplement: 400-800 mcg (2)
Good Food Sources: Vegetables (especially dark green leafy vegetables), fruits and fruit juices, nuts, beans, peas, dairy products, poultry and meat, eggs, seafood, and grains, spinach, liver, yeast, asparagus, and brussels sprouts (3)
How much you may need per day if you use a supplement: 50-200 mg (2)
Good Food Sources: Oysters, beef, crab, fortified breakfast cereals, lobster, pork, baked beans, cheese, cashews, chicken, peas, flounder, almonds, chickpeas, kidney beans (3)
How much you may need per day if you use a supplement: 100-300 mg (2)
Good Food Sources: dried figs, California avocado, papaya, banana, dates, citrus fruits, milk, yogurt, nuts, beef, chicken, fish, potatoes (with skins) (2,3)
How much you may need per day if you use a supplement: 250-1500 mg (2)
Good Food Sources: Red peppers, orange juice, citrus fruit, green peppers, broccoli, strawberries, tomato juice, brussel sprouts, spinach, cauliflower (3)
How much you may need per day if you use a supplement: 11-18 mg (3)
Good Food Sources: Fortified breakfast cereals, beef, beans, oysters, lentils, tofu, nuts, spinach, dark chocolate, poultry, eggs, fish, green peas, potato (3)
How much you may need per day if you use a supplement: Healthy adults should limit their sodium intake to around 2,300 mg and people with high blood pressure should limit their intake to around 1.500 mg (3)
Food Sources: Processed foods, milk, beets, and celery also naturally contain sodium (3)
How much you may need per day if you use a supplement: 800-2,000 mg n-acetyl cysteine (a precursor to glutathione) (3)
Other supplements that can support the production of glutathione in the body: Bioactive why protein, alpha lipoic acid, folate, B6, B12, Selenium, Vitamins C and E, milk thistle (4)
Food Sources: Garlic, onions and the cruciferous vegetables (broccoli, kale, collards, cabbage, cauliflower, watercress) (4)
* Individual needs may vary. Speak with your health care provider or nutritionist for your personalized recommendations.
About the Author: Leanne DiMaio earned her Master’s degree in Applied Clinical Nutrition from New York Chiropractic College in December 2017. She is currently working on her Doctorate degree in Clinical Nutrition degree at Maryland University of Integrative Health. Leanne is passionate about helping others achieve their optimal state of health and wellness. She is currently earning clinical hours toward the Certified Nutrition Specialist (CNS) credential under Kim Ross's supervision.
1. Consumer Healthcare Products Association. Statistics on OTC Use. Chpaorg. 2018. Available at: https://www.chpa.org/MarketStats.aspx. Accessed June 24, 2018.
2. Vagnini F, Fox B. The Side Effects Bible. New York: Broadway Books; 2005.
3. United States Department of Agriculture. Vitamins and Minerals | Food and Nutrition Information Center. Nalusda.gov. 2018. Available at: https://www.nal.usda.gov/fnic/vitamins-and-minerals. Accessed June 3, 2018.
4. Hyman M. Essential Glutathione: The Mother of All Antioxidants. Dr Mark Hyman. 2010. Available at: http://drhyman.com/blog/2010/05/19/glutathione-the-mother-of-all-antioxidants/. Accessed June 24, 2018.