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Drug Induced Nutrient Depletions: Acid Reducers



In part five, we continue our exploration of the nutrients that are depleted when taking prescription or over-the-counter medications. Drug induced nutrient depletions (DIND) occurs when medications causes nutrients to be depleted from our bodies. This has been a multi-part series in which I focused on a different drug class each week. In previous weeks, we focused on the nutrients depleted from the use of antibiotics, oral contraceptives, antihyperlipidemics, and pain relievers.

This week for part five, we will explore the nutrients that are depleted due to the use of prescription and over-the-counter acid reducing agents. These are the medications that people take for Gastroesophageal reflux disease (GERD).

GERD occurs when acid from the stomach flows backward up into the esophagus (1). According to the American College of Gastroenterology over 60 million people in the United States experience heartburn monthly. Even more alarming is that studies have found that at least 15 million people state that they have heartburn symptoms every day (1).

Common medications used for GERD or heartburn include: Nexium, Protonix, Prilosec, Zantac, Prevacid, and Tagamet. The nutrients that can be depleted when using these medications include folic acid, zinc, iron, sodium, vitamin D, calcium, beta-carotene, vitamin B12, and thiamin.

Here are some guidelines on how much of the depleted nutrients you may need each day as well as some good food sources.

Folic Acid

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)

Zinc

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)

Iron

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)

Sodium

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)

Vitamin D

How much you may need per day if you use a supplement: 400 IU (2)

Good Food Sources: Salmon, mackerel, sardines, eel, fortified milk, cod liver oil, sword fish, tuna, fortified orange juice (2,3)

Calcium

How much you may need per day if you use a supplement: 1,200 mg (2)

Good Food Sources: Milk, dried figs, cheese, yogurt tofu, sardines, dairy alternatives, fortified cereal, salmon, dark leafy greens (2,3)

Beta Carotene

How much you may need per day if you use a supplement: 25,000 IU (2)

Good Food Sources: Carrots, spinach, mango, cantaloupe, apricot nectar (2)

B12

How much you may need per day if you use a supplement: 500-1000 mcg (2)

Good Food Sources: Clams, beef liver, fortified breakfast cereals, trout salmon, tuna, milk, yogurt, cheese, eggs chicken, haddock (3)

Thiamin

How much you may need per day if you use a supplement: 25-100 mg (2)

Good Food Sources: braised liver, turkey heart, roasted chicken, gefilte fish, sardines (2)

Suggestions for Prevention and Therapeutics Strategies (4)

  • Maintain an ideal body weight

  • Reduce stress

  • Learn what foods trigger symptoms and limit/avoid them

  • Avoid large meals

  • Avoid drinking large volumes of liquid with meals

  • Quit smoking (if you do)

  • If you are experiencing symptoms (elevate your pillow at night)

  • Herbs that may help include

  • Deglycyrrhizinated licorice (2, 380 mg tablets before meals)

  • Slippery Elm (1-2 TBSP of powered root in water, 3-4 times daily)

  • Other herbs that may give some relief chamomile, marshmallow, skullcap, and valerian

* 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.

References

1.American College of Gastroenterology. Acid Reflux | ACG Patients. Patientsgi.org. 2018. Available at: http://patients.gi.org/topics/acid-reflux/. Accessed June 30, 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. Rakel D. Integrative Medicine. Philadelphia: Elsevier; 2018.