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Note: The resources listed in this guide are not intended to be fully systematic or complete, nor does inclusion here imply any endorsement or recommendation by The University of Maryland or the Center for Integrative Medicine. The University of Maryland and the Center for Integrative Medicine make no warranties, express or implied, about the value or utility for any purpose of the information and resources contained herein.

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Antibiotic medications - antituberculosis agents

Medications:

  • Rifampin
  • Isoniazid
  • Ethambutol

Depletions:

Calcium

Osteoporosis (bone loss) is the primary disease associated with long term calcium deficiency; it may be associated with bone pain and spinal deformity. Depleted levels can also cause muscle cramps, irregular heartbeat, and depression.

Probiotics

Reducing the number of probiotic organisms, such as Lactobacillus acidophilus and Bifidobacterium bifidum, in the gastrointestinal tract may decrease the body's ability to resist infections and diseases. Symptoms of deficiency include gas, abdominal distress, diarrhea, and yeast infections.

Vitamin B3 (Niacin)

Because this nutrient plays a key role in many metabolic processes, low levels may impair the breakdown and use of starches, fats, and proteins. Symptoms of deficiency may occur within 1 - 2 months. Severely low levels of niacin cause pellagra, a condition characterized by inflammation of the skin, mental depression, abdominal pain, and diarrhea.

Vitamin B6 (Pyridoxine)

Symptoms of vitamin B6 deficiency may include weakness, nervousness, insomnia, mental confusion, irritability, and anemia. Long term low levels of this nutrient may also increase the risk of heart disease, as well as colon and prostate cancers.

Vitamin D

Vitamin D deficiency leads to abnormal bone formation (rickets) in children and softening of the bones (osteomalacia) in adults. Vitamin D deficiency interferes with calcium absorption, which leads to deficiency of that nutrient and its associated symptoms (such as increased risk of fractures, osteoporosis (bone loss), and muscle weakness). Because this nutrient is fat soluble, prolonged periods of deficiency are required to produce these symptoms.

Vitamin E

While deficiency of this nutrient is uncommon, it negatively affects muscle tissue, red blood cells, nervous, and reproductive systems. Over the long term, depleted levels of this nutrient may also be associated with cancer, heart disease, and altered immune function.

Vitamin K

The major symptom of vitamin K deficiency is an inability of the blood to clot properly, which may lead to excessive bleeding and a tendency to bruise easily.

Zinc

Signs and symptoms of zinc deficiency include loss of appetite or sense of taste, growth retardation, skin changes, and increased susceptibility to infection.

Editorial Note:

The selected depletions information presented here identifies some of the nutrients that may be depleted by certain medications. The signs and symptoms associated with nutrient deficiency may also indicate conditions other than nutrient deficiency. If you are experiencing any of the signs or symptoms mentioned, it does not necessarily mean that you are nutrient deficient. Nutrient depletion depends upon a number of factors, including your medical history, diet, and lifestyle, as well as the length of time you have been taking the medication. Please consult your health care provider; he or she can best assess and address your individual health care needs, and determine if you are at risk for nutrient depletions from these medications, as well as others not listed here.

  • Reviewed last on: 4/19/2010
  • Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed HealthCare Network.

Supporting Research

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Brodie MJ. and Hillyard CJ. Calcium metabolism during rifampicin and isoniazid therapy for tuberculosis. J Royal Soc Med. 1982;75:919.

Cashman KD. Diet, nutrition, and bone health. J Nutr. 2007;137(11):2507S-12S.

Conly J, Stein K. Reduction of vitamin K2 concentrations in human liver associated with the use of broad spectrum antimicrobials. Clin Invest Med. 1994;17(6):531-539.

de Vrese M, Marteau PR. Probiotics and prebiotics: effects on diarrhea. J Nutr. 2007;137(3 Suppl 2):803S-11S.

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Pelton R, LaValle J, Hawkins EB, et al. Drug Induced Nutrient Depletion Handbook. Hudson, OH:LexiComp, Inc.;2001:374-385.

Powers HJ. Current knowledge concerning optimum nutritional status of riboflavin, niacin and pyridoxine. Proc Nutr Soc. 1999;58(2):435-440.

Powers HJ. Riboflavin (vitamin B-2) and health. Am J Clin Nutr. 2003;77(6):1352-60.

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