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Medications can affect levels of nutrients


Kathy Kolasa


Kathy Kolasa

Wednesday, January 3, 2018

Q I heard you speak about dietary supplements recently. I didn’t realize you needed to know how medications affect your levels of nutrients. Can you tell us more about that? — F.H., Greenville

A Thanks for asking. There are some medicines that interact with a nutrient which might keep the medicine from working properly or might decrease or increase the amount of a nutrient in your body. I asked Lauren Boyd, a senior ECU dietetic student, to tell you about ways you can make sure you are getting the most out of the foods you eat and the medicine you take. Here is what she wants you to know.

You might ask yourself what exactly is a drug-nutrient interaction? A drug interaction occurs when a food or beverage consumed affects the drug’s properties or activity of a medicine, or a medicine affects the way your body uses a nutrient. It’s more common for health care providers to talk with their patients about taking medicines in a way that will make them work best than about how their nutrition might be affected.

Taking a drug can impact how your body uses the nutrients you expect to get from certain foods. This can be a concern for people who are prescribed a lot of medications to manage their health. 

I worked in a pharmacy for more than five years and saw first-hand just how difficult it is for people to remember exactly what medications they are taking and why. People often would say to me, “Wait, what is this for?” I have watched pharmacists talk with customers about the potential nutrient problems they might experience when taking certain medications.

Fortunately, the American Academy of Family Physicians (AAFP) was supported by Nature Made, a company that makes supplements, to create a helpful drug-nutrient interaction and drug-nutrient depletions tool. This tool is accessible on your phone. Just download it from your app store. Search for AAFP Drug-Nutrient Interactions.

People should keep a list on a piece of paper or on their phones containing all the medications they are taking, what the medications are prescribed for, what side effects could occur and what potential nutrient interactions could occur. To find out the specific interactions, your medication(s) could have, once you installed the app, select “Drug-Nutrient Interaction.” Then select from the two categories: “Drug-Categories” or “Supplements/Foods.”

The drug categories selection will let you choose from the different classes of drugs. For example, someone taking lisinopril for high blood pressure would select “Antihypertensive (Angiotensin-converting enzyme inhibitors)” and then select lisinopril. The app will then list a major interaction and moderate interactions if any exist. If you do not know what type of drug class your medication(s) are, then you could find out from your doctor or pharmacist.

The “Supplements/Food” category is also useful for anyone who is taking over the counter medications including but not limited to fish oil, melatonin or any type of vitamin supplement. Many people do not realize over-the-counter items could also influence their body with certain nutrients, which is why it is important to write down every type of pill you are taking.

As I went through the app, I found that the supplements/food category had more drug-nutrient interactions than actual prescription medication. Although each drug has its own nutrient interaction, researchers have pinpointed grapefruit juice as the No. 1 concern for interaction with all types of drugs. When the juice is consumed, it disrupts the liver’s natural way of metabolizing the medication through the body. Therefore, if you are going to consume grapefruit juice, it is best to consume it one to two hours after taking the drug.

Researches also have studied the effects of metformin, a diabetes medication, and vitamin B12 deficiency. Studies show that patients who take metformin on a regular basis and for a longer duration are at risk for this deficiency. There is not sufficient evidence as to why patients taking metformin are at risk for malabsorption of vitamin B12, but researchers believe diabetes mellitus alters the way the body absorbs vitamin B12. If you are prescribed metformin and are concerned about your vitamin B12 levels, you can ask your health care provider if you need an oral supplement or an or an injection.

These only a few that occur. You can find more by going to www.familydoctor.org and put “drug and nutrient interaction” in the search box. There also is an eight-part webcast that was delivered to family doctors in 2016 about drug and nutrient interaction. It’s available online at https://www.aafp.org/patient-care/public-health/fitness-obesity/dni-dsi-webcast.html.

We suggest you make and keep a 2018 resolution to understand how your body, the medicines you need to take and the diet you follow all work together to keep you at your best.

Professor emeritus Kathy Kolasa, a registered dietitian nutritionist and Ph.D., is an affiliate professor in the Brody School of Medicine at ECU. Contact her at kolasaka@ecu.edu.