There’s no doubt that the U.S. health-care system is built on a foundation of pharmaceutical drug use. Four out of every five patients who visit a doctor leave with a prescription. It’s projected that during 2001 there will have been three billion prescriptions written which, if you do the math, comes out to more than ten prescriptions for every man, woman, and child in America. Of course, not everyone takes prescribed pharmaceuticals so this means that many individuals are taking a number of drugs at once, a situation known as polypharmacy. Often, people in assisted-care facilities or nursing homes take between eight and fifteen medications a day!
In doing what drugs are suppose to do — that is effecting change in the body by altering its normal metabolism — pharmaceuticals can cause untold numbers of other reactions to occur as well. We know them as side effects. However, one very profound side effect that appears to be a well-kept secret is that more often than not, a particular drug will deplete the body of valuable nutrients — vitamins, minerals, etc. — that, in turn, can cause even bigger health problems.
Ross Pelton, Ph.D. (in psychology and health), is one of the foremost experts on drug-induced nutrient depletions. As a pharmacist and a certified clinical nutritionist, Pelton has coauthored two books on the subject — one for health professionals and the other for consumers. Pelton is a staunch advocate of nutritional supplementation regardless of whether one is taking drugs. He encourages everyone to take a good daily high-potency multivitamin and multimineral supplement to cover all the nutritional bases. He scoffs at the recommended dietary allowances (RDAS), calling them the "really dumb allowances." After all, he says, the RDAs are the levels of nutrients that we have been led to believe are adequate — that is, adequate for staving off very serious end-stage diseases such as scurvy (vitamin C deficiency) and beriberi (vitamin B1 deficiency). He points out that vitamin deficiencies could be one of the reasons the United States has the highest rate of chronic degenerative diseases in the world.
In his research, Pelton has found hundreds of studies demonstrating that numerous drugs — from antacids, antibiotics, and anti-inflammatories to birth control pills, cholesterol-lowering drugs, chemotherapy, and even aspirin — deplete the body of nutrients. The result is nutrient deficiencies that can complicate and compromise health.
"We’re just touching the tip of an iceberg," Pelton says, "because the Food and Drug Administration has never made it a priority that drug companies need to research and look into whether or not their particular drug causes nutrient depletions.... I’m sure there are thousands of drugs and thousands of nutrient depletions that are out there but because nobody has been able to fund a study and look into it yet, we don’t know about them."
However, for many other drugs, there’s substantial evidence. Let’s take the case of birth control pills. One in four women aged eighteen to thirty-four are currently using the pill. Other women also take the pill to reduce symptoms of hot flashes or irregular periods or to treat acne. Some are on the pill for years. Pelton says he’s very concerned about the nutrient deficiencies that the pill, as well as other estrogen drugs, can trigger. "There’s solid documentation that multiple nutrient depletions can cause a wide range of health problems in women due to the estrogen medications." The estrogen in the pill depletes vitamin C, magnesium, selenium, and zinc, and it really does a number on nearly all the B vitamins, which are essential in a multitude of enzymatic reactions. For instance, a deficiency of the B vitamin folic acid can cause birth defects, cervical dysplasia (a possible precursor to cancer), anemia, and cardiovascular disease.
Another key nutrient, coenzyme Q-10 (CoQ10), is depleted by an assortment of widely used drugs. CoQ10 is so vital to bodily functions that it has been likened to a spark plug in a car engine. Just as a car cannot function without that initial spark, the human body cannot function without CoQ10. Beta-blockers, diabetic drugs, blood pressure medications, cholesterol-lowering drugs, and vasodilators all zap CoQ10. Pelton cautions, "[A depletion] can not only increase the risk of cardiovascular disease but can speed up mitochondrial DNA damage which actually accelerates the aging process."
So, what to do? As a first line of defense Pelton recommends that multivitamin and multimineral supplement he believes everyone should be taking. But because many of these don’t contain CoQ10, he advises supplementing daily with at least 100 to 120 milligrams of it. However, he adds, "You can’t say what level a person should take. Many of the studies on this topic will give whatever level of coenzyme Q-10 is necessary in order to get people up to a specific blood level and the range of supplementation varies from 75 mg up to 600 mg a day."
The rate at which nutrient depletions occur, according to Pelton, is also another wild card as each of us is so different. "It depends on a whole range of things and each individual’s lifestyle...their diet, their nutritional status, the level of stress, the level of toxins in their environment, what their nutritional status was before they started taking the birth control pill or hormone replacement or whatever it is. There is no rule of thumb."
Over-the-counter drugs are culprits of nutrient-depletion as well. Pelton reels a list off the top of his head. "There are certainly a lot of them that are [nutrient-depleting]. Laxative medications, antacid medications, antiulcer medications, things like aspirin and Tylenol and some of the anti-inflammatory things...so yes, there are lots of them."
The entire subject of drug-induced nutrient depletions may be news to many. Pelton notes that even most pharmacists and physicians are not aware of the magnitude of this problem. Hence, customers and patients are generally not informed about the fact that the drugs they’re taking are depleting their bodies of nutrients. His party line: "We need to educate both physicians and pharmacists and other health professionals as well as the general public." That’s not an easy task. New studies and information on the subject are hard to come by because, as Pelton says, "...drug companies are not interested in funding studies that tell you and me that their drug is causing nutrient depletions."
However, Pelton and his coauthors have gotten a good handle on the available research and have put it in their books. I believe the consumer version, The Nutritional Cost of Prescription Drugs (800-348-3777, about $15) and the health practitioners’ version, Drug-Induced Nutrient Depletion Handbook (800-837-5394, about $30) are important tools in the pursuit of better health or, ideally, optimal health.
Disclaimer: This column is for information only and no part of its contents should be construed as medical advice, diagnosis, recommendation or endorsement by Ms. Ephraim.
Rebecca Ephraim is a registered dietitian, certified clinical nutritionist and a nutrition reporter specializing in integrative medicine issues.
© Rebecca Ephraim. All rights reserved.