If you’ve ever watched television, you’ve undoubtedly heard a list of side effects that sound as though they are read by the Micro Machine Man. What you may not have heard them mention however, are significant depletions in nutrients essential for cellular function that some common meds cause.
Depletions in critical nutrients like magnesium, B12, and coenzyme Q10 can leave you feeling worse than when you started, even when the medication is “working.”
The ways in which these depletions occur vary from medication to medication. Some directly affect how your body absorbs nutrients, others how it processes them. Still others have an indirect effect. They may cause nausea, GI upset, blood sugar dysregulation, or changes in weight. The bottom line is the same: when your body is depleted of nutrients, it’s not functioning optimally.
So, what can you do about it?
Your local pharmacist is an excellent resource (did you know most pharmacists have a 4-year doctorate degree?). They can help point you toward food or supplement solutions to help combat these depletions. They can also advise you on how to time medications or make lifestyle adjustments to minimize impact. This is by no means an exhaustive list, but read below for commonly prescribed medications with not-so-commonly known concerns.
Common drug-nutrient depletions
Statin Medications (e.g., Atorvastatin, Simvastatin)
Used for: Lowering cholesterol
Depletes: Coenzyme Q10 (CoQ10)
Why it matters:
CoQ10 is vital for energy production in your cells, especially those of your heart and muscles. When levels drop, you may feel fatigued, sore, or foggy. In fact, CoQ10 depletion is believed to be a major contributor to the muscle aches many people experience while on statins. If you’re taking a statin, ask your provider or pharmacist about CoQ10 supplementation.
Increasing fatty fish, nuts and seeds and cruciferous vegetables like cauliflower and broccoli can help boost CoQ10 naturally.
Proton Pump Inhibitors (e.g., Omeprazole, Pantoprazole)
Used for: Acid reflux, heartburn, GERD
Depletes: Magnesium, Vitamin B12, Iron, Calcium. Microbiome changes associated with lowering of acid production.
Why it matters:
These nutrients are critical for bone health, nerve function, red blood cell production, and mood. Long-term PPI use can lead to deficiencies, increasing the risk of osteoporosis, anemia, fatigue, and even memory issues. If you’re using these medications for more than a few months, nutrient monitoring is a smart idea.
If you find you are needing frequent acid reduction, consider implementing non-pharmaceutical strategies like mindful eating, minimizing food several hours before bed and sleeping on your left side or with the head of bed slightly elevated to reduce acid back flow.
**Always see a doctor if heartburn persists – this could indicate serious conditions like an ulcer, H pylori infection or cardiac concerns.**
Oral Contraceptives (Birth Control Pills)
Used for: Contraception, menstrual regulation
Depletes: B Vitamins (especially B6, B12, Folate), Magnesium, Zinc, Vitamin C
Why it matters:
These vitamins and minerals support mood, metabolism, and hormone detoxification.
Deficiencies may show up as irritability, anxiety, low energy, or irregular cycles. Supporting your body with a quality multivitamin and nutrient-rich food becomes even more important when using hormonal contraception.
Metformin
Used for: Type 2 diabetes, PCOS
Depletes: Vitamin B12, Folate
Why it matters:
B12 and folate play a key role in nerve health, brain function, and red blood cell production. Long-term use of metformin is associated with B12 deficiency, which may cause numbness, tingling, fatigue, or mood changes. Annual B12 lab checks are recommended for anyone on metformin long term. Supplementation with an oral formulation or quality multivitamin is generally recommended. Injections are available with a prescription if oral intake is not sufficient.
Antibiotics (Broad-Spectrum)
Used for: Bacterial infections
Depletes: Gut flora (beneficial bacteria), Vitamin K, B Vitamins
Why it matters:
Antibiotics disrupt the gut microbiome, where many vitamins, especially B vitamins and Vitamin K, are produced. After a course of antibiotics, you may experience digestive issues, reduced immune function, or low energy.
Probiotic-rich foods (or supplements) and nutrient repletion can help restore balance.
Consider incorporating fermented foods such as kombucha, kimchi or (sugar free) yogurt into your daily diet. Supplements with probiotics are also very helpful, but be sure to talk to your pharmacist about which types and dosing strategies that are right for you.
ACE inhibitors or ARBs (e.g., Lisinopril, enalapril, losartan)
Used for: High blood pressure, heart failure, kidney protection (especially in diabetes)
Depletes: Zinc
Why it matters:
Zinc plays a crucial role in immune function, wound healing, hormone balance, and taste/smell perception.
Long-term use of ACE inhibitors and ARBs has been associated with reduced zinc levels, which may lead to poor immune resilience, low libido, or skin issues in some individuals.
If you’re on these medications, consider asking your provider about checking zinc status or incorporating zinc-rich foods (like pumpkin seeds, beef, or lentils) into your diet. **Supplementation with zinc before testing is not recommended**. Copper deficiency, GI upset, cholesterol effects and neurological symptoms may occur with excessive zinc intake.
Diuretics (e.g., Furosemide, Hydrochlorothiazide)
Used for: High blood pressure, fluid retention, heart failure
Depletes: Magnesium, Potassium, Sodium, Thiamine (Vitamin B1), Zinc
Why it matters:
Diuretics increase urination, which can flush out electrolytes and water-soluble nutrients. This may result in muscle cramps, fatigue, irregular heartbeat, or brain fog, particularly if you’re not replenishing lost minerals. Thiamine (B1) depletion, often overlooked, is especially important in heart failure, where low levels can worsen cardiac function.
Regular electrolyte monitoring is important for anyone on diuretics. Foods like leafy greens, bananas, avocados, and bone broth can help restore balance.
Anticonvulsant Medications (e.g., Phenytoin, Carbamazepine, Valproic Acid, Phenobarbital, Topiramate, Oxcarbazepine
Used for: Seizure disorders, bipolar disorder, migraine prevention, neuropathic pain
Depletes: Folate (B9), Vitamin D, Calcium, Vitamin K, Biotin (B7), Carnitine (especially with valproic acid)
Why it matters:
Anticonvulsants can interfere with nutrient absorption and increase nutrient breakdown through liver enzyme induction. Over time, this may lead to:
Bone loss or osteopenia (due to Vitamin D and Calcium depletion)
Fatigue, low mood, or cognitive issues (linked to folate and biotin depletion)
Increased bleeding risk (due to Vitamin K depletion, especially in children or those with liver issues)
Liver toxicity or muscle weakness (from carnitine depletion, mainly with valproic acid)
Patients on long-term anticonvulsant therapy may benefit from bone density monitoring, lab evaluation for B vitamins and Vitamin D, and targeted supplementation if needed.
Next steps:
Ask questions. Don’t be afraid to bring this up with your healthcare team. Your pharmacist is one of the most accessible members of your team. (Side note – give them ample time to get back to your on your question)
Eat whole, nutrient-dense foods. Focus on leafy greens, healthy fats, proteins, and fermented foods.
Monitor with labs. Periodic nutrient testing can help you stay ahead of deficiencies.
Supplement wisely. If needed, use targeted supplements to restore optimal levels with guidance from your healthcare team.
Functional Pharmacist Perspective
In functional medicine, we’re always asking “why?” Why are you tired, foggy, or anxious? Why did your labs shift unexpectedly? Medication-induced nutrient depletion is a hidden root cause that deserves more attention, and it’s one you can absolutely do something about.
If you’re unsure how your medications may be affecting your nutrient status, reach out. At Canopy Wellness we can help with comprehensive medication reviews and more. You deserve to feel your best.
To learn more about Functional Medicine and see how it may help you, schedule a free 15 minute consultation or head to our Work With Me page! Don’t forget to sign up for our newsletter below as we delve into topics like lifestyle medicine, ingredient highlights, medication concerns and more.
Anytime that you are experiencing a health concern, please contact a healthcare professional for guidance. In the meantime, ensuring that you are providing your body with the nutrients it needs and supporting it through sleep and stress reduction will always provide benefit. The content on this site is for informational or educational purposes only and does not substitute professional medical advice or consultations with healthcare professionals.
References
- Point Institute. (2022). Drug-induced nutrient depletions: A scientific review of common medications and associated nutrient losses (Monograph). Point Institute.
Ferreri, S. P. (2018). Drug-induced nutrient depletions: What pharmacists need to know. U.S. Pharmacist. https://www.uspharmacist.com/article/druginduced-nutrient-depletions-what-pharmacists-need-to-know
Coastal Pharmacy & Wellness. (n.d.). Nutrient depletion from medications. Retrieved July 12, 2025, from https://www.coastalpharmacyandwellness.com/resources/knowledge-center/nutrient-depletion-from-medications/
Nutrition Review. (2016, December). A practical guide to avoiding drug-induced nutrient depletion. https://nutritionreview.org/2016/12/practical-guide-avoiding-drug-induced-nutrient-depletion/
Skalny, A. V., Simashkova, N. V., Skalnaya, M. G., Grabeklis, A. R., Tinkov, A. A., & Nikonorov, A. A. (2018). Zinc and copper metabolism in epilepsy. Biology Trace Element Research, 183(1), 182–196. https://pmc.ncbi.nlm.nih.gov/articles/PMC6109862/