The Hungry Pharmacist

Regular therapy brings many benefits to chronically ill patients, regardless of the disease. The development of medications has made it possible to control numerous diseases, such as high blood pressure, Hashimoto’s syndrome, or diabetes, enabling patients to lead relatively normal lives. This allows them to participate in daily activities without their illness significantly affecting their everyday lives.

Most people are successful in their professions, even if they are diabetic. Mothers can function almost effortlessly within their families, despite suffering from GERD, and fathers can drive their children to training and watch their matches, even after years of living with diabetes.

Despite the significant benefits these medications offer, their drawbacks must also be addressed. Primarily, these are side effects, which can be numerous and occur daily. For instance, metformin, a drug used for type 2 diabetes, can cause frequent and uncomfortable diarrhea, especially at the beginning of treatment. These side effects usually subside after a few weeks as the body adapts; however, in some cases, they may persist, requiring the medication to be discontinued. Certain antibiotics, such as amoxicillin, can cause mild to severe allergic reactions, ranging from a minor skin rash to anaphylactic shock. Additionally, some medications can cause adverse reactions when taken together. For example, statins (used for lowering cholesterol) can cause muscle pain when combined with certain antibiotics like clarithromycin, resulting in statin-induced myopathy. Such adverse reactions are a consequence of drug interactions.

One rarely discussed or written-about topic is the impact of medications on the absorption of vitamins and minerals—micronutrients—from food into the bloodstream. Many medications can affect how certain vitamins or minerals are absorbed. For instance, prolonged use of stomach medications like pantoprazole can reduce magnesium absorption. This is particularly important for individuals in training who use magnesium to prevent cramps, as pantoprazole may hinder their body from obtaining enough magnesium.

1. ACE inhibitors, such as lisinopril, ramipril, or captopril, to regulate blood pressure. However, long-term use of these medications can lead to zinc deficiency. Zinc is an essential mineral involved in the body’s immune response, and its deficiency can impair wound healing and increase susceptibility to infections due to a weakened immune system.
2. Beta-blockers (e.g., metoprolol or bisoprolol), may result in a deficiency of the antioxidant coenzyme Q10, a side effect also caused by the diabetes medication glibenclamide.
3. Acetylsalicylic acid, better known as aspirin, can reduce the absorption of vital micronutrients such as iron, folic acid, vitamin B12, and vitamin C. Early signs of iron deficiency include fatigue and muscle weakness due to reduced oxygen levels. Deficiencies in folic acid and vitamin B12 can cause apathy and, in severe cases, dementia. A vitamin C deficiency, historically known to cause scurvy (leading to tooth loss in extreme cases), can also manifest as depression and increased susceptibility to infections in milder cases.
4. Glucocorticoids, hormones from the adrenal glands often used for treating inflammation, arthritis, or allergic reactions, can impair the absorption of potassium, vitamin D, vitamin K, and zinc during prolonged use. Potassium deficiency is characterized by loss of appetite and fatigue, while vitamin D deficiency is a precursor to frequent seasonal colds and flu. Vitamin D’s importance during the COVID-19 pandemic underscored its role in infection protection.
5. Pantoprazole – magnesium deficiency is equally critical, causing muscle cramps, nervousness, headaches, and a reduced stress threshold. Proton pump inhibitors (PPIs) like pantoprazole and omeprazole, aside from causing magnesium deficiency, can also reduce the absorption of iron, folic acid, calcium, vitamin D, and zinc. Calcium deficiency manifests as brittle nails and dry skin. It’s worth noting that magnesium, vitamin C, and vitamin B12 deficiencies are associated with oral contraceptives and metformin.
6. Atorvastatin, one of the most commonly prescribed medications in the USA in 2022, is used to reduce cholesterol. However, long-term use can cause a deficiency of coenzyme Q10 and selenium. Selenium is a critical micronutrient, and the presence of white spots under nails may indicate a selenium deficiency.
7. Diuretics, another major class of drugs, can reduce vitamin B1 levels, with symptoms of deficiency including fatigue and muscle weakness.

If you are taking any of the medications mentioned, pay attention to the possible deficiencies or symptoms outlined here. Always consult your doctor beforehand and, if necessary, determine the levels of specific micronutrients in your blood through laboratory testing.

Timely dietary adjustments or the addition of supplements can help maintain your health.

This topic highlights the importance of a balanced approach to therapy and nutrition—health depends not only on medications but also on the adequate support the body receives through essential nutrients.