Medications can play a necessary role in managing certain health conditions, but they can also have unintended consequences on nutritional status. Many commonly prescribed drugs can deplete essential vitamins, minerals, and other nutrients, potentially leading to adverse effects on health. In this article, we explore five drug classes notorious for causing nutritional deficiencies and the importance of proactive management to mitigate these risks.

  1. Proton Pump Inhibitors (PPIs): Proton pump inhibitors, used to treat acid reflux and ulcers, work by reducing stomach acid production. While effective for managing gastrointestinal symptoms, long-term use of PPIs has been associated with decreased absorption of essential nutrients such as vitamin B12, magnesium, and calcium.

Vitamin B12 deficiency can lead to neurological symptoms, fatigue, and anemia, while magnesium deficiency may manifest as muscle cramps, weakness, and cardiac arrhythmias. Calcium deficiency increases the risk of osteoporosis and bone fractures.

  1. Antidepressants: Certain antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs), can impact nutrient absorption and metabolism. SSRIs may interfere with the absorption of vitamins B12 and D, as well as folate.

Vitamin B12 deficiency can exacerbate symptoms of depression and contribute to cognitive impairment, while vitamin D deficiency is linked to mood disorders and compromised bone health. Folate deficiency is associated with depression and may reduce the effectiveness of antidepressant therapy.

  1. Statins: Statins are commonly prescribed to lower cholesterol levels. However, long-term use of statins has been linked to depletion of coenzyme Q10 (CoQ10), a crucial antioxidant and energy-producing compound in the body.

CoQ10 deficiency may manifest as muscle weakness, fatigue, and impaired cardiovascular function. Supplementation with CoQ10 is often recommended for individuals taking statins to mitigate these effects.

  1. Diuretics: Diuretics, also known as water pills or fluid pills, are prescribed to treat hypertension and edema by increasing urine output. However, diuretics can lead to electrolyte imbalances, particularly depletion of potassium and magnesium.

Potassium deficiency can cause muscle cramps, weakness, and cardiac arrhythmias, while magnesium deficiency may result in muscle spasms, irregular heart rhythms, and fatigue. Monitoring electrolyte levels and supplementation may be necessary for individuals on long-term diuretic therapy.

  1. Oral Contraceptives: Oral contraceptives, commonly used for birth control, can impact nutrient metabolism and absorption. These medications may deplete levels of B vitamins, including folate, B6, and B12, as well as vitamin C, zinc, and magnesium.

Folate deficiency during oral contraceptive use may increase the risk of neural tube defects in pregnant women. Low levels of vitamin C, zinc, and magnesium can compromise immune function, energy metabolism, and overall well-being.

While medications may at times play a necessary role in managing various health conditions, it’s essential to be aware of their potential impact on nutritional status. Individuals taking medications should consider proactive measures such as dietary modification, supplementation, and regular monitoring of nutrient levels to prevent or address deficiencies associated with common drug classes. By addressing these nutritional concerns, you can optimize your outcomes and promote overall health and well-being.

Dr. Amanda Childress, PharmD


Freedberg DE, Kim LS, Yang YX. The Risks and Benefits of Long-term Use of Proton Pump Inhibitors: Expert Review and Best Practice Advice From the American Gastroenterological Association. Gastroenterology. 2017;152(4):706-715.

Fava M, Mischoulon D. Folate in depression: efficacy, safety, differences in formulations, and clinical issues. J Clin Psychiatry. 2009;70 Suppl 5(Suppl 5):12-17.

Marcoff L, Thompson PD. The role of coenzyme Q10 in statin-associated myopathy: a systematic review. J Am Coll Cardiol. 2007;49(23):2231-2237.

Nakanishi T, Ohara T, Hata J, et al. Serum coenzyme Q10 levels and the 10-year risk of myocardial infarction: the Japanese population-based Shiga study. Atherosclerosis. 2011;217(1):291-296.

Hodgkinson E, Neville KA, Spinks AB, et al. Coenzyme Q10 improves blood pressure and glycaemic control: a controlled trial in subjects with type 2 diabetes. Eur J Clin Nutr. 2002;56(11):1137-1142.

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71(19).

Grossman F, Potter WZ. Antidepressants. In: Brunton LL, Chabner BA, Knollmann BC, eds. Goodman & Gilman’s: The Pharmacological Basis of Therapeutics. 12th ed. McGraw-Hill Education; 2011:409-440.

Brown ES, Varghese FP, McEwen BS. Association of depression with medical illness: does cortisol play a role? Biol Psychiatry. 2004;55(1):1-9.

Shams T, Firwana B, Habib F, et al. SSRIs for hot flashes: a systematic review and meta-analysis of randomized trials. J Gen Intern Med. 2014;29(1):204-213.

Serfaty D, Masterson A. Diuretics and electrolyte disturbances in the elderly. Br J Clin Pharmacol. 2013;76(3):503-514.

Wannamethee SG, Papacosta O, Lennon L, Whincup PH. Serum magnesium and risk of incident heart failure in older men: the British Regional Heart Study. Eur J Epidemiol. 2018;33(10):951-959.

Adams MM, Reedy D. Diuretic-induced hypokalemia. Cardiology. 1987;74(2):101-104.

Aghajafari F, Nagulesapillai T, Ronksley PE, Tough SC, O’Beirne M, Rabi DM. Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. BMJ. 2013;346.

Lopez-Ridaura R, Willett WC, Rimm EB, et al. Magnesium intake and risk of type 2 diabetes in men and women. Diabetes Care. 2004;27(1):134-140.

Sahraian MA, Radue EW, Eshaghi A, Besliu S, Minagar A. Progressive multiple sclerosis: from pathogenic mechanisms to treatment. Brain. 2017;140(3):527-546.