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As patients, we all strive to do what is best for our bodies. We eat well, exercise, and take any necessary medications when needed. However, what is not well known is that sometimes the medications we take can cause a depletion of important nutrients.

Don’t get me wrong, prescription medications are a necessity for many people and I am not in any way advising you to NOT take your prescribed medications. I simply would like to educate you on the nutrients you will need additional intake of, when taking certain medications.

Since there are a lot of medications that can cause nutrient depletion, I am going to break them up into a two-part series and only tell you about a couple of drugs at a time. This month I would like to address Antacids and Non-Steroidal Anti-Inflammatories (NSAIDs).

This category includes medications such as Pepcid, Tagamet, Prevacid, Prilosec, and magnesium & aluminum containing antacids (such as Gaviscon, Maalox, Mylanta).

Antacids work by neutralizing stomach acid or by inhibiting the release of a digestive enzyme (like pepcin). Unfortunately stomach acid is necessary to release vitamins from food, and when you decrease or stop the production of it, you absorb fewer vitamins.

These medications can cause deficiencies in the following nutrients:

Vitamin B12
Folic Acid
Vitamin D

Most common of these is deficiencies is B12. Vitamin B12 deficiency can cause anemia, depression, tiredness, and weakness. The good news is that Vitamin B12 is easy to supplement. When choosing a B12 supplement, you want to look exclusively for the methylated form…Methylcobalamin. Dosages range from 1 to 5mgs and it can be taken twice daily if needed. I recommend taking it in the morning and around noon. Vitamin B12 provides energy, so never take it too close to bedtime. Vitamin B12 is also “water soluble” meaning that you cannot overdose on it since the body automatically eliminates any excess through urine.

Talk to your doctor about the proper dosing for you when supplementing for Folic Acid, Vitamin D, Calcium, Iron, and Zinc. Vitamin D is a fat-soluble vitamin. You can take too much of it, so be sure to have your blood tested to keep your levels in check.

This group includes medications such as Motrin, Aleve, Advil, Anaprox, Dolobid, Feldene, and Naprosyn.

These are all known to cause folic acid deficiency due to a decrease in the body’s ability to absorb folate from the intestine.

Folic acid deficiency can cause birth defects, anemia, and a higher risk of cardiovascular disease.

Also in this group is aspirin and other salicylates.

Long term use of aspirin is linked to deficiency in the following nutrients:

Vitamin C
Folic Acid
Vitamin B5 (Pantothenic Acid)

Aspirin can cause the body to expel more Vitamin C in urine than normal and Vitamin C is essential for a healthy immune response. Calcium is necessary for bone, heart & dental health. Iron prevents anemia, weakness, fatigue, hair loss, and brittle nails. Vitamin B5 helps with fatigue and listlessness.

Most of these nutrients are available in a high-quality multivitamin, however if you are on an aspirin therapy regimen, I recommend talking to your doctor about dosage to replenish these nutrients.

Next month we will talk about some additional medications that can cause nutrient depletion. If you currently take any of these medications and want to know if you are nutrient deficient, we offer testing in our office through a company called Spectracell. You call any of our offices to request Spectracell testing. Until then I wish you continued good health.


Dr. Melissa Miskell


Antioxidant Boxers

Every so often a patient asks me, “What are antioxidants and why do I need them?”  My answer is always the same.  To understand what antioxidants are, you need to understand what a free radical is.

Let’s Start from the Top

Free radicals consist of harmful molecules that are missing electrons.  Electrons typically come in pairs.  This lack of electrons cause the molecule to be highly reactive and cause damage by attacking the most basic parts of our healthy cells causing what is considered “oxidation”.  Oxidation can set off an entire cascade of chemical reactions causing damage.  Free radicals can even cause cancer.

Ways we encounter free radicals every day:

Cigarette smoking
Airborne emissions/pollution
Ultraviolet radiation
Herbicides & pesticides

Free radicals aren’t entirely bad.  There are some body systems that require free radicals to complete their processes.  They actually play a role in the immune response to fight off viruses and bacteria and they start the process of inflammation that helps to repair injuries.  However free radicals obtained from the sources above definitely cause premature aging and disease, so we fight these with antioxidants.

What Antioxidants Do

Antioxidants basically have the ability to “render harmless” free radicals.  They provide the missing electron or break down the free radical molecule.  This then stops the cascade of chemical reactions (oxidation), thus   the name, anti-oxidant.  This process depletes the antioxidants, to where there are none remaining and must be replaced.

Where Do I Get Antioxidants?

Antioxidants are found in most fruits, vegetables, and nuts.  Vitamins such as A, C, and E have antioxidant properties.  Some foods that have more antioxidants are:

Blueberries, Dark Chocolate, Pecans, Artichoke, Kidney Beans, Cranberries, Blackberries, Cilantro

Antioxidants are also available in supplement form.  Remember to talk to your doctor before adding any supplement to your diet.  Just to name a few antioxidant supplements…

1. Glutathione is truly the master of all antioxidants, glutathione boosts the activities of all other antioxidants and vitamins. Up until a few years ago, glutathione was not stable when taken orally.  However recent advances have created S-Acetyl Glutathione that can be taken orally and has proven to boost the body’s antioxidant levels.

2. Vitamin C has been shown to regenerate other antioxidants in the body including Vitamin E. It is not made by the body and must be consumed in food or by supplementation.

3. Curcumin comes from Turmeric which is a member of the ginger family. Its roots are dried and ground into an orange-yellowish powder.  Curcumin has been shown to inhibit certain enzymes that cause inflammation in the body.

Because antioxidants are depleted when fighting free radicals, you want to be sure to eat a balanced diet that includes fruits, vegetables, and nuts every day to replenish your fighting power.  If you are using a supplement as well, be sure to check with your doctor and chose a high-quality supplement brand (preferably pharmaceutical grade).  Let’s do everything we can to keep ourselves healthy and young for as long as possible!

May you have continued good health,

Dr. Melissa Miskell

At Focus Total Health, our goal is to help you live as well as you can while feeling good. The aging process can take a toll, but its effect can be minimized with the use of appropriate hormone therapy and excellent nutrition.

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