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Prescription RX Part 2

This is part two in my series on nutrient deficiencies that can result from long term use of medications.  This month I am going to address anti-depressants, antibiotics, cholesterol lowering drugs, and diabetic drugs.  I would like to stress that I am NOT advocating that you stop taking any medication that your doctor has prescribed, only letting you know that you may require additional amounts of these nutrients to stay healthy while on that medication.


Anti-depressants include Prozac, Effexor, Lexapro, Wellbutrin, and many more.  With long-term use of anti-depressants, you are going to deplete two things:  Coenzyme Q10 (CoQ10) and Vitamin B2 (Riboflavin).  You can get some CoQ10 from your diet, but most patients require a supplement.  Natural sources are: red meat, oily fish, and some nuts.  When choosing a CoQ10 supplement, make sure the manufacturer is reputable (preferably pharmaceutical grade).  Your doctor can help you understand what dose of CoQ10 is right for you.

Vitamin B2 (Riboflavin) is found in foods such as beef liver, lamb, mushrooms, spinach and almonds.  You can also find B2 as a supplement alone or in a B-Complex.


Antibiotics include medications such as Gentamycin, Neomycin, Streptomycin, Cephalosporins, Penicillins, and Tetracyclines.  Most antibiotics are used only for a short amount of time.  However, some patients are put on long-term antibiotic therapies.  This long-term use can lead to depletion of:

  • B Vitamins
  • Vitamin K
  • Calcium
  • Magnesium
  • Iron
  • Zinc

You can increase intake of these vitamins and minerals through a healthy diet, but some patients will need to incorporate a high-quality multivitamin daily.  No matter what choice you make for vitamin repletion, every patient will require a high-dose probiotic to recolonize the bacteria in the gastrointestinal tract.  Talk to your doctor about what probiotic is right for you.

Cholesterol Drugs:

Drugs in this category are collectively called “statins” and include names like: Lipitor, Crestor, Zocor, and others.  They too deplete Coenzyme Q10.  Low energy is a common complaint from patients on statins and this can be partially due to depleted CoQ10.  Seek a high-quality CoQ10 supplement to fight this fatigue.

Diabetic Drugs:

Metformin and Sulfonylurea drugs are used to manage Type 2 Diabetes.  Metformin being the oldest and most common drug in this category, depletes: Coenzyme Q10, Vitamin B12, and Folic Acid.  All three of these directly affect energy levels, cardiovascular health, and the immune system.  Since most patients continue with long-term Metformin therapy, I recommend repletion with high-quality supplements for these nutrients.  When purchasing your supplements, be sure that your Vitamin B12 and Folic Acid are in the active/bioavailable form.  Look for “methylcobalamin” for B12 and “5-methyltetrahydrofolic acid” for Folic Acid.

Want to know if you are nutrient depleted?  We offer Spectracell Micronutrient Testing.  This test looks at your nutritional status from a cellular level checking vitamins and minerals such as: B Vitamins, Vitamin K, Vitamin D, Selenium, Coenzyme Q10, Copper, and many more.  Test results come with repletion suggestions for foods or supplements and the appropriate dosing.  Come by our office today and ask for Spectracell.



The health of your gastrointestinal tract (GI tract) affects your entire body.  One of the main supplements that I recommend to my patients is a good quality high-dose probiotic. Why you ask? Let me tell you...

Your gastrointestinal tract is a complex ecosystem containing thousands of species of bacteria. These bacteria can be found in your stomach and small intestines, but the majority are found in your colon.  Collectively these areas make up your “microbiome.” These intestinal flora aid in digestion, synthesize vitamins and nutrients, metabolize some medications, support the development and functioning of the gut, and enhance the immune system.

There are times when this balance of beneficial bacteria gets out of balance such as with the extended or recurrent use of antibiotics, poor dietary habits, or recent infection.  This is where the use of a probiotic becomes advantageous.  A good multi-strain probiotic can help to recolonize the GI tract to the proper balance of beneficial bacteria.  But how do you recognize a high-quality probiotic?

Here's how:

  1. It is multi-strain.  This means that it has more than one type of bacteria in each capsule. The one I recommend the most contains Lactobacillus acidophilus, Lactobacillus plantarum, Bifidobacterium longum, & Bifidobacterium lactis.
  2. It is packaged so that oxygen cannot reach the capsules or is consistently refrigerated (even during transport) so that the organisms cannot get overheated and die.
  3. It is high dose.  For maximum results the GI tract needs maximum exposure.  For those patients that have GI issues or tend to have weakened immune systems, I recommend 100 Billion CFU (the measurement for bacteria is Colony Forming Units) daily.  Other patients that simply need to maintain GI health can take the 100 Billion CFU capsule every other day or just several times per week.

Some foods also promote healthy and abundant GI flora.  For example, sauerkraut and kimchi are fermented foods that contain probiotics.  Other foods provide the precursors to probiotics called “prebiotics”.  Those are foods like: asparagus, onions, garlic, cabbage, and artichokes.  These foods are mainly carbohydrates that cannot be digested by the body, but are food for the probiotic (or good) bacteria.  Following these guidelines will get you to a better place with your bowel movements (diarrhea or constipation), vaginal health, skin health, and even a healthier immune system.  Here’s to a healthy microbiome!



I have quite a few patients that are concerned about their bone health, and the first question they normally ask is “how much calcium should I be taking?” The answer is that amounts vary according to the patient, and you should not be taking calcium alone.

The first question you should ask is what is bone made of? Bone is composed of several calcium-based minerals and collagen. This means that if you are going to take a supplement to support your bones, you need to take multiple supplements.

Here's the basics...
1. Calcium is still a necessity. However, not all calcium supplements are created equal. My preference is for what is called MCHC (Microcrystalline Hydroxyapatite Concentrate). This is a standardized, and safe-source bone extract from New Zealand bovine, that contains a crystalline calcium and phosphorus matrix. It is also what your bones are made of.

2. Vitamin D3. Yes, you need Vitamin D3 (cholecalciferol) to support bone health as well. Vitamin D’s best-known role is to keep bones healthy by increasing the intestinal absorption of calcium.

3. Collagen. This is supported through a silicon based supplement (specifically orthosilicic acid). Collagen helps bone withstand sudden impact, and determines how “tough” your bones are.

4. Vitamin K2. Vitamin K2 (as menaquinone-7) supports calcium utilization and absorption. Some younger patients do not require added Vitamin K2 supplements.

How do you know the right combination of supplements for your bone health? Ask your doctor. The good news is that there are supplements available that contain all these ingredients in one packet, or you can purchase them separately. If you are a post-menopausal woman with osteopenia or osteoporosis, you are going to need considerably more of each of these supplements to ensure that you arrest your bone loss.



A brief introduction...

When most practitioners talk about “anti-inflammatory” they are generally referring to prescriptions that mask swelling such as NSAIDs like ibuprofen or naproxen.  When functional medicine practitioners talk about anti-inflammatory we are referring to the foods and supplements that prevent the cause of inflammation in the body.

Inflammation is the beginning of all disease states whether acute or chronic.  Obviously acute inflammation is necessary for the body to start repairing damage from some harm inflicted recently such as a sprained ankle or a cut finger.  Chronic inflammation is what you never want your body to experience.

First, how do I know if I have chronic inflammation? 

Chronic inflammation manifests itself in many different ways.  The most common are:

  • Joint swelling & tenderness
  • Muscle aches (not muscle soreness from exercise)
  • Abdominal pain & bloating
  • Chronic headaches
  • Constipation
  • Constant fatigue
  • Any autoimmune disorder

If you have one or more of these symptoms, you are experiencing chronic inflammation.

So I have chronic inflammation, what do I do now?

Step number one when working to combat chronic inflammation is to look at your diet.  I firmly believe that “you are what you eat.”  However, making healthy choices can be confusing.  The media and the internet are filled with conflicting information on “eat this food...but don't eat this, it's ok to eat this food in moderation.”  So what's a person to do?  I'm going to make this relatively simple.

A simple summary of what to eat:

  1. Eat organic, grass-fed/free-range meats or wild-caught seafood/fish
  2. Eat organic produce (this includes all fruits and veggies)

What not to eat:

Avoid as much of these as possible:

  • Grains of any type (yes, that means no bread)
  • Sugar in any form (use Stevia instead)
  • Artificial sweeteners (yes, pink ones, yellow ones & blue ones)
  • Caffeinated beverages (substitute herbal teas or better yet, just drink water)
  • Alcohol in excess
  • All dairy (yes, cheese too)
  • Eggs (food allergy testing can confirm if you must avoid these long-term)

If you have already progressed to an autoimmune disorder, then you need to be especially diligent in your eating habits and avoid everything on this list.

If you would like to get a firm answer on what exactly your food allergies & sensitivities are that are causing your chronic inflammation, see a practitioner that does testing.  In my office, we use Alletess Food Allergy/Sensitivity testing.  We welcome current patients to come in and request the test.

Focus on Curcumin

Once patients have begun to work on their diet to eliminate the foods that are perpetuating chronic inflammation, I look to one of my favorite supplements that can help reduce any remaining swelling & discomfort...Curcumin.

Curcumin is the active compound in Turmeric.  It is yellowish in color and has been a part of Indian and Asian diets for centuries.  Interestingly enough researchers began to notice that those countries had a much lower incidence of arthritis and other inflammatory diseases.  Additional research has found that Curcumin plays a role in decreasing inflammation and protecting the body from inflammation.

I never recommend starting any supplement without speaking with your physician first.  As with all medications your healthcare provider will make sure it will not interfere with any of your other medications.  I also recommend that you consult a physician on what dosage of curcumin would be best for you.

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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