Supplement Your Prescription cover image

Supplement Your Prescription

  • How Do Medications Affect Your Nutrition?
  • Why Is This A Problem?
  • What Can You Do About It?

Read more. Find out how to maintain your health while taking prescription drugs.

Almost all commonly used medications, even those purchased over-the-counter, cause an important but little known side effect.

This side effect is nutrient depletion. Many people who suffer from this kind of depletion think their mounting health problems are a normal part of aging. They make appointments with their doctors about their new symptoms.

Commonly, more drugs are prescribed to stop the symptoms. In general, this happens because most physicians are unaware of the potential of drugs to deplete nutrients.

Supplement Your Prescription cover image

Supplement Your Prescription

  • How Do Medications Affect Your Nutrition?
  • Why Is This A Problem?
  • What Can You Do About It?

Read more. Find out how to maintain your health while taking prescription drugs.

Almost all commonly used medications, even those purchased over-the-counter, cause an important but little known side effect.

This side effect is nutrient depletion. Many people who suffer from this kind of depletion think their mounting health problems are a normal part of aging. They make appointments with their doctors about their new symptoms.

Commonly, more drugs are prescribed to stop the symptoms. In general, this happens because most physicians are unaware of the potential of drugs to deplete nutrients.

Supplement Your Prescription cover image

Supplement Your Prescription

  • How Do Medications Affect Your Nutrition?
  • Why Is This A Problem?
  • What Can You Do About It?

Read more. Find out how to maintain your health while taking prescription drugs.

Almost all commonly used medications, even those purchased over-the-counter, cause an important but little known side effect.

This side effect is nutrient depletion. Many people who suffer from this kind of depletion think their mounting health problems are a normal part of aging. They make appointments with their doctors about their new symptoms.

Commonly, more drugs are prescribed to stop the symptoms. In general, this happens because most physicians are unaware of the potential of drugs to deplete nutrients.

Supplement Your Prescription cover image

Supplement Your Prescription

  • How Do Medications Affect Your Nutrition?
  • Why Is This A Problem?
  • What Can You Do About It?

Read more. Find out how to maintain your health while taking prescription drugs.

Almost all commonly used medications, even those purchased over-the-counter, cause an important but little known side effect.

This side effect is nutrient depletion. Many people who suffer from this kind of depletion think their mounting health problems are a normal part of aging. They make appointments with their doctors about their new symptoms.

Commonly, more drugs are prescribed to stop the symptoms. In general, this happens because most physicians are unaware of the potential of drugs to deplete nutrients.

Supplement Your Prescription cover image

Supplement Your Prescription

  • How Do Medications Affect Your Nutrition?
  • Why Is This A Problem?
  • What Can You Do About It?

Read more. Find out how to maintain your health while taking prescription drugs.

Almost all commonly used medications, even those purchased over-the-counter, cause an important but little known side effect.

This side effect is nutrient depletion. Many people who suffer from this kind of depletion think their mounting health problems are a normal part of aging. They make appointments with their doctors about their new symptoms.

Commonly, more drugs are prescribed to stop the symptoms. In general, this happens because most physicians are unaware of the potential of drugs to deplete nutrients.

Supplement Your Prescription cover image

Supplement Your Prescription

  • How Do Medications Affect Your Nutrition?
  • Why Is This A Problem?
  • What Can You Do About It?

Read more. Find out how to maintain your health while taking prescription drugs.

Almost all commonly used medications, even those purchased over-the-counter, cause an important but little known side effect.

This side effect is nutrient depletion. Many people who suffer from this kind of depletion think their mounting health problems are a normal part of aging. They make appointments with their doctors about their new symptoms.

Commonly, more drugs are prescribed to stop the symptoms. In general, this happens because most physicians are unaware of the potential of drugs to deplete nutrients.

Supplement Your Prescription cover image

Supplement Your Prescription

  • How Do Medications Affect Your Nutrition?
  • Why Is This A Problem?
  • What Can You Do About It?

Read more. Find out how to maintain your health while taking prescription drugs.

Almost all commonly used medications, even those purchased over-the-counter, cause an important but little known side effect.

This side effect is nutrient depletion. Many people who suffer from this kind of depletion think their mounting health problems are a normal part of aging. They make appointments with their doctors about their new symptoms.

Commonly, more drugs are prescribed to stop the symptoms. In general, this happens because most physicians are unaware of the potential of drugs to deplete nutrients.

Supplement Your Prescription cover image

Supplement Your Prescription

  • How Do Medications Affect Your Nutrition?
  • Why Is This A Problem?
  • What Can You Do About It?

Read more. Find out how to maintain your health while taking prescription drugs.

Almost all commonly used medications, even those purchased over-the-counter, cause an important but little known side effect.

This side effect is nutrient depletion. Many people who suffer from this kind of depletion think their mounting health problems are a normal part of aging. They make appointments with their doctors about their new symptoms.

Commonly, more drugs are prescribed to stop the symptoms. In general, this happens because most physicians are unaware of the potential of drugs to deplete nutrients.

Supplement Your Prescription cover image

Supplement Your Prescription

  • How Do Medications Affect Your Nutrition?
  • Why Is This A Problem?
  • What Can You Do About It?

Read more. Find out how to maintain your health while taking prescription drugs.

Almost all commonly used medications, even those purchased over-the-counter, cause an important but little known side effect.

This side effect is nutrient depletion. Many people who suffer from this kind of depletion think their mounting health problems are a normal part of aging. They make appointments with their doctors about their new symptoms.

Commonly, more drugs are prescribed to stop the symptoms. In general, this happens because most physicians are unaware of the potential of drugs to deplete nutrients.

Supplement Your Prescription cover image

Supplement Your Prescription

  • How Do Medications Affect Your Nutrition?
  • Why Is This A Problem?
  • What Can You Do About It?

Read more. Find out how to maintain your health while taking prescription drugs.

Almost all commonly used medications, even those purchased over-the-counter, cause an important but little known side effect.

This side effect is nutrient depletion. Many people who suffer from this kind of depletion think their mounting health problems are a normal part of aging. They make appointments with their doctors about their new symptoms.

Commonly, more drugs are prescribed to stop the symptoms. In general, this happens because most physicians are unaware of the potential of drugs to deplete nutrients.

Supplement Your Prescription cover image

Supplement Your Prescription

  • How Do Medications Affect Your Nutrition?
  • Why Is This A Problem?
  • What Can You Do About It?

Read more. Find out how to maintain your health while taking prescription drugs.

Almost all commonly used medications, even those purchased over-the-counter, cause an important but little known side effect.

This side effect is nutrient depletion. Many people who suffer from this kind of depletion think their mounting health problems are a normal part of aging. They make appointments with their doctors about their new symptoms.

Commonly, more drugs are prescribed to stop the symptoms. In general, this happens because most physicians are unaware of the potential of drugs to deplete nutrients.

Supplement Your Prescription cover image

Supplement Your Prescription

  • How Do Medications Affect Your Nutrition?
  • Why Is This A Problem?
  • What Can You Do About It?

Read more. Find out how to maintain your health while taking prescription drugs.

Almost all commonly used medications, even those purchased over-the-counter, cause an important but little known side effect.

This side effect is nutrient depletion. Many people who suffer from this kind of depletion think their mounting health problems are a normal part of aging. They make appointments with their doctors about their new symptoms.

Commonly, more drugs are prescribed to stop the symptoms. In general, this happens because most physicians are unaware of the potential of drugs to deplete nutrients.

Supplement Your Prescription cover image

Supplement Your Prescription

  • How Do Medications Affect Your Nutrition?
  • Why Is This A Problem?
  • What Can You Do About It?

Read more. Find out how to maintain your health while taking prescription drugs.

Almost all commonly used medications, even those purchased over-the-counter, cause an important but little known side effect.

This side effect is nutrient depletion. Many people who suffer from this kind of depletion think their mounting health problems are a normal part of aging. They make appointments with their doctors about their new symptoms.

Commonly, more drugs are prescribed to stop the symptoms. In general, this happens because most physicians are unaware of the potential of drugs to deplete nutrients.

Supplement Your Prescription cover image

Supplement Your Prescription

  • How Do Medications Affect Your Nutrition?
  • Why Is This A Problem?
  • What Can You Do About It?

Read more. Find out how to maintain your health while taking prescription drugs.

Almost all commonly used medications, even those purchased over-the-counter, cause an important but little known side effect.

This side effect is nutrient depletion. Many people who suffer from this kind of depletion think their mounting health problems are a normal part of aging. They make appointments with their doctors about their new symptoms.

Commonly, more drugs are prescribed to stop the symptoms. In general, this happens because most physicians are unaware of the potential of drugs to deplete nutrients.

Supplement Your Prescription cover image

Topic: Prescription Impact On Nutrition

“Every person who takes prescription drugs 

needs to know about drug-induced nutrient 

depletion, and about how to effectively balance this side effect with appropriate nutrition from foods and supplements.” 

Supplement Your Prescription, Hyla Cass, MD

Supplement Your Prescription

• How Do Medications Affect Your Nutrition?

• Why Is This A Problem?

• What Can You Do About It?

Look inside. Find out how to maintain your health while taking prescription drugs.

Almost all commonly used medications, even those purchased over-the-counter, cause an important but little known side effect. This side effect is nutrient depletion. Many people who suffer from this kind of depletion think their mounting health problems are a       normal part of aging. They make appointments with their doctors about their new symptoms.

Commonly, more drugs are prescribed to stop the symptoms. In general, this happens because most physicians are unaware of the potential of drugs to deplete nutrients.

Currently, nearly 50 percent of American adults take at least one prescription medication daily while over half of those 65 take three. And, our use of medication is increasing. In 2004, nearly $200 billion was spent on prescriptions – an increase of 450 percent over the amount spent in 1990.

Surprisingly, almost every prescription is harmful in some way. In fact, over the last few years, more than a dozen drugs approved by the FDA turned out to be so dangerous they were withdrawn. (Some of these were used by millions worldwide.) As Hyla Cass, MD, writes, “Any drug powerful enough to have substantial effects on a disease process will be powerful enough to cause harm.” 

   As it stands, there are currently 100,000 deaths annually due to drugs. (And, these are drugs that were actually taken correctly.) This statistic makes death from medication the fourth leading cause of death in the country.

Although it is highly unlikely that your prescription will kill you, it can still harm you over time. Nutrient depletion is one of the most ignored and likeliest of side effects. As Dr. Cass puts it, “These subtle effects can cramp your style in a big way. Get educated. – Read the book!”

Which book? Supplement Your Prescription: What Your Doctor Doesn’t Know About Nutrition, published by Basic Health Publications, 2007  ($14.95). This book is Dr. Cass’s latest contribution to our health. As soon as I received my review copy, I knew Nutrition News would interview Dr. Cass.

Our Interview With Hyla Cass, MD

NN: Welcome, Hyla. I’m so happy to have you share your new book with our readers.

HC: Thank you, Siri. It’s great to be here.

NN: With this book, you provide a real service to people who are on prescription meds. What motivated you to write it?

HC: In my practice, I deal primarily with drugs intended for long-term use. These cause slow nutrient depletions over time with serious side effects. The effects are so subtle that mainstream medicine rarely traces them back to the medication. Unfortunately, patients are generally told that their symptoms are “part of the illness” and then they’re given an additional drug (or two) to deal with the new symptoms.

After seeing case after case of patients suffering from nutrient loss due to their prescriptions,  I was compelled to write the book. After all, there is a simple, natural, nutritional solution to what appears to be a complex problem.

NN: Have you noticed any commonalities in the cases?

HC: Yes. For one thing, most side effects are dose-related. This is because the standard starting doses of many top-selling drugs are too strong for millions of patients. Medications should always be started at the lowest possible dose and built up gradually. In addition, as I mentioned, many doctors simply prescribe additional medications to get rid of the symptom complaints. 

This takes us to another problem: the mystery of drug interactions. Medical science doesn’t always know how drugs will interact in a patient’s body. For example, a patient might simultaneously be put on Lipitor to bring their cholesterol down, prednisone for respiratory relief, and Motrin for pain. How many of the health problems that crop up in this patient are caused by drug side effects and interactions? We just don’t have any long term studies to tell us.

NN: You know, Hyla, this seems so contradictory. Don’t most people expect to “get well” once they start on a medication?

HC: That is a common misconception, Siri. With the possible exception of bioidentical hormones, drugs do not  “correct imbalances” or nudge a malfunctioning body system back to its perfect function.

For a drug to be approved by the FDA, it has to target a specific pathway or function in the body. However, it’s just not possible to target a single reaction in the body without  tipping others into imbalance. No matter how specific a drug is designed to be, it will have effects that go beyond its intended actions. This leads to side effects, including that of robbing the body of important nutrients.

To affect health, the body must be approached as a whole. It operates as a fine-tuned interplay among various systems. Treatment should address the deepest root cause, and be as safe and natural as possible. Medication should be kept at the lowest effective dose. This greatly decreases or eliminates side effects.

I want to say here that not all doctors lack knowledge of nutrition or of alternative care approaches. Many patients would rather take a pill than change their behavior. This will remain true for some even when they understand the risks.

NN: Dr. Cass, how do medications cause nutrient depletion?

HC: There are five major ways this happens. They are explained fully in the book. And, then, there are a number of other possible depleting factors. [See sidebar “How Medications Deplete Nutrients”.]

NN: We often suggest a combination of nutrition and nutritional supplements to address various conditions.

HC: Yes, in my practice, I use many nutritional protocols. They include a number of nutrients that provide condition specific natural alternatives to medications.

This is not to say that drugs don’t have their place. However, I devote a chapter each to the nutritional adjuncts to drugs for diabetes, high blood pressure, high cholesterol, acid reflux, heartburn, constipation, arthritis, and depression. I also include supplement programs.

Plus, I’ve written a chapter about depletions related to less commonly used medicines. These include drugs for obesity, epilepsy, AIDS, contraception, menopausal symptoms, bipolar disorder, gout, and cancer.

My final chapter covers a phenomenon known as polypharmacy, which means taking multiple drugs. I discuss some general principles to help people optimize their prescription use. Finally, a resource section is included to help the reader access more information. I believe that by learning about drug side effects and nutrient depletions, you’ll have the tools to best approach the issue, whether you’re treating yourself or helping someone else.

NN: On behalf of all of us, thank you, Dr. Hyla Cass.

The Fix For Your Rx

Our formula is Good Nutrition + Supplements = Better Health (with any condition). In this section, we first emphasize good nutrition. Secondly, we talk about the signs and symptoms of depletions in specific conditions. In general, for each condition, we have chosen the depletion side effect of the most widely used drug. Then we introduce Dr. Cass’s supplement protocol for preventing the loss of nutrients and replacing those that may have been lost.

Good Nutrition

Good nutrition is always the first line of defense against nutrient depletion. As Dr. Cass writes, “Depressed, tired, foggy-brained individuals are often told by their doctors that they need an antidepressant. All many of them really need is a steady supply of real food to get their brains and bodies back on track.”

  Over time, scientific research has demonstrated several long term outcomes of healthy eating. Good nutrition can: 

• Improve your mood.

• Increase your mental and physical stamina and your

overall health.

• Enhance your concentration, memory, and overall

mental ability.

• Reduce your stress level.

Diet is the bottomline. Years of poor eating can cause subclinical nutrient deficiency or general long term nutritional imbalances. This can be going on long before you begin to take any prescription drugs.

  The key to good nutrition is eating foods that are whole, fresh, and lively. If this describes your diet, you are on the right tract. A jillion issues of Nutrition News have been dedicated to right eating. A jillion books and articles abound to give you guidance if you need it. Take on the undeniable importance of healthy eating. Don’t forget to exercise. Drink plenty of water. Now, let’s go on to….

Supplement Your Prescriptions

Behind all the specific supplement recommendations is the expectation that you are following a basic supplement program. This one comes from Dr. Cass: a high potency multivitamin-mineral formula, 1-3 grams of vitamin C, 30 mg of CoQ10, a probiotic (containing 1 billion live bacteria per dose), an antioxidant formula, and 1 gram of fish oil taken twice daily.

In this section, we cover the protocols for countering nutrient depletions for the most commonly used drugs in the following conditions: diabetes; high cholesterol and high blood pressure; arthritis; GI function (acid reflux, heartburn, and constipation); and antidepressants. In her book, Dr. Cass includes a discussion of many more drugs in each category, plus a supplement program for the condition. (She has also written a chapter covering antibiotics, drugs for birth control, bipolar disorder, cancer, and more.)

Diabetes

Dr. Cass reports that junk food accounts for 90 percent of diabetes diagnoses, affecting nearly 200 million people worldwide. Metformin (also as Glucophage, Glucophage XR, and Glucovance) is the most popular oral antidiabetic drug in America. In 2006, nearly 35 million prescriptions were written for just one generic form of the drug. 

Metformin depletes vitamin B12 and folic acid. It also reduces a substance called intrinsic factor, needed for the proper absorption of B12 by the small intestine. One study showed that patients on metformin had average B12 levels only half those of people not on medication. The longer the drug is used, the lower the B12 levels. This drug may also deplete the body of the antioxidant and heart protector coenzyme (CoQ10).

Take daily: B12, 200 – 1000 mcg; folic acid, 400 – 800 mcg; CoQ10, 30 – 200 mg. In addition to these imperative nutrient replacements, Dr. Cass includes a Diabetes Supplement Program for you.

High Cholesterol and High Blood Pressure

Both of these conditions can be improved by lifestyle changes, diet, and supplements. Statin drugs are the most prescribed meds for lowering cholesterol. One of them, Lipitor, is the top selling drug on the planet, a $20 billion dollar a year industry. Dr. Cass writes that you may benefit from statins if: 1) you are diabetic; 2) you have had a heart attack; 3) you have heart disease but have not had a heart attack.

She also acknowledges that blood pressure lowering drugs may be necessary. HBP is dangerous and damages the artery walls. However, drugs for both high cholesterol and HBP cause nutrient depletion. Once again, Dr. Cass includes a diet and supplement program to improve these conditions.

Statins deplete the body of coenzyme Q10, a substance necessary to heart health. Studies have shown increased risk of heart failure in statin users. Cass writes that this is likely related to the CoQ10-depleting effect of the drugs. This depletion can also result in muscle pain, weakness, and lack of energy. Do not ignore these signs, AND Do Not Take Statin Drugs Without Supplementing CoQ10! Take 100 to 300 mg of CoQ10 daily. It is better utilized when taken with a meal or a food containing oil.

Noting that there is a huge volume of drugs for hypertension, Cass writes that thiazide diuretics are usually the first-line therapy.1 These drugs deplete magnesium, potassium, zinc, sodium, and CoQ10. Take magnesium, 250 – 500 mg; potassium, 100 mg; zinc, 25 mg; and CoQ10, 100-300.

1 These include chlorothiazide (Diuril), chlorthalidone (Hygroton), hydrocholorothiazide (Hydrodiuril), metolazone (Mykrox, Zaroxolyn). Incidentally, current laws allow drug makers to hold sole rights to sell a new drug for 20 years, after which generics can be made and sold at much lower prices.

Arthritis

In this chapter, Dr. Cass discusses both rheumatoid and osteo- arthritis. She takes on NSAIDs, the non-steroidal anti-inflammatory drugs commonly used to relieve the muscle and joint pain of these diseases. (The OTC drugs include Aleve, Motrin, and Advil). Further, she explains the heart failure connected to VIOXX, and reveals how all NSAIDs can affect heart health as well as putting us at risk for ulcers and internal bleeding.

Paradoxically, these drugs also inhibit the action of enzymes that are needed to create healthy cartilage. This means the very substances used to relieve arthritis pain accelerate the progression of the disease. NSAIDs deplete folic acid and vitamin C. Take 500-1000 mg of vitamin C and 400-800 mg of folic acid.

Acid Reflux, Heartburn, and Constipation

These are problems that are intimately connected with what you choose to put in your mouth every day. Further, as with NSAIDs (above), the drugs used to relieve the           symptoms often result in making the problem worse. Unfortunately, this is another situation in which many people choose to continue to squelch their symptoms rather than get to the root cause of the problem by changing their behavior.

Regarding heartburn and acid reflux, we’ll look briefly at antacids and H2 blockers. Antacids include Mylanta, Maalox, Tums, and Rolaids. These neutralize stomach acids and often cause constipation. H2 blockers block the production of histamine, a chemical which signals the stomach to produce acid. H2 blockers include Tagamet and Zantac. Dr. Cass warns that you should not use an H2 blocker to treat heartburn for more than two weeks without checking in with your doctor.

A little known fact is that stomach acid not only helps us digest our food, it helps to kill off bacteria, viruses, and other microorganisms than can otherwise cause serious infections, such as pneumonia.

For antacids, take calcium, 1000-2000 mg; folic acid, 400 mcg; phosphorus, 700 mg; B12, 200 mcg; vitamin D 600-1000 IU; and zinc, 25-50 mg. 

For H2 blockers, take calcium, 1000-2000 mg; vitamin B12, 200 mcg; and vitamin D, 600-1000 mg.

In an interesting discussion of normal elimination and of constipation as a diagnosis, Dr. Cass remarks that unless you have diarrhea, there are no known nutrient depletions relative to laxative substances.

Antidepressants

Because Dr. Cass is a psychiatrist, she has a uniquely practical understanding of these medications. She opens with a reminder: “The truth is, rather than being crazy, neurotic, or hopelessly psychologically damaged, you may simply be deficient in certain nutrients.” Diet is discussed as it relates to the production of neurotransmitters. She also discusses mood stabilizers. 

Today, the most commonly prescribed class of antidepressants is the SSRIs, selective serotonin reuptake inhibitors, typified by Prozac. There are no nutrient depletions known. Nor are there any known for the newer “atypical antidepressants” such as Wellbutrin and Effexor.

On the other hand, tricyclic antidepressants, such as Elavil, deplete B2 and CoQ10. Take B2, 25 mg; CoQ10, 30-100 mg. Monoamine oxidase inhibitors (MAOIs), such as Nardil, deplete B6. Take B6, 25-50 mg daily. (There may be sufficient in your multi.)

“No matter what condition you find yourself wrestling with, know that excellent nutrition and specific supplementation will help any person, ill or well, to get the most out of life.” – Dr. Cass

From Dr. Cass’s BookShelf

The Truth About the Drug Companies: How They Deceive Us and What to Do About It. Marcia Angell, MD (Random House, 2004). Former editor of the NEJM.

Overdosed America. John Abramson, MD. (Harper Perennial, 2005). Member of the clinical faculty at Harvard Medical School.

Over Dose: The Case Against the Drug Companies. Jay S. Cohen, MD. (Tarcher/Putnam, 2001). Nationally recognized expert on medications and side effects.

Sidebar #1

How Medications Deplete Nutrients

1. Decrease appetite in general or increase your appetite for unhealthy foods.

2. Reduce the absorption of nutrients in the gastrointestinal (GI) tract.

3. Increase the rate at which the body breaks down a nutrient.

4. Block the action or formation of nutrients at the level of individual cells.

5. Increase the amount of nutrients flushed out of the body through the kidneys.

Dr. Cass also discusses 8 other depleting factors. Among these are pre-existing GI problems that reduce the ability to absorb nutrients (e.g., inadequate stomach acid, a common problem in older people); alcohol abuse or use of recreational drugs; use of multiple medications, increasing the risk of depletion; and poor diet.

Sidebar #2

Who Is Hyla Cass, MD?

Dr. Cass is an often-quoted expert in the field of integrative medicine and psychiatry. In her clinical practice, writings, lectures, and nationwide media appearances, Dr. Cass combines the best of leading-edge natural medicine  with modern science.

She is a former faculty member at the UCLA School of Medicine and the author of several groundbreaking books, including Natural Highs (Avery, 2003) and 8 Weeks to Optimum Health (McGraw-Hill, 2004). She has also authored several books in the User’s Guide to…. series (Basic Health Publications).

For more information, see her website:  HYPERLINK “http://www.drcass.com” www.drcass.com.

Nutrition News 2008 VOL XXXII, No. 7