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Table of Contents > Depletions > Anti-inflammatory Medications, ...
Anti-inflammatory Medications
Inhalant, Systemic, and Topical Corticosteroids

  • Beclomethasone
    (Beclovent®; Beconase®; Beconase® AQ; QVAR™; Vancenase®; Vancenase® AQ; Vanceril®)
  • Budesonide
    (Pulmicort Respules™; Pulmicort® Turbuhaler®; Rhinocort®; Rhinocort® Aqua™)
  • Dexamethasone
    (AK-Dex® Ophthalmic; Baldex®; Dalalone D.P.®; Dalalone L.A.®; Dalalone®; Decadron®; Decadron® Phosphate; Decadron®-LA; Decaject-LA®; Decaject®; Decaspray®; Dexacort® Phosphate Turbinaire®; Dexasone®; Dexasone® L.A.; Dexone®; Dexone® LA; Hexadrol®; Hexadrol® Phosphate; Maxidex®; Solurex L.A.®; Solurex®)
  • Fluticasone
    (Cutivate™; Flonase®; Flovent®; Flovent® Diskus®; Flovent® Rotadisk®)
  • Hydrocortisone
    (A-hydroCort®; Ala-Cort®; Ala-Scalp®; Anucort-HC® Suppository; Anusol-HC® Suppository; Anusol® HC 1 [OTC]; Anusol® HC 2.5% [OTC]; Cetacort®; Clocort® Maximum Strength; Cort-Dome®; Cortaid® Maximum Strength [OTC]; Cortaid® With Aloe [OTC]; Cortef®; Cortef® Feminine Itch; Cortenema®; Corticaine®; Cortifoam®; Cortizone®-10 [OTC]; Cortizone®-5 [OTC]; Delcort®; Dermacort®; DermiCort®; Dermolate®[OTC]; Dermtex® HC With Aloe; Eldecort®; Gynecort®[OTC]; Hemril-HC® Uniserts®; Hi-Cor® 1.0; Hi-Cor® 2.5; Hycort®; Hydrocort®; Hydrocortone® Acetate; Hydrocortone® Phosphate; HydroTex®[OTC]; Hytone®; LactiCare-HC®; Lanacort®[OTC]; Locoid®; Nutracort®; Orabase® HCA; Pandel®; Penecort®; Procort®[OTC]; Proctocort™; S-T Cort®; Scalpicin®; Solu-Cortef®; Synacort®; Tegrin®-HC [OTC]; Texacort®; Westcort®)
  • Methylprednisolone
    (no brand names listed)
  • Mometasone Furoate
    (Elocon®; Nasonex®)
  • Prednisone
    (Deltasone®; Liquid Pred®; Meticorten®; Orasone®; Prednicen-M®)
  • Triamcinolone
    (Amcort®; Aristocort®; Aristocort® A; Aristocort® Forte; Aristocort® Intralesional; Aristospan® Intra-Articular; Aristospan® Intralesional; Atolone®; Azmacort™; Delta-Tritex®; Flutex®; Kenacort®; Kenaject-40®; Kenalog-10®; Kenalog-40®; Kenalog®; Kenalog® H; Kenalog® in Orabase®; Kenonel®; Nasacort®; Nasacort® AQ; Tac™-3; Tac™-40; Tri-Kort®; Tri-Nasal®; Triacet™; Triam Forte®; Triam-A®; Triderm®; Trilog®; Trilone®; Tristoject®)


Osteoporosis (bone loss) is the primary disease associated with long-term calcium deficiency; it may be associated with bone pain and spinal deformity. Depleted levels can also cause muscle cramps, irregular heartbeat, and depression.

Dehydroepiandrosterone (DHEA)

Decreased blood levels of DHEA have been linked to various conditions such as certain cancers, heart disorders, inflammatory diseases, and Type II diabetes mellitus.


Magnesium deficiency affects calcium and vitamin D levels in the body and may be associated with muscle cramps, heart irregularities, high blood pressure, diabetes, and osteoporosis (bone loss).


Reduced levels of melatonin in the body have been associated with sleep disturbances and jet lag.


Symptoms of deficiency include loss of appetite, nausea, drowsiness, feelings of apprehension, excessive thirst, irrational behavior, fatigue, muscle pain and weakness (usually of the lower limbs); severe cases may lead to irregular heartbeat.

Protein & Amino Acids

Protein deficiencies are characterized by weakened immune status, including increased susceptibility to infection, impaired wound healing, muscle and weight loss, growth retardation, and deterioration in skin and hair condition.


Selenium deficiency may be associated with muscular, digestive, and heart disorders; long-term deficiency may be associated with increased risk of developing certain chronic illnesses such as cancer, diabetes, or liver disease.

Vitamin B6 (Pyridoxine)

Symptoms of vitamin B6 deficiency may include weakness, nervousness, insomnia, mental confusion, irritability, and anemia. Long-term low levels of this nutrient may also increase the risk of heart disease as well as colon and prostate cancers.

Vitamin B9 (Folic Acid)

Low levels of folic acid have been linked to anemia, heart disease, and birth defects.

Vitamin B12 (Cobalamin)

Symptoms of vitamin B12 deficiency are rare because it takes years to develop complications associated with long-term depletion of this nutrient. Irritability, weakness, numbness, anemia, loss of appetite, headache, personality changes, and confusion are some of the signs and symptoms associated with vitamin B12 depletion. Low levels of this vitamin may also be associated with an increased risk of colon cancer, heart disease, brain disorders, and birth defects.

Vitamin C (Ascorbic Acid)

Vitamin C deficiency may include bruising, fever, anemia, emotional changes, swollen and bleeding gums, fatigue, lethargy, jaundice (yellowing of the skin and eyes), increased susceptibility to infections, slow wound healing, and swelling of the lower limbs. Severe deficiency leads to scurvy, a disorder that affects muscles and bones and is potentially fatal. However, scurvy is rare these days because of the wide availability of vitamin C from dietary sources.

Vitamin D

Vitamin D deficiency leads to abnormal bone formation (rickets) in children and softening of the bones (osteomalacia) in adults. Vitamin D deficiency interferes with calcium absorption, leading to deficiency of that nutrient with all of the associated symptoms (such as increased risk of fractures, osteoporosis (bone loss), and muscle weakness). Because this nutrient is fat-soluble, prolonged periods of deficiency are required to produce these symptoms.


Signs and symptoms of zinc deficiency include loss of appetite or sense of taste, growth retardation, skin changes, and increased susceptibility to infection.

Editorial Note

The selected depletions information presented here identifies some of the nutrients that may be depleted by certain medications. The signs and symptoms associated with nutrient deficiency may also indicate conditions other than nutrient deficiency. If you are experiencing any of the signs or symptoms mentioned, it does not necessarily mean that you are nutrient deficient. Nutrient depletion depends upon a number of factors, including your medical history, diet, and lifestyle as well as the length of time you have been taking the medication. Please consult your healthcare provider; he or she can best assess and address your individual healthcare needs, and determine if you are at risk for nutrient depletions from these medications as well as others not listed here.

Supporting Research

Adam WR, Goland GJ, Wellard RM. Renal potassium adaptation in the rat: role of glucocorticoids and aldosterone. Am J Physiol. 1984;246(3 Pt 2):F300-F308.

Ames BN. Micronutrient deficiencies: A major cause of DNA damage. Ann NY Acad Sci. 2000;889:87-106.

Atkinson SA, Halton JM, Bradley C, Wu B, Barr RD. Bone and mineral abnormalities in childhood acute lymphoblastic leukemia: influence of disease, drugs and nutrition. Int J Cancer Suppl. 1998;11:35-39.

Avery D, Lenz M, Landis C. Guidelines for prescribing melatonin. Ann Med. 1998;30:122-130.

Berger W. Incidence of severe side effects during therapy with sulfonylureas and biguanides. Horm Metab Res Suppl. 1985;15:111-115.

Carpentier JL, Bury J, Luyckx A, Lefebvre P. Vitamin B12 and folic acid serum levels in diabetics under various therapeutic regimens. Diabetes Metab. 1976;2(4):187-190.

Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr 1999;69:1086-1087.

Cashman K, Flynn A. Optimal nutrition: calcium, magnesium and phosphorus. Proc Nutr Soc. 1999;58:477-487.

Chesney RW, Maxess RB, Harnstra AJ, et al. Reduction of serum-1,12-dihydroxyitamin- D3 in children receiving glucocorticoids. Lancet. 1978;2(8100):1123-1125.

Chowdhury AR, Kapil N. Interaction of dexamethasone and dehydroepiandrosterone on testicular ascorbic acid and cholesterol in prepubertal rat. Arch Androl. 1984;12(1):65-67.

Covington T, ed. Nonprescription Drug Therapy Guiding Patient Self-Care. St Louis, MO: Facts and Comparisons; 1999:467-545.

Demisch L, et al. Influence of dexamethasone on nocturnal melatonin production in healthy adult subjects. J Pineal Res. 1988;5(3):317-322.

Falchuk KH. Disturbances in Trace Elements. In: Fauci A, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill Companies Health Professional Division; 1998:490-491.

Flynn A, Pories WJ, Strain WH, et al. Rapid serum-zinc depletion associated with corticosteroid therapy. Lancet. 1971;2(7735):1169-1172.

Fodor L, Ahnefeld FW, Fazekas AT. [Studies on the glucocorticoid control of zinc metabolism]. Infusionsther Klin Ernahr. 1975;2(3):210-213.

Fontaine J, Neve J, Peretz A, et al. Effects of acute and chronic prednisolone treatment on serum zinc levels in rats with adjuvant arthritis. Agents Actions. 1991;33(3-4):247-253.

Frequin ST, et al. Decreased vitamin B12 and folate levels in cerebrospinal fluid and serum of multiple sclerosis patients after high-dose intravenous methylprednisolone. J Neurol. 1993;240(5):305-308.

Garrel DR, Delmas PD, Welsh C, et al. Effects of moderate physical training on prednisone-induced protein wasting: a study of whole-body and bone protein metabolism. Metab. 1988;37(3):257-262.

Gennari C. Differential effect of glucocorticoids on calcium absorption and bone mass. Br J Rheumatol. 1993;32(Suppl 2):11-14.

Hambidge M. Human zinc deficiency. J Nutr. 2000;130(5S Suppl):1344S-1349S.

Hinson JP, Raven PW. DHEA deficiency syndrome: a new term for old age? J Endocrinol. 1999;163:1-5.

Holick MF, Krane SM, Potts JT. Calcium, phosphorus, and bone metabolism: calcium-regulating hormones. In: Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York: McGraw-Hill Companies Health Professional Division; 1998:2221-2222.

Lems WF, Jacobs JW, Netelenbos JC, et al. [Pharmacological prevention of osteoporosis in patients on corticosteroid medication]. Ned Tijdschr Geneeskd. 1998;142(34):10904-10908.

Levine MA & Pollard HB. Hydrocortisone inhibition of ascorbic acid transport by chromaffin cells. FEBS Lett. 1983;158(1)L134-L138.

Mehra KS, Kumar A, Dubey SS, Palodhi GR. The effect of vitamin A and cortisone on ascorbic acid content in the aqueous humor. Ann Ophthalmol. 1982;14(11):1013-1015.

National Research Council. Recommended Dietary Allowances. 10th ed. Washington, DC: National Academy Press; 1989.

Navarro-Alarcon M, Lopez-Martinez MC. Essentiality of selenium in the human body: relationship with different diseases. Sci Total Environ. 2000;249:347-371.

Nielson HK, Charles P, Mosekilde L. The effect of single oral doses of prednisone on the circadian rhythm of serum osteocalcin in normal subjects. J Clin Endocrinol Metab. 1988;67(5):1025-1030.

Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol. 1987;14(6):1104-1107.

Potts JT. Diseases of the parathyroid gland and other hyper- and hypocalcemic disorders. In: Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York: McGraw-Hill Companies Health Professional Division; 1998:2241.

Rao DS. Perspective on assessment of vitamin D nutrition. J Clin Densitom. 1999:2(4):457-464.

Reid IR, Ibbertson HK. Calcium supplements in the prevention of steroid-induced osteoporosis. Am J Clin Nutr. 1986;44(2):287-290.

Rolla G, Bucca C, Bugiani M. Hypomagnesemia in chronic obstructive lung disease: effect of therapy. Magnes Trace Elem. 1990;9(3):132-136.

Simeckova A, Neradilova M, Reisenauer R. Effect of prednisolone on the rat bone calcium, phosphorus and magnesium concentration. Physiol Bohemoslov. 1985;34(2):155-160.

Smith BJ, et al. Does beclomethasone dipropionate suppress dehydroepiandrosterone sulfate in postmenopausal women? Aust N Z J Med. 1994;24(4):396-401.

Stanton B, Giebisch G, Klein-Robbenhaar G, et al. Effects of adrenalectomy and chronic adrenal corticosteroid replacement on potassium transport in rat kidney. J Clin Invest. 1985;75(4):1317-1326.

Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr. 1999;69:842-856.

Wilson JD. Vitamin deficiency and excess. In: Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York: McGraw-Hill Companies Health Professional Division; 1998:483-485.

Yunice, AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci. 1981;282(2):68-74.

Review Date: October 2000
Reviewed By: All depletions monographs have been reviewed by a team of experts including Derrick M. DeSilva, Jr., MD, Raritan Bay Medical Center, Perth Amboy, NJ; Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University and Senior Medical Editor, A.D.A.M., Inc., Boston, MA; John Hinze, PharmD, NMD, Woodbine, IA; Ruth Marlin, MD, Medical Director and Director of Medical Education, Preventive Medicine Research Institute, Sausalito, CA; Brian T Sanderoff, PD, BS in Pharmacy, Clinical Assistant Professor, University of Maryland School of Pharmacy; President, Your Prescription for Health, Owings Mills, MD; Leonard Wisneski, MD, FACP, George Washington University, Rockville, MD; Ira Zunin, MD, MPH, MBA, President and Chairman, Hawaii State Consortium for Integrative Medicine, Honolulu, HI.

Copyright © 2004 A.D.A.M., Inc

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.


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