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Table of Contents > Depletions > Cholesterol-Lowering Medications, Bile ...
Cholesterol-Lowering Medications
Bile Acid Sequestrants

  • Cholestyramine
    (no brand names listed)
  • Colestipol
    (no brand names listed)


Depletions
Beta-Carotene

This nutrient is converted to vitamin A by the body, therefore, deficiency symptoms are the same as those of vitamin A. The earliest symptom is night blindness. Prolonged deficiency leads to more advanced changes in eye tissue. Other potential signs of mild to moderate deficiency include rough, dry skin, loss of appetite, loss of hair luster, brittle nails, joint pain, and possibly increased susceptibility to infection.


Fat

Deficiency may lead to depletion of fat-soluble vitamins (A, D, E, and K), eczema, and other skin disorders. In children, fat deficiency could cause growth retardation. Long-term deficiency could be associated with many chronic illnesses. Fats are stored in the body as fatty acids. There are three essential fatty acids that the body cannot make and, therefore, must get from dietary sources or supplements.


Iron

Depleted levels of iron may lead to anemia and weakened immune function. In the event of anemia, symptoms include dizziness, fatigue, shortness of breath, pale skin color, and possibly irregular heartbeat.


Vitamin A (Retinol)

The earliest symptom of deficiency of this nutrient is night blindness. Prolonged deficiency leads to more advanced changes in eye tissue. Other potential signs of mild to moderate deficiency include rough, dry skin, loss of appetite, loss of hair luster, brittle nails, joint pain, and possibly increased susceptibility to infection.


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 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.


Vitamin E

While deficiency of this nutrient is uncommon, it negatively affects muscle tissue, red blood cells, nervous, and reproductive systems. Over the long-term, depleted levels of this nutrient may also be associated with cancer, heart disease, and altered immune function.


Vitamin K

The major symptom of vitamin K deficiency is an inability of the blood to clot properly, which may lead to excessive bleeding and a tendency to bruise easily.


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

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

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.

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

Fauci A. ed. et. al. Harrison's Principles of Internal Medicine. Fourteenth Edition. New York, Mc-Graw-Hill Companies Health Professional Division, 1998.

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.

International Life Sciences Institute, Present Knowledge in Nutrition. Seventh Edition. Washington, DC, ILSI Press, 1996.

Kirschmann G. and Kirschmann J. Nutrition Almanac. Fourth Edition. McGraw-Hill, 1996.

National Research Council, Recommended Dietary Allowances. Tenth Edition. Washington, DC, National Academy Press, 1989.

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

Roe DA. Drug Induced Nutritional Deficiencies. Second Edition. Westport, CT, Avi Publishing, pp. 158-159, 1985.

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


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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