Cholesterol-Lowering Medications, Bile Acid Sequestrants
Bile Acid Sequestrants
(no brand names listed)
(no brand names listed)
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.
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.
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.
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
Low levels of folic acid have been linked to anemia, heart disease, and birth
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 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
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.
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
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
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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.
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Fauci A. ed. et. al. Harrison's Principles of Internal Medicine.
Fourteenth Edition. New York, Mc-Graw-Hill Companies Health Professional
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.
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
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,
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