Because of the wide availability of sodium in dietary sources, deficiency is
very uncommon. In the rare instances where it does occur, depleted levels have
been associated with gas, nausea and vomiting, headache, memory impairment,
diminished attention, muscle weakness, heart palpitations, lethargy, and
confusion. Extreme cases can cause stupor, seizures, and possibly coma. The
development of symptoms depends in large part on the rate of the loss of
A deficiency of the antioxidant coenzyme Q10 may be associated with long-term
conditions including heart disease and high blood pressure. Symptoms of
deficiency include gingivitis, and weakened immune
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).
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
Signs and symptoms of zinc deficiency include loss of appetite or sense of
taste, growth retardation, skin changes, and increased susceptibility to
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
Abraham AS, Brooks BA, Grafstein Y, et al. Effects of hydrochlorothiazide,
diltiazem and enalapril on mononuclear cell sodium and magnesium levels in
systemic hypertension. Am J Cardiol. 1991;68:1357-1361.
Ames BN. Micronutrient deficiencies: A major cause of DNA damage. Ann NY
Acad Sci. 2000;889:87-106.
Cashman K, Flynn A. Optimal nutrition: calcium, magnesium and phosphorus.
Proc Nutr Soc. 1999;58:477-487.
Chan A, Reichmann H, Kogel A, et al. Metabolic changes in patients with
mitochondrial myopathies and effects of coenzyme Q10 therapy. J Neurol.
Covington T, ed. Nonprescription Drug Therapy Guiding Patient
Self-Care. St Louis, MO: Facts and Comparisons; 1999:467-545.
Dai LJ, Friedman PA, Quamme GA. Cellular mechanisms of chlorothiazide and
cellular potassium depletion on Mg2+ uptake in mouse distal convoluted tubule
cells. Kidney Int. 1997;51(4):1008-1017.
Dyckner T, Wester PO. Potassium/magnesium depletion in patients with
cardiovascular disease. Am J Med. 1987;82(3A):11-17.
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
Folkers K, Morita M, McRee J Jr. The activities of coenzyme Q10 and vitamin
B6 for immune responses. Biochem Biophys Res Commun. 1993;
Folkers K. Basic chemical research on coenzyme Q-10 and integrated
clinical research on therapy of diseases, in Coenzyme Q, G. Lenaz, ed. John
Wiley & Sons, 1985.
Golik A, Zaidenstein R, Dishi V, et al. Effects of captopril and enalapril on
zinc metabolism in hypertensive patients. J Am Coll Nutr.
Hambidge M. Human zinc deficiency. J Nutr. 2000;130(5S
Hines Burnham T, et al, eds. Drug Facts and Comparisons. St. Louis,
MO:Facts and Comparisons; 2000:617.
Kamikawa T, Kobayashi A, Yamashita T, et al. Effects of coenzyme Q10 on
exercise tolerance in chronic stable angina pectoris. Am J Cardiol.
Kaplan NM. The dietary guideline for sodium: should we shake it up? NAm J
Clin Nutr. 2000;71:1020-1026.
Kishi H, Kishi T, Folkers K. Bioenergetics in clinical medicine. III.
Inhibition of coenzyme Q10-enzymes by clinically used anti-hypertensive drugs.
Res Commun Chem Pathol Pharmacol. 1975;12(3):533-540.
Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild
hypertensive patients treated with diuretics. J Hypertens Suppl.
Munkholm H, Hansen HH, Rasmussen K. Coenzyme Q10 treatment in serious heart
failure. Biofactors. 1999;9(2-4):285-289.
Nakamura R, Littarru GP, Folkers R, et al. Study of CoQ10-enzymes in gingiva
from patients with periodontal disease and evidence for a deficiency of coenzyme
Q10. ProcNatl Acad SciUSA. 1974;71(4):1456-1460.
National Research Council. Recommended Dietary Allowances. 10th ed.
Washington, DC: National Academy Press; 1989.
Peczkowska M. [Influence of angiotensin I converting enzyme inhibitors on
selected parameters of zinc metabolism]. Pol Arch Med Wewn.
Reyes AJ, Leary WP, Lockett CJ, et al. Diuretics and zinc. S Afr Med
Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics,
zinc deficiency and some side effects of diuretics. S Afr Med J.
Singer GG, Brenner BM. Fluid and electrolyte disturbances. 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
Singh RB, Niaz MA, Rastogi SS, et al. Effect of hydrosoluble coenzyme Q10 on
blood pressure and insulin resistance in hypertensive patients with coronary
heart disease. J Hum Hypertens. 1999;13(3):203-208.
Singh RB, Wander GS, Rastogi A, et al. Randomized, double-blind
placebo-controlled trial of coenzyme Q10 in patients with acute myocardial
infarction. Cardiovasc Drugs Ther. 1998;12(4):347-353.
Wester PO. Urinary zinc excretion during treatment with different diuretics.
Acta Med Scand. 1980;208:209-212.
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