Abstract

DRUG INDUCED NUTRIONAL DEFICIENCY A CLINICAL IMPLICATIONS AND PREVENTIVE MANAGEMENT

R. Nisha*, S. Kanimozhi, I. Surya Prakash, S. Ramakrishnan, M. Manisha, C. Jothimanivannan

Abstract

Chronic use of various pharmacological agents is a cornerstone in managing numerous medical conditions, yet it can inadvertently disrupt the body’s micronutrient balance, leading commonly prescribed drugs and nutrient status, highlighting how medication such as proton pump inhibitor (PPIs), metformin, statins, anticonvulsants and diuretics alter the absorption, metabolism, or excretion essential vitamins and minerals. Mechanistically, these drugs interfere with physiological pathways crucial for maintaining nutrient homeostasis _ for instance; PPIs reduce gastric acidity necessary for vitamin B12. Absorption, while metformin impairs calcium dependent ileal uptake of vitamin B12. Statins decrease endogenous synthesis of coenzymes Q10 by inhibiting the mevalonate pathway, contributing to muscle –related side effects. Anticonvulsants induce hepatic enzymes that accelerate folate and vitamin D catabolism, and diuretics promote renal losses of potassium and magnesium. Such alterations often manifest as anemia, neuropathies, osteoporosis, muscle weakness, and cardiac arrhythmias, significantly impacting patient quality of life. At-risk populations include the elderly, patients on long-term or multiple medications, and individuals with chronic illnesses. The review synthesizes current evidence from clinical studies and pharmacological research to elucidate these drugs – nutrient interactions, underscoring the need for routine monitoring, dietary counseling, and supplementation where necessary. Increased awareness and proactive management can prevent morbidity associated with nutrient deficiencies, ensuring safer and more effective pharmacotherapy. This article aims to provide clinicians and researchers with a comprehensive understanding of drug – induced nutrient deficiencies and practical strategies for optimizing patient care.

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