Chapter 1 | Nutrient RobberyS
ixty-five-year-old Hannah had been struggling with stiff and painful fingers for some time before she went to see her physician. The disturbing diagnosis was rheumatoid arthritis (RA), for which Hannah was given a drug named Naprosyn. This painkiller helped considerably, but after she had been taking it for a while, Hannah became concerned about the fact that she was bruising easily and often, and was constantly constipated.
Her doctor assured her that there was nothing to worry about, for these were common side effects of Naprosyn. “I’ll give you another medicine, Dulcolax, for your bowels,” he told her with a smile, “and we’ll keep our eye on that bruising.”
The Dulcolax worked well; Hannah’s constipation quickly disappeared. But months later she started noticing that she felt weak all the time, and she could swear that her stomach was “funny.”
When Hannah went back to see her doctor, he reassured her that these were “standard side effects, nothing to worry about.” Reaching for his prescription pad, he began scribbling new prescriptions for drugs that would alleviate her weakness and stomach distress. He then warned her about the side effects she might experience from taking these new drugs.
Hannah’s story is unfortunate, but very common. You may have experienced it yourself.
You have a problem, for which your physician prescribes a drug. That’s Round One.
The medicine works, but it triggers a side effect--or maybe a few of them. Naturally, you return to your doctor, who gives you a new drug or two to eliminate the side effects of the first round of medicines. That’s Round Two.
These new medicines take care of the side effects from Round One, but cause a few more of their own. So you go back to your doctor, who prescribes a new set of drugs. That’s Round Three, and it may go on even further. Some people go through four, five, even ten rounds of drugs/side effects/new drugs, and end up taking a cornucopia of pills, most of which were given to cure the side effects caused by other drugs.
If this was absolutely necessary, you might just accept your fate, swallow your daily cocktail of chemicals, and suffer the consequences. But it’s not. You don’t have to swim in a sea of medications that can make you feel even worse just to keep yourself going.It’s Not the Drugs, It’s the “Nutrient Robbery”
We think that the side effects of drugs are the inevitable by-products of mysterious biochemical processes that we can neither understand nor influence. Many side effects are, indeed, beyond our understanding and control. But others--10, 20, perhaps 30 percent of them--can be explained and cured. These millions of curable side effects are the direct result of drug-induced nutrient deficiencies. In other words, a drug “robs” you of one or more nutrients or other helpful substances, and the lack of the nutrient(s) causes unpleasant symptoms. In a sense, the drug acts as an “anti–vitamin pill,” taking away the substances you need for good health.
The drugs aren’t directly responsible for many of the side effects associated with them; it’s really the nutrient robbery.
Remember the Naprosyn that Hannah took for her arthritis? This well-known painkiller, which has been prescribed to millions of people, depletes the body’s stores of folic acid. A member of the B family of vitamins, folic acid helps the body produce red blood cells. A shortage of this vitamin means you’ll have fewer red blood cells ferrying oxygen to your body tissues, which means that you’ll soon start feeling very tired. A lack of folic acid can also set off gastrointestinal difficulties by triggering abnormal development of the cells lining the stomach and intestines.
The obvious solution is to give everyone who takes Naprosyn a folic acid supplement--or to make sure that their diets contain plenty of the vitamin--to replace what the drug takes away. But very few physicians are aware of the Naprosyn–folic acid connection. Neither do they know that this drug-induced nutrient deficiency is the real cause of some of the drug’s annoying side effects. Instead, when patients on Naprosyn complain of fatigue, diarrhea, nausea, or other problems, most doctors simply will prescribe another drug to fix these “unavoidable side effects.”
The fix-it drug that Hannah was given, Dulcolax, depletes the body’s potassium stores. Low potassium causes a variety of problems, including fatigue, dizziness, mental confusion, and continuous thirst, plus the weakness and irregular heartbeat that Hannah experienced. Instead of automatically heading for the prescription pad, Hannah’s doctor should have recommended supplemental potassium or encouraged her to eat more bananas.
Hannah and millions of other Americans are suffering from an almost completely ignored epidemic of drug-induced nutrient depletion. They’re tormented despite the publication of hundreds of scientific articles that prove numerous popular drugs rob the body of nutrients, and this nutrient robbery is the cause of many drug side effects.A Major Problem
We don’t know exactly how many millions of Americans are suffering from drug-induced nutrient depletion, but we do know that there are of millions of instances of drug side effects every year. Even if only 20 percent of these side effects are, in fact, the result of “stolen nutrients,” it means that hundreds of thousands of Americans suffer from this misunderstood and, therefore, undertreated problem. Despite the best intentions of doctors, all the fix-it drugs in the world won’t get to the root of this problem.
A growing body of scientific evidence proves that many common drugs interfere with our ability to digest, absorb, transport, metabolize, synthesize, utilize, or excrete certain vitamins, minerals, and other vital substances. These drugs can also hamper the actions of these vital substances within the body.
Several drugs make it difficult to absorb nutrients. For example, Tagamet (cimetidine), a medicine used for ulcers, gastroesophageal reflux disease (heartburn), and other problems, can reduce the secretion of intestinal fluids needed to absorb vitamin B12. When B12 levels fall, fatigue, allergies, and other problems may develop. The ability to absorb nutrients may also be hampered by drugs that damage the lining of the intestines, including Aldomet (methyldopa), which is used to treat elevated blood pressure, and colchicine, a medicine prescribed for gout. A chemotherapy agent named doxorubicin is close enough in structure to riboflavin to compete with it for binding sites on enzymes, thus “shutting out” the real vitamin and possibly triggering fatigue, a swollen and cracked tongue, bloodshot eyes, sensitivity to light, and painfully chapped lips. Questran (cholestyramine), a drug used to reduce elevated blood fats and cholesterol, can hamper the absorption of vitamins A, D, E, and K, causing a host of problems, including dry eyes, rough and scaly skin, increased vulnerability to colds and skin abscesses, muscle weakness, anemia, and easy bruising. “Bulk agents” such as psyllium gum, used to keep blood sugar under control and reduce weight, can diminish the absorption of riboflavin, vitamins A, C, and B12, prompting increased susceptibility to infections, sore tongue, depression, anxiety, crusty skin, reproductive problems, and dry eyes. And that’s just the beginning of the list of medications that can block the absorption of nutrients.
Unfortunately, even when nutrients are properly absorbed, they aren’t necessarily “protected,” because certain drugs increase their rate of excretion from the body. For example, the thiazide diuretics used to reduce blood pressure may speed up the rate at which magnesium, potassium, and sodium are flushed out of the body via the urine. A lack of magnesium can cause fatigue, muscle spasms, confusion, and irregular heartbeat, while a deficiency of potassium can trigger muscle weakness, nausea, vomiting, and diarrhea, among other things. And even the over-the-counter drugs found in almost everyone’s medicine cabinet can be troublesome. Consuming large quantities of aspirin can increase the excretion of folic acid, which the body uses to synthesize DNA, regulate cell division and growth, and manufacture red blood cells. A deficiency of folic acid can trigger fatigue, shortness of breath, weakness, and irritability. Millions of people swallow large amounts of aspirin every day for headaches, joint pain, and other problems, and many of them wind up complaining of symptoms that are quite likely due to folic acid deficiency.
These are just a few examples of ways in which drugs can interfere with the digestion, absorption, transportation, metabolic activity, synthesis, utilization, or excretion of nutrients in the body--and the side effects that result. The only true solution to these problems is to replace the nutrients that have disappeared via supplements, wise dietary choices, or both.Even a Small Deficiency Can Be Dangerous
Most of us are well aware that a severe lack of vitamin C can cause scurvy and death, while a serious shortfall of calcium can cause osteoporosis. But what about the small to moderate nutrient deficiencies caused by the use of medications? Are they really a problem?
Yes--it’s a serious problem, for even minor deficiencies can bring on major difficulties. For example:
• A “minor” deficiency of thiamin can induce depression, muscle weakness, generalized swelling of the body, and irritability.
• A “minor” deficiency of riboflavin can trigger reddening, burning, itching and tearing of the eyes, as well as dry, scaly, and itchy skin.
• A “minor” deficiency of vitamin B6 can harm the heart and bring about sleep disturbances
• A “minor” deficiency of vitamin B12 can lead to loss of appetite, nausea, vomiting, poor blood clotting, and fatigue.
• A “minor” deficiency of vitamin C can result in weakening of the immune system, swollen and tender joints, and bleeding gums.
• A “minor” deficiency of vitamin D can touch off muscle weakness and osteoporosis.
• A “minor” deficiency of vitamin E can weaken the immune system.
• A “minor” deficiency of calcium can provoke irregular heartbeat and high blood pressure.
• A “minor” deficiency of magnesium can induce breathing difficulties, muscle cramps, and premenstrual syndrome (PMS).
• A “minor” deficiency of potassium can force the heart to beat irregularly, and cause muscle weakness and fatigue.
• A “minor” deficiency of iron can trigger weakness and fatigue.
• A “minor” deficiency of zinc can hamper the immune system, paving the way for cancer and autoimmune diseases.
• A “minor” deficiency of biotin can set the stage for depression and skin and heart problems.An In-Depth Look at Statins, Coenzyme Q10, and Heart Health
One of the best-researched instances of drug-induced nutrient robbery involves the statin drugs and coenzyme Q10 (CoQ10). Since their introduction in the late 1980s, the statins have rapidly become the dominant class of drugs used to treat elevated cholesterol (hypercholesterolemia) and are among the most commonly prescribed drugs in the United States. There are several different statin drugs, including Lipitor (atorvastatin), Mevacor (lovastatin),
Zocor (simvastatin), and Pravachol (pravastatin). Millions of Americans--especially the elderly--currently take statin drugs, and millions more will soon join them, because the new National Cholesterol Education Program guidelines suggest that they be prescribed even for people with low-normal cholesterol levels. This means that more people will soon be taking these drugs, they’ll start them at a younger age, and they’ll continue taking them for longer periods of time. Indeed, there’s no “exit strategy” for the statins. Once you swallow your first pill, you can expect to take statins for the rest of your life--unless the side effects become too troublesome.
There’s no doubt that the statins reduce cholesterol--and do so quite well. They work by slowing the action of an enzyme called HMG CoA reductase, which is a precursor of cholesterol. This means that the body produces less cholesterol, one of the major risk factors for heart disease and stroke. But this cholesterol precursor has another duty: It helps produce a substance called coenzyme Q10. So while the statins reduce production of cholesterol, they also reduce manufacture of CoQ10, which may be bad for the heart.
CoQ10 is a vitamin-like substance that helps produce energy in the mitochondria, the tiny “energy factories” located inside cells. CoQ10 is essential for heart health, for there are tremendous concentrations of mitochondria in the cells that make up the heart muscle and they require prodigious quantities of CoQ10 to keep the heart beating. Without sufficient CoQ10, the amount of blood pumped by the heart with each beat falls, leading to symptoms such as fatigue, muscle weakness, chest pain, and heart palpitations. If the problem is severe enough, heart failure and death can result. Key statin/CoQ10 researchers have pointed out that the “overwhelming international evidence over at least 15 years” points to “an indispensability of CoQ10 for human cardiac function.” Specifically, low levels of CoQ10 in the blood and body tissues have been associated with heart failure, and “the severity of heart failure correlates with the severity of CoQ10 deficiency.”
CoQ10 has a second duty that makes it indispensable to the health of the entire cardiovascular system. It’s a powerful antioxidant that slows the oxidation of LDL cholesterol, often called the “bad” cholesterol. When LDL is oxidized, it’s more likely to damage the inner linings of the arteries and trigger cardiovascular disease, which can lead to heart attack, stroke, or other serious problems.
Clearly, you want to have ample stores of CoQ10 in the body. You can get small amounts of CoQ10 from many different foods, but the bulk of our supply is produced in the body. If you’re taking statin drugs, your levels of the vital substance will automatically decrease. Numerous studies have examined the deleterious effects of statins on CoQ10. Let’s take a look at some of the key findings.Statins Lower CoQ10 and Harm the Heart
The statin/CoQ10 connection in humans first came to light in 1990, when researchers noted that the blood levels of CoQ10 fell in five patients who were taking lovastatin. By itself, this finding may have passed without much comment, except that all five were also suffering from a potentially fatal disease of the heart muscle (cardiomyopathy). Their heart problems grew worse as their CoQ10 levels fell, but then improved when they were given supplemental CoQ10 to replace what the statin drug took away. This was the first study with humans to show that: statin drugs could lower CoQ10; the shortfall could harm the heart; and both the deficit and the accompanying heart damage could easily be reversed.The Greater the Statin Dose, the Lower the CoQ10
Three years later, a group of British researchers examined the effects of a different statin drug, simvastatin, on CoQ10. For their study, they compared groups of people who were either taking the drug and eating a special diet, were only eating the special diet, or were doing nothing. Those on simvastatin had significantly lower levels of CoQ10 in their blood. And the greater the drug dosage, the lower the blood levels of CoQ10.Statins Lower CoQ10 in the Platelets and the Blood
In 1994, a team of Italian researchers gave either simvastatin or simvastatin plus CoQ10 to 34 people with elevated cholesterol levels. Blood samples taken from each group revealed that the statin drug lowered CoQ10 levels in the blood and in the platelets (small cells within the blood that are essential for coagulation). However, the supplemental CoQ10 reversed the CoQ10 deficit in the blood and platelets.Statins Increase LDL Oxidation
Finnish doctors examined the effects of lovastatin on CoQ10 and LDL oxidation in 29 men with elevated cholesterol. Lovastatin triggered a significant drop in CoQ10 in the blood. It also triggered increased oxidation of LDL, thus heightening the risk of heart attack, stroke, and other cardiovascular diseases.Statin Drugs Harm the Heart
In 1999, a team of French researchers compared the effects of simvastatin to a nonstatin drug called fenofibrate. After 12 weeks, they noted that the statin weakened the heart muscle.From the Trade Paperback edition.
Excerpted from The Side Effects Bible by Frederic Vagnini M.D. and Barry Fox Ph.D.. Copyright © 2005 by Frederic Vagnini, M.D.. Excerpted by permission of Harmony, a division of Random House LLC. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.