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If you’ve ever taken prescription or over-the-counter drugs, then you’ve experienced drug-nutrient interaction. Officially, this is defined as “physical, chemical, physiologic, or pathophysiologic relationships between a drug and a nutrient.” Put simply, this just means that medication has an effect on the nutrients in your food, which in turn affects how it interacts with your body. For example, many people that take ADHD medication cite loss of appetite as a side effect. Or, laxatives can decrease the absorption of vitamins and minerals to cause the body to excrete. Those would both be classified as drug-nutrient interactions.
So what does this mean for medication users?
It’s important to know what’s in your medication and how that metabolizes in your body. If you’re feeling more tired or hungry or less yourself than usual, it’s a sign that drug-nutrient interactions in your body might not be conducive to your overall health. In that case, supplementing with micronutrients may be a good way to ensure your body is getting more of what it needs. Let’s break it down.
Drugs Affect on Food
According to the nutrition section of the Merck Manual, foods can enhance, delay, or decrease drug absorption, and can impair the absorption of many antibiotics.
“They can alter metabolism of drugs; eg, high-protein diets can accelerate metabolism of certain drugs by stimulating cytochrome P-450. Eating grapefruit can inhibit cytochrome P-450 34A, slowing metabolism of some drugs (eg, amiodarone, carbamazepine, cyclosporine, and certain calcium channel blockers). Diets that alter the bacterial flora may markedly affect the overall metabolism of certain drugs,” the manual states.
Some foods affect the body’s response to drugs, such as tyramine. This common component of cheese has a history of causing a hypertensive crisis, or elevated blood pressure with a high risk of complications, in patients who take monoamine oxidase inhibitors (a drug commonly used to treat depression).
Nutritional deficiencies can also affect drug absorption and metabolism.
“Severe energy and protein deficiencies reduce enzyme tissue concentrations and may impair the response to drugs by reducing absorption or protein binding and causing liver dysfunction. Changes in the gastrointestinal tract can impair absorption and affect the response to a drug. Deficiency of calcium, magnesium, or zinc may impair drug metabolism. Vitamin C deficiency decreases activity of drug-metabolizing enzymes, especially in older people,” the manual reports.
It all comes down to the simple basis that many drugs affect appetite, food absorption, and tissue metabolism. Be it a drug that increases gastrointestinal motility and decreases food absorption, or a drug that does the exact opposite, what we know is what we take has repercussions on the body. While there are some things we can do to enhance results, such as taking certain drugs with food, overall it’s best to know what drug-nutrient interactions are happening inside us and make informed decisions from there.
Factors That May Affect Drug-Nutrient Interactions
Now we understand a little more about drug-nutrient interactions and how they can exist within our bodies. But what about factors that could affect them?
When you take a drug, like a pain reliever for your headache, it doesn’t actually just go to the problem area (in this case, your head). After a drug enters the body, it’s distributed to all of the body’s tissues. Generally, this is uneven because of the differences in blood perfusion, tissue binding, regional pH, and permeability of cell membranes. From here, the body sets out to achieve distribution equilibrium, which is when the entry and exit rates are the same throughout the body. Once metabolism and excretion occur simultaneously with distribution the process is dynamic and complex.
The next step is volume distribution. The fluid volume required to contain the drug in the body at the same concentration as plasma is known as the volume distribution. While this gives us a little insight into the plasma concentration expected for a given dose of mediation, it doesn’t provide too much information on the specific pattern of distribution. Drugs are uniquely distributed throughout the body - some going into fat, others to tissues, or so on- this can affect the body as well.
“Many acidic drugs (eg, warfarin, salicylic acid) are highly protein-bound and thus have a small apparent volume of distribution. Many basic drugs (eg, amphetamine, meperidine) are avidly taken up by tissues and thus have an apparent volume of distribution larger than the volume of the entire body,” this paper concludes.
The next factor that pharmaceuticals don’t talk much about is the process of binding. There are two types of binding that pertain to drug-nutrient interactions: plasma and tissue.
Plasma binding refers to which medications attach to proteins within the blood. So a drug’s efficiency may be affected by the degree to which it binds. I.e., the less bound a drug is, the more efficiently it can travel through the body.
“The ratio of bound to unbound drug in plasma is mainly determined by the reversible interaction between a drug and the plasma protein to which it binds, as governed by the law of mass action. Many plasma proteins can interact with drugs. Albumin, 1-acid glycoprotein, and lipoproteins are most important.”
Tissue binding refers to drugs that bind to substances other than proteins- such as fat, brain, liver, and kidney. The more bound a drug is in the tissue can cause an accumulation of the compound in the body outside of blood circulation.
Some drugs do accumulate and produce higher concentrations in cells than in ECF, most commonly a result of them binding with protein, phospholipids, or nucleic aids.
And finally, let’s discuss the blood-brain barrier.
Although the brain receives about one-sixth of cardiac output, the distribution of drugs to brain tissue is restricted. Some drugs have the ability to get to the brain rapidly, but most drugs - particularly the more water-soluble ones- enter it so slowly.
“Another barrier to water-soluble drugs is the glial connective tissue cells (astrocytes), which form an astrocytic sheath close to the basement membrane of the capillary endothelium. The capillary endothelium and the astrocytic sheath form the blood-brain barrier. Because the capillary wall, rather than the parenchymal cell forms the barrier, the brain's permeability characteristics differ from those of other tissues. Thus, polar compounds cannot enter the brain but can enter the interstitial fluids of most other tissues. The observation that polar dyes enter most tissues but not the CNS led to the concept of the blood-brain barrier,” Merck writes.
Broad Spectrum Micronutrients Impact on This Phenomenon
Early on, psychiatrists really didn’t think that vitamins or minerals would play a big role in the effects of psychiatric medications. But the research paper entitled “Do vitamins or minerals (apart from lithium) have mood-stabilizing effects,” published in 2001, quickly came in to change the narrative.
After introducing patients to medication with a broad spectrum micronutrient, researchers saw the supplement was generally potentiating the clinical properties of psychiatric drugs. Meaning most of the patients in the study could be managed with less medication after the nutrient supplement was added into the mix.
“When the Hardy formula is added to a regimen of psychiatric medications, it appears as if the micronutrients potentiate the effects of the psychiatric drugs, potentially flooding the patient with adverse effects unless the doses of the drugs are concurrently lowered. The potentiation is about threefold to fivefold, so psychiatric drug doses need to be gradually and carefully lowered to about 20% to 30% of the original level (although patients actually do better once the psychiatric medications are discontinued entirely),” one paper concluded.
Psychiatrists agreed, the tricky part of introducing the micronutrients into the picture wasn’t whether or not they’d work, but how to approach lessening medication dosage at a pace that wouldn’t leave patients feeling side effects or experiencing withdrawals.
For this reason, it was recommended that clinicians first consult with a health professional with experience using micronutrient before starting treatments on a client, both before and during the addition of treatment, to fully track and monitor results.
In the review paper, Single-micronutrient and broad-spectrum micronutrient approach for treating mood disorders in youth and adults, the authors noted, “In other cases in which micronutrients appear effective but additional fine-tuning is needed, it is possible to combine broad-spectrum micronutrient treatment with certain other “natural” treatments without incurring drug-nutrient interactions.”
In conclusion, understanding drug-nutrient interactions is critical for better understanding your body and attaining the outcomes you want from your medication choices. If your medications aren’t giving you the results you’re hoping for, or if it’s just time to lessen the dosage, looking into a broad-spectrum micronutrient could be a healthy alternative to improving your lifestyle.
Dive into over thirty published and peer-reviewed studies on broad-spectrum micronutrients. Hardy’s Daily Essential Nutrients has been helping thousands of people all over the globe get back to being the person they want to be and is clinician recommended. Visit our website to learn more.