– Mehmet Oz, M.D., Professor of Surgery at Columbia University
 and author of bestsellers “YOU: The Owner’s Manual” and “YOU: On A Diet”

A little known but potentially life-saving fact is that common medications deplete vital nutrients essential to your health. Here’s a practical guide to avoid drug-induced nutrient depletion, and even replace your medications with natural supplements.

We have been called a pill-popping society, and statistics bear this out. Nearly 50 percent of American adults take at least one prescription drug, and 20 percent take three or more. In a survey(1), more than half of those over 65 and 30 percent of people 45 to 65 used at least three prescription drugs in a one-month period. With our increasing reliance on medications comes nutrient depletion, a problem we can’t ignore. Every medication, including over-the-counter drugs, will drain the body of specific nutrients. On top of this, most Americans are already suffering from nutrient depletion. In fact, many of the conditions we see in everyday practice may actually be related to this deficiency.

The good news is that with the right supplements, you can avoid depletion side effects, and even better, you may be able to control and prevent chronic diseases, such as diabetes, cardiovascular disease and osteoporosis.

A Common Scenario

I have seen case after case of patients who have experienced nutrient loss from taking prescribed medications. Too often, neither the patients nor their doctors were aware that the cause of symptoms was the medications themselves.

For example, a 57-year-old retired schoolteacher, Kathy, was being treated by her internist with three medications: the thiazide diuretic, Diuril, for high blood pressure; Fosamax for osteoporosis; and the beta-blocker, Tenormin, for heart palpitations.

She was referred to me, an integrative psychiatrist, because she suffered from fatigue, anxiety, depression and insomnia. I couldn’t find an obvious psychological explanation for these symptoms, except perhaps for the stress of her physical illnesses.

The likeliest cause of her symptoms was the drugs themselves. So, rather than adding an antidepressant, an anti-anxiety pill or sleeping agent, I checked the known nutrient depletions associated with these medications. Lab results confirmed that Kathy was deficient in three essential minerals: magnesium, potassium and zinc.

Any one of her three medications could deplete potassium and magnesium, causing arrhythmias, hypertension, fatigue and depression. The diuretic also could be depleting zinc. Her internist agreed that he would continue to oversee her medications while I supervised her nutritional regimen.

Daily doses of magnesium, zinc and potassium, in addition to a high-potency multivitamin, resolved Kathy’s “psychiatric” symptoms. Once her mineral levels were restored, her energy and mood were back to normal. She was not only spared the burden of an additional medication, but was able to lower the doses of the three she was taking.

I see cases similar to Kathy’s more frequently than I’d like. Physicians will often tell these patients that their symptoms are “part of the illness” or “just signs that they’re getting older.” They then prescribe an additional drug or two for the side effects, further compounding the problem.

To understand the role of medications in nutrient depletion, we must first understand the variety of nutrient-depleting mechanisms in pharmacy.

Many drugs, such as the stimulants Ritalin (methylphenidate) and Adderall, are prescribed for attention deficit disorder. These can reduce appetite. This, in turn, decreases the intake of beneficial nutrients. Some antidepressants also tend to have this appetite-reducing effect.

On the flip side, a drug can reduce nutritional status by increasing the desire for unhealthy foods, such as refined carbohydrates. Many of the neuroleptics (antipsychotic drugs) and some antidepressants cause insulin resistance or metabolic syndrome, with resulting blood sugar swings. Patients then crave simple carbohydrates, such as sugar, bread and pasta. Steroid drugs, including those given by an inhaler, can create similar issues as well.

Certain medications reduce the absorption of nutrients. In passing through the gastrointestinal tract, drugs often bind to specific nutrients before they’re absorbed into the bloodstream. The antibiotic, tetracycline, for example, can block absorption by binding with minerals such as calcium, magnesium, iron and zinc in the GI tract.

Weight loss drugs and cholesterol lowering medicines similarly bind to fats, preventing them from being absorbed. Drugs that treat acid reflux or heartburn raise the pH environment of the upper GI tract, which reduces absorption of needed vitamins and minerals. This is especially problematic among the elderly, who often are already low in stomach acid.

Nutrients are essential to the metabolic activities of every cell in the body. They’re used up in the process and need to be replaced by new nutrients in food or supplements. Some drugs deplete nutrients by speeding up this metabolic rate. These drugs include antibiotics (including penicillin and gentamicin) and steroids, such as prednisone and the gout medication, colchicine.

Other drugs block the nutrients’ effects or production at the cellular level. In addition to the intended effect on enzymes or receptors, medications can influence enzymes or receptors that help process essential nutrients. For example, widely prescribed statin drugs block the activity of HMG-CoA, an enzyme that’s required to manufacture cholesterol in the body. This action also depletes the body of coenzyme Q10, which requires HMG-CoA for its production. This has a serious negative impact on muscle and heart health.

Drugs also can increase the loss of nutrients through the urinary system. Any drug that does this can drain the body’s levels of water-soluble nutrients, including B vitamins and minerals, such as magnesium and potassium. The major offenders are medications to treat hypertension, particularly the diuretics that reduce blood pressure by increasing the volume of water flushed out of the body.

Drug-induced nutrient depletion is far more common than we think. In evaluating patients’ symptoms, doctors must assess whether symptoms are due to the illness, to side effects of the drugs or to drug-induced nutrient depletion. Considering the inadequate nutrition of most people, we must remember that the illness itself may be due, in part, to nutrient deficiency. To cover all bases, it is easiest to provide baseline coverage: a daily high potency multivitamin mineral formula, CoQ10 (200 mg), omega-3 fatty acids (2 grams) and additional vitamin D and probiotics, especially if you’ve taken antibiotics.

The bottom line: As physicians, we must look more deeply and determine underlying causes to determine whether drugs are harming patients, and what we can do to reverse these effects. As a consumer, be aware of these drug-nutrient depletions, and do what you can to avoid taking medications whenever you can, using natural products instead.

1. Centers for Disease Control and Statistics. Health United States 2006. Accessed via www.cdc.gov/nchs/data/hus/hus06.pdf#093.

I will also continue this theme in subsequent blogs, discussing various categories of medications, their nutrient depletions, and natural, healthier substitutes.

A more complete article can be found at Total Health Magazine, p. 40 ff.

For more information, see my book, Supplement Your Prescription: What Your Doctor Doesn’t Know About Nutrition available at my website, www.cassmd.com.

After treating hundreds of people abusing alcohol, cocaine, heroin and other drugs, as well as treating the “legal” addictions of caffeine, tobacco, and sugar, I have seen how a series of popular myths has often clouded the issue of addiction.

Here are some popular misconceptions:

Myth #1: Most of those suffering from addiction are mentally ill.
Fact: Once the correct treatment is given, the so-called “addictive personality” and a lot of other psychopathology simply disappear. This, of course, does not negate the tremendous importance of social and emotional support, psychotherapy, and 12-step programs, but adds the missing piece to treatment and relapse prevention. It also allows you to begin to examine old traumas which themselves cause chronic (and often unconscious) stress, which continues to deplete your brain chemistry.

Myth #2: Compulsive use of an addictive substance is a sign of weakness or poor moral character.
Fact: You are not a weak or “bad” person. Rather, you have a brain chemistry imbalance, and moral character may have little to do with it. To prove the point, researchers took a group of rats, made them “alcoholic,” and then treated them with amino acids. When tested further, they had lost their cravings and addiction. Of course, human beings are more complex, have social cues, and emotional baggage. In any case these life issues are all best dealt with by a well-nourished brain.

Myth #3: Chronic addiction is a disease can only be treated with prescription drugs.
Fact: While someone may have a chemical imbalance, it’s not a Prozac or Klonopin deficiency. As a psychiatrist who can prescribe drugs, but most of time chooses not to, I urge moderation in the use of multiple drug “cocktails.” Medication should be used only under the care of a specialist, and preferably one who also understands the importance of nutritional supplementation along with it. Being overly medicated interferes with mental and emotional rehabilitation: you can’t participate fully in therapy or a 12-step program when you’re in a medication-induced fog!

Myth #4: Avoiding relapse is a constant struggle for those in recovery.
Fact: Once you’re in balance, any craving to use is simply a sign that you need to correct your nutrition once again. It works!

Myth #5: “Substance abuse runs in my family so I can’t help it.”
Fact: If you have a family history of substance abuse, you simply have to be more careful than most to take the appropriate nutrients. You do not have to be a slave to your genes!

The Nutrient Link

Recovery will progress far better if you know about using specific supplements to restore your brain chemical balance. Why? There are millions of chemical reactions that occur every second in every cell of our bodies. These reactions require specific nutrients in order to function properly. Particularly sensitive are the neurons or nerve cells, requiring just the right raw materials to manufacture neurotransmitters, the chemical messengers that control mind, mood, and behavior. When we don’t have the materials we need, we become depressed, drowsy, irritable, or agitated, or we can’t think or concentrate properly.

Along come our fixes: caffeine or cocaine to sharpen your mind and raise your energy, alcohol or valium to calm you down, heroin to take you away from it all — or whatever your substance of choice happens to be. The problem is, you’re not giving the cells what they really need, but only fooling them for a brief moment. Not only does that substance hit wear off, but you are left feeling worse than before! You may continue chasing that initial high, hoping that it will return with the next dose, and become caught in the cycle of addiction. Of course, it doesn’t work,

The good news is that there is a healthy “fix” that actually works, with no withdrawal or other negative effects. Since neurotransmitters are literally made from nutrients—amino acids, vitamins, and minerals—we can formulate the perfect “brain food” to restore them, thereby breaking the cycle of addiction. Nutritional supplements can restore balance, and create a state of high energy, increased focus, and good mood, with no withdrawal or side effects, since you’re giving your brain cells exactly what they need to operate at their best.  The program may take some fine-tuning, but generally works quite quickly and effectively.

Sugar Blues

Sugar addiction is closely related to most of the other addictions. By keeping your blood sugar level throughout the day with the proper diet and supplements, you can avoid those dips that lead to cravings for alcohol or cocaine (or any other substance of choice). I also recommend the supplements chromium and glutamine to help reduce sugar cravings. They act like glucose on the brain cells, but are a far safer solution, with no rebound hypoglycemia, or lows.

Here are the neurotransmitters (chemical messengers) and their functions:

• Dopamine, norepinephrine (NE): Stimulating, supplies good mood, focus and alertness
• Serotonin: Elevates mood and calms, relaxes
• GABA: Calms, relaxes, modulates; “chill factor”
• Acetylcholine: Supports mind and memory

General Prescription

Now that we understand the relationship between brain chemistry and addiction, let’s see what I would add to first help stop the addict’s downward spiral and then, to restore brain chemistry balance.

Eating for Recovery

A nutritious, balanced diet is foremost, to provide a steady supply of the raw materials your brain needs to restore and maintain optimal brain function, and remain addiction –free. Even with simply the dietary adjustments, many find they are feeling much better, with fewer cravings.  Here are the basics:

• Eat whole foods and fresh foods; avoid processed foods.
• Eat three servings a day of top-quality protein foods—fish, poultry, lean meat (free range), egg, soy, or combinations of beans, lentils, and grains.
• Choose complex carbohydrates such as whole grains, vegetables, and most fruits, and avoid sugar and refined foods.
• Eat fish three times a week, or take fish-oil supplements.
• Drink at least a quart of water, if not two, a day, either pure or in diluted juices and herbal or fruit teas.
• Minimize your intake of tea, coffee, and soft drinks.
• Eat lots of antioxidant-rich fruits and vegetables—at least five servings a day.

Supplements

Start with a multi vitamin-mineral formula, generally 2 capsules twice daily with meals, unless otherwise noted, with the following additional supplements:

1. Chromium (200 mcg) and glutamine (500 mg twice daily and also as needed for cravings) to regulate blood sugar and thereby reduce brain fog and cravings for sugar, alcohol, or drugs.
2. 5-hydroxytryptophan (5-HTP), to boost serotonin levels: 50-100 mg in AM, and 100-400 mg at bedtime both for depression and sleep problems.  If you are on an SSRI antidepressant, use 5- HTP with caution and take at least 2 hrs away from meds. The theoretical risk here is serotonin syndrome, in fact rarely seen with combining amino acids with medication – far likelier a result of mixing serotonin enhancing drugs.
3. Calming amino acids, theanine 200 mg and taurine 500 -1000 mg to boost GABA when anxious or irritable; calming herbs valerian 100 mg (or 100-200 at bedtime), lemon balm, passion flower for calming and for sleep enhancement.
4. Tyrosine (500-1000 mg) and/or phenylalanine (500-1000 mg) to boost dopamine for enhanced mood and concentration,  first thing in AM and then early PM if needed.
5. Omega-3 fatty acids in the form of fish oil 1000 mg twice daily to help restore the cell wall in which neurotransmitters are made.
6. B vitamins (25-100 mg of each) and magnesium 200 mg  (may be found in a high potency multi) to handle the depletion due to addiction and stress.
7. Specific brain cell nutrients such as phosphatidyl serine(100 mg) and phosphatidyl choline (GPC 500 mg), acetyl-l-carnitine (500 mg), and ginkgo (60 – 90 mg) to enhance acetylcholine, brain blood flow and brain cell health; especially in those over 45, and/or with memory problems
8. “Adaptogenic” herbs such as ashwaganda, and ginseng to support the adrenal glands which are depleted by stress, both physical (from addictive substances) and emotional.

Nutrients for Recovery

Recovery is difficult enough without having to keep track of multiple bottles and formulas. There are combination formulas available, particularly one that contains the equivalent of 6 different formulas into 2 daily packets of capsules, in the balanced amounts needed. They can control cravings and restore brain chemistry in substance abuse recovery, and also useful for ADD, anxiety, and depression. Here is what they contain:

1. A potent combination of essential vitamins and minerals for optimum nutrition of brain and body.
2. The amino acids and supportive nutrients as mentioned above, to optimize neurotransmitter production.
3. Nutrients that diminish sugar cravings (alpha lipoic acid, glutamine)
4. Omega-3 fatty acids (EPA, DHA) from fish oil, essential for formation of brain cells and neurotransmitters, and a key nutrient for healing depression, ADD, and addiction.
5. Powerful antioxidants and liver support nutrients including alpha lipoic acid, NAC, and silymarin (milk thistle), essential for detoxification from toxic substances.

Another formula contains powerful revitalizing nutrients to restore, protect and maintain brain cell function for optimum mood, cognition and memory. It helps prevent age related cognitive impairment, including Alzheimer’s disease and dementia. Some of these nutrients can be felt within several hours (acetyl-L-carnitine, GPC, inositol), and  others (phosphatidylserine, ginkgo) over months, as they gradually restore the brain cells.

Common in addiction is an overactive “fight- or-flight” response leads to adrenal exhaustion or “burn-out.”  Focusing on both catecholamine (“feel good neurotransmitters”) and cortisol (adrenal hormone) balance, take a formula that contains adaptogenic herbs and nutrients to calm the stress response and restore adrenal gland health, depleted in anxiety, chronic stress, post-traumatic stress disorder and prolonged substance abuse.

If anxiety persists, take a GABA enhancer to stabilize mood and relieving stress — without side effects, impairment, drowsiness, or loss of judgment.

Add sedating herbs such as valerian to help you fall asleep and stay asleep.

Where to Start

Since each component has its unique role, most people find they do best when they take a whole system. They find that they can decrease their dose over time, but stay on a maintenance program to keep their mind sharp, their mood even, and to maintain sobriety.

You can also read Natural Highs: Supplements, Nutrition and Mind-Body Techniques to Help You Feel Good All the Time, brain chemistry made simple, with specific questionnaires,  detailed (and understandable) explanations about how the brain works, nutrient protocols and mind-body techniques to enhance mind, mood and memory.

You can find more information, including how to order supplements and Natural Highs at www.drcass.com.

Nutrition Review
April 28, 2009
Special Issue…

At a press briefing on Sunday, US officials announced that the government is taking swift measures to contain an influenza outbreak that threatens to turn into a pandemic. Several hundred people in Mexico and 20 people in the United States have come down with a new kind of swine flu. People are concerned because some of those infected in Mexico have died, and because this is the kind of virus that could become a serious worldwide epidemic.

“This is moving fast,” said Richard Besser, acting director of the US Centers for Disease Control and Prevention. “We do think that this will continue to spread, but we are taking aggressive actions to minimize the impact on people’s health.”
The epidemic is almost certain to spread further, but officials attempted to assuage concerns the current swine flu epidemic could play out like the 1918 influenza pandemic, which killed millions.

Should I Worry About This Outbreak?
That depends on two things: how severe this flu really is, and how far it spreads. Its severity is currently unknown, but those who died in Mexico were young adults who don’t often die of flu, so this virus can potentially be serious. Conversely, the cases picked up in the US have been mild, which may indicate that the virus is weakening as it spreads.
Outbreak investigators are trying to find out how many people have caught the virus, and how many of those are seriously ill. For up-to-date information on the current outbreak we recommend monitoring local and national news broadcasts. Additionally, the Centers for Disease Control maintains a swine flu web page that is frequently updated.

Immune Support for Influenza – Discounts Below

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BronchoPhase® supports lung health and aids in soothing inflamed tissues to resolve chest discomfort and relieve persistent cough. The herbs contained in BronchoPhase have been shown to shorten the duration of a viral attack, resolve inflammation of bronchial tissues, relieve chest discomfort and aid in expelling phlegm.
All-natural AllerPhase® is specially formulated for individuals sensitive to seasonal and perennial pollens, house dust, molds and pet dander.AllerPhase promotes and supports healthy respiratory function and supports the immune system to resolve seasonal imbalances and reduce the potential for allergic reactions.

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Powerful Immune Defense Against Colds and Flu

Clinical Experiences with ImmunoPhase, AllerPhase and BronchoPhase

By Mitchell A. Fleisher, M.D., D.Ht., D.A.B.F.M.
As a very busy homeopathic family physician, I see lots of patients of all ages that are exposed to, and come down with, many variations of viral influenza. Usually, they respond very nicely to a series of specific, acute homeopathic remedies uniquely suited to their flu symptoms, along with additional buffered vitamin C and hot lemon ginger tea. But, sometimes much more is required to support the healing process, when the virus is particularly aggressive and the immune system is unprepared.

Last month, my nurse and I unfortunately got to experience this dilemma firsthand. Put simply, we’re virtually never ill, because we practice what we preach and take good care of ourselves. However, my lovely wife returned from a faraway seminar and brought back with her a virulent, very nasty strain of viral influenza that apparently spread from the Belgian participants at her conference.

This was a bug newly introduced to the Americas to which none of us had had an opportunity to develop immunity, i.e., effective antibody defenses. Needless-to-say, after being exposed to my wife’s constant sneezing and hacking cough for a week, I, too, began to come down with symptoms over the weekend.
Beginning as slight burning in my throat and upper chest, my symptoms rapidly progressed into a severe sore throat, thick, copious, sinus congestion, postnasal drip, raspy, irritating cough, lightheadedness, fatigue and severe muscle ache in my lower back and anterior thighs. Feeling sore all over, I felt as if I‘d been beaten with a club and worried if I’d be able to work the following week, since I had a full schedule of patients, coming from far and wide.

At first, a series of acute homeopathic remedies took some of the edge off, but my symptom pattern changed so rapidly that it was difficult to keep up with them and I often relapsed. High dose vitamin C, tinctures of Echinacea, Astragalus, Lomatium and Aloe helped somewhat, but didn’t hold.
Finally, in desperation, I happened to email a friend and colleague on the west coast to ask if they were also experiencing this horrible flu out in California Sure enough, he’d already seen several cases and warned me that, without adequate treatment, the illness was lasting three to six weeks, and some elderly patients required hospitalization for viral pneumonia. My colleague strongly recommended the following regimen: ImmunoPhase, 3 capsules every 3 to 4 hours; BronchoPhase, 4 capsules every 3 to 4 hours; and, AllerPhase, 2 capsules every 3 to 4 hours. I had several bottles overnighted for myself, my poor ailing wife, and my nurse, who’d also been struck by this belligerent bug.

Rapid Healing with “3 Phases”

We all began following the prescribed regimen soon thereafter, and, within 24 to 36 hours, were noticing significant improvement. I augmented the therapeutic program with 2,000 mg of buffered vitamin C every 3 to 4 hours as well. Thankfully, I was physically able to tend to my scheduled patients that week without mishap. It was a fortunate thing too, because many of my patients were also suffering with a similar, nasty viral illness for which the usual remedies weren’t working well, so I had the opportunity to prescribe lots of the “Three Phases,” as we now like to call them, and was able to observe rapid recoveries in my afflicted patients. Many of these patients reported that their neighbors, friends and co-workers had been sick for several weeks with this virus. After it was passed onto them, they were very grateful to heal so much more rapidly.

To reiterate, the antiviral flu regimen that really worked the best consisted of: ImmunoPhase – 3 capsules every 3 to 4 hours;BronchoPhase – 4 capsules every 3 to 4 hours; AllerPhase – 2 capsules every 3 to 4 hours; and, buffered vitamin C with bioflavonoids – 2,000 mg every 3 to 4 hours.

Healing Mists

When the cough is very deep and there is an obvious viral bronchitis (for which antibiotics are useless and probably harmful), I also recommend the following supportive care that I call the “Healing Mists.” Purchase a cool mist, ultrasound humidifier and several pint bottles of 3% hydrogen peroxide at your local pharmacy; into the reservoir of the humidifier, pour the entire contents of one pint bottle of 3% hydrogen peroxide; next, pour two pints of water into the reservoir of the humidifier (this results in a 1% solution of hydrogen peroxide); set up the ultrasound humidifier by your bedside, or wherever you’re resting, and breathe in deeply the cool vapors for several hours; this will help your immune system fight the viral infection in your lungs (your white blood cells actually use little packets filled with hydrogen peroxide to fight off infectious pathogens).

Finally, what has been working very well as an antiviral flu ‘prevention program’ is the following: ImmunoPhase, 2 capsules daily;BronchoPhase, 3 capsules daily; and, buffered vitamin C, 2,000 mg daily.

* The content provided herein is for informational purposes only and has not been approved by the U.S. FDA. This information is not intended to provide personal medical advice, which should be obtained from a medical professional.