2018 update: Drug–Nutrient Interactions with Chronic Use of Commonly Prescribed Medications

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jimmylegs
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2018 update: Drug–Nutrient Interactions with Chronic Use of Commonly Prescribed Medications

Post by jimmylegs » Fri Jan 25, 2019 5:37 am

Evidence of Drug–Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update (2018)
https://www.mdpi.com/1999-4923/10/1/36/htm

The long-term use of prescription and over-the-counter drugs can induce subclinical and clinically relevant micronutrient deficiencies, which may develop gradually over months or even years. Given the large number of medications currently available, the number of research studies examining potential drug–nutrient interactions is quite limited. A comprehensive, updated review of the potential drug–nutrient interactions with chronic use of the most often prescribed medications for commonly diagnosed conditions among the general U.S. adult population is presented. For the majority of the interactions described in this paper, more high-quality intervention trials are needed to better understand their clinical importance and potential consequences. A number of these studies have identified potential risk factors that may make certain populations more susceptible, but guidelines on how to best manage and/or prevent drug-induced nutrient inadequacies are lacking. Although widespread supplementation is not currently recommended, it is important to ensure at-risk patients reach their recommended intakes for vitamins and minerals. In conjunction with an overall healthy diet, appropriate dietary supplementation may be a practical and efficacious way to maintain or improve micronutrient status in patients at risk of deficiencies, such as those taking medications known to compromise nutritional status. The summary evidence presented in this review will help inform future research efforts and, ultimately, guide recommendations for patient care

take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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Re: 2018 update: Drug–Nutrient Interactions with Chronic Use of Commonly Prescribed Medications

Post by jimmylegs » Tue Jan 29, 2019 4:33 am

[b]Vitamin and mineral needs during the oral contraceptive therapy: a systematic review (2014)[/b]
https://www.ijrcog.org/index.php/ijrcog ... e/view/737

Objectives: There is growing evidence that women using OCs change in serum trace elements and vitamins. Nowadays, in many cases, side effects associated with low levels of micronutrients are not considered during oral contraceptives (OCs) therapy. This review aims at checking the present literature in order to verify the evidences. Our purpose is to underline this aspect contributing to improve the therapeutic approach with OCs.

Methods: Systematic literature search was performed in electronic databases, covering the period from January 1967 to January 2012.

Results: Ninety-five articles were located; a cross sectional randomized and three RCTs studies were considered eligible.

Conclusions: [b]A decrease in the serum concentrations of zinc, selenium, phosphorus and magnesium have been reported in OC users. Such reductions were proportional to the duration of contraceptive use.[/b] These reductions may imply a reduction in the probability of having a pregnancy and/or an increase of serious illness for the unborn. In this regard, a supplementation with the above compounds could be useful in OC users, namely for reducing side effects.

[b]Oral Contraceptives and Multiple Sclerosis/Clinically Isolated Syndrome Susceptibility (2016)[/b]
https://journals.plos.org/plosone/artic ... ne.0149094

Abstract
Background
The incidence of multiple sclerosis (MS) is rising in women.

Objective
To determine whether the use of combined oral contraceptives (COCs) are associated with MS risk and whether this varies by progestin content.

Methods
We conducted a nested case-control study of females ages 14–48 years with incident MS or clinically isolated syndrome (CIS) 2008–2011 from the membership of Kaiser Permanente Southern California. Controls were matched on age, race/ethnicity and membership characteristics. COC use up to ten years prior to symptom onset was obtained from the complete electronic health record.

Results
We identified 400 women with incident MS/CIS and 3904 matched controls. Forty- percent of cases and 32% of controls had used COCs prior to symptom onset. The use of COCs was associated with a slightly increased risk of MS/CIS (adjusted OR = 1.52, 95%CI = 1.21–1.91; p<0.001). This risk did not vary by duration of COC use. The association varied by progestin content being more pronounced for levenorgestrol (adjusted OR = 1.75, 95%CI = 1.29–2.37; p<0.001) than norethindrone (adjusted OR = 1.57, 95%CI = 1.16–2.12; p = 0.003) and absent for the newest progestin, drospirenone (p = 0.95).

Conclusions
Our findings should be interpreted cautiously. While the use of some combination oral contraceptives may contribute to the rising incidence of MS in women, an unmeasured confounder associated with the modern woman’s lifestyle is a more likely explanation for this weak association.
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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