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Cholesterol-lowering medications - bile acid sequestrants

Table of Contents > Depletions > Cholesterol-lowering medications - bile acid sequestrants     Print

Medications
Depletions
Editorial Note
Supporting Research
 

Medications

  • Cholestyramine (Questran, Questran Light)
  • Colestipol (Colestid)

Depletions

Beta-Carotene

This nutrient is converted to vitamin A by the body, therefore, deficiency symptoms are the same as those of vitamin A. The earliest symptom is night blindness. Prolonged deficiency leads to more advanced changes in eye tissue. Other potential signs of mild to moderate deficiency include rough, dry skin, loss of appetite, loss of hair luster, brittle nails, joint pain, and possibly increased susceptibility to infection.

Fat

Deficiency may lead to depletion of fat-soluble vitamins (A, D, E, and K), eczema, and other skin disorders. In children, fat deficiency could cause growth retardation. Long-term deficiency could be associated with many chronic illnesses. Fats are stored in the body as fatty acids. There are three essential fatty acids that the body cannot make and, therefore, must get from dietary sources or supplements.

Iron

Depleted levels of iron may lead to anemia and weakened immune function. In the event of anemia, symptoms include dizziness, fatigue, shortness of breath, pale skin color, and possibly irregular heartbeat.

Vitamin A (Retinol)

The earliest symptom of deficiency of this nutrient is night blindness. Prolonged deficiency leads to more advanced changes in eye tissue. Other potential signs of mild to moderate deficiency include rough, dry skin, loss of appetite, loss of hair luster, brittle nails, joint pain, and possibly increased susceptibility to infection.

Vitamin B9 (Folic Acid)

Low levels of folic acid have been linked to anemia, heart disease, and birth defects.

Vitamin B12 (Cobalamin)

Obvious symptoms of vitamin B12 deficiency are rare because it takes years to develop complications associated with long-term depletion of this nutrient. Irritability, weakness, numbness, anemia, loss of appetite, headache, personality changes, and confusion are some of the signs and symptoms associated with vitamin B12 depletion. Low levels of this vitamin may also be associated with an increased risk of colon cancer, heart disease, brain disorders, and birth defects.

Vitamin D

Vitamin D deficiency leads to abnormal bone formation (rickets) in children and softening of the bones (osteomalacia) in adults. Vitamin D deficiency interferes with calcium absorption, leading to deficiency of that nutrient with all of the associated symptoms (such as increased risk of fractures, osteoporosis (bone loss), and muscle weakness). Because this nutrient is fat-soluble, prolonged periods of deficiency are required to produce these symptoms.

Vitamin E

While deficiency of this nutrient is uncommon, it negatively affects muscle tissue, red blood cells, nervous, and reproductive systems. Over the long-term, depleted levels of this nutrient may also be associated with cancer, heart disease, and altered immune function.

Vitamin K

The major symptom of vitamin K deficiency is an inability of the blood to clot properly, which may lead to excessive bleeding and a tendency to bruise easily.

Editorial Note

The selected depletions information presented here identifies some of the nutrients that may be depleted by certain medications. The signs and symptoms associated with nutrient deficiency may also indicate conditions other than nutrient deficiency. If you are experiencing any of the signs or symptoms mentioned, it does not necessarily mean that you are nutrient deficient. Nutrient depletion depends upon a number of factors, including your medical history, diet, and lifestyle as well as the length of time you have been taking the medication. Please consult your healthcare provider; he or she can best assess and address your individual healthcare needs, and determine if you are at risk for nutrient depletions from these medications as well as others not listed here.

Supporting Research

Ames BN. Micronutrient deficiencies: A major cause of DNA damage. Ann NY Acad Sci. 2000;889:87-106.

Boivin MA, Kahn SR. Symptomatic hypocalcemia from oral sodium phosphate: a report of two cases. Am J Gastroenterol. 1998;93(12):2577-9.

Cashman KD. Calcium and vitamin D. Novartis Found Symp. 2007;282:123-38; discussion 138-42, 212-8.

Fitzgerald MA. Drug-induced vitamin B12 deficiency. Nurse Pract. 2007;32(9):6-7.

Guardia G, Parikh N, Eskridge T, Phillips E, Divine G, Rao DS. Prevalence of vitamin D depletion among subjects seeking advice on osteoporosis: a five-year cross-sectional study with public health implications. Osteoporos Int. 2007; [Epub ahead of print].

Hvas AM, Nexo E. Diagnosis and treatment of vitamin B12 deficiency--an update. Haematologica. 2006;91(11):1506-12.

Moretti R, Torre P, Antonello RM, Cazzato G, Cattaruzza T, Scapicchio PL. Vitamin B12 and folate depletion: clinical evidence in a neurological population. Neurologist. 2004;10(6):338-43.

Mustacich DJ, Bruno RS, Traber MG. Vitamin E. Vitam Horm. 2007;76:1-21.

Reynolds E. Vitamin B12, folic acid, and the nervous system. Lancet Neurol. 2006;5(11):949-60.

Schnyder G, Roffi M, Flammer Y, Pin R, Hess OM. Effect of homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin B6 on clinical outcome after percutaneous coronary intervention: the Swiss Heart study: a randomized controlled trial. JAMA. 2002;288(8):973-9.

Stahl W, Heinrich U, Aust O, Tronnier H, Sies H. Lycopene-rich products and dietary photoprotection. Photochem Photobiol Sci. 2006;5(2):238-42.

Stocker R. Vitamin E. Novartis Found Symp. 2007;282:77-87; discussion 87-92, 212-8.

Svenson J. Neurologic disease and vitamin B12 deficiency. Am J Emerg Med. 2007;25(8):987.e3-4.

van Bennekum AM, Nguyen DV, Schulthess G, Hauser H, Phillips MC. Mechanisms of cholesterol-lowering effects of dietary insoluble fibres: relationships with intestinal and hepatic cholesterol parameters. Br J Nutr. 2005;94(3):331-7.

Voutilainen S, Nurmi T, Mursu J, Rissanen TH. Carotenoids and cardiovascular health. Am J Clin Nutr. 2006;83(6):1265-71.

Vroonhof K, van Rijn HJ, van Hattum J. Vitamin K deficiency and bleeding after long-term use of cholestyramine. Neth J Med. 2003;61(1):19-21.

West KP Jr. Vitamin A deficiency disorders in children and women. Food Nutr Bull. 2003;24(4 Suppl):S78-90.

Review Date: 12/24/2007
Reviewed By: All depletions monographs have been reviewed by a team of experts including Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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