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4 . 2021

Iatrogenic deficits of micronutrients


Long-term use of certain drugs causes subclinical and clinically significant micronutrient deficiencies, which can affect the course of the disease, its prognosis, quality of life, and patient compliance with therapy.

The aim of the study was to single out groups of drugs, which long-term use leads to micronutrient deficiency, and to determine vitamins, minerals and trace elements, which supply can be reduced as a result of pharmacotherapy, basing on the analysis of data published in the scientific literature.

Material and methods. This review analyzes articles on medical sciences from MEDLINE and PubMed-NCBI bibliographic databases.

Results. Combined oral contraceptives reduce woman’s supply with B vitamins (B6, B12, B9), can cause hypomagnesemia, affect the calcium/magnesium blood ratio, reduce the amount of vitamin E circulating in blood. Proton pump inhibitors reduce the absorption of vitamin B12, calcium, magnesium, iron, zinc. Aspirin increases ascorbic acid metabolism. Loop diuretics increase urinary excretion of calcium, magnesium, thiamine, thiazide ones elevate zinc and vitamin B9 excretion. Loss of taste when taking captopril is associated with a decrease in zinc supply. The use of calcium channel blockers interfere with the absorption of folic acid by gingival fibroblasts.

Conclusion. Given the growing prevalence of long-term drug use, it is necessary to be able to predict and prevent potential consequences of interactions with micronutrients. It is advisable, along with a varied and healthy diet, to provide patients with supplementation in order to prevent micronutrient deficiencies. Optimization of vitamin status of the population in terms of its significance for public health is comparable to drug therapy and is one of the technologies for reducing losses from chronic diseases.

Keywords:medicines, vitamins, trace elements, minerals, interaction

Funding. The study was carried out without financial support.

Conflict of interest. The authors declare no conflicts of interest.

For citation: Shikh E.V., Makhova A.A., Chemeris A.V., Tormyshov I.A. Iatrogenic deficits of micronutrients. Voprosy pitaniia [Problems of Nutrition]. 2021; 90 (4): 53-63. DOI: (in Russian)


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Viktor A. Tutelyan
Full Member of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Scientific Director of the Federal Research Centre of Nutrition, Biotechnology and Food Safety (Moscow, Russia)
Medicine today

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