Antibiotic medications - aminoglycosides

Selected Medications 

  • Gentamicin
  • Neomycin
  • Tobramycin



Osteoporosis (bone loss) is the main disease associated with not getting enough calcium. Lack of calcium may be associated with bone pain and spinal problems. Low levels of calcium can also cause muscle cramps, irregular heartbeat, and depression.


Low levels of iron may lead to anemia and a weakened immune system. Symptoms of anemia include dizziness, fatigue, shortness of breath, pale skin color, and sometimes an irregular heartbeat.


Magnesium deficiency also affects calcium and vitamin D levels in the body. It may be associated with muscle cramps, heart problems, high blood pressure, diabetes, and osteoporosis.


Not having enough nitrogen may make it hard for your body to form protein, which could lead to stunted growth, poor muscle development or loss of muscle mass, being more prone to infection, weakness, and slower wound healing.


Symptoms of potassium deficiency include loss of appetite, nausea, drowsiness, feelings of apprehension, fatigue, muscle pain, and weakness (usually of the legs). Severe deficiency may lead to irregular heartbeat.


Probiotics, or "good" bacteria, live in the gut and help your body maintain intestinal health. When the number of these organisms (such as Lactobacillus acidophilus and Bifidobacterium bifidum) goes down, your body may not be as able to resist infections and diseases. Symptoms of deficiency include gas, indigestion, diarrhea, and yeast infections.


Much of our food has salt in it. So it's very rare to have low levels of sodium. In the rare cases where it does happen, low levels have been associated with gas, nausea and vomiting, headache, memory problems, diminished attention, muscle weakness, heart palpitations, lethargy, and confusion. Extreme deficiency can cause stupor, seizures, and possibly coma. How symptoms develop depends mostly on how fast the body loses sodium.

Vitamin A (Retinol)

One of the earliest symptoms of a vitamin A deficiency is night blindness. If low levels continue, there could be more changes in eye tissues and development of eye problems. Other potential signs of mild-to-moderate vitamin A deficiency include rough or dry skin, loss of appetite, dull hair, brittle nails, joint pain, and possibly an increased risk of infection.

Vitamin B12 (Cobalamin)

Noticeable symptoms of vitamin B12 deficiency can take years to show up, such as irritability, weakness, numbness, anemia, loss of appetite, headache, personality changes, and confusion. Low levels of vitamin B12 may also be associated with an increased risk of colon cancer, heart disease, brain problems, and birth defects.

Vitamin K

Vitamin K helps blood clot. So the major symptom of deficiency is that blood can't clot as it should. This may lead to excessive bleeding and a tendency to bruise easily.

Editorial Note

The information presented here covers some of the nutrients that may be depleted when you take certain medications. If you have these signs and symptoms, it doesn't necessarily mean you have low levels of these nutrients. Many factors affect the level of nutrients, including your medical history, diet, and lifestyle, as well as how long you have been taking the medication. Talk to your health care provider. He or she can best addresses your health care needs and see if you are at risk for low levels of any nutrients.

Supporting Research

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

Bissram M, Scott FD, Liu L, Rosner MH. Risk factors for symptomatic hyponatraemia: the role of pre-existing asymptomatic hyponatraemia. Intern Med J. 2007;37(3):149-155.

de Vrese M, Marteau PR. Probiotics and prebiotics: effects on diarrhea. J Nutr. 2007;137(3 Suppl 2):803S-811S.

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

Fox C, Ramsoomair D, Carter C. Magnesium: its proven and potential clinical significance. South Med J. 2001;94(12):1195-1201.

Gürer US, Göçer P, Erçag E, et al. The effects of some antibiotics on polymorphonuclear leukocyte functions of elderly patients in vitro before and after zinc supplementation. Int Immunopharmacol. 2006;6(5):808-816.

Hickson M, D'Souza AL, Muthu N, Rogers TR, Want S, Rajkumar C, Bulpitt CJ. Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial. BMJ. 2007;335(7610):80.

Hussain SM, Sureshkumar KK, Marcus RJ. Recent advances in the treatment of hyponatremia. Expert Opin Pharmacother. 2007;8(16):2729-2741.

Hvas AM, Nexo E. Diagnosis and treatment of vitamin B12 deficiency -- an update. Haematologica. 2006;91(11):1506-1512.

Isakow W, Morrow LE, Kollef MH. Probiotics for preventing and treating nosocomial infections: review of current evidence and recommendations. Chest. 2007;132(1):286-294.

McFarland LV. Diarrhoea associated with antibiotic use. BMJ. 2007;335(7610):54-55.

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):338-343.

Pelton R, LaValle J, Hawkins EB, et al. Drug Induced Nutrient Depletion Handbook. Hudson, OH:LexiComp, Inc.; 2001:374-385.

Powers HJ. Riboflavin (vitamin B-2) and health. Am J Clin Nutr. 2003;77(6):1352-1360.

Reynolds E. Vitamin B12, folic acid, and the nervous system. Lancet Neurol. 2006;5(11):949-960.

Saavedra JM. Use of probiotics in pediatrics: rationale, mechanisms of action, and practical aspects. Nutr Clin Pract. 2007;22(3):351-365.

Svenson J. Neurologic disease and vitamin B12 deficiency. Am J Emerg Med. 2007;25(8):987.e3-e4.

Vermeer C, Schurgers LJ. A comprehensive review of vitamin K and vitamin K antagonists. Hematol Oncol Clin North Am. 2000;14(2):339-353.

Zimmermann MB, Hurrell RF. Nutritional iron deficiency. Lancet. 2007;370(9586):511-520.

Version Info

  • Last reviewed on 5/26/2014
  • Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed HealthCare Network. Also reviewed by the A.D.A.M. Editorial team.

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