Anticonvulsant medications - hydantoin derivatives

Medications

  • Phenytoin
    • Dilantin

Depletions

Calcium

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

Vitamin B1 (Thiamine)

Symptoms of low levels of thiamine include weakness, fatigue, anorexia, constipation, memory loss, confusion, and depression. Severe deficiency can cause beriberi, a potentially serious condition that affects the brain, heart, and muscles.

Vitamin B3 (Niacin)

Niacin plays a key role in the body's metabolism, and low levels can lead to problems with the skin, digestive system, and nervous system. Symptoms include fatigue, stomach problems, depression, and vomiting. Severe deficiency can cause pellagra, a disease that can be life-threatening if not treated. Symptoms of pellagra include inflammation of the skin, depression, abdominal pain, and diarrhea.

Vitamin B9 (Folic Acid)

Low levels of folic acid have been linked to anemia, heart disease, birth defects, and colon cancer. Symptoms may include fatigue, mouth sores, swollen tongue, and poor growth.

Vitamin B12

Noticeable symptoms of a vitamin B12 deficiency can take years to show up. Irritability, weakness, numbness, anemia, loss of appetite, headache, personality changes, and confusion are some of the signs and symptoms associated with very low levels of vitamin B12. Low levels of this vitamin may also raise the risk of colon cancer, heart disease, brain problems, and birth defects.

Vitamin H (Biotin)

Low levels of biotin are linked with dry skin, hair that breaks easily, hair loss, depression or altered mental status, nausea and vomiting, loss of appetite, and muscle pain.

Vitamin D

Vitamin D works with calcium to keep bones strong. Over a long period of time, levels of vitamin D can cause rickets in children and osteomalacia in adults, conditions where the bones get soft and thin. It can also raise the risk of osteoporosis and it may increase the risk of some cancers.

Editorial Note

The information presented here covers some of the nutrients that may be lowered when you take certain medications. The signs and symptoms listed can be caused by other conditions. So if you have these signs and symptoms, it doesn't always mean you have low levels of these nutrients. Many things affect the level of nutrients, including your medical history, diet, and lifestyle, as well as how long you have been taking the medication. Please talk with your health care provider. He or she can best address 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.

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

Cashman KD. Diet, nutrition, and bone health. J Nutr. 2007;137(11):2507S-12S.

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].

Lyon VB, Fairley JA. Anticonvulsant-induced pellagra. J Am Acad Dermatol. 2002;46:597-9.

Pelton R, LaValle J, Hawkins EB, et al. Drug Induced Nutrient Depletion Handbook. Hudson, OH:LexiComp, Inc. 2001:395-404.

Ondrak KS, Morgan DW. Physical activity, calcium intake and bone health in children and adolescents. Sports Med. 2007;37(7):587-600.

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

Sheweita SA, Khoshhal KI. Calcium metabolism and oxidative stress in bone fractures: role of antioxidants. Curr Drug Metab. 2007;8(5):519-25.

Version Info

  • Last Reviewed on 09/29/2012
  • Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed HealthCare Network.

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This page was last updated: May 31, 2013

         
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