Medications that interfere with vitamin d absorption
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Medications That Interfere with Vitamin D Absorption
Introduction to Vitamin D and Medication Interactions
Vitamin D is essential for calcium absorption, bone health, and immune function. However, certain medications can interfere with vitamin D metabolism, leading to deficiencies that may impact overall health. This article explores various drugs known to affect vitamin D absorption and metabolism.
Anti-Epileptics and Vitamin D Absorption
Anti-epileptic drugs (AEDs) are commonly associated with reduced vitamin D levels. These medications can induce liver enzymes that accelerate the breakdown of vitamin D, leading to lower serum levels and potential deficiencies .
Impact of Diuretics on Vitamin D Status
Diuretics, including loop diuretics and thiazide diuretics, can also affect vitamin D metabolism. Loop diuretics may increase the excretion of calcium, indirectly affecting vitamin D status, while thiazide diuretics can increase calcium levels, potentially leading to imbalances in vitamin D metabolism .
Proton Pump Inhibitors and Histamine H2-Receptor Antagonists
Proton pump inhibitors (PPIs) and histamine H2-receptor antagonists, commonly used to treat acid reflux and peptic ulcers, can interfere with vitamin D absorption by reducing stomach acidity, which is necessary for the absorption of vitamin D .
Bile Acid Sequestrants and Lipase Inhibitors
Bile acid sequestrants and lipase inhibitors, used to manage cholesterol levels and obesity, respectively, can bind to vitamin D in the gut, preventing its absorption and leading to deficiencies .
Corticosteroids and Vitamin D Metabolism
Corticosteroids, often prescribed for inflammatory conditions, can impair vitamin D metabolism by reducing calcium absorption in the intestines and increasing calcium excretion in the kidneys, which can lead to lower vitamin D levels .
Antimicrobials and Antiretroviral Agents
Certain antimicrobials and highly active antiretroviral agents (HAART) used in the treatment of infections and HIV can disrupt vitamin D metabolism. These drugs may induce liver enzymes that metabolize vitamin D, leading to decreased levels .
Statins and Vitamin D
Statins, widely used to lower cholesterol, have been shown to interfere with vitamin D metabolism. However, some studies suggest that vitamin D supplementation can enhance the pharmacologic action of statins, indicating a complex interaction 23.
Conclusion
A wide range of medications, including anti-epileptics, diuretics, PPIs, bile acid sequestrants, corticosteroids, antimicrobials, and statins, can interfere with vitamin D absorption and metabolism. Healthcare providers should be aware of these interactions, especially in patients on long-term medication regimens, and consider vitamin D supplementation when necessary to prevent deficiencies and maintain optimal health.
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