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Drug-Nutrient Depletion Checker

Select your medications and see which vitamins and minerals they are documented to deplete, how strong the evidence is, and what you can do about it.

Read this first. This tool is educational. Never stop, skip, or change the dose of a prescribed medication because of anything you read here; the conditions these drugs treat are almost always a bigger risk than the depletions they cause. Bring the output to your prescriber or pharmacist and decide together.

Type to filter, or scroll the list. Check everything you take regularly.

How this works

Medications deplete nutrients through four main routes: blocking absorption, increasing urinary loss, speeding up a nutrient's breakdown, or directly antagonizing its biochemical role. Metformin interferes with the calcium-dependent uptake of the intrinsic factor-B12 complex in the terminal ileum; in the Diabetes Prevention Program Outcomes Study, each year of metformin use raised the odds of B12 deficiency by 13% (OR 1.13, 95% CI 1.06-1.20), with deficiency in 4.3% of metformin users versus 2.3% of placebo at 5 years. That is why ADA Standards of Care advise periodic B12 testing in long-term metformin users. Proton pump inhibitors impair active magnesium transport through intestinal TRPM6/7 channels; the FDA's 2011 safety review of 61 case reports found most hypomagnesemia occurred after a year or more of use, and about one quarter of cases required stopping the drug. Loop diuretics block the Na-K-2Cl cotransporter and flush potassium, magnesium, and thiamine out in urine. Enzyme-inducing anticonvulsants accelerate vitamin D catabolism through CYP induction. Methotrexate inhibits dihydrofolate reductase outright, which is why folic acid 1 to 5 mg is co-prescribed as standard of care. Statins block HMG-CoA reductase upstream of CoQ10 synthesis and lower circulating CoQ10 by roughly 20 to 40%, though trials of CoQ10 for statin muscle symptoms remain genuinely mixed.

Each drug-nutrient pairing carries an evidence grade. Strong means the depletion is recognized in clinical guidelines or regulatory labeling (metformin-B12, PPI-magnesium, corticosteroid-calcium). Moderate means consistent human studies without formal guideline adoption. Limited means the support is mechanistic or comes from small studies; these are worth knowing about, not worth alarm.

Results are grouped by nutrient rather than by drug, because depletion risk stacks. The base priority comes from the strongest evidence grade among your selected drugs, and it is bumped one level when two or more of your medications hit the same nutrient through additive mechanisms; metformin plus a PPI on vitamin B12 is the classic example, since one blocks ileal uptake and the other blocks acid-dependent release of B12 from food.

What this tool is not: it is not a complete interaction checker, it does not cover every drug or dose-dependence, and a flagged nutrient is a reason to test and discuss, not a diagnosis. SSRIs appear here for hyponatremia via SIADH, which is water retention diluting sodium rather than a true depletion; it is flagged because the monitoring advice matters, not because salt or supplements would help.

References

Mohn ES, et al. Evidence of Drug-Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update. Pharmaceutics. 2018;10(1):36.

Daniels MS, Park BI, McKay DL. Adverse Effects of Medications on Micronutrient Status: From Evidence to Guidelines. Annu Rev Nutr. 2021;41:411-431.

Aroda VR, et al. Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study. J Clin Endocrinol Metab. 2016;101(4):1754-1761.

US Food and Drug Administration. FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of proton pump inhibitor drugs (PPIs). 2011.