Drug-Induced Nutrient Depletion -

Hormone Replacement Therapy & Oral Contraceptives

Drug-induced nutrient depletion occurs when medications that we take for various health reasons block the absorption, storage, metabolism, or synthesis of

essential nutrients in the body. Over time, these depletions can lead to secondary problems. People on multiple medications may be more likely to have reduced levels of certain nutrients. Although these nutrients are in many foods, the amount of nutrients may not be sufficient, and you may need supplementation from a high-quality vitamin/supplement.


Different types of drugs can deplete different nutrients. This week we will look at hormone replacement therapy and oral contraceptives. For a full list of drug-induced nutrient depletions, please click here.

What nutrients can be depleted with hormone replacement therapy or oral contraceptives?

Drug Category
Drug Class Description
Drug-Induced Nutrient Depletions
Recommended Supplementation
Dietary Supplements with potential for interactions with drug or drug class

Oral Contraceptives (OCPs)

Synthetic and semi-synthetic analogs of estrogen and/or progesterone are used to prevent pregnancy by

• inhibiting ovulation

• thickening cervical mucus

• diminishing endometrial integrity

• Folic Acid

• Magnesium

• Vitamin B6

• Folic Acid: 240mcg daily

• Magnesium: 250-400mg

daily

• Vitamin B6: 5mg daily Additional Supplementation: Calcium: 500mg daily

• Copper and Iron: OCPs may increase serum copper and iron

levels.

• Garlic and St. John’s wort: Garlic and St. John’s wort

supplements may decrease effectiveness of OCPs. St. John’s wort also causes photosensitivity which may be exacerbated by OCPs.

• Green Tea: Use caution with green tea and OCPs. OCPs can decrease caffeine clearance by 40–65% and may increase adverse effects of caffeine in green tea. Adjust dose or discontinue if necessary.

Hormone Replacement Therapy (Estrogens)

Hormone replacement therapy (HRT) is used to replace female hormones that are no

longer produced after menopause

• Folic Acid

• Magnesium

• Vitamin B6

• Vitamin B12

• Folic acid: 240mcg daily

• Magnesium: 250–400mg daily

• Vitamin B6: 5mg daily

• Vitamin B12: 25–1000mcg daily

• Caffeine: The stimulating effects of caffeine may be increased due to inhibition of metabolism or clearance of caffeine by HRT.

• Calcium and Vitamin D: Calcium and vitamin D may

increase absorption of hormone replacements. These supplements are

recommended to improve bone mineral density during estrogen therapy.

• Red Clover Extract and Soy Isoflavones: These supplements may interfere with the activity or absorption of HRT.

• St. John’s wort: St. John’s wort may alter hormone

metabolism including estrogen and progesterone. This supplement is not recommended during HRT.

• Zinc and Magnesium: Excretion of these minerals is reduced by HRT.

At Compounding Solutions Pharmacy & Wellness, we offer a wide range of high-quality vitamins and supplements from brands like Pure Encapsulations, Thorne Health, our own private line, and more. For more information about vitamins and supplements, ask one of our knowledgeable pharmacists.

Sources:

https://www.uspharmacist.com/article/druginduced-nutrient-depletions-what-pharmacists-need-to-know

https://www.aafp.org/dam/AAFP/documents/about_us/sponsored_resources/Nature%20Made%20Handout.pdf