Are your prescription drugs causing Vitamin D deficiency?
Prescription drugs have many side effects, especially in the elderly. Some common drugs that are prescribed to the elderly are metformin, coumadin, many blood pressure medications, and SSRIs (depression medication). This polypharmacy, or use of multiple medications, is linked to a low Vitamin D level.
Vitamin D deficiency is linked to chronic pain, bone pain and fractures, difficulty thinking clearly, muscle weakness and unexplained fatigue. If you or a loved one is on one of the listed medications, having a vitamin D level checked could be critical.
The Research
Eur J Clin Pharmacol. 2016 May;72(5):605-14. doi: 10.1007/s00228-016-2016-2. Epub 2016 Feb 12.
Vitamin D deficiency as adverse drug reaction? A cross-sectional study in Dutch geriatric outpatients.
van Orten-Luiten AC1,2, Janse A3, Dhonukshe-Rutten RA4, Witkamp RF5.
Abstract
PURPOSE:
Adverse drug reactions as well as vitamin D deficiency are issues of public health concern in older people. However, relatively little is known about the impact of drug use on vitamin D status. Our primary aim is to explore associations between drug use and vitamin Dstatus in older people. Furthermore, prevalence of drug use and vitamin D deficiency are estimated.
METHODS:
In a population of 873 community-dwelling Dutch geriatric outpatients, we explored the cross-sectional relationships of polypharmacy (≥5 medications concomitantly used), severe polypharmacy (≥10 medications), and use of twenty-one specific drug groups, with serum 25-hydroxyvitamin D (25(OH)D) by analysis of covariance.
RESULTS:
Overall prevalence of polypharmacy was 65 %, of severe polypharmacy 22 %. Depending on the cut-off value, prevalence of vitamin D deficiency was 49 % (<50 nmol/l) or 77 % (<75 nmol/l). Of the patients using a vitamin D supplement, 17 % (<50 nmol/l) or 49 % (<75 nmol/l) were still deficient. In non-users of supplemental vitamin D, after adjustment for age and gender, negative associations were found for severe polypharmacy, metformin, sulphonamides and urea derivatives (SUDs), vitamin K antagonists, cardiac glycosides, loop diuretics, potassium-sparing diuretics, ACE inhibitors, and serotonin reuptake inhibitors; for non-selective monoamine reuptake inhibitors (NSMRIs) the association was positive. The most extreme impacts of drug use on adjusted mean 25(OH)D were -19 nmol/l for SUDs and +18 nmol/l for NSMRIs.
CONCLUSION:
Drug use should be considered a risk factor for vitamin D deficiency amongst geriatric outpatients.
