Side Effects: Medications and the Nutrients they Deplete

We know that the health of the GI tract is fundamental to equine, canine and human health. It is the seat of the immune system, it is the seat of nutrient absorption. What happens when we have to give drugs like antibiotics, ulcer medications, antacids, or anti-inflammatory drugs? Perhaps not surprisingly, these different classifications of drugs can diminish or deplete important gut microorganisms and/or nutrients.

Ulcer Medications:
Common ulcer medications like the proton pump inhibitor Omeprazole can deplete or diminish B12, beta carotene, folate, iron, zinc, calcium, magnesium, vitamin C, and vitamin D. Cimetidine and ranitidine can deplete or diminish calcium, chromium, folate, iron, B12, and zinc. Sucralfate diminishes phosphorus.

Corticosteroids:
These drugs which include cortisone, dexamethasone, hydrocortisone and prednisone can deplete calcium, folate, magnesium, chromium, potassium, zinc, vitamin C, and vitamin D.

Aspirin:
Depletes folate, iron, and vitamin C.

Equioxx and Previcox:
Diminishes folate.

Naproxen:
Depletes iron and folate.

Antibiotics:
Amoxicillin, penicillin, sulfonamide, and erythromycin deplete beneficial bacterial strains bifidobacteria and lactobacillus, as well as vitamins B1, B2, B3, B5, B6, B12, vitamin K, calcium, magnesium, and potassium.

Fluoroquinolone antibiotics:
Cipro and Baytril will deplete or diminish lactobacillus and bifidobacteria, calcium, magnesium, iron, and zinc.

Tetracycline antibiotics:
Doxycycline and minocycline will deplete or diminish lactobacillus, bifidobacteria, calcium, magnesium, potassium, iron, zinc, vitamins B1, B2, B5, B6, B12, vitamin K, and folate.

Folate versus Folic Acid:
As you have probably noticed after reading the list of nutrients that are affected by these medications, folate shows up quite frequently. There is a general confusion over the term folate and the term folic acid:

• Folic Acid is the synthetic version of folate, also known as vitamin B9. Folic acid is not found in fresh whole foods. Folic acid is added to processed foods and supplements as a fortifier.

• Folate is found in green grass, green vegetables, super green foods like spirulina and chlorella, as well as legumes like alfalfa, timothy hay, orchard grass, and some grains.

Folate is required for DNA synthesis and cell growth and is important for red blood cell formation and energy production, as well as the formation of some amino acids. Folate is essential for creating heme, the iron-containing substance in hemoglobin that is crucial for oxygen support.

Horses with EPM:
EPM horses treated with sulfadiazine and pyrimethamine can be affected with lower folate levels. These two drugs inhibit the metabolism and absorption of folate. Two studies have highlighted that supplementation with folic acid only made the problems worse. Don’t add more folic acid!  The best course of action when using these medications is fresh grass, super green foods, and/or alfalfa pellets/cubes for increased folate.

How to nutritionally support horses on drug therapies:
One of the most important things to remember about horses is their GI tract: access to fresh grass, even hand-grazing is critical for the health of the intestinal tract. Nutrients in grass and the microbes in the soil help support the digestive system. Grass and forage also supply vitamin K.

Super green foods: Spirulina and chlorella provide not only folate, but also plant-chelated macro- and micro-minerals including, but not limited to, calcium, magnesium, chromium, zinc, potassium, and iron which can be depleted or diminished by various drug therapies. Spirulina also provides the B complex vitamins including B12 and beta carotene.

Beneficial microorganisms (probiotics): Particularly for horses on antibiotic therapies, re-colonizing the GI tract is essential.   Look for Lactobacillus strains that supply at least 100 billion CFUs (colony forming units) per serving. Multi-strain formulas are better than single-strain formulas because the GI tract is home to a variety of beneficial organisms. Micro-encapsulated formulas are best, as they protect the viable, beneficial organisms from the acid environment of the stomach. Do not give probiotics at the same time you are giving antibiotics; I prefer to give probiotics 1-2 hours after each antibiotic treatment.

Vitamin D: Two hours of sunlight per day can provide most horses with enough vitamin D. Forages that have been sun-dried also supply adequate amounts of vitamin D, particularly alfalfa.

Some nutritionists have pointed out that horses wearing blankets may need vitamin D supplementation. However, a study done in New Zealand that was presented at the American College of Veterinary Medicine Internal Medicine Forum (June 4-6, 2015) showed that blanketing does not appear to impact vitamin D status in horses, and that pasture vitamin D and forage vitamin D are important for ensuring adequate vitamin D levels.

Vitamin D, commonly found in supplements and feed, can be derived from irradiated cattle brains, from ultraviolet irradiation of lanolin from sheep’s wool, or from fish oil.

The Whole Food Approach:
When I developed Optimum, Biostar’s whole food multi-vitamin/mineral supplement, I did so for my own horses. I could no longer put a scoop of coal tar derivative B vitamins, inorganic minerals, and vitamin A from petroleum in my horses’ feed buckets. I created Optimum because I wanted the best multi-nutrient supplement for them. Optimum is 100% whole food that includes the super-green food spirulina.

My horse Lionheart, who is now 29 years young, and the rescue horse Ringo Starr, age 20, whose owner wanted to put him down because she didn’t want to pay the bills on him anymore, have been on Optimum for 8 years. They have no health issues: no metabolic challenges, no ulcers, no allergies. They are barefoot.

Lionheart and Kemosabe

My friends who know Lionheart remember that he once was a walking vet bill and a farrier’s challenge. If I have any regrets, it is that I didn’t make the connection between food and health when Lionheart was younger.

Medications are important and necessary, so doesn’t it make sense to support the body as best we can with real food that is brimming with enzymes, nutrients, antioxidants, and a life force? Foods which haven’t been processed to death. Foods that won’t put stress on the GI tract. Foods that will replenish, and support the body system at large.