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- Prednisone and nutritional deficiencies
Bone loss may lead to osteoporosis. Here is a video of Dr. Megan explaining this to other pharmacists. Prednisone causes the greatest loss of bone density within the first months. A myth perpetuated on patient support groups is that osteoporosis is a side effect that only affects very long-term users of prednisone. For those taking it less than 2 weeks, osteoporosis is not much of a concern. But for those taking prednisone longer than 3 months , the doctors who prescribe prednisone the most, rheumatologists , recommend supplementing calcium and vitamin D.
According to new research, prednisone depletes vitamin D which also affects the balance of calcium in the body. Vitamin D helps improve calcium absorption, so whenever someone takes calcium, vitamin D should also be taken.
Since prednisone affects calcium, vitamin D also needs to be supplemented alongside the depleted calcium. We found that after two years of treatment, the bone mineral density of the lumbar spine and forearm of patients taking calcium and vitamin D therapy improved more than patients who had no treatment. English translation? The experts say that there is evidence that taking calcium and vitamin D works to prevent bone loss caused by prednisone.
Prednisone can cause the body to remove chromium through the urine. Chromium is a metal mineral which our bodies use to keep blood sugar steady. One of the most common side effects of prednisone is hyperglycemia, or high blood sugar, and may be caused by chromium deficiency. High blood sugar can lead to diabetes and weight gain. It is important for those taking prednisone to have enough chromium. Using prednisone for a long time can lead to magnesium loss in urine.
In our bodies, magnesium is related to bones, so when the body breaks down bones, the body gets rid of the magnesium. Magnesium may also help with keeping healthy blood sugar levels. When a person takes doses over 2. The HPA axis helps control zinc levels, so when someone takes prednisone, zinc levels can fall. Prednisone interferes with the normal balance of electrolytes sodium, potassium, and other salts in the body, causing too much potassium to be removed in the urine.
High blood pressure is another complication and is found 4 times as often in people taking prednisone than not taking prednisone. While on prednisone, limit your sodium intake and try to eat foods high in potassium. MedlinePlus , a publication of the U. National Library of Medicine, stated the following about special dietary instructions for people taking prednisone:. Your doctor may also prescribe or recommend a calcium or potassium supplement.
Prednisone may cause a loss of folic acid, but the mechanism is not clear. According to Clinical Pharmacology , folic acid loss from prednisone may lead to glossitis, which is swelling of the tongue. Folic acid is important for keeping a good mood and a healthy heart. How prednisone lowers the amount of vitamin A in the blood is unclear. Rarely, prednisone use may cause symptoms of vitamin A deficiency. Many symptoms of vitamin A deficiency overlap with prednisone side effects, so these may be related:.
According to the CDC :. Be careful not to take too much Vitamin A as it can become toxic. Similar to Vitamin A, taking prednisone can decrease the amount of vitamin C in the blood. Megan created a supplement designed especially for people taking prednisone. Melatonin , the hormone our bodies use for helping regulate our sleep-wake cycle, may be depleted by prednisone, according to new research.
Never stop taking prednisone suddenly, as your body needs time to fix this disruption and start making its own cortisol again. Prednisone also tells the body to hold onto too much sodium, or salt. The Experts : The American College of Rheumatology , the doctors who prescribe prednisone the most, created a guideline for people taking prednisone. Eating a whole food, plant-based diet with enough protein is vital for adequate nutrition while on prednisone.
For more help, visit www. A registered dietitian emailed me to let me know exactly how he often sees these complications of prednisone treatment.
People taking oral steroids are twice as likely as the general population to have severe vitamin D deficiency, according to a study of more than 31, children and adults by scientists at Albert Einstein College of Medicine of Yeshiva University. Their findings, in the September 28 online edition of The Journal of Clinical Endocrinology and Metabolism, suggest that physicians should more diligently monitor vitamin D levels in patients being treated with oral steroids.
The severe vitamin D deficiency assessed in this study defined as levels below 10 nanograms per milliliter of blood is known to be associated with osteomalacia softening of the bones , rickets softening of bones in children and clinical myopathy muscle weakness. Steroids have been shown to cause vitamin D deficiency, possibly by increasing levels of an enzyme that inactivates the vitamin.
Smaller studies involving people often prescribed steroids i. To further assess this association between steroid use and vitamin D levels, the Einstein researchers carried out the first-ever study of a large, nationally representative sample of people. The researchers examined data collected from participants who had participated in the National Health and Nutrition Examination Survey About one percent of the participants answered "yes" when asked if they had used oral steroids during the previous 30 days.
Eleven percent of the self-reported steroid users had severely low vitamin D levels compared with a severe vitamin D deficiency of 5 percent for people not taking steroids -- a two-fold increased risk for severe vitamin D deficiency. The risk was particularly pronounced for steroid users under 18, who were 14 times more likely to have a severe vitamin D deficiency compared with young non-steroid users.
Participants who reported using inhaled steroids were not included in the steroid-user group. Materials provided by Albert Einstein College of Medicine. Note: Content may be edited for style and length. Science News.
❿Prednisone and nutritional deficiencies. Prednisone
They are needed in small amounts to perform a specific metabolic function or prevent an associated deficiency disease. Most vitamins cannot be manufactured by the body and must be supplied through the diet. Consult your physician prior to taking any supplement. Prednisone is a corticosteroid used to treat a variety of ailments. Corticosteroids mimic the effect of the adrenal hormones the body naturally produces.
When taken in doses higher than the body produces, corticosteroids can suppress inflammation alleviating symptoms of arthritis and asthma as well as suppressing the immune system. Traditionally prednisone usages include arthritis, asthma, severe allergic reactions, multiple sclerosis, lupus, certain cancers and diseases that affect the lungs, skin, eyes, kidneys, blood, thyroid, stomach and intestines.
The variety of side effects of prednisone matches the extensive ailments it is used to treat. Side effects include headaches, dizziness, extreme changes in mood and personality, thin and fragile skin, difficulty sleeping, slow healing of wounds, bulging eyes and red or purple blotches under the skin. Severe side effects include depression, vision problems, excessive weight gain, numbness, burning, and tingling in the face and limbs, seizures, loss of touch with reality, difficulty breathing and swallowing and swelling in the head and limbs.
Corticosteroids in general can decrease the amounts of certain vitamins in the body and supplementation may be required to prevent deficiencies. The B vitamins folic acid, B6 and B12 have an increased loss from the body in the presence of prednisone. Folic acid plays a role in cell division and can decrease the risk of heart attacks and birth defects.
Vitamin B6 primarily functions in heart disease prevention. Vitamin B12 primarily functions in prevention of pernicious anemia and may be needed for potassium deficiencies. Prednisone interferes with the normal balance of electrolytes sodium, potassium, and other salts in the body, causing too much potassium to be removed in the urine. High blood pressure is another complication and is found 4 times as often in people taking prednisone than not taking prednisone.
While on prednisone, limit your sodium intake and try to eat foods high in potassium. MedlinePlus , a publication of the U. National Library of Medicine, stated the following about special dietary instructions for people taking prednisone:. Your doctor may also prescribe or recommend a calcium or potassium supplement. Prednisone may cause a loss of folic acid, but the mechanism is not clear. According to Clinical Pharmacology , folic acid loss from prednisone may lead to glossitis, which is swelling of the tongue.
Folic acid is important for keeping a good mood and a healthy heart. How prednisone lowers the amount of vitamin A in the blood is unclear. Rarely, prednisone use may cause symptoms of vitamin A deficiency. Many symptoms of vitamin A deficiency overlap with prednisone side effects, so these may be related:. According to the CDC :. Be careful not to take too much Vitamin A as it can become toxic.
Similar to Vitamin A, taking prednisone can decrease the amount of vitamin C in the blood. Megan created a supplement designed especially for people taking prednisone.
Melatonin , the hormone our bodies use for helping regulate our sleep-wake cycle, may be depleted by prednisone, according to new research. Never stop taking prednisone suddenly, as your body needs time to fix this disruption and start making its own cortisol again.
Prednisone also tells the body to hold onto too much sodium, or salt. The Experts : The American College of Rheumatology , the doctors who prescribe prednisone the most, created a guideline for people taking prednisone. Eating a whole food, plant-based diet with enough protein is vital for adequate nutrition while on prednisone.
For more help, visit www. A registered dietitian emailed me to let me know exactly how he often sees these complications of prednisone treatment. Read the next article in this series to understand which foods contain these vital nutrients. These 10 Nutrients You Need will help you focus your diet on the foods most likely to help you give back the nutrients depleted by prednisone. You can even watch a video explanation if you prefer to watch instead of read!
You are being redirected to our trusted and authorized Nutranize product website. The Nutranize website is designed, constructed and endorsed by Dr. Megan Milne, the Prednisone Pharmacist. Please grant us just a few seconds to get you there. What is Nutrient Depletion? Nutrients, also called micronutrients , are vitamins or minerals that your body needs to eat to live. Common nutrients include calcium mineral and vitamin D vitamin.
So what is Depletion? Depletion is the emptying of an important substance. When you drive, you deplete your gas tank of gasoline. When you spend money, you deplete your bank account.
Without nutrients, deficiencies occur and people can suffer diseases like: Osteoporosis lack of calcium Rickets lack of vitamin D Pellagra lack of niacin Scurvy lack of vitamin C. Which Nutrients does Prednisone Deplete? Watch Dr. Is prednisone making you miserable, too?
Find Replenishment Dr. What else does prednisone change? What can I do? Megan A registered dietitian emailed me to let me know exactly how he often sees these complications of prednisone treatment.
Things are
❾-50%}Prednisone and nutritional deficiencies.Contraindications of Vitamins & Prednisone
Whether this effect would occur with oral corticosteroids and licorice supplements is unknown. An animal study has shown that glycyrrhizin prevents the immune-suppressing actions of cortisone—the natural corticosteroid hormone produced by the body. More research is necessary to determine if this action is significant in humans taking oral corticosteroids. Until more is known, people should not take licorice with corticosteroids without first consulting a doctor.
Use of buckthorn Rhamnus catartica, Rhamnus frangula, Frangula alnus or alder buckthorn Rhamnus catartica , Rhamnus frangula , for more than ten days consecutively may cause a loss of electrolytes especially the mineral potassium.
Because corticosteroids also cause potassium loss, buckthorn or alder buckthorn should be used with caution if corticosteroids are being taken. Taking the oral corticosteroid methylprednisolone with grapefruit juice has been shown to delay the absorption and increase the blood concentration of the drug.
The mechanism by which grapefruit juice increases the concentration of methylpredniolone in the blood is not known, but it is suspected that it may interfere with enzymes in the liver responsible for clearing the drug from the body.
In certain people, grapefruit juice may, therefore, enhance the effects of methylprednisolone. The combination should be avoided unless approved by the prescribing doctor. Some doctors recommend that people taking corticosteroids for more than two weeks supplement with — mg of magnesium per day. Magnesium has also been reported to interfere with the absorption of dexamethasone. Pomegranate juice has been shown to inhibit the same enzyme that is inhibited by grapefruit juice.
The degree of inhibition is about the same for each of these juices. Therefore, it would be reasonable to expect that pomegranate juice might interact with oral corticosteroids in the same way that grapefruit juice does.
Oral corticosteroids cause both sodium and water retention. People taking corticosteroids should talk with their doctor about whether they should restrict salt intake. In some people, treatment with corticosteroids can impair wound healing. In one study, topical or internal vitamin A improved wound healing in eight of ten patients on corticosteroid therapy.
In theory, vitamin A might also reverse some of the beneficial effects of corticosteroids, but this idea has not been investigated and no reports exist of such an interaction in people taking both vitamin A and corticosteroids. People using oral corticosteroids should consult with a doctor to determine whether improved wound healing might outweigh the theoretical risk associated with concomitant vitamin A use. Although blood levels of vitamin A appear to increase during dexamethasone therapy—most likely due to mobilization of the vitamin from its stores in the liver—evidence from animal studies has also indicated that corticosteroids can deplete vitamin A from tissues.
Please read the disclaimer about the limitations of the information provided here. Do NOT rely solely on the information in this article. The TraceGains knowledgebase does not contain every possible interaction. Learn more about TraceGains, the company. The information presented by TraceGains is for informational purposes only. It is based on scientific studies human, animal, or in vitro , clinical experience, or traditional usage as cited in each article.
The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available.
Information expires December PeaceHealth endeavors to provide comprehensive health care information, however some topics in this database describe services and procedures not offered by our providers or within our facilities because they do not comply with, nor are they condoned by, the ethics policies of our organization. This information does not replace the advice of a doctor.
Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use and Privacy Policy. Learn how we develop our content. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
All rights reserved. What Are Nutrient Interactions. Types of interactions: Beneficial Adverse Check. The severe vitamin D deficiency assessed in this study defined as levels below 10 nanograms per milliliter of blood is known to be associated with osteomalacia softening of the bones , rickets softening of bones in children and clinical myopathy muscle weakness.
Steroids have been shown to cause vitamin D deficiency, possibly by increasing levels of an enzyme that inactivates the vitamin. Smaller studies involving people often prescribed steroids i. To further assess this association between steroid use and vitamin D levels, the Einstein researchers carried out the first-ever study of a large, nationally representative sample of people.
The researchers examined data collected from participants who had participated in the National Health and Nutrition Examination Survey About one percent of the participants answered "yes" when asked if they had used oral steroids during the previous 30 days. Eleven percent of the self-reported steroid users had severely low vitamin D levels compared with a severe vitamin D deficiency of 5 percent for people not taking steroids -- a two-fold increased risk for severe vitamin D deficiency.
The risk was particularly pronounced for steroid users under 18, who were 14 times more likely to have a severe vitamin D deficiency compared with young non-steroid users. Participants who reported using inhaled steroids were not included in the steroid-user group. Materials provided by Albert Einstein College of Medicine.
Note: Content may be edited for style and length. Science News. ScienceDaily, 30 September Albert Einstein College of Medicine.
Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D called 1,25 dihydroxycholecalciferol to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription.
A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1, mg of calcium per day plus IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis.
Most doctors recommend 1, mg of calcium and — IU vitamin D per day for the prevention of osteoporosis. Preliminary data suggest that corticosteroid treatment increases chromium loss. Double-blind trials are needed to confirm these observations. A controlled trial found that a single dose of the synthetic corticosteroid dexamethasone suppressed production of melatonin in nine of 11 healthy volunteers.
Further research is needed to determine if long-term use of corticosteroids interferes in a meaningful way with melatonin production, and whether supplemental melatonin would be advisable for people taking corticosteroids. Oral corticosteroids increase the urinary loss of potassium. This may not cause a significant problem for most people. Individuals who wish to increase potassium intake should eat more fruits, vegetables, and juices rather than taking over-the-counter potassium supplements, which do not contain significant amounts of potassium.
Oral corticosteroids have been found to increase urinary loss of vitamin Kvitamin Cseleniumand zinc. The importance of these losses is unknown.
Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day. Propoxyphene may cause gastrointestinal GI upset.
Propoxyphene-containing products may be taken with food to reduce or prevent GI upset. A common side effect of narcotic analgesics is constipation. Increasing dietary fiber especially vegetables and whole-grain foods and water intake can ease constipation. Preliminary data suggest that supplementation with chromium mcg per day in the form of chromium picolinate may prevent corticosteroid-induced diabetes.
According to preliminary human studies, horny goat weed offset some of the side effects of corticosteroids. One preliminary study found that in people with fibrosing alveolitis a rare lung diseasesupplementation with mg N-acetyl cysteine three times per day increased the effectiveness of prednisone therapy.
Licorice Glycyrrhiza glabra extract was shown to decrease the elimination of prednisone in test tube studies.
If this action happens in people, it might prolong prednisone activity and possibly increase prednisone-related side effects. A small, controlled study found that intravenous iv glycyrrhizin an active constituent in licorice given with iv prednisolone prolonged prednisolone action in healthy men. Whether this effect would occur with oral corticosteroids and licorice supplements is unknown.
An animal study has shown that glycyrrhizin prevents the immune-suppressing actions of cortisone—the natural corticosteroid hormone produced by the body. More research is necessary to determine if this action is significant in humans taking oral corticosteroids. Until more is known, people should not take licorice with corticosteroids without first consulting a doctor.
Use of buckthorn Rhamnus catartica, Rhamnus frangula, Frangula alnus or alder buckthorn Rhamnus catarticaRhamnus frangulafor more than ten days consecutively may cause a loss of electrolytes especially the mineral potassium. Because corticosteroids also cause potassium loss, buckthorn or alder buckthorn should be used with caution if corticosteroids are being taken. Taking the oral corticosteroid methylprednisolone with grapefruit juice has been shown to delay the absorption and increase the blood concentration of the drug.
The mechanism by which grapefruit juice increases the concentration of methylpredniolone in the blood is not known, but it is suspected that it may interfere with enzymes in the liver responsible for clearing the drug from the body.
In certain people, grapefruit juice may, therefore, enhance the effects of methylprednisolone. The combination should be avoided unless approved by the prescribing doctor. Some doctors recommend that people taking corticosteroids for more than two weeks supplement with — mg of magnesium per day. Magnesium has also been reported to interfere with the absorption of dexamethasone.
Pomegranate juice has been shown to inhibit the same enzyme that is inhibited by grapefruit juice. The degree of inhibition is about the same for each of these juices. Therefore, it would be reasonable to expect that pomegranate juice might interact with oral corticosteroids in the same way that grapefruit juice does.
Oral corticosteroids cause both sodium and water retention. People taking corticosteroids should talk with their doctor about whether they should restrict salt intake. In some people, treatment with corticosteroids can impair wound healing. In one study, topical or internal vitamin A improved wound healing in eight of ten patients on corticosteroid therapy.
In theory, vitamin A might also reverse some of the beneficial effects of corticosteroids, but this idea has not been investigated and no reports exist of such an interaction in people taking both vitamin A and corticosteroids. People using oral corticosteroids should consult with a doctor to determine whether improved wound healing might outweigh the theoretical risk associated with concomitant vitamin A use.
Although blood levels of vitamin A appear to increase during dexamethasone therapy—most likely due to mobilization of the vitamin from its stores in the liver—evidence from animal studies has also indicated that corticosteroids can deplete vitamin A from tissues. Please read the disclaimer about the limitations of the information provided here.
Do NOT rely solely on the information in this article. The TraceGains knowledgebase does not contain every possible interaction. Learn more about TraceGains, the company. The information presented by TraceGains is for informational purposes only. It is based on scientific studies human, animal, or in vitroclinical experience, or traditional usage as cited in each article.
The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Information expires December PeaceHealth endeavors to provide comprehensive health care information, however some topics in this database describe services and procedures not offered by our providers or within our facilities because they do not comply with, nor are they condoned by, the ethics policies of our organization.
This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use and Privacy Policy. Learn how we develop our content. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
All rights reserved. What Are Nutrient Interactions. Types of interactions: Beneficial Adverse Check. Replenish Depleted Nutrients Calcium Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Reduce Side Effects Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss.
Support Medicine Horny Goat Weed According to preliminary human studies, horny goat weed offset some of the side effects of corticosteroids. Reduces Effectiveness none. Potential Negative Interaction none. Explanation Required Licorice Licorice Glycyrrhiza glabra extract was shown to decrease the elimination of prednisone in test tube studies.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist. Top of the page Next Section:. Previous Section: Drug Information Top of the page. Topic Contents Drug Information.
Health Information Library.
Oral corticosteroids have been found to increase urinary loss of vitamin K, vitamin C, selenium, and zinc. The importance of these losses is unknown. The. This medication has some potential side effects that relate to the food we eat. These dietary guidelines may help to minimize these possible. Steroids (such as prednisone or methylprednisolone) are strong medicines that decrease swollen airways. Unfortunately, they also have some nutritional side. People taking oral steroids are twice as likely as the general population to have severe vitamin D deficiency, according to a study of more. The mechanism of action of glucocorticoids and its association with vitamin D deficiency is not completely understood. Glucocorticoids are known to enhance bone. Some nutrient depletion can even lead to death.Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Doctors can measure levels of activated vitamin D called 1,25 dihydroxycholecalciferol to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription.
A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1, mg of calcium per day plus IU of vitamin D per day for two years experienced no bone loss during that time period. An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis.
Most doctors recommend 1, mg of calcium and — IU vitamin D per day for the prevention of osteoporosis. Preliminary data suggest that corticosteroid treatment increases chromium loss. Double-blind trials are needed to confirm these observations.
A controlled trial found that a single dose of the synthetic corticosteroid dexamethasone suppressed production of melatonin in nine of 11 healthy volunteers. Further research is needed to determine if long-term use of corticosteroids interferes in a meaningful way with melatonin production, and whether supplemental melatonin would be advisable for people taking corticosteroids.
Oral corticosteroids increase the urinary loss of potassium. This may not cause a significant problem for most people. Individuals who wish to increase potassium intake should eat more fruits, vegetables, and juices rather than taking over-the-counter potassium supplements, which do not contain significant amounts of potassium.
Oral corticosteroids have been found to increase urinary loss of vitamin K , vitamin C , selenium , and zinc. The importance of these losses is unknown. Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.
Propoxyphene may cause gastrointestinal GI upset. Propoxyphene-containing products may be taken with food to reduce or prevent GI upset. A common side effect of narcotic analgesics is constipation. Increasing dietary fiber especially vegetables and whole-grain foods and water intake can ease constipation. Preliminary data suggest that supplementation with chromium mcg per day in the form of chromium picolinate may prevent corticosteroid-induced diabetes.
According to preliminary human studies, horny goat weed offset some of the side effects of corticosteroids. One preliminary study found that in people with fibrosing alveolitis a rare lung disease , supplementation with mg N-acetyl cysteine three times per day increased the effectiveness of prednisone therapy.
Licorice Glycyrrhiza glabra extract was shown to decrease the elimination of prednisone in test tube studies. If this action happens in people, it might prolong prednisone activity and possibly increase prednisone-related side effects.
A small, controlled study found that intravenous iv glycyrrhizin an active constituent in licorice given with iv prednisolone prolonged prednisolone action in healthy men.
Whether this effect would occur with oral corticosteroids and licorice supplements is unknown. An animal study has shown that glycyrrhizin prevents the immune-suppressing actions of cortisone—the natural corticosteroid hormone produced by the body. More research is necessary to determine if this action is significant in humans taking oral corticosteroids. Until more is known, people should not take licorice with corticosteroids without first consulting a doctor.
Use of buckthorn Rhamnus catartica, Rhamnus frangula, Frangula alnus or alder buckthorn Rhamnus catartica , Rhamnus frangula , for more than ten days consecutively may cause a loss of electrolytes especially the mineral potassium. Because corticosteroids also cause potassium loss, buckthorn or alder buckthorn should be used with caution if corticosteroids are being taken.
Taking the oral corticosteroid methylprednisolone with grapefruit juice has been shown to delay the absorption and increase the blood concentration of the drug. The mechanism by which grapefruit juice increases the concentration of methylpredniolone in the blood is not known, but it is suspected that it may interfere with enzymes in the liver responsible for clearing the drug from the body. In certain people, grapefruit juice may, therefore, enhance the effects of methylprednisolone.
The combination should be avoided unless approved by the prescribing doctor. Corticosteroids may increase the body's loss of magnesium. Some doctors recommend that people taking corticosteroids for more than two weeks supplement with — mg of magnesium per day. Magnesium has also been reported to interfere with the absorption of dexamethasone. Pomegranate juice has been shown to inhibit the same enzyme that is inhibited by grapefruit juice.
The degree of inhibition is about the same for each of these juices. Therefore, it would be reasonable to expect that pomegranate juice might interact with oral corticosteroids in the same way that grapefruit juice does.
Oral corticosteroids cause both sodium and water retention. People taking corticosteroids should talk with their doctor about whether they should restrict salt intake. In some people, treatment with corticosteroids can impair wound healing. In one study, topical or internal vitamin A improved wound healing in eight of ten patients on corticosteroid therapy. In theory, vitamin A might also reverse some of the beneficial effects of corticosteroids, but this idea has not been investigated and no reports exist of such an interaction in people taking both vitamin A and corticosteroids.
People using oral corticosteroids should consult with a doctor to determine whether improved wound healing might outweigh the theoretical risk associated with concomitant vitamin A use. Although blood levels of vitamin A appear to increase during dexamethasone therapy—most likely due to mobilization of the vitamin from its stores in the liver—evidence from animal studies has also indicated that corticosteroids can deplete vitamin A from tissues. Please read the disclaimer about the limitations of the information provided here.
Do NOT rely solely on the information in this article. The TraceGains knowledgebase does not contain every possible interaction. Learn more about TraceGains, the company. The information presented by TraceGains is for informational purposes only. It is based on scientific studies human, animal, or in vitro , clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals.
For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Information expires December This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.
Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. What Are Nutrient Interactions.
Types of interactions: Beneficial Adverse Check. Replenish Depleted Nutrients Calcium Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss. Reduce Side Effects Calcium and Vitamin D Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin, increasing the risk of bone loss.
Support Medicine Horny Goat Weed According to preliminary human studies, horny goat weed offset some of the side effects of corticosteroids. Reduces Effectiveness none. Potential Negative Interaction none. Explanation Required Licorice Licorice Glycyrrhiza glabra extract was shown to decrease the elimination of prednisone in test tube studies. The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects.
For details, refer to the manufacturers' package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist. Top of the page Next Section:. Previous Section: Drug Information Top of the page.
All rights reserved. Search the Healthwise Knowledgebase. Help Healthwise Index. Topic Contents Drug Information. Chromium Preliminary data suggest that corticosteroid treatment increases chromium loss. Melatonin A controlled trial found that a single dose of the synthetic corticosteroid dexamethasone suppressed production of melatonin in nine of 11 healthy volunteers.
Potassium Oral corticosteroids increase the urinary loss of potassium. Selenium Oral corticosteroids have been found to increase urinary loss of vitamin K , vitamin C , selenium , and zinc. Vitamin B6 Corticosteroids may increase the loss of vitamin B6. Fiber Propoxyphene may cause gastrointestinal GI upset. Chromium Preliminary data suggest that supplementation with chromium mcg per day in the form of chromium picolinate may prevent corticosteroid-induced diabetes.
N-Acetyl Cysteine One preliminary study found that in people with fibrosing alveolitis a rare lung disease , supplementation with mg N-acetyl cysteine three times per day increased the effectiveness of prednisone therapy. Reduces Effectiveness none Potential Negative Interaction none Explanation Required Licorice Licorice Glycyrrhiza glabra extract was shown to decrease the elimination of prednisone in test tube studies.
Alder Buckthorn Use of buckthorn Rhamnus catartica, Rhamnus frangula, Frangula alnus or alder buckthorn Rhamnus catartica , Rhamnus frangula , for more than ten days consecutively may cause a loss of electrolytes especially the mineral potassium. Buckthorn Use of buckthorn Rhamnus catartica, Rhamnus frangula, Frangula alnus or alder buckthorn Rhamnus catartica , Rhamnus frangula , for more than ten days consecutively may cause a loss of electrolytes especially the mineral potassium.
Grapefruit Taking the oral corticosteroid methylprednisolone with grapefruit juice has been shown to delay the absorption and increase the blood concentration of the drug. Magnesium Corticosteroids may increase the body's loss of magnesium.
Pomegranate Pomegranate juice has been shown to inhibit the same enzyme that is inhibited by grapefruit juice. Sodium Oral corticosteroids cause both sodium and water retention.
Vitamin A In some people, treatment with corticosteroids can impair wound healing.
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