Oral steroids linked to severe vitamin D deficiency in nationwide US study -- ScienceDaily - Drug Information
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- Vitamin d and prednisone
Vitamin D 3 - 3 H metabolism was studied in 4 normal adult subjects before and during periods of prednisone administration. The biological activity of plasma vitamin D3 and its metabolites was assayed by in vitro measurements of 45 Ca accumulation by duodenal slices. In each instance prednisone induced a decrease in the plasma half-time of vitamin D 3 - 3 H, a decrease in the accumulation of a biologically active vitamin D 3 metabolite and the rapid appearance of chloroform-soluble biologically inactive metabolites without concomitant alterations in water-soluble vitamin D 3 metabolites.
These experiments support the conclusion that the observed antagonism of glucocorticoids to the action of vitamin D in man is related to the rapid turnover of vitamin D 3a diminished production of a biologically active vitamin D metabolite and the subsequent decrease in the intestinal absorption of calcium. Access to content on Oxford Academic is often provided through institutional subscriptions and purchases.
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Sign In or Create an Account. Sign In. Endocrine Society Journals. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Abstract. Journal Article. Louis, Missouri Oxford Academic. Google Scholar. Select Format Select format. Permissions Icon Permissions. Abstract Vitamin D 3 - 3 H metabolism was studied in 4 normal adult subjects before and during periods of prednisone administration.
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❾-50%}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. 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 steroids linked to severe vitamin D deficiency in nationwide US study. Retrieved November 21, from www. Print Email Share.
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 bonesrickets 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 steroids linked to severe vitamin D deficiency in nationwide US study. Retrieved November 21, from www. Print Email Share. Wireless Earphones as Inexpensive Hearing Aids. Unlocking the Power of Our Emotional Memory. Explore More. The study is the first The discovery could help prevent some cases of the disease by treating The study findings suggest Living Well.
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A new study shows that vitamin D, taken in combination with steroids, can enhance the effect of these drugs to subdue an overactive immune. Prednisone depletes vitamin D, shown by lower blood levels of vitamin D in those taking corticosteroids like prednisone. Vitamin D is vital for bone health. In each instance prednisone induced a decrease in the plasma half-time of vitamin DH, a decrease in the accumulation of a biologically active vitamin D3. Prednisone depletes vitamin D, shown by lower blood levels of vitamin D in those taking corticosteroids like prednisone. Vitamin D is vital for bone health. Prednisone not only increases the catabolism of 25(OH)D (8, 17, 36) but may also induce significant weight gain. Obesity may then compound the deleterious. 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. 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 bonesrickets softening of bones in children and clinical myopathy muscle weakness. Do NOT rely solely on the information in this article. Purchase Subscription prices and ordering for this journal. Citing articles via Web of Science There is emerging evidence that Vitamin D, a nutrient largely produced in the skin upon exposure to sun-light, may possess properties regulating the immune system in IBD.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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