A Literature Review of the Potential Impact of Medication on Vitamin D Status

Abstract

In recent years, there has been a significant increase in media coverage of the putative actions of vitamin D as well as the possible health benefits that supplementation might deliver. However, the potential effect that medications may have on the vitamin D status is rarely taken into consideration. This literature review was undertaken to assess the degree to which vitamin D status may be affected by medication. Electronic databases were searched to identify literature relating to this subject, and study characteristics and conclusions were scrutinized for evidence of potential associations. The following groups of drugs were identified in one or more studies to affect vitamin D status in some way: anti-epileptics, laxatives, metformin, loop diuretics, angiotensin-converting enzyme inhibitors, thiazide diuretics, statins, calcium channel blockers, antagonists of vitamin K, platelet aggregation inhibitors, digoxin, potassium-sparing diuretics, benzodiazepines, antidepressants, proton pump inhibitors, histamine H 2 -receptor antagonists, bile acid sequestrants, corticosteroids, antimicrobials, sulphonamides and urea derivatives, lipase inhibitors, hydroxychloroquine, highly active antiretroviral agents, and certain chemotherapeutic agents. Given that the quality of the data is heterogeneous, newer, more robustly designed studies are required to better define likely interactions between vitamin D and medications. This is especially so for cytochrome P450 3A4 enzyme (CYP3A4)-metabolized medications. Nevertheless, this review suggests that providers of health care ought to be alert to the potential of vitamin D depletions induced by medications, especially in elderly people exposed to multiple-drug therapy, and to provide supplementation if required.

Effects of Vitamin D and K on Interleukin-6 in COVID-19

“…It is found that hydroxychloroquine prevents vitamin D deficiency in patients with systemic lupus erythematosus. It is suggested that this may be a result of limited conversion of 25(OH)D to 1,25(OH) 2 D ( 47 ). In contrast, low molecular weight heparins possibly adversely affect vitamin D metabolism ( 47 ).…”

“…It is suggested that this may be a result of limited conversion of 25(OH)D to 1,25(OH) 2 D ( 47 ). In contrast, low molecular weight heparins possibly adversely affect vitamin D metabolism ( 47 ). However, there is a low probability of any affect during the short time period these drugs were prescribed.…”

Vitamin D Status and All-Cause Mortality in Patients With Type 2 Diabetes in China

“…First and foremost, the present study is a cohort study rather than a cross-sectional study, thus providing an accurate and comprehensive analysis. A recent literature review (51) has summarized published articles on the potential effects of medication such as glucose-lowering agents, anti-hypertensive drugs, and cholesterol-lowering agents on the vitamin D concentration. Thus, the other important advantage of our study is that some potential factors, such as glucose-lowering agents, anti-hypertensive drugs, and cholesterol-lowering agents which could affect the vitamin D level, were taken into consideration.…”

Dietary vitamin D intake and sun exposure are not associated with type 1 diabetic schoolchildren and adolescents: a first report in Algerian Sahara

“…VD can be available from sunlight, and it varies related to endogenous factors such as : skin pigmentation, genetics, physiology (bioavailability, bioequivalence and safety), adiposity, bile acid secretion and exogenous factors: socio-demographic (age, income, race/ethnicity, gender), physical inactivity, nutrition (food VD intake (food sources (food rich in VD, competing foods (cholesterol, tocopherol, phytosterols [20]), diet habits (cooking method, including skipping a meal, dairy and animal product exclusion (lactose intolerance, cow's milk food allergy [21], ovo-vegetarianism, veganism), VD supplementation and fortification, sun exposure (latitude, season, outdoor physical activity, use of sunscreens, cultural differences in dress, tanning bed), drugs (anticonvulsants (phenobarbital, dilantin, tegretol), bisphosphonates [22], ketoconazole, thiazides [23] and toxic habits including smoking. The classical role of VD to promote the human growth is very important in childhood and adolescence, in which the individual spends considerable time in education and school activities such as sport.…”