Budesonide & Nutrient Depletion
Also searched as Entocort EC, Pulmicort, Uceris. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.
Budesonide has been associated with depletion of ZINC, CALCIUM, CHROMIUM and MAGNESIUM and 4 more. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Budesonide long-term, worth raising with your pharmacist or healthcare provider.
Take more than one medication? Open the checker with Budesonide pre-loaded and add the rest to see overlapping nutrient signals.
Reported nutrient depletions with Budesonide
Each record below is shown as published in our licensed clinical database, with its evidence rating and citations. Expand a section for food sources and talking points.
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ZINC
Insignificant DepletionCORTICOSTEROIDS
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc helps your immune system work and supports wound healing, so it is worth knowing that budesonide, like other corticosteroids, may cause a modest shift in zinc levels. Researchers think this happens partly because the hormone-signaling pathway that corticosteroids affect also plays a role in how the body manages zinc, possibly moving it from the bloodstream into tissues or nudging the kidneys to excrete a little more of it. That said, the evidence rates this as insignificant for most people, meaning routine zinc supplements are not considered necessary. If you have other reasons to be at risk for low zinc, it is worth mentioning that to your pharmacist or doctor.
What Zinc does & food sources
Zinc supports immune function, wound healing, taste and smell, and many enzyme systems.
Common food sources:
- Meat and shellfish (especially oysters)
- Beans and lentils
- Nuts and seeds
- Whole grains
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask about zinc status if you take an associated medication long-term and notice slow wound healing, frequent infections, or taste changes — a clinician can decide whether testing or an empiric plan makes sense.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Zinc competes with copper for absorption — long-term, higher-dose zinc without medical guidance can cause copper deficiency. Zinc also binds some antibiotics in the gut, so dose timing matters.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Keep zinc doses moderate and time them away from interacting medications — ask your pharmacist.
Learn more about this nutrient: Zinc — uses, safety & interactions
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
CALCIUM
Moderate DepletionCORTICOSTEROIDS
Corticosteroids, in daily doses equivalent to 7.5 mg prednisone or more, cause significant bone loss, osteoporosis, and increased risk of fractures. The severity increases with duration of therapy. Mechanisms include decreased absorption and increased excretion of calcium, reduction in sex hormones, and inhibition of bone formation. Advise adults taking prednisone 7.5 mg/day (or equivalent doses of other corticosteroids) for six months or longer to maintain a daily calcium intake of 1500 mg/day. They may also need a vitamin D supplement (e.g., 800 IU/day). Monitor serum calcium. For information on foods that are rich in calcium, see our chart.
Calcium is the mineral your bones and teeth are built from, and budesonide, like other corticosteroids, can work against it in two ways: it makes the gut absorb less calcium from food, and it nudges the kidneys to flush more of it out in urine. Over time, especially with longer-term or higher-dose use, this can put real pressure on bone strength. If you take budesonide regularly, it is worth asking your pharmacist or doctor whether your calcium intake is adequate or whether a supplement makes sense for you.
What Calcium does & food sources
Calcium builds and maintains bone and is essential for muscle contraction and nerve signaling.
Common food sources:
- Dairy products (milk, yogurt, cheese)
- Fortified plant milks and juices
- Canned fish with bones (sardines, salmon)
- Leafy greens like kale
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask your provider whether bone health monitoring (and vitamin D testing) makes sense with long-term use of an associated medication — a blood calcium level alone does not capture bone calcium status.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Calcium can interfere with the absorption of several medications (some antibiotics, thyroid medication, iron) — separate the doses and confirm timing with your pharmacist. Total intake from food plus supplements matters more than supplements alone.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Very high calcium intake has its own risks (kidney stones in susceptible people) — more is not better.
Learn more about this nutrient: Calcium — uses, safety & interactions
References (7)
- Recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. American College of Rheumatology Task Force on Osteoporosis Guidelines. Arthritis Rheum 1996;39:1791-801. PubMed
- Lems WF, Van Veen GJ, Gerrits MI, et al. Effect of low-dose prednisolone (with calcium and calcitriol supplementation) on calcium and bone metabolism in healthy volunteers. Br J Rheumatol 1998;37:27-33.
- Reid DM, Kennedy NS, Smith MA, et al. Total body calcium in rheumatoid arthritis: Effects of disease activity and corticosteroid treatment. Br Med J (Clin Res Ed) 1982;285:330-2. PubMed
- Lems WF, Jacobs JW, Netelenbos JC, et al. [Pharmacological prevention of osteoporosis in patients on corticosteroid medication]. Ned Tijdschr Geneeskd 1998;142:1904-8.
- Gennari C. Differential effect of glucocorticoids on calcium absorption and bone mass. Br J Rheumatol 1993;32:11-4. PubMed
- Need AG, Philcox JC, Hartley TF, et al. Calcium metabolism and osteoporosis in corticosteroid-treated postmenopausal women. Aust N Z J Med 1986;16:341-6. PubMed
- Reid IR, Ibbertson HK. Calcium supplements in the prevention of steroid-induced osteoporosis. Am J Clin Nutr 1986;44:287-90. PubMed
CHROMIUM
Moderate DepletionCORTICOSTEROIDS
Use of corticosteroids can increase urinary chromium excretion, which might lead to chromium deficiency and/or corticosteroid-induced hyperglycemia.
Chromium is a trace mineral that helps the body use insulin properly and keep blood sugar steady. Budesonide, like other corticosteroids, appears to cause the kidneys to flush out more chromium than usual through urine, which over time can chip away at your levels. This is rated as a moderate concern, meaning some people on long-term budesonide may genuinely need to address it. It is worth bringing up with your pharmacist or doctor, especially if you have any blood sugar issues.
Learn more about this nutrient: Chromium — uses, safety & interactions
References (2)
- Ravina A, Slezak L, Mirsky N, et al. Reversal of corticosteroid-induced diabetes mellitus with supplemental chromium. Diabet Med 1999;16:164-7.
- Ravina A, Slezak L, Mirsky N, and et al. Control of steroid-induced diabetes with supplemental chromium. J Trace Elem Exper Med 1999;12(4):375-378. DOI
MAGNESIUM
Moderate DepletionCORTICOSTEROIDS
Chronic use of corticosteroids increases the amount of magnesium excreted in the urine. This is thought to be due to catabolism of bone, releasing magnesium and increasing the amount available for excretion. Generally, there is not a significant effect on serum levels. For information on foods that are rich in magnesium, see our chart.
Magnesium helps keep your muscles working properly, supports your heart rhythm, and is important for strong bones. Long-term budesonide use, like other corticosteroids, may cause your kidneys to release more magnesium into the urine than usual, partly because the medication can break down bone tissue and free up magnesium that then gets flushed out. That said, actual blood levels often stay in the normal range for most people, so this is something to keep an eye on rather than panic about. If you have been on budesonide for a long time, it is worth asking your pharmacist or doctor whether your magnesium levels should be checked.
What Magnesium does & food sources
Magnesium is involved in muscle and nerve function, heart rhythm, blood sugar control, and bone health.
Common food sources:
- Nuts and seeds (almonds, pumpkin seeds)
- Whole grains
- Leafy green vegetables
- Beans and legumes
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask whether a magnesium level is worth checking if you take an associated medication long-term — particularly with symptoms like muscle cramps, twitching, or palpitations. Blood levels do not always reflect total body stores, which is worth discussing too.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Magnesium supplements come in many forms and can cause loose stools at higher doses. They can also bind some medications in the gut (certain antibiotics, thyroid medication), so timing matters — check with your pharmacist.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Magnesium supplementation can be risky in kidney disease, where magnesium can accumulate — always check with a clinician first if your kidney function is reduced.
Learn more about this nutrient: Magnesium — uses, safety & interactions
References (5)
- Quamme GA. Renal handling of magnesium: drug and hormone interactions. Magnesium 1986;5:248-72..
- Kleeman CR, Levi J, Better O. Kidney and adrenocortical hormones. Nephron 1975;15:261-78.. PubMed
- Rolla G, Bucca C, Bugiani M, et al. Hypomagnesemia in chronic obstructive lung disease: effect of therapy. Magnes Trace Elem 1990;9:132-6..
- Lund B, Storm TL, Lund B, et al. Bone mineral loss, bone histomorphometry and vitamin D metabolism in patients with rheumatoid arthritis on long-term glucocorticoid treatment. Clin Rheumatol 1985;4:143-9.. PubMed
- Rickers H, Deding A, Christiansen C, Rodbro P. Mineral loss in cortical and trabecular bone during high-dose prednisone treatment. Calcif Tissue Int 1984;36:269-73.. PubMed
POTASSIUM
Moderate DepletionCORTICOSTEROIDS
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention, resulting in compensatory renal potassium excretion and hypokalemia. This effect is dose-related and depends on mineralocorticoid potency. Monitor serum potassium regularly. If levels become low, change to a glucocorticoid with less mineralocorticoid activity, or give potassium supplements. For information on foods that are rich in potassium, see our chart.
Potassium is a mineral your heart, muscles, and nerves depend on to work properly. Budesonide is a corticosteroid, and some corticosteroids signal the kidneys to hold onto sodium, which causes extra potassium to get flushed out in the urine as a trade-off. This is rated a moderate concern, so it is worth keeping on your radar, especially if you use budesonide long-term or at higher doses. Ask your pharmacist or doctor whether checking your potassium level makes sense for you.
What Potassium does & food sources
Potassium keeps nerve signals, muscle contractions, and heart rhythm working normally.
Common food sources:
- Bananas and citrus fruits
- Potatoes and sweet potatoes
- Beans and lentils
- Tomatoes and leafy greens
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Potassium is routinely checked with basic blood work. If you take a medication associated with potassium loss (like some diuretics), ask your provider how often your electrolytes should be monitored.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Do not start potassium supplements on your own. Both low and high potassium can affect heart rhythm, and several common medications (ACE inhibitors, ARBs, potassium-sparing diuretics) raise potassium.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Potassium supplementation can be dangerous in kidney disease or alongside potassium-raising medications — this is a decision for your prescriber, guided by lab results.
Learn more about this nutrient: Potassium — uses, safety & interactions
References (1)
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
VITAMIN D
Moderate DepletionCORTICOSTEROIDS
Corticosteroids, in daily doses equivalent to 7.5 mg or more of prednisone, cause significant bone loss, osteoporosis, and increased risk of fractures. The severity increases with duration of therapy. Although this is due mainly to disturbances in calcium homeostasis and bone formation, rather than vitamin D depletion, supplements of vitamin D are helpful to improve calcium absorption. Advise people taking corticosteroids in doses equivalent to prednisone 7.5 mg daily or more for 6 months or longer to maintain a daily calcium intake of 1500 mg, and to take a daily supplement of vitamin D 800 IU. Serum calcium should be monitored regularly. For information on foods that are rich in vitamin D, see our chart.
Vitamin D helps your body absorb calcium and keep your bones strong, so it matters quite a bit when you're on a corticosteroid like budesonide. These medications can interfere with how the body handles calcium and bone formation, and over time that can put real stress on bone density. For people using budesonide at higher doses for six months or more, this is worth a practical conversation with your doctor or pharmacist about whether a vitamin D supplement makes sense for you.
What Vitamin D does & food sources
Vitamin D helps the body absorb calcium and supports bone, muscle, and immune health.
Common food sources:
- Fatty fish (salmon, mackerel)
- Fortified milk and cereals
- Egg yolks
- Sunlight exposure (the main natural source)
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
A 25-hydroxyvitamin D blood test is the standard way to assess status — ask whether it is appropriate if you take an associated medication long-term, have limited sun exposure, or have bone concerns.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Vitamin D dosing varies a lot between people; some medications change how vitamin D is processed. Your provider can target a dose to your level instead of guessing.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Vitamin D is fat-soluble and can accumulate — very high doses over time can cause harm, so follow a clinician-guided plan.
Learn more about this nutrient: Vitamin D — uses, safety & interactions
References (1)
- Recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. American College of Rheumatology Task Force on Osteoporosis Guidelines. Arthritis Rheum 1996;39:1791-801. PubMed
SELENIUM
Insufficient EvidenceCORTICOSTEROIDS
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a mineral your body uses to support the immune system, thyroid function, and antioxidant defenses. Research on budesonide and selenium is genuinely mixed: some studies found lower blood selenium levels with corticosteroid use, others found no change, and some actually found higher levels in the blood, possibly because the mineral shifted out of tissues rather than truly increasing overall. Because the evidence points in different directions and clinical importance is unknown, this is something to be aware of rather than worried about. If you are a long-term budesonide user with questions, it is worth a quick conversation with your pharmacist or doctor.
Learn more about this nutrient: Selenium — uses, safety & interactions
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
STRONTIUM
Insufficient EvidenceCORTICOSTEROIDS
Limited data suggest urinary strontium excretion is increased after 5-6 weeks of treatment with high doses of corticosteroids (e.g., hydrocortisone 80-120 mg/day, prednisone 20-30 mg/day, dexamethasone 3mg/day, triamcinolone 12-18 mg/day). The clinical significance of this is unknown.
Strontium is a mineral that the body handles similarly to calcium, and some research suggests it may play a small role in bone health. There is limited data from studies using high-dose corticosteroids showing that the kidneys may excrete more strontium in the urine during treatment, which could theoretically lower levels in the body. That said, the evidence here is rated as insufficient, so we really do not know whether budesonide causes a meaningful change in strontium status for most people. This is not something to worry about on your own, but if you have questions about your bone health while taking budesonide long-term, it is worth bringing up with your pharmacist or doctor.
Learn more about this nutrient: Strontium — uses, safety & interactions
References (1)
- Eisenberg E. Effects of androgens, estrogens and corticoids on strontium kinetics in man. J Clin Endocrinol Metab 1966;26:566-72.
This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.
Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
More about Budesonide
What drug-induced nutrient depletion means
Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.
Association is not deficiency
An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.
Evidence varies by pair
Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.
When to ask about labs
If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.
Don't self-supplement blindly
Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.
Never stop a medication over this
These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.
Food first, usually
For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.
Budesonide & nutrients: FAQs
Does Budesonide deplete ZINC?
Should I take a supplement because I take Budesonide?
Should I stop taking Budesonide?
Where does this information come from?
Questions about Budesonide and your nutrition?
Ask a licensed pharmacist — free, no appointment needed.
Sources & How We Checked
Nutrient depletion records for Budesonide are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for drug-induced nutrient depletions, supplements, and interactions — the basis for this page.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for medication overviews across the site.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.