Chlorthalidone, Clonidine & Nutrient Depletion
Also searched as Clorpres, Combipres. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.
Chlorthalidone, Clonidine has been associated with depletion of POTASSIUM, VITAMIN C, MAGNESIUM and THIAMINE and 4 more. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Chlorthalidone, Clonidine long-term, worth raising with your pharmacist or healthcare provider.
Take more than one medication? Open the checker with Chlorthalidone, Clonidine pre-loaded and add the rest to see overlapping nutrient signals.
Reported nutrient depletions with Chlorthalidone, Clonidine
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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POTASSIUM
Major DepletionDIURETIC DRUGS
Potassium is a mineral your heart, muscles, and nerves depend on to work properly, and chlorthalidone (the thiazide-type diuretic in this combination) can cause your kidneys to flush out more potassium than usual in your urine. This is rated as a major depletion concern, meaning low potassium levels are a real, well-documented risk for many people on this medication, not just a theoretical one. Your doctor will likely want to check your serum potassium periodically, and some patients do need a supplement or dietary changes to keep levels in a safe range. Please talk with your pharmacist or doctor before adding any potassium on your own.
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
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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.
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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.
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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 (3)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
- Robertson JI. Diuretics, potassium depletion and risk of arrhythmias. Eur Heart J 1984;5(Suppl A):25-8.
VITAMIN C
Insignificant DepletionDIURETIC DRUGS
In people with chronic renal failure, a 20 mg intravenous dose of furosemide (Lasix) increases urinary losses of vitamin C, probably due to increased water excretion. Significant vitamin C depletion hasn't been reported with long-term oral use of furosemide or other diuretics.
Vitamin C is something your immune system, skin, and blood vessels all count on every day. Because chlorthalidone is a diuretic, it makes the kidneys pass more water, and some research suggests that extra fluid loss could carry a small amount of vitamin C out with it. That said, this has only been seen with intravenous doses in specific situations, and meaningful vitamin C depletion has not been reported with regular long-term use of oral diuretics like chlorthalidone. For most people taking this combination, no special action is needed, but mention it to your pharmacist or doctor if you have any concerns.
What Vitamin C does & food sources
Vitamin C is an antioxidant that supports the immune system, collagen formation, and iron absorption.
Common food sources:
- Citrus fruits
- Bell peppers
- Strawberries and kiwi
- Broccoli and Brussels sprouts
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What to discuss with your clinician
Frank vitamin C deficiency is uncommon with a varied diet. If your diet is limited and you take an associated medication, ask your provider whether your intake is adequate.
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Supplement considerations
Vitamin C is water-soluble and generally low-risk at food-level intakes; very high supplemental doses can cause stomach upset and may not add benefit.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
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Learn more about this nutrient: Vitamin C — uses, safety & interactions
References (1)
- Mydlik M, Derzsiova K, Zemberova E. Influence of water and sodium diuresis and furosemide on urinary excretion of vitamin B6, oxalic acid and vitamin C in chronic renal failure. Miner Electrolyte Metab 1999;25:352-6..
MAGNESIUM
Moderate DepletionDIURETIC DRUGS
Loop diuretics and, to a lesser extent thiazide diuretics, interfere with magnesium reabsorption in the kidneys, increasing urinary losses and reducing serum magnesium levels. Potassium-sparing diuretics, such as amiloride, triamterene, or spironolactone, are also magnesium-sparing, and can therefore counteract the magnesium losses seen with loop diuretics and thiazides. For information on foods that are rich in magnesium, see our chart.
Chlorthalidone is a thiazide-type diuretic, and one thing thiazide diuretics are known to do is cause the kidneys to flush out more magnesium than usual in the urine. Magnesium is a mineral your muscles, heart, and nerves depend on to work properly, so losing extra amounts over time is worth keeping an eye on. This interaction is rated as moderate, meaning some long-term users do end up needing a supplement, though not everyone does. If you have been on this medication for a while, it is worth asking your pharmacist or doctor whether checking your magnesium level makes sense for you.
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
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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.
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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 (4)
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Ryan MP. Diuretics and potassium/magnesium depletion. Directions for treatment. Am J Med 1987;82:38-47.. PubMed
- Hollifield JW. Magnesium depletion, diuretics, and arrhythmias. Am J Med 1987;82:30-7.. PubMed
- Heidenreich O. Mode of action of conventional and potassium-sparing diuretics--aspects with relevance to Mg-sparing effects. Magnesium 1984;3:248-56..
THIAMINE
Moderate DepletionDIURETIC DRUGS
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Chlorthalidone is a diuretic, meaning it helps your kidneys remove extra fluid, and that same process can flush thiamine (vitamin B1, which your heart and nervous system depend on for energy) out through your urine faster than usual. This concern is rated moderate, and it tends to be most relevant for older adults, people eating a limited diet, or those who have been on higher diuretic doses for many months. Most younger, well-nourished patients do not develop a problem, but if you have been on this medication long-term, it is worth bringing up with your pharmacist or doctor to see whether monitoring or a supplement makes sense for you.
What Vitamin B1 (thiamine) does & food sources
Thiamine helps convert food into energy and is essential for nerve and heart function.
Common food sources:
- Whole grains and fortified cereals
- Pork
- Beans and lentils
- Nuts and seeds
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What to discuss with your clinician
Ask about thiamine if you take an associated medication (for example, a long-term loop diuretic in heart failure) and have symptoms like fatigue or worsening heart failure control — this is an area your care team can weigh.
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Supplement considerations
Thiamine is water-soluble and generally low-risk, but supplementing to treat a suspected problem should still be clinician-guided so the real cause is not missed.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
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Learn more about this nutrient: Thiamine — uses, safety & interactions
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
ZINC
Moderate DepletionTHIAZIDE DIURETICS
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Chlorthalidone belongs to the thiazide diuretic family, and one well-documented effect of these medications is that they cause the kidneys to flush out more zinc in the urine, sometimes increasing that loss by more than half. Zinc is a mineral your immune system, wound healing, and hormone function all depend on. Blood levels often stay within the normal range, but research suggests that long-term use could quietly reduce zinc in the body's tissues over time. If you have been on this medication for a while, it is worth asking your pharmacist or doctor whether monitoring or a supplement makes sense for you.
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.
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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.
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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 (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
COENZYME Q10
Insufficient EvidenceTHIAZIDE DIURETICS
Thiazide diuretics might decrease endogenous levels of coenzyme Q10. However, it is not clear if this reduction is clinically significant. There is no reliable evidence that coenzyme Q10 depletion contributes to thiazide c side effects.
Coenzyme Q10 is a natural compound your cells use to produce energy, and it may also play a role in heart health. Some research suggests that thiazide-type diuretics like chlorthalidone can modestly reduce the body's own coenzyme Q10 levels, possibly by interfering with how the body makes or maintains it. That said, the evidence here is really preliminary, and it is not known whether this small change actually causes any health problems in practice. If you are curious, it is worth a quick conversation with your pharmacist or doctor before considering any supplement.
What Coenzyme Q10 (CoQ10) does & food sources
CoQ10 helps cells produce energy and acts as an antioxidant; heart and muscle tissue use it heavily.
Common food sources:
- Organ meats and fatty fish
- Whole grains
- Nuts and seeds
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What to discuss with your clinician
There is no routine blood test for CoQ10 in everyday practice. If you have new, unexplained muscle symptoms on a medication linked to CoQ10 (statins are the best-known example), talk to your prescriber before changing anything — symptoms have many possible causes and your prescriber has several options.
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Supplement considerations
CoQ10 is generally well tolerated, but evidence for supplementing (for example, for statin muscle symptoms) is mixed. It may also modestly affect warfarin — check with your pharmacist before combining.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
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Caution: Do not stop a prescribed medication because of this association — discuss any symptoms with your prescriber first.
Learn more about this nutrient: Coenzyme Q10 — uses, safety & interactions
References (1)
- LaValle JB. Hidden disruptions in metabolic syndrome: drug-induced nutrient depletion as a pathway to accelerated pathophysiology of metabolic syndrome. Altern Ther Health Med. 2006 Mar-Apr;12(2):26-31; quiz 32-3.
FOLIC ACID
Insufficient EvidenceDIURETIC DRUGS
Limited data suggests diuretics may increase excretion of folic acid. Reduced red blood cell folate levels, possibly contributing to increased homocysteine levels, were found in one group of people taking diuretics for six months or longer. The need for folic acid supplementation during diuretic therapy hasn't been adequately studied. Advise patients to maintain a good dietary intake of folic acid. For information on foods that are rich in folate, see our chart.
Folic acid is something your body uses to build healthy red blood cells and keep certain chemical levels in balance. Chlorthalidone is a diuretic, meaning it makes your kidneys remove extra fluid, and there is some early research suggesting this process may also cause a little more folic acid to leave the body in urine than usual. That said, the evidence right now is really thin, so no one can say for certain this is a meaningful concern for most people taking it. Keeping folate-rich foods like leafy greens and beans in your regular diet is a reasonable step, and if you have questions about whether anything more is needed, your pharmacist or doctor is the right person to ask.
What Folic acid (folate) does & food sources
Folate is needed for cell division, red blood cell formation, and healthy fetal development.
Common food sources:
- Leafy green vegetables
- Beans, lentils, and peas
- Fortified grains and cereals
- Citrus fruits
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What to discuss with your clinician
Ask your provider whether folate monitoring or supplementation is appropriate for you — this matters most before and during pregnancy, and with long-term use of certain seizure or arthritis medications.
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Supplement considerations
Folate needs are individual. With some medications (for example, methotrexate), folic acid is often prescribed deliberately on a specific schedule — follow your prescriber's instructions rather than adding your own.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
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Caution: High-dose folic acid can mask vitamin B12 deficiency, so the two are often evaluated together.
Learn more about this nutrient: Folic Acid — uses, safety & interactions
References (1)
- Morrow LE, Grimsley EW. Long-term diuretic therapy in hypertensive patients: effects on serum homocysteine, vitamin B6, vitamin B12, and red blood cell folate concentrations. South Med J 1999;92:866-70. PubMed
SODIUM
Insufficient EvidenceDIURETIC DRUGS
Loop and thiazide diuretics increase sodium excretion by preventing sodium from being reabsorbed by the kidneys. Although uncommon, loop or thiazide diuretics can cause severe hyponatremia in some patients.
Sodium is something your body depends on for fluid balance, nerve signals, and muscle function. Chlorthalidone is a thiazide-like diuretic, meaning it works partly by telling your kidneys to release more sodium into your urine. That process is actually the point of the medication, but in rare cases it can push sodium levels too low. The evidence here is rated insufficient, so this is something worth mentioning to your doctor or pharmacist if you ever feel unusually fatigued, confused, or dizzy while taking it.
What Sodium does & food sources
Sodium maintains fluid balance, blood pressure, and nerve/muscle function.
Common food sources:
- Table salt and most processed foods — dietary shortage is rare; medication-related loss is about balance, not intake
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What to discuss with your clinician
Sodium is part of routine blood work. If you take an associated medication (like certain diuretics or antidepressants), ask how often your electrolytes should be checked — especially if you feel confused, weak, or unusually tired.
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Supplement considerations
Low sodium from a medication is managed by your care team (often by adjusting the medication or fluids) — not by eating more salt on your own.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
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Caution: Significant symptoms of low sodium (confusion, severe weakness) warrant prompt medical attention.
Learn more about this nutrient: Sodium — uses, safety & interactions
References (2)
- Sardar GK, Eilbert WP. Severe Hyponatremia Associated with Thiazide Diuretic Use. J Emerg Med 2015;48(3):305-9. PubMed
- Diaconu CC, Balaceanu A, Bartos D. Diuretics, first-line antihypertensive agents: are they always safe in the elderly? Rom J Intern Med 2014;52(2):87-90.
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 Chlorthalidone, Clonidine
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.
Chlorthalidone, Clonidine & nutrients: FAQs
Does Chlorthalidone, Clonidine deplete POTASSIUM?
Should I take a supplement because I take Chlorthalidone, Clonidine?
Should I stop taking Chlorthalidone, Clonidine?
Where does this information come from?
Questions about Chlorthalidone, Clonidine and your nutrition?
Ask a licensed pharmacist — free, no appointment needed.
Sources & How We Checked
Nutrient depletion records for Chlorthalidone, Clonidine 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.