Cisplatin & Nutrient Depletion
Also searched as Platinol-AQ. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.
Cisplatin has been associated with depletion of ACETYL-L-CARNITINE, L-CARNITINE, PROPIONYL-L-CARNITINE and ZINC and 2 more. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Cisplatin long-term, worth raising with your pharmacist or healthcare provider.
Take more than one medication? Open the checker with Cisplatin pre-loaded and add the rest to see overlapping nutrient signals.
Reported nutrient depletions with Cisplatin
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.
ACETYL-L-CARNITINE
Insignificant DepletionCISPLATIN (Platinol-AQ)
Increased urinary losses of L-carnitine can occur during cisplatin therapy. Cisplatin might increase L-carnitine mobilization due to tissue injury and reduce renal tubular reabsorption due to kidney injury. Theoretically, cisplatin may also increase losses of acetyl-L-carnitine. Deficiency of carnitines is unlikely in people who can maintain adequate dietary intake.
Acetyl-L-carnitine is a compound your body uses to help cells produce energy, and it plays a role in protecting nerve function. Cisplatin can be hard on the kidneys, and when the kidneys are stressed, they may not recapture as much carnitine from the urine as they normally would, so some extra is lost. That said, this is considered a theoretical concern, and most people eating a normal diet are unlikely to develop a meaningful deficiency. This one is rated insignificant, so no action is needed for most patients, though if you have questions about your nutrition during cisplatin therapy, your care team is a great place to start.
Learn more about this nutrient: Acetyl-l-carnitine — uses, safety & interactions
References (1)
- Heuberger W, Berardi S, Jacky E, et al. Increased urinary excretion of carnitine in patients treated with cisplatin. Eur J Clin Pharmacol 1998;54:503-8. PubMed
L-CARNITINE
Insignificant DepletionCISPLATIN (Platinol-AQ)
Increased urinary losses of L-carnitine can occur during cisplatin therapy. Cisplatin might increase L-carnitine mobilization due to tissue injury, and reduced renal tubular reabsorption due to renal injury. L-carnitine deficiency is unlikely in people who can maintain adequate dietary intake.
L-carnitine is a compound your body uses to turn fat into energy, and cisplatin has been reported to raise the amount lost through urine, likely because the drug can injure the kidneys and reduce how well they recapture carnitine before it gets flushed out. That said, the evidence rates this as insignificant, meaning most patients eating a reasonably normal diet are unlikely to develop a true deficiency. This is not something that typically calls for action, but if you are on long-term cisplatin therapy or have concerns about your diet, it is worth mentioning to your doctor or pharmacist.
What Carnitine does & food sources
Carnitine shuttles fatty acids into cells' mitochondria so they can be burned for energy.
Common food sources:
- Red meat (the richest source)
- Poultry and fish
- Dairy products
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Carnitine questions come up with specific medications (for example, valproic acid) and specific situations — this is a conversation for your prescriber, who can weigh testing or supplementation.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Carnitine supplements are usually reserved for clinician-identified situations rather than general use.
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.
Learn more about this nutrient: L-carnitine — uses, safety & interactions
References (1)
- Heuberger W, Berardi S, Jacky E, et al. Increased urinary excretion of carnitine in patients treated with cisplatin. Eur J Clin Pharmacol 1998;54:503-8. PubMed
PROPIONYL-L-CARNITINE
Insignificant DepletionCISPLATIN (Platinol-AQ)
Increased urinary losses of L-carnitine can occur during cisplatin therapy. Cisplatin might increase L-carnitine mobilization due to tissue injury and reduce renal tubular reabsorption due to kidney injury. Theoretically, cisplatin may also increase losses of propionyl-L-carnitine. Deficiency of carnitines is unlikely in people who can maintain adequate dietary intake.
Propionyl-L-carnitine is a compound your muscles and heart use to turn fat into usable energy. Cisplatin can damage the kidneys, and because the kidneys normally recapture carnitine from urine, that injury may allow more of it to slip out of the body than usual. That said, this is listed as an insignificant depletion, meaning it is considered theoretical and most patients eating a normal diet are not expected to run low. No action is needed for most people, but if you have concerns about your diet or kidney function during cisplatin therapy, it is worth raising with your care team.
Learn more about this nutrient: Propionyl-l-carnitine — uses, safety & interactions
References (1)
- Heuberger W, Berardi S, Jacky E, et al. Increased urinary excretion of carnitine in patients treated with cisplatin. Eur J Clin Pharmacol 1998;54:503-8. PubMed
ZINC
Insignificant DepletionCISPLATIN (Platinol-AQ)
Limited research suggests that an acute increase in urinary zinc excretion occurs after a dose of cisplatin. Plasma zinc levels are sometimes reduced, but usually return to normal within 24-48 hours. Supplements aren't routinely necessary.
Zinc helps your immune system, wound healing, and many enzymes throughout the body, so keeping levels steady matters. Cisplatin appears to cause the kidneys to spill a bit more zinc into the urine shortly after each dose, which can nudge blood zinc levels down temporarily. The good news is that levels typically bounce back on their own within a day or two, and the evidence rates this as insignificant for most patients. Zinc supplements are not routinely recommended here, but if you have concerns, a quick conversation with your pharmacist or doctor can put your mind at ease.
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 (2)
- Sweeney JD, Ziegler P, Pruet C, Spaulding MB. Hyperzincuria and hypozincemia in patients treated with cisplatin. Clin Nephrol 1982;17:254-7. PubMed
- Zumkley H, Bertram HP, Preusser P, et al. Renal excretion and magnesium and trace elements during cisplatin treatment. Clin Nephrol 1982;17:254.
SELENIUM
Insufficient EvidenceCISPLATIN (Platinol-AQ)
Preliminary evidence suggests that cisplatin lowers plasma selenium levels in humans. Levels appear to recover between courses, but the decrease can become progressively larger with each course of the drug. In one study, the decrease was only 1% with the first course, but reached 19% by the fourth course. This might indicate that tissues are becoming progressively more selenium-depleted, so that less is available to replenish plasma levels. The mechanism might involve binding of cisplatin to methylselenol, a selenium metabolite formed in the kidneys, resulting in increased selenium excretion. There is not enough data to know whether selenium supplements should be recommended for patients receiving cisplatin. Preliminary evidence suggests selenium supplements do not affect the systemic availability or antitumor actions of cisplatin in animal models.
Selenium is a trace mineral your body uses for immune defense, thyroid function, and protecting cells from damage. Some early research found that cisplatin may gradually lower selenium levels in the blood, possibly because the drug binds to a selenium byproduct in the kidneys and causes more of it to be flushed out in the urine. That said, the evidence here is still very preliminary, and researchers do not yet know whether this drop is clinically meaningful or whether selenium supplements are needed. If you are on cisplatin and have questions, it is worth bringing this up with your oncologist or pharmacist.
Learn more about this nutrient: Selenium — uses, safety & interactions
References (5)
- Sieja K, Talerczyk M. Selenium as an element in the treatment of ovarian cancer in women receiving chemotherapy. Gynecol Oncol 2004;93:320-7. PubMed
- Vernie LN, de Goeij JJ, Zegers C, et al. Cisplatin-induced changes of selenium levels and glutathione peroxidase activities in blood of testis tumor patients. Cancer Lett 1988;40:83-91. PubMed
- Baldew GS, van den Hamer CJ, Los G, et al. Selenium-induced protection against cis-diamminedichloroplatinum(II) nephrotoxicity in mice and rats. Cancer Res 1989;49:3020-3.
- Baldew GS, Mol JG, de Kanter FJ, et al. The mechanism of interaction between cisplatin and selenite. Biochem Pharmacol 1991;41:1429-37. PubMed
- Vermeulen NP, Baldew GS, Los G, et al. Reduction of cisplatin nephrotoxicity by sodium selenite. Lack of interaction at the pharmacokinetic level of both compounds. Drug Metab Dispos 1993;21:30-6. DOI
VITAMIN E
Insufficient EvidenceALKYLATING AGENTS
Some alkylating chemotherapy drugs might reduce serum vitamin E levels, usually when used in high doses. These drugs include cisplatin, etoposide, busulfan, cyclophosphamide, cytosine arabinoside, and thiotepa. The clinical significance isn't clear, but there is some concern that low vitamin E levels might increase the risk of chemotherapy-associated toxicity. In some cases, vitamin E levels return to normal between chemotherapy cycles. The role of supplements hasn't been established.
Vitamin E is an antioxidant your cells use to protect themselves from damage. High-dose cisplatin and similar chemotherapy drugs have been associated with lower vitamin E levels in the blood, though exactly why is not fully understood. The evidence here is still thin, and whether this actually affects how you feel or how well treatment goes remains unclear. If you are on cisplatin long-term or at high doses, it is worth mentioning this to your oncologist or pharmacist rather than starting a supplement on your own.
What Vitamin E does & food sources
Vitamin E is a fat-soluble antioxidant that protects cell membranes.
Common food sources:
- Vegetable oils
- Nuts and seeds
- Wheat germ
- Leafy greens
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Deficiency is rare; ask your provider before supplementing, particularly if you take blood thinners.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Higher-dose vitamin E can increase bleeding tendency, especially with warfarin or antiplatelet medications.
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: Discuss vitamin E supplements with your provider if you take any blood thinner.
Learn more about this nutrient: Vitamin E — uses, safety & interactions
References (4)
- Jonas CR, Puckett AB, Jones DP, et al. Plasma antioxidant status after high-dose chemotherapy: a randomized trial of parenteral nutrition in bone marrow transplantation patients. Am J Clin Nutr 2000;72:181-9. PubMed
- Pace A, Savarese A, Picardo M, et al. Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy. J Clin Oncol 2003;21:927-31.. PubMed
- Weijl NI, Hopman GD, Wipkink-Bakker A, et al. Cisplatin combination chemotherapy induces a fall in plasma antioxidants of cancer patients. Ann Oncol 1998;9:1331-7. PubMed
- Ladas EJ, Jacobson JS, Kennedy DD, et al. Antioxidants and cancer therapy: a systematic review. J Clin Oncol 2004;22:517-28. PubMed
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 Cisplatin
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.
Cisplatin & nutrients: FAQs
Does Cisplatin deplete ACETYL-L-CARNITINE?
Should I take a supplement because I take Cisplatin?
Should I stop taking Cisplatin?
Where does this information come from?
Questions about Cisplatin and your nutrition?
Ask a licensed pharmacist — free, no appointment needed.
Sources & How We Checked
Nutrient depletion records for Cisplatin 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.