Drug-induced nutrient depletion

Simvastatin, Sitagliptin & Nutrient Depletion

Also searched as Juvisync. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.

2Nutrient associations
Insignificant DepletionHighest rating
The bottom line

Simvastatin, Sitagliptin has been associated with depletion of BETA-CAROTENE and COENZYME Q10. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Simvastatin, Sitagliptin long-term, worth raising with your pharmacist or healthcare provider.

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The evidence

Reported nutrient depletions with Simvastatin, Sitagliptin

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.

BETA-CAROTENE

Insignificant Depletion

SIMVASTATIN (Zocor)

Simvastatin might modestly reduce levels of beta-carotene.

Clinical research shows that simvastatin can reduce serum levels of circulating beta-carotene, but this is probably only in proportion to the lowering of cholesterol (on which beta-carotene is transported). Supplements are not usually needed.
Taking Simvastatin, Sitagliptin? A supplement is not needed for most patients.
Dr. Brian Staiger, Pharm.D explains

Beta-carotene is an antioxidant the body converts into vitamin A, which supports healthy vision, skin, and immune function. Because beta-carotene hitches a ride in the bloodstream on cholesterol particles, simvastatin's job of lowering cholesterol can bring beta-carotene levels down a little along with it. That said, this is rated insignificant, meaning the drop appears to simply reflect lower cholesterol transport rather than a true shortage in your body. For most people on simvastatin, no extra beta-carotene is needed, but feel free to mention it to your pharmacist if you have questions.

What Vitamin A does & food sources

Vitamin A supports vision, immune function, and skin health.

Common food sources:

  • Liver and fish oils
  • Dairy and eggs
  • Orange and yellow vegetables (as beta-carotene)
  • Leafy greens

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Ask your provider before supplementing vitamin A — status testing is not routine, and intake from food plus multivitamins is often already adequate.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Vitamin A is fat-soluble and accumulates; excess is harmful (and dangerous in pregnancy). Prefer food sources unless a clinician advises otherwise.

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: Avoid high-dose vitamin A in pregnancy or when trying to conceive unless a clinician directs it.

Learn more about this nutrient: Beta-carotene — uses, safety & interactions

References (2)
  1. Jula, A., Marniemi, J., Huupponen, R., Virtanen, A., Rastas, M., and Ronnemaa, T. Effects of diet and simvastatin on serum lipids, insulin, and antioxidants in hypercholesterolemic men: a randomized controlled trial. JAMA 2-6-2002;287(5):598-605. PubMed
  2. Tonstad S, Silverstein M, Aksnes L, Ose L. Low dose colestipol in adolescents with familial hypercholesterolemia. Arch Dis Child 1996;74:157-60.

COENZYME Q10

Insignificant Depletion

ANTIDIABETES DRUGS

Metformin and sulfonylureas can modestly decrease endogenous levels of coenzyme Q10, but coenzyme Q10 supplements are not likely to be needed for patients taking these drugs.

Some antidiabetes drugs, including metformin and sulfonylureas, appear to inhibit coenzyme Q10 enzyme activity and decrease endogenous levels of coenzyme Q10. However, there is no strong evidence that coenzyme Q10 depletion is the cause of antidiabetes drug-related side effects. Furthermore, taking coenzyme Q10 does not seem to improve fasting glucose levels or glycated hemoglobin in patients with diabetes.
Taking Simvastatin, Sitagliptin? A supplement is not needed for most patients.
Dr. Brian Staiger, Pharm.D explains

Coenzyme Q10 is a compound your cells use to produce energy, and it also acts as an antioxidant. Some antidiabetes medications have been shown to slightly reduce the body's own CoQ10 activity, though the exact reason is not fully understood. For most people taking sitagliptin or simvastatin, this is considered an insignificant concern, meaning routine supplementation is not something most patients need to worry about. If you have questions about your specific situation, your pharmacist or doctor is the best person to ask.

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

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

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.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

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.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

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 (4)
  1. Kishi T, Kishi H, Watanabe T, et al. Bioenergetics in clinical medicine. XI. Studies on coenzyme Q and diabetes mellitus. J Med 1976;7:307-21.
  2. Moradi M, Haghighatdoost F, Feizi A, Larijani B, Azadbakht L. Effect of coenzyme Q10 supplementation on diabetes biomarkers: a systematic review and meta-analysis of randomized controlled clinical trials. Arch Iran Med. 2016;19(8):588-96. doi: 0161908/AIM
  3. Stojanovic M, Radenkovic M. A meta-analysis of randomized and placebo-controlled clinical trials suggests that coenzyme Q10 at low dose improves glucose and HbA1c levels. Nutr Res. 2017 Feb;38:1-12. PubMed
  4. Suksomboon N, Poolsup N, Juanak N. Effects of coenzyme Q10 supplementation on metabolic profile in diabetes: a systematic review and meta-analysis. J Clin Pharm Ther. 2015 Aug;40(4):413-8.
Important

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.
Understand the basics

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.

Common questions

Simvastatin, Sitagliptin & nutrients: FAQs

Does Simvastatin, Sitagliptin deplete BETA-CAROTENE?
Simvastatin, Sitagliptin has been associated with lower BETA-CAROTENE levels in the clinical literature — see the evidence rating and details above. An association is not a guarantee: dose, duration, diet, and your own health all matter. If you take Simvastatin, Sitagliptin long-term, ask your healthcare provider whether checking your BETA-CAROTENE status is appropriate.
Should I take a supplement because I take Simvastatin, Sitagliptin?
Not automatically. The right first step is usually a conversation with your pharmacist or provider — they can weigh your dose and duration, decide whether testing makes sense, and recommend food-first strategies or a supplement if genuinely needed. Some supplements can interact with medications, so do not add one without checking.
Should I stop taking Simvastatin, Sitagliptin?
No — never stop a prescribed medication because of a nutrient association. Simvastatin, Sitagliptin is prescribed for good reasons, and nutrient considerations are usually manageable with monitoring or diet. Any change to your medication belongs in a conversation with your prescriber.
Where does this information come from?
The depletion records come from the Natural Medicines (Therapeutic Research Center) database — an evidence-graded clinical reference — and are displayed as published, with their citations. The plain-English context is written and reviewed by licensed HelloPharmacist pharmacists.

Questions about Simvastatin, Sitagliptin and your nutrition?

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Sources

Sources & How We Checked

Nutrient depletion records for Simvastatin, Sitagliptin are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.