Pharmacist-built clinical tool

Does My Medication Cause Nutrient Depletion?

Some prescription and over-the-counter medications can lower your levels of important vitamins and minerals over time. Search your medication below to see what it may deplete — with evidence ratings and what to discuss with your pharmacist.

Medical content reviewed by Dr. Brian Staiger, PharmD, BCPS · Last reviewed July 2026
971Medications
32Nutrients
8,447Depletion records
Your results

Potential nutrient considerations for your selected medication

1 medication checked · 1 nutrient with reported associations. These are talking points for your care team — not a diagnosis.

Methotrexate

1 nutrient association

FOLIC ACID

Major Depletion

METHOTREXATE (Trexall, others)

Methotrexate reduces serum folate levels and increases the risk of folate deficiency.

Methotrexate is a folate antagonist which prevents conversion of folic acid to its active form, and lowers plasma and red blood cell folate levels. In patients treated with long-term, low-dose methotrexate for rheumatoid arthritis (RA) or psoriasis, the development of folate deficiency is associated with increased risk of certain side effects. These include gastrointestinal effects, stomatitis, alopecia, abnormal liver function tests, myelosuppression, megaloblastic anemia, and increased homocysteine levels. Folic acid 0.8-5 mg daily reduces these side effects without reducing the efficacy of methotrexate. Advise patients taking methotrexate for these conditions to take a folic acid supplement, especially if their dietary folate intake is low and they are experiencing the side effects described. It's likely that people who have experienced side effects will need to continue taking folic acid for the duration of methotrexate therapy. Advise patients being treated with methotrexate for cancer to avoid folic acid supplements, unless recommended by their oncologist. Folic acid could interfere with the anticancer effects of methotrexate.
Taking Methotrexate? A supplement is needed for most patients. ⓘ
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

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

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.

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

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.

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

Caution: High-dose folic acid can mask vitamin B12 deficiency, so the two are often evaluated together.

References (11)
  1. Leeb BF, Witzmann G, Ogris E, et al. Folic acid and cyanocobalamin levels in serum and erythrocytes during low-dose methotrexate therapy of rheumatoid arthritis and psoriatic arthritis patients. Clin Exp Rheumatol 1995;13:459-63.
  2. Morgan SL, Baggott JE, Lee JY, Alarcón GS. Folic acid supplementation prevents deficient blood folate levels and hyperhomocysteinemia during longterm, low dose methotrexate therapy for rheumatoid arthritis: implications for cardiovascular disease preventi
  3. Dijkmans BA. Folate supplementation and methotrexate. Br J Rheumatol 1995;34:1172-4. PubMed
  4. Amer College of Rheumatology ad hoc committee on clinical guidelines. Guidelines for monitoring drug therapy in rheumatoid arthritis. Arthritis Rheum 1996;39:723-31. DOI
  5. Duhra P. Treatment of gastrointestinal symptoms associated with methotrexate therapy for psoriasis. J Am Acad Dermatol 1993;28:466-9. PubMed
  6. Morgan SL, Baggott JE, Vaughn WH, et al. Supplementation with folic acid during methotrexate therapy for rheumatoid arthritis. A double-blind, placebo-controlled trial. Ann Intern Med 1994;121:833-41. PubMed
  7. Ortiz Z, Shea B, Suarez Almazor M, et al. Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis (Cochrane Review). Cochrane Database Syst Rev 2000;2:CD000951. PubMed
  8. Griffith SM, Fisher J, Clarke S, et al. Do patients with rheumatoid arthritis established on methotrexate and folic acid 5 mg daily need to continue folic acid supplements long term? Rheumatology (Oxford) 2000;39:1102-9. PubMed
  9. Stamp LK, O'Donnell JL, Frampton C, et al. A Pilot Randomized Controlled Double-Blind Trial of High- Versus Low-Dose Weekly Folic Acid in People With Rheumatoid Arthritis Receiving Methotrexate. J Clin Rheumatol. 2019 Oct;25(7):284-287. PubMed
  10. Endresen GK, Husby G. Folate supplementation during methotrexate treatment of patients with rheumatoid arthritis. An update and proposal for guidelines. Scand J Rheumatol 2001;30:129-34.
  11. Schroder H, Clausen N, Ostergard E, Pressler T. Folic acid supplements in vitamin tablets: a determinant of hematological drug tolerance in maintenance therapy of childhood acute lymphoblastic leukemia. Ped Hematol Oncol 1986;3:241-7. PubMed
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

Nutrient depletion FAQs

Can medications really deplete nutrients?
Yes — some medications can lower levels of certain vitamins, minerals, or other nutrients over time, by reducing absorption, increasing loss through the kidneys or gut, or changing how the body uses them. Well-known examples include metformin (vitamin B12) and proton pump inhibitors like omeprazole (magnesium and B12). How much it matters varies a lot between medications and between people.
Does an entry in this checker mean I am deficient?
No. An entry means a depletion has been reported or studied with that medication — it does not mean it happens to everyone, or that it has happened to you. Dose, how long you have taken the medication, your diet, and your overall health all influence the actual risk. Think of the results as conversation starters for your pharmacist or doctor, not a diagnosis.
Should I take a supplement if my medication appears here?
Not automatically. Supplements are not risk-free — some interact with medications (for example, calcium, magnesium, iron, and zinc can reduce absorption of certain antibiotics and thyroid medication), and some can be risky in kidney disease. The better first step is usually to ask your healthcare provider whether testing or dietary changes make sense for you.
What labs should I ask about?
It depends on the nutrient. Some, like vitamin B12, vitamin D, potassium, magnesium, and sodium, have routine blood tests; others, like CoQ10, are not usually tested in everyday practice. Each nutrient entry in this tool notes what is commonly discussed. Your provider can decide whether testing is appropriate — routine testing is not necessary for everyone.
Can supplements interact with my medications?
Yes — that is one of the main reasons not to start supplements blindly. Interactions can change how much of a medication your body absorbs or how it works. You can check specific products and ingredients against your medications with our drug–supplement interaction checker, and confirm anything important with your pharmacist.
Where does this information come from, and how is it reviewed?
The depletion records come from the Natural Medicines (Therapeutic Research Center) database — an evidence-graded clinical reference used by pharmacists and clinicians — and are displayed as published, with their evidence ratings and citations. The surrounding plain-English education is written and reviewed by licensed HelloPharmacist pharmacists.

Not sure what your results mean?

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Sources

Sources & How We Checked

Nutrient depletion records are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations. The plain-English education is written and reviewed by licensed HelloPharmacist pharmacists.

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