deficiency
17 interactions related to deficiency
prednisone + vitamin d
Glucocorticoids accelerate the catabolism of 25-hydroxyvitamin D, lower active vitamin D metabolites at the gut, and impair calcium absorption. Population data show oral steroid users have more than double the rate of severe vitamin D deficiency compared to non-users.
carbamazepine + biotin
Carbamazepine reduces biotin status by inhibiting sodium-dependent biotin uptake in the intestine, decreasing renal reabsorption, and accelerating biotin catabolism through enzyme induction; long-term users often have measurably lower plasma biotin and elevated organic-acid markers of biotin insufficiency.
phenobarbital + vitamin d
Phenobarbital activates the pregnane X receptor and constitutive androstane receptor, strongly inducing hepatic CYP3A4 while also directly suppressing CYP27A1 (a 25-hydroxylase), so it both accelerates breakdown of 25-hydroxyvitamin D and slows its formation; serum 25(OH)D drops substantially over weeks to months of therapy, with osteomalacia and increased fracture risk documented in long-term users.
famotidine + vitamin b12
Famotidine, an H2-receptor antagonist, reduces gastric acid secretion and thereby impairs cleavage of vitamin B12 from food proteins, which is required for B12 absorption. The effect is less pronounced than with PPIs but is clinically relevant with long-term use.
esomeprazole + vitamin b12
Esomeprazole, the S-isomer of omeprazole, profoundly suppresses gastric acid required to liberate vitamin B12 from food proteins, impairing its absorption with long-term use. Studies confirm a dose- and duration-dependent reduction in serum B12 with chronic PPI therapy.
vitamin a + zinc
Zinc is required for the hepatic synthesis of retinol-binding protein, the carrier that mobilizes vitamin A from liver stores into circulation. Zinc deficiency lowers circulating retinol even when liver vitamin A is adequate, and combined supplementation outperforms either alone in deficient populations.
alcohol + folate
Chronic alcohol use causes folate deficiency through multiple mechanisms: it inhibits the reduced folate carrier in the intestine (blocking absorption), reduces hepatic uptake and storage, and increases urinary folate excretion. Folate depletion accelerates alcohol-induced liver injury and disrupts one-carbon metabolism and DNA methylation.
alcohol + zinc
Chronic alcohol use causes zinc deficiency through reduced intake, impaired absorption, increased urinary excretion, and altered zinc transporters (especially ZIP14). Zinc deficiency in turn worsens alcoholic liver disease by disrupting intestinal barrier function, increasing endotoxin leak, and amplifying hepatic oxidative stress.
phenytoin + folate
Phenytoin lowers serum and red-cell folate through enzyme induction and impaired absorption of polyglutamate folates, but high-dose folate supplementation in turn accelerates phenytoin metabolism and can drop drug levels enough to cause seizure breakthrough.
phenytoin + vitamin d
Phenytoin induces hepatic CYP3A4 and CYP24A1, accelerating conversion of 25-hydroxyvitamin D to inactive metabolites and lowering circulating 25(OH)D, which over time produces secondary hyperparathyroidism, reduced calcium absorption, and a measurably increased risk of osteomalacia and fractures.
omeprazole + vitamin b12
Omeprazole suppresses gastric acid, which is required to cleave vitamin B12 from dietary proteins before it can bind intrinsic factor and be absorbed in the ileum. Long-term use (typically >2 years) is associated with measurably lower serum B12 levels and increased risk of clinical deficiency.
coffee + vitamin b1
Some early studies suggested coffee contains compounds with antithiamine activity, but follow-up work showed chlorogenic and caffeic acids are not active antithiamine agents under physiological conditions. Heavy coffee or tea intake on a marginal thiamine diet can still modestly worsen thiamine status.
valproate + biotin
Valproate appears to reduce biotinidase activity and impair mitochondrial biotin handling, leading to subnormal biotin status that has been linked to the drug's signature alopecia (hair loss) and brittle nails; biotin supplementation has reversed hair loss in case reports.
carbamazepine + vitamin d
Carbamazepine activates the pregnane X receptor and strongly induces hepatic CYP3A4 and CYP24A1, accelerating catabolism of 25-hydroxyvitamin D into inactive metabolites; meta-analyses confirm consistently lower 25(OH)D in long-term users along with secondary hyperparathyroidism and reduced bone mineral density.
smoking + vitamin b12
Cyanide in cigarette smoke binds to active forms of vitamin B12 (methylcobalamin and hydroxocobalamin), converting them to the inactive cyanocobalamin form which is excreted, and chronic smoking damages the gastric mucosa, reducing intrinsic factor production and B12 absorption.
alcohol + thiamine
Alcohol blocks thiamine (vitamin B1) at every level — reducing intestinal absorption, impairing hepatic phosphorylation to its active form, and accelerating urinary loss. Thiamine deficiency in drinkers causes Wernicke encephalopathy (acute) and Korsakoff syndrome (chronic, often irreversible).
alcohol + magnesium
Alcohol acts as an acute magnesium diuretic, dramatically increasing urinary magnesium excretion within hours of intake. Chronic drinking depletes body magnesium stores through this renal wasting combined with reduced intestinal absorption, leading to hypomagnesemia in up to 60 percent of heavy drinkers.