Jessica-Beal-Stahl-PharmD-1--400w-400h

Medications, whether prescribed or over the counter can have a significant impact on an athletes ability to perform their best. Knowing how medications and supplements interact with performance, exercise, environment, and other medications is crucial not only for athletes but also, providers, coaches, and parents. Drug-induced nutrient depletion is a big concern because many medications have the potential to deplete, block absorption, increase excretion, or increase utilization of nutrients all resulting in nutrient deficiency. Recognizing and addressing these nutrient depletions are critical to the health and performance of athletes. Education is key to mitigate the impacts that can come from medications that are often needed by athletes for many individual reasons.

Q&A for Session #2

  • How do biologics drugs that help to treat inflammation (humira, taltz, etc) affect nutrition depletion?
    • Biologics drugs that treat inflammation can affect nutrition by causing gut related side effects, such as diarrhea and nausea, which can lead to malnutrition if severe and prolonged. Additionally, biologics can alter the absorption of certain nutrients in the gut, leading to a depletion of essential vitamins and minerals. It is important for individuals taking these medications to closely monitor their nutrient levels and talk to their doctor about any concerns.
  • Aside from going to school to for pharmacy or working for an institution with lots of journal access, how can we learn more about these nutrient interactions or depletions? What are some sound resources?
    • Pure encapsulation has a nice nutrient depletion 2 page document that outlines common medications, their known nutrient depletions.
  • PPI specific to B12 or multiple?
    • Multiple - known to deplete all the B vitamins. One of the hardest things to get off of - recommends B complex because they deplete all B vitamins due to change in pH.
  • How are nutrient levels tested/monitored in the research looking at nutrient depletion as a result of medications? Blood levels, tissue samples? Particularly for nutrients where blood levels are not a reliable indicator of intake such as calcium.
    • The studies I referenced, they make the claims of the nutrient depletion, they have different ways of assessing them. Varies from study to study. Sometimes its working backwards - its the actual result, then they work it backwards to what was their bone mineral density. They see the result, then they go backwards to see what may have caused that result.
  • If an individual were to take berberine rather than Metformin, would we still see the same deficiencies?
    • Don't see the same deficiencies. Berberine not recommended consistently because there is some effect on bacteria in the GI tract. Don't see the same deficiencies as Metformin, but do see changes in gut - recommends taking a break from it.
  • What form of magnesium do you typically recommend for supplementation?
    • Dilikes MgOxide. GI Motility - citrate causes the most motility; make sure to start low and don't overdo it. Mg Glycinate or disglycinate helps w/sleep and a lot of people can be depleted or low in glycine (depleted or suboptimal, may not be totaly depleted) Mg Threonate crosses blood line barrier so more effect on brain.
  • CoQ10 dosage recommendations?
    • If you're on a statin, 100-200 mg Start at 100, if no result, then go to 200, if still no result, call doctor - may not be the best choice for you.
  • Appropriate CoQ10 dosage for athlete’s on antidepressants?
    • 50-100 mg, maybe up to 200 depending on dose of antidepressant (high dose, then go up to 200).
  • What should you take instead of pain relievers, to replace using pain relievers often?
    • Omega 3 is a good choice. Some people do well on CBD. Some do well on Tumeric, some don't notice a difference. Tumeric w/black pepper to help w/absorption, otherwise it's not absorbed well. Using an antiinflammatory if you direly have to is ok. Topical antiinflammatory may be helpful as well to avoid GI side effects.
  • What are the side effects of Ozempic?
    • Everything under the sun. Wegove and Mounjaro are the same type of medication.
  • At what age can you start taking supplements, and in what situations are supplements needed? is protein a supplement?
    • Any age - youngest she has is 12 (taking BC and MVI) Does continue protein a supplement - protein powder - encourages food first, but if you aren't getting enough in, then recommends protein powder.
  • Do the dosing recommendations change between forms? I.e. a glycinate form vs a citrate
    • Yes. They come in all different strengths. 200 mg of Mg glycinate is usually what she recommends. Doesn't recommend citrate often except for the laxative effect (Calm) 200 mg of Mg glycinate is usual recommendation.
  • What genetic test do you recommend?
    • Pure genomics for Nutrigenomics testing. Three by Four for nutrigenomic testing. Pure Genomics, 23 and Me or Ancestry you can request nutrigenomics as well.
  • Diphenhydramine has been popular as a sleep aid, I've heard it could be an inhibitor when it comes to muscle recovery and growth, any truth to that?
    • It's not on her recommendation for sleep protocol - not sure if it is an inhibitor when it comes to muscle recovery and growth.