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PrepperMed 101: Antibiotics and Vitamins: Both Good, but Not Always Together

A couple of days ago, we listened to Todd Sepulveda’s Prepper Website Podcast Episode 190 (CLICKY) which featured Spice’s article Situations Change. Sometimes The SHTF. Life Changes. Medication Changes. But How? A Prepping Example. (CLICKY)

We always enjoy listening to the podcast, and find especially interesting to hear his comments when he includes one of our stories.

During Episode 190, which talks about antibiotics, Todd paused during the reading of our article to share the following from his own experience (quoted from the podcast and used here with Todd’s permission) (NOTE:  Salty, Spice and Todd are NOT physicians and this article’s content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition):

Todd said that in the past, he had an abscess in a tooth. At first, he thought it was allergies and sinus congestion (which can cause dental pain), but that the pain intensified so he went to see a dentist. “The dentist looked and said ‘yep, you have an infection, you have an abscess, we are going to have to pull it… but first we need to get rid of the infection before we can do any kind of work on you.'”

The dentist did a tooth cleaning, and prescribed a strong antibiotic to knock out the infection. “I started taking it,” he says, “it wasn’t going away. The pain was still there. After about three or four days, I went to go back to see him and and he says ‘yeah, I’m going to give you another antibiotic*, but if this doesn’t catch it, if this doesn’t take care of it, you might have to go to the hospital.’ I’ve never had to deal with that, so I’m like ‘what the heck? What’s going on here?'”

*Important note: If this situation ever happens to you, consult your physician to get his or her advice about how it it critically important that you continue taking the original antibiotic through it’s full course to reduce the chances of developing antibiotic resistant germs in your system. It is a core principle in the medical community that all antibiotic drug prescriptions should be taken in full, even if you feel better after a few days, so please confirm this with your doctor or pharmacist. 

Following the session with the dentist, Todd went to the pharmacy to pick up the additional prescription, and while there he started talking to the pharmacist about his situation. “I brought up that I was taking vitamins. He asked me what vitamins I was taking. I think I was taking Vitamin C and some other things, and he said ‘No, you don’t want to be taking vitamins when you take antibiotics because vitamins will absorb the antibiotics.”

“I’m like what?”, Todd asked.

The pharmacist continued “It’s like you think you are taking something good for you, vitamins, but it’s actually harming you when you are taking antibiotics because it’s absorbing the antibiotics and your body’s not getting them.”

So Todd stopped taking the vitamins, started taking the second antibiotic and the situation cleared up for him quickly.

“That’s something I always remember,” he said, “The dentist did not know that at all; he was a good dentist he knew what he was doing, if he hadn’t retired I’d still be going to him, but he didn’t realize that (vitamins obstruct antibiotics), he didn’t know that but the pharmacist did.”

In the original story, Spice mentioned talking to the pharmacist about drug interactions.

In the podcast, Todd said “when she brought up talking to the pharmacist, I think that’s a great idea, because they can really talk about the drug interactions…” 

At this point in time, I paused Todds podcast, looked at Spice and said “OK, now what’s up with this? I’ve never heard that vitamins can affect antibiotics”.

She nodded back at me and said “yes, they can…”

I grinned back at her sheepishly and said “Why, exactly, is that…” knowing that I was opening myself up to a 20-minute long sciencegasm explanation. 

To her credit, her answer was brief and didn’t use any “sciencespeak”…

I mentioned that this would be a good topic for a 3BY article, and she agreed… but, being the scientist that she is, she needed to check with creditable peer-reviewed scientific data to make sure her explanation was entirely accurate.

Part two of this series, PrepperMed: Antibiotics and Vitamins – When They Make a Good Team, is available by clicking HERE!

Spice, take it away!

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Bad vitamin interactions can occur in both directions:

Think about the combinations before you pop one of these babies along with a dose of antibiotics.

Vitamins indeed do some funky things when taken alongside antibiotics, as they can “mess up” antibiotic activity while antibiotics can interfere with what vitamins are doing for you. 

Here are examples:  

Vitamin B12’s action is blocked by some antibiotics, including chloramphenicol (1).  This isn’t a problem when the course of antibiotics is two weeks or less; you can do reduced B12 action for that long.  If you have to take the antibiotics for an extended period though, anemia tends to develop since B12 is needed to make red blood cells.  If the situation extends long enough, there can also be neural impairment, as one can’t make proper insulation for the nerve cells.

It apparently goes the other way, too.Taking some B vitamin (including B12, B6, and biotin) with some antibiotics, including all the tetracyclines (including doxycycline and terramycin) can stop the antibiotic from being absorbed from the gut, so it does you no good. This comes from a reputable source, the University of Maryland Medical Center (2), but I couldn’t trace down the original research or find it mentioned in four other drug interaction guides….odd.  So I’m not positive on this one but I won’t be taking supplements of those B vitamins while on antibiotics.  Normal dietary intake of these vitamins is too small to do much blocking.

High doses of Vitamin C are popular among some, but they may not mix well with chloramphenicol (3).  The chloramphenicol didn’t work as well against a common pneumonia-causing bacterium when the Vit C was taken as well.  (Other antibiotics played nicely with Vit C.  More on that in a separate post coming soon to 3BY.)

Vitamin K suffers in response to many antibiotics.  Some of our Vit K is made by the bacteria that live in our guts (it’s ok; good actually; they belong there).  Oral antibiotics kill off a lot of those bacteria, making us more dependent on dietary Vit K.  Since Vit K is found primarily in leafy greens, Americans often don’t eat enough of it at any time, much less when fresh food isn’t available.  A tendency to bleed too much can result.  The good news is that Vit K is a fat-soluble vitamin, so our bodies store some.  A couple weeks without it wouldn’t normally cause a problem.

One of the best known problem combinations involves tetracycline and fluoroquinolone classes of antibiotics.  Doxycycline and Cipro are examples of these common in prepping circles.  The problems come not from vitamins, but minerals which are often included alongside multi-vitamins in daily supplements like many popular “once a day” tablets.  Several minerals, including calcium, iron, aluminum, and magnesium, tend to bind with these antibiotics in the gut.  They combo of mineral and antibiotic then leaves the gut in the feces.  You might as well not have even taken the antibiotic (or the mineral, for that matter). (4)  Again, normal diet amounts aren’t likely to be a big deal so long as you don’t put them both in the gut within a couple of hours of one another.

Perhaps not the best drink to wash down a dose of Cipro.

Think about the combinations before you pop one of these babies along with a dose of antibiotics.

What might help:

When an antibiotic is labelled not to be taken with food, it’s usually because they suspect something in the food (such as calcium from dairy) might interfere with the antibiotic. A prepper storing antibiotics could look them up ahead of time (Hey!  Now would be great!) and label the bottles as to if they should be taken on an empty or full stomach, with whatever additional recommendations are given with prescriptions.  Places like drugs.com give instruction on how to take various drugs.

When taking any of the antibiotics known to interact badly with vitamins, vitamin supplements could be stopped for the duration of the antibiotic course.  Most people don’t need vitamin and mineral supplements anyway.  On average, they don’t extend lifespan or health measurably, as it stands today — though I can see where that might change in the dicier food situation of a crisis.  At any rate, most preppers wouldn’t be likely to take antibiotics for more than two weeks, and could do without vitamin supplements for that long at least, I suspect.

Some vitamins actually work and play well with some antibiotics; and those will be covered in a later post.  If I weren’t taking one of the known ‘good combos’, I wouldn’t be inclined to keep up a vitamin supplement I was taking ‘just in case’ while taking an antibiotic.



 

Some references I consulted:

(1) Scott JL, Finegold SY, Belkin GA, Lawrence JS “A controlled double-blind study of the hematologic toxicity of chloramphenicol.” N Engl J Med 272 (1965): 1137-42

(2) U of Maryland Medical Center, http://www.umm.edu/health/medical/altmed/supplement/vitamin-b12-cobalamin

(3) Cursino, Luciana, Chartone-Souza, Edmar, & Nascimento, Andréa Maria Amaral. (2005). Synergic interaction between ascorbic acid and antibiotics against Pseudomonas aeruginosa. Brazilian Archives of Biology and Technology, 48(3), 379-384. https://dx.doi.org/10.1590/S1516-89132005000300007

(4) Maria Marzella Sulli, Danielle C. Ezzo. Drug Interactions with Vitamins and Minerals. US Pharm. 2007;1:42-55.

Salty and Spice

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