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Anti-inflammatory medications - inhalant, systemic, and topical corticosteroids

Selected Medications
Editorial Note
Supporting Research

Selected Medications

  • Beclomethasone
    • Beclovent
    • Beconase
    • Beconase AQ
    • QVAR
    • Vancenase
    • Vancenase AQ
    • Vanceril
  • Budesonide
    • Pulmicort Respules
    • Pulmicort Turbuhaler
    • Rhinocort
    • Rhinocort Aqua
  • Dexamethasone
    • AK-Dex Ophthalmic
    • Baldex
    • Dalalone D.P.
    • Dalalone L.A.
    • Dalalone
    • Decadron
    • Decadron Phosphate
    • Decadron-LA
    • Decaject-LA
    • Decaject
    • Decaspray
    • Dexacort Phosphate Turbinaire
    • Dexasone
    • Dexasone L.A.
    • Dexone
    • Dexone LA
    • Hexadrol
    • Hexadrol Phosphate
    • Maxidex
    • Solurex L.A.
    • Solurex
  • Fluticasone
    • Cutivate
    • Flonase
    • Flovent
    • Flovent Diskus
    • Flovent Rotadisk
  • Hydrocortisone
    • A-hydroCort
    • Ala-Cort
    • Ala-Scalp
    • Anucort-HC Suppository
    • Anusol-HC Suppository
    • Anusol HC 1 [OTC]
    • Anusol HC 2.5% [OTC]
    • Cetacort
    • Clocort Maximum Strength
    • Cort-Dome
    • Cortaid Maximum Strength [OTC]
    • Cortaid With Aloe [OTC]
    • Cortef
    • Cortef Feminine Itch
    • Cortenema
    • Corticaine
    • Cortifoam
    • Cortizone-10 [OTC]
    • Cortizone-5 [OTC]
    • Delcort
    • Dermacort
    • DermiCort
    • Dermolate[OTC]
    • Dermtex HC With Aloe
    • Eldecort
    • Gynecort[OTC]
    • Hemril-HC Uniserts
    • Hi-Cor 1.0
    • Hi-Cor 2.5
    • Hycort
    • Hydrocort
    • Hydrocortone Acetate
    • Hydrocortone Phosphate
    • HydroTex[OTC]
    • Hytone
    • LactiCare-HC
    • Lanacort[OTC]
    • Locoid
    • Nutracort
    • Orabase HCA
    • Pandel
    • Penecort
    • Procort[OTC]
    • Proctocort
    • S-T Cort
    • Scalpicin
    • Solu-Cortef
    • Synacort
    • Tegrin-HC [OTC]
    • Texacort
    • Westcort
    • Methylprednisolone
  • Mometasone Furoate
    • Elocon
    • Nasonex
  • Prednisone
    • Deltasone
    • Liquid Pred
    • Meticorten
    • Orasone
    • Prednicen-M
  • Triamcinolone
    • Amcort
    • Aristocort
    • Aristocort A
    • Aristocort Forte
    • Aristocort Intralesional
    • Aristospan Intra-Articular
    • Aristospan Intralesional
    • Atolone
    • Azmacort
    • Delta-Tritex
    • Flutex
    • Kenacort
    • Kenaject-40
    • Kenalog-10
    • Kenalog-40
    • Kenalog
    • Kenalog H
    • Kenalog in Orabase
    • Kenonel
    • Nasacort
    • Nasacort AQ
    • Tac-3
    • Tac-40
    • Tri-Kort
    • Tri-Nasal
    • Triacet
    • Triam Forte
    • Triam-A
    • Triderm
    • Trilog
    • Trilone
    • Tristoject



Osteoporosis (bone loss) is the primary disease associated with long term calcium deficiency; it may be associated with bone pain and spinal deformity. Depleted levels can also cause muscle cramps, irregular heartbeat, and depression.

Dehydroepiandrosterone (DHEA)

Decreased blood levels of DHEA have been linked to various conditions such as certain cancers, heart disorders, inflammatory diseases, and Type II diabetes mellitus.


Magnesium deficiency affects calcium and vitamin D levels in the body and may be associated with muscle cramps, heart irregularities, high blood pressure, diabetes, and osteoporosis (bone loss).


Reduced levels of melatonin in the body have been associated with sleep disturbances and jet lag.


Symptoms of deficiency include loss of appetite, nausea, drowsiness, feelings of apprehension, excessive thirst, irrational behavior, fatigue, muscle pain, and weakness (usually of the lower limbs); severe cases may lead to irregular heartbeat.

Protein and Amino Acid

Protein deficiencies are characterized by weakened immune status, including increased susceptibility to infection, impaired wound healing, muscle and weight loss, growth retardation, and deterioration in skin and hair condition.


Selenium deficiency may be associated with muscular, digestive, and heart disorders; long term deficiency may be associated with increased risk of developing certain chronic illnesses such as cancer, diabetes, or liver disease.

Vitamin B6 (Pyridoxine)

Symptoms of vitamin B6 deficiency may include weakness, nervousness, insomnia, mental confusion, irritability, and anemia. Long term low levels of this nutrient may also increase the risk of heart disease, as well as colon and prostate cancers.

Vitamin B9 (Folic Acid)

Low levels of folic acid have been linked to anemia, heart disease, and birth defects.

Vitamin B12 (Cobalamin)

Obvious symptoms of vitamin B12 deficiency are rare because it takes years to develop complications associated with long term depletion of this nutrient. Irritability, weakness, numbness, anemia, loss of appetite, headache, personality changes, and confusion are some of the signs and symptoms associated with vitamin B12 depletion. Low levels of this vitamin may also be associated with an increased risk of colon cancer, heart disease, brain disorders, and birth defects.

Vitamin C (Ascorbic Acid)

Vitamin C deficiency may include bruising, fever, anemia, emotional changes, swollen and bleeding gums, fatigue, lethargy, jaundice (yellowing of the skin and eyes), increased susceptibility to infections, slow wound healing, and swelling of the lower limbs. Severe deficiency leads to scurvy, a disorder that affects muscles and bones and is potentially fatal. However, scurvy is rare these days because of the wide availability of vitamin C from dietary sources.

Vitamin D

Vitamin D deficiency leads to abnormal bone formation (rickets) in children and softening of the bones (osteomalacia) in adults. Vitamin D deficiency interferes with calcium absorption, leading to deficiency of that nutrient with all of the associated symptoms such as increased risk of fractures, osteoporosis (bone loss), and muscle weakness. More recently, vitamin D deficiency has been linked to compromised immunity, cancer, and other chronic conditions. Because this nutrient is fat soluble, prolonged periods of deficiency are required to produce these symptoms.


Signs and symptoms of zinc deficiency include loss of appetite or sense of taste, growth retardation, skin changes, and increased susceptibility to infection.

Editorial Note

The selected depletions information presented here identifies some of the nutrients that may be depleted by certain medications. The signs and symptoms associated with nutrient deficiency may also indicate conditions other than nutrient deficiency. If you are experiencing any of the signs or symptoms mentioned, it does not necessarily mean that you are nutrient deficient. Nutrient depletion depends upon a number of factors, including your medical history, diet, and lifestyle, as well as the length of time you have been taking the medication. Please consult your healthcare provider; he or she can best assess and address your individual healthcare needs and determine if you are at risk for nutrient depletions from these medications, as well as others not listed here.

Supporting Research

Acuna-Castroviejo D, Escames G, Rodriguez MI, Lopez LC. Melatonin role in the mitochondrial function. Front Biosci. 2007;12:947-63.

Adam WR, Goland GJ, Wellard RM. Renal potassium adaptation in the rat: role of glucocorticoids and aldosterone. Am J Physiol. 1984;246(3 Pt 2):F300-F308.

Ahmed W, Khan N, Gluect C, Pandey S, Wang P, Goldenberg N, Uppal M, Khamal S. Low serum 25 (OH) vitamin D levels (32 ng / m L )Trans Res. 2009;153(1):11-6.

Altun A, Ugur-Altun B. Melatonin: therapeutic and clinical utilization. Int J Clin Pract. 2007;61(5):835-45.

Ames BN. Micronutrient deficiencies: A major cause of DNA damage. Ann NY Acad Sci. 2000;889:87-106.

Bauer ME. Stress, glucocorticoids and ageing of the immune system. Stress. 2005;8(1):69-83.

Bierwirth J, Ulbricht KU, Schmidt RE, Witte T. Association of common variable immunodeficiency with vitamin B(6) deficiency. Eur J Clin Nutr. 2007; [Epub ahead of print].

Chesney RW, Maxess RB, Harnstra AJ, et al. Reduction of serum-1,12-dihydroxyitamin- D3 in children receiving glucocorticoids. Lancet. 1978;2(8100):1123-1125.

Chiang EP, Smith DE, Selhub J, Dallal G, Wang YC, Roubenoff R. Inflammation causes tissue-specific depletion of vitamin B6. Arthritis Res Ther. 2005;7(6):R1254-62.

Chowdhury AR, Kapil N. Interaction of dexamethasone and dehydroepiandrosterone on testicular ascorbic acid and cholesterol in prepubertal rat. Arch Androl. 1984;12(1):65-67.

Curtis JR, Saag KG. Prevention and treatment of glucocorticoid-induced osteoporosis. Curr Osteoporos Rep. 2007;5(1):14-21.

Demisch L, et al. Influence of dexamethasone on nocturnal melatonin production in healthy adult subjects. J Pineal Res. 1988;5(3):317-322.

Fitzgerald MA. Drug-induced vitamin B12 deficiency. Nurse Pract. 2007;32(9):6-7.

Flynn A, Pories WJ, Strain WH, et al. Rapid serum-zinc depletion associated with corticosteroid therapy. Lancet. 1971;2(7735):1169-1172.

Fontaine J, Neve J, Peretz A, et al. Effects of acute and chronic prednisolone treatment on serum zinc levels in rats with adjuvant arthritis. Agents Actions. 1991;33(3-4):247-253.

Frequin ST, et al. Decreased vitamin B12 and folate levels in cerebrospinal fluid and serum of multiple sclerosis patients after high-dose intravenous methylprednisolone. J Neurol. 1993;240(5):305-308.

Gennari C. Differential effect of glucocorticoids on calcium absorption and bone mass. Br J Rheumatol. 1993;32(Suppl 2):11-14.

Hambidge M. Human zinc deficiency. J Nutr. 2000;130(5S Suppl):1344S-1349S.

Hinson JP, Raven PW. DHEA deficiency syndrome: a new term for old age? J Endocrinol. 1999;163:1-5.

Humphreys M. Potassium disturbances and associated electrocardiogram changes. Emerg Nurse. 2007;15(5):28-34.

Hvas AM, Nexo E. Diagnosis and treatment of vitamin B12 deficiency -- an update. Haematologica. 2006;91(11):1506-12.

Kinoshita Y, Masuoka K, Miyakoshi S, Taniguchi S, Takeuchi Y. Vitamin D insufficiency underlies unexpected hypocalcemia following high dose glucocorticoid therapy. Bone. 2007; [Epub ahead of print].

Lewy AJ, Emens J, Jackman A, Yuhas K. Circadian uses of melatonin in humans. Chronobiol Int. 2006;23(1-2):403-12.

Liamis G, Mitrogianni Z, Liberopoulos EN, Tsimihodimos V, Elisaf M. Electrolyte disturbances in patients with hyponatremia. Intern Med. 2007;46(11):685-90.

Lin SH, Halperin ML. Hypokalemia: a practical approach to diagnosis and its genetic basis. Curr Med Chem. 2007;14(14):1551-65.

Moretti R, Torre P, Antonello RM, Cazzato G, Cattaruzza T, Scapicchio PL. Vitamin B12 and folate depletion: clinical evidence in a neurological population. Neurologist. 2004;10(6):338-43.

Navarro-Alarcon M, Lopez-Martinez MC. Essentiality of selenium in the human body: relationship with different diseases. Sci Total Environ. 2000;249:347-371.

Nielson HK, Charles P, Mosekilde L. The effect of single oral doses of prednisone on the circadian rhythm of serum osteocalcin in normal subjects. J Clin Endocrinol Metab. 1988;67(5):1025-1030.

Pelton R, LaValle J, Hawkins EB, et al. Drug Induced Nutrient Depletion Handbook. Hudson, OH:LexiComp, Inc.;2001:413-422.

Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol. 1987;14(6):1104-1107.

Piccirillo JF. Melatonin. Prog Brain Res. 2007;166:331-3.

Powell SR. The antioxidant properties of zinc. J Nutr. 2000;130(5S Suppl):1447S-54S.

Reiter RJ. Melatonin: clinical relevance. Best Pract Res Clin Endocrinol Metab. 2003;17(2):273-85.

Reynolds E. Vitamin B12, folic acid, and the nervous system. Lancet Neurol. 2006;5(11):949-60.

Smith BJ, et al. Does beclomethasone dipropionate suppress dehydroepiandrosterone sulfate in postmenopausal women? Aust N Z J Med. 1994;24(4):396-401.

Spinneker A, Sola R, Lemmen V, Castillo MJ, Pietrzik K, González-Gross M. Vitamin B6 status, deficiency and its consequences -- an overview. Nutr Hosp. 2007;22(1):7-24.

Svenson J. Neurologic disease and vitamin B12 deficiency. Am J Emerg Med. 2007;25(8):987.e3-4.

Tubek S, Grzanka P, Tubek I. Role of Zinc in Hemostasis: A Review. Biol Trace Elem Res. 2007; [Epub ahead of print].

Review Date: 5/10/2010
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed HealthCare Network.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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