PRC Elective: Food-Drug-Herb-Nutrient Interactions & Depletions
Gain a working knowledge of, identify, and understand the significance of drug-food-herb-nutrient interactions and drug-induced nutrient depletions.
Need to know
*Please note that many of the associations listed under ‘CEUs/PDAs’ do not formally pre-approve online courses for credits, and thus require the student to track their own online course hours to submit for approval for their annual CEU/PDA requirements.
Meet your course instructor
RoseMarie Pierce | B.Sc. Pharm
RoseMarie Pierce has over 45 years of extensive experience as a pharmacist and natural health advocate. RoseMarie earned her degree in Pharmacy from Dalhousie University in 1972. After extensive studies in herbology and nutritional medicine, RoseMarie integrated these disciplines with her pharmacy practice to become Canada’s first Holistic Pharmacist. Proficient in the fields of phyto-pharmacy, herbal medicine, holistic health and nutrition, RoseMarie has a natural ability to present technical information in an easy-to- understand format. She is a highly respected lecturer, writer, and media personality within the natural health industry. You can locate her at www.holistic-pharmacist.com. Listen to RoseMarie on episode 28 of Pacific Rim College Radio.
*This is a 0.75 credit PRC-Approved credit course for on-campus students only. Please note that online PRC Electives taken through Pacific Rim College Online do not qualify for Student Loans.
A patient on medication(s) can often present with what seem like mysterious symptoms or general depletions that don’t seem related to their lifestyle or diet. In order to understand how to work with patients on medication(s), you must know how their drugs potentially interact with food and herbs and if they are causing specific or general depletions.
Valuable for all practitioners, this course provides a comprehensive, updated review of common drug-food-herb-nutrient interactions and drug-induced nutrient depletions.
You will gain knowledge of:
- Common drug categories and specific drugs; how they may cause the depletion of certain vitamins, minerals, and other important nutrients, and the significance of the depletion.
- The most common interactions between drugs and food, herbs and supplements, and the significance of the interactions.
- Recent stats and trends for prescription drugs & Natural Health Products (NHP).
- The prevalence of drug-food-herb-nutrient interactions and drug-induced nutrient depletions.
- Interactions and adverse effects when specific drugs are combined with certain foods, herbs, or nutrients.
- The mechanisms of action by which certain drugs are known to interact with specific foods, herbs, and nutrients.
- The difference between pharmacokinetic and pharmacodynamic interactions.
- Certain therapeutic classes of drugs that can cause noteworthy nutrient depletions.
- Types of evidence used to document both interactions and depletions.
- Comprehend the importance of a drug’s therapeutic index.
- Understand the mechanisms of action for interactions and depletions.
- List & discuss examples of significant drug-food-herb-nutrient interactions and drug-induced nutrient depletions.
- Develop knowledge of certain (1) therapeutic classes of drugs, (2) medical conditions, and (3) Natural Health Products (NHP) which have noteworthy interactions/depletions.
- Identify reliable resources for the identification of both drug-food-herb-nutrient interactions and drug-induced nutrient depletions.
Herbs covered in RoseMarie’s course:
- Ginger (Zingiber officinale/Sheng Jiang)
- Turmeric (Curcuma longa rhizome/Jiang Huang)
- Ginkgo biloba (Yin Xing Ye)
- St. John’s Wort (Hypericum perforatum/Guan Ye Lian Qiao)
- Curcumin from Turmeric (Curcuma longa) root
- Ginsenosides from Panax ginsen (Ren Shen)
- Piperine from Black Pepper (Piper nigrum/Hei Hu Jiao)
- Some catechins from Green Tea (Camellia sinensis)
- Silymarin from Milk Thistle (Silybum marianum/Da Ji)
- Garlic (Allium sativum)
- Black Cohosh (Cimicifuga racemosa), Black cohosh (Actaea racemosa/Sheng Ma)
- Goldenseal (Hydrastis canadensis – contains berberine)
- Panax ginseng (Ren Shen)
- American ginseng (Panax quinquefolius/Xi Yang Shen)
- Naringenin containing food (citrus juices, fennel, bell pepper, celery, carrots as well as Psoralens or furanocoumarin containing food (grapefruit)
- Ephedra (Ma Huang)
- Bitter orange (Citrus aurantium/Zhi Shi)
- Licorice (Glycyrrhiza glabra/Gan Cao)
- (Solanaceae Family): Atropa belladonna (Deadly Nightshade)
- Datura species
- Brugmansia species (Angel’s Trumpet)
- Hyoscyamus niger (Henbane)
- Mandragora officinarum (Mediterranean Mandrake)
- Alkaloids: caffeine, nicotine & cocaine
- Phytates & Oxalates
- Bitter melon (Momordica charantia/Ku Gua)
- Red Yeast Extract
- Cranberry (Vaccinium spp.)
- Saw palmetto (Serenoa repens/Ju Ye Zong)
- Valerian (Valeriana officinalis/Xie Cao)
Section I | Drug-Food-Herb-Nutrient Interactions
1. Biography & Objectives
Welcome! Meet your instructor RoseMarie Pierce as she shares a bit about her professional background and journey to becoming a holistic pharmacist.
2. Terminology, Stats, Interactions & Evidence
To begin, RoseMarie introduces important terminology, statistics, and trends and speaks to the prevalence and risk of drug-food-herb-nutrient interactions and the evidence and identification of both interactions and depletions.
3. Mechanisms of Interactions
Understanding the physiological mechanisms of interactions is essential before moving deeper into specific interactions. RoseMarie shares the pharmacokinetic basics and pharmacokinetic A.D.M.E. (absorption, distribution, metabolism, excretion). She introduces the role of metabolism and metabolic enzymes, and distinguishes between inducers and inhibitors.
4. Pharmacokinetics: Metabolism & CYP3A4
Focusing on pharmacokinetic metabolism, RoseMarie introduces the most important CYP enzyme involved in drug metabolism, CYP3A4. She explains how both CYP3A4 and common drugs are induced by St. John’s Wort.
5. Pharmacokinetics: Distribution & Excretion
RoseMarie introduces how P-Glycoprotein (P-Gp), a transmembrane efflux pump, contributes to the distribution of drugs and toxins within the body. She also explains how St. John’s Wort induces P-Gp with certain drugs and how other substances can inhibit its function.
6. Food & Natural Health Product Inhibitors
RoseMarie looks at several herbs and natural health products that inhibit the CYP enzyme and increase drug levels. She also focuses specifically on grapefruit juice and the drug categories it impacts via CYP enzyme inhibition. Other fruits are also addressed as potential inhibitors.
7. Factors Affecting CYP enzyme system
RoseMarie discusses the various diet, environmental, and lifestyle factors that can contribute to the induction or inhibition of the CYP enzymes and how they impact drug levels.
8. Pharmacokinetic Excretion & Absorption
Expanding on pharmacokinetic excretion, RoseMarie demonstrates how the absorption of calcium, magnesium, potassium, and iron are impacted by specific drugs and even phytochemicals within certain foods.
9. Pharmacodynamic Interactions
RoseMarie looks at how certain foods and herbs can interact with a drug when they have the same effect on the body as the drug. She explores some of the dangers associated with these types of interactions.
10. Serotonin Syndrome
RoseMarie explains how the use of specific natural health products can lead to a life-threatening condition when combined with certain prescription and over-the-counter medications, or even illicit drugs.
11. Black Pepper & Black Pepper Extract
RoseMarie looks at how a chemical compound found within black pepper enhances the absorption of certain drugs and natural health products.
12. Hypertension & NHPs
RoseMarie explains how specific natural health products can impact blood pressure and potential precautions for those with a blood pressure-related condition.
13. Antihistamines as Anticholinergics
RoseMarie focuses on antihistamine as anticholinergic. First, she explains what anticholinergic substances are, and then she lists common antihistamines that have anticholinergic effects. RoseMarie then discusses the statistically significant association between anticholinergic drugs and dementia. Finally, she lists both the drug categories and herbs that have anticholinergic effects.
14. Iodine Interactions with Certain Drugs
RoseMarie demonstrates how iodine deficiency may be exacerbated by concurrent vitamin and mineral deficiencies and interactions that iodine has with a number of drug categories.
15. Daylight Saving Time & Melatonin
RoseMarie details several factors that influence melatonin levels and the public health ramifications associated with lower levels. She explains how the body synthesizes melatonin and the vitamin and mineral deficiencies associated with lower melatonin levels.
Section II | Drug-Induced Nutrient Depletions
16. Drug Categories Responsible for Depletion
RoseMarie begins Section II by introducing the drug categories responsible for most nutrient depletions.
This lesson explores the first major category of drug-induced nutrient depletion. RoseMarie leads with a discussion on the national and global antibiotic crisis. She also explains how antibiotic use impacts the microbiome, what precautions to follow when taking antibiotics, and how to reestablish your gut flora. Finally, she details specific antibiotic categories and their associated nutrient depletions.
18. Oral Contraceptives, Estrogen, & HRT
RoseMarie presents the evidence associated with oral contraceptives, estrogen, and hormone replacement therapy and how they impact nutrient depletion. She also looks further into the depletion of an important trio of nutrients, magnesium, vitamin b6, and zinc, and the associated physiological implications.
19. Antidepressant & Anti-Anxiety Medications
RoseMarie discusses the nutrient depletions associated with both common anti-anxiety drugs and antidepressants, including Selective Serotonin Reuptake Inhibitors (SSRIs) and Tricyclics.
20. The Effect of Drugs on Melatonin
RoseMarie shifts her focus to melatonin and how this hormone is impacted by several drug categories via different mechanisms.
21. Cholesterol & the Statins
In this major drug category, RoseMarie first details the functions of cholesterol in the body and the conventional theory associated with the prescription of cholesterol-lowering drugs. She then explains the mechanisms by which statins work and illustrates how they interfere with an important pathway involved in the production of several other important body compounds. RoseMarie then explains the various side effects and toxicity of statin drugs and finishes the lesson by covering three categories of cholesterol-lowering drugs and the associated nutrient depletions.
22. Coenzyme Q10
RoseMarie builds the connection between Coenzyme Q10 and statin drugs. She also covers other drug categories implicated in Coenzyme Q10 depletion.
23. Cardiovascular Drugs
RoseMarie discusses several cardiovascular drugs and the nutrients they deplete. She also provides an explanation of how ACE inhibitors and Angiotensin Receptor Blockers work on the same biochemical pathway to stop high blood pressure. Lastly, RoseMarie expands her discussion on magnesium: how it is impacted by several other drug categories and the important roles it has on our physiology.
24. Anti-Diabetic Drugs
RoseMarie discusses the nutrient depletions associated with certain common glucose-lowering drugs. She also delves into the topic of insulin-resistance and alternative strategies for treating it. Lastly, she discusses melatonin’s role in insulin and how that impacts Type 2 Diabetes patients.
25. Thyroid Replacement Medications
RoseMarie looks at common thyroid replacement medications and which nutrients they deplete. She also looks at certain toxic agents in these drugs and how they impact iodine in the body. Lastly, RoseMarie discusses how cruciferous vegetables and even smoking can impact the body’s uptake of iodine.
26. Miscellaneous Medications
RoseMarie covers miscellaneous medications and their associated nutrient depletions.
27. Anti-Inflammatory Medications
RoseMarie introduces common over-the-counter and prescription anti-inflammatory medications and the extensive list of nutrients they are associated with. She also offers some precautions and guidelines associated with taking Acetaminophen (Paracetamol). Lastly, RoseMarie offers her recommendations for vitamin, mineral, and superfood supplementation.
28. Acid-Reducing Drugs & Depletions
RoseMarie covers acid-reducing drug categories and the associated nutrient depletions. She also details the importance of maintaining alkalinity within the body and acid production within the stomach. She then shares her expertise on various stomach pH tests.
29. Electrolytes & Alkaline Minerals
RoseMarie explains how medications impact pH within the body. She also details the importance of electrolytes within the body, and the physiological effects associated with electrolyte depletion. Recommendations for electrolyte intake are provided. RoseMarie also provides an extensive list of alkaline-forming foods and a separate list of drugs that reduce bone density and cause Osteoporosis.
30. References & Conclusion
RoseMarie concludes the course by sharing a number of useful resources and provides some advice and guidance for those wishing to apply this knowledge to their practice.
Students are saying…
“The material covered was very thorough. Very happy with the class. I enjoyed this class as a complement to my studies in Holistic Nutrition. This information is very important in assisting clients who are taking pharmaceuticals and understanding nutrient depletions/interactions.”
“This course was excellent, I would recommend it for sure. I thought RoseMarie was an excellent presenter and I really liked her manner and approachability—I would like to learn more from her. I learned a great deal and found the three most significant herbal interactions (St. John’s wort, goldenseal and black pepper) most helpful.”
“RoseMarie Pierce offers a wealth of knowledge and experience in the Drug-Food-Herb-Nutrient online course. She provides science-based evidence and a host of resources and articles to support the teachings. I recommend this course to every health practitioner.”
“It was a really great experience attending your workshop. Thank you for sharing your knowledge; it is a treasure.”
“Extremely helpful and valuable for our practice. This provided us with useful information to help our patients, and I have already advised them based on RoseMarie’s advice; they are grateful. Anecdotal evidence based on personal and professional experience is invaluable.”
“Enjoyable and informative course. Clear and well articulated presenter. “
“Thank you so much for your time and teaching RoseMarie. The course was very helpful and interesting.”
Please note, this elective course is for PRC Campus students only.