There is a time and a place for the meds. They're wonderful at what they do. But sometimes this comes at a price. Often, side effects are simply nutrient deficiencies induced by their long-term use. The good news? Prevention of complications is simple, it just involves knowing what to take.

Here's the meds a lot of my patients are on, indications of their depletion, and what to do about it. If you have a suitcase of meds, you might want to ask your ND or MD. Lastly, this entry is dedicated to one particular patient of mine. :)

Metformin: notorious for depleting vitamin B12. Symptoms of B12 deficiency often include fatigue and neuropathies such as numbness and tingling, or slight tremors. The problem here is that neuropathies are also expected with poorly-controlled diabetes so most often people are blamed for not being good with their meds when really it could be the start of a slippery neurological slope. If you're on Metformin, B12 is required, and you may need some folic acid as well.

Acid blockers: also wonderful at depleting B12 which needs stomach acid in order to be absorbed. Same symptoms happen when it gets low. Sublingual (under the tongue) B12 is recommended in this case rather than a pill you swallow, but there will be other issues resulting from chronically low stomach acid such as acne rosacea, gas and bloating, heartburn, and likely a host of other nutrient deficiencies.

Statins: great at reducing cholesterol...and Coenzyme Q10. Most people after a while start feeling muscle aches and pains. Some people have this to such an extreme that they stop the meds. While other options exist for cholesterol control, if you're on a statin such as Crestor or Lipitor, get on CoQ10 as well.

Diuretics (aka "water pills"): deplete magnesium, potassium (though some don't), calcium, and some B-vitamins including folic acid and B1. Most often I see the complications with electrolyte imbalances and particularly magnesium since it's difficult to get a good dose through the diet as-is. Muscle cramps and twitches, heart palpitations, and anxious feelings often happen. Because most of the depletions here are the water-soluble vitamins, I usually recommend a good multi.

Birth control pills: these deplete a number of nutrients in small quantities - even the low-dose pills. I usually recommend a good multi or even a prenatal vitamin while on the pill which may help to ease the transition when you stop it. The hefty dose of B-vitamins in a good prenatal can help with stress and likely PMS symptoms as well!

Reference: Natural Medicines Comprehensive Database: Drug Influences on Nutrient Levels and Depletion.

Obesity has now been declared a disease in the US. The health risks of carrying around a spare tire are nearly endless: diabetes, insulin resistance, heart attack, stroke, blood clotting, fatty liver, etc, etc, ETC. Know all this but can't quite make the huge shift? Start small and simple.

Central obesity specifically refers to the increased amount of fat around the midsection, or the 'spare tire'. The issue here is that it's an indicator that fat isn't only in the skin, it's packing in around your organs. Not to mention the amount of fat you carry influences your hormones. Abdominal fat acts differently than, say, thigh fat (ladies, we'll discuss the saddle bags further on another day) in that it increases inflammatory markers associated with diabetes, cardiovascular events, and also infertility in both men and women by affecting sperm quality, egg quality, and ovarian function. The insulin resistance induced by obesity contributes to hair loss (looking at you men out there...) or hair growth in women in all the wrong places as we see in polycystic ovarian syndrome, or PCOS.

Ditch the spare tire. You will be amazed at the health benefits that follow. They are endless. Your loved ones will also thank you.

Wondering where to start? 9 not-so-fancy starting tips for you:

1. MOVE. You don't have to train for a marathon, just get moving. Walk, bike, hike, play the Wii, park farther away, get off the bus/subway one stop early, get a pedometer... JUST MOVE.
2. Stop the pop.
3. Cut the booze. Limit to one drink per day.
4. Cut the sweet treats in half for 2-3 weeks. Then cut them in half again, but always leave yourself time to indulge. Be gentle yet strict.
5. Make sure half your plate is veggies. Potatoes don't count. And they can't be fried.
6. No fried foods. Grill, sautee, stir-fry, or steam.
7. Night snacker? Try popcorn, veggies & hummus, edamame, frozen fruit sorbet (blend frozen fruit, a dash of vanilla extract, and a wee bit of milk), roasted veggies, or a bowl of soup.
8. Breathe. Reducing stress reduces cortisol. Cortisol will help pump up the spare tire.
9. Be accountable. To anyone. Find yourself a team and get them cheering for you.

YOU CAN DO THIS. If I can be of help, or if you need a team member, please ask. :)

Just a few of the many research papers supporting weight loss:
Abdominal fat and inflammatory markers. http://www.ncbi.nlm.nih.gov/pubmed/23712970
Effects of 4 different diets on adipose tissue. http://www.ncbi.nlm.nih.gov/pubmed/22258266
Effects of abdominal fat on insulin resistance. http://www.ncbi.nlm.nih.gov/pubmed/23739143
BMI and sperm quality. http://www.ncbi.nlm.nih.gov/pubmed/22693175
Adipokines and infertility. http://www.ncbi.nlm.nih.gov/pubmed/21510912
Androgenic alopecia and insulin resistance. http://www.ncbi.nlm.nih.gov/pubmed/19094069