• Gentamicin

  (no brand names listed)

• Neomycin

  (no brand names listed)

• Tobramycin

  (no brand names listed)

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.

Depleted levels of iron may lead to anemia and weakened immune function. In the event of anemia, symptoms include dizziness, fatigue, shortness of breath, pale skin color, and possibly irregular heartbeat.

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).

Deficiency may impair formation of protein, which could lead to stunted growth, poor muscle development or loss of muscle mass, increased susceptibility to infection, weakness, and impaired wound healing.

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

Reducing the number of probiotic organisms in the gastrointestinal tract may decrease the body's ability to resist infections and diseases. Symptoms of deficiency include gas, abdominal distress, diarrhea, and yeast infections.

Because of the wide availability of sodium in dietary sources, deficiency is very uncommon. In the rare instances where it does occur, depleted levels have been associated with gas, nausea and vomiting, headache, memory impairment, diminished attention, muscle weakness, heart palpitations, lethargy, and confusion. Extreme cases can cause stupor, seizures, and possibly coma. The development of symptoms depends in large part on the rate of the loss of sodium.

The earliest symptom of deficiency of this nutrient is night blindness. Prolonged deficiency leads to more advanced changes in eye tissue. Other potential signs of mild to moderate deficiency include rough, dry skin, loss of appetite, loss of hair luster, brittle nails, joint pain, and possibly increased susceptibility to infection.

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.

The major symptom of vitamin K deficiency is an inability of the blood to clot properly, which may lead to excessive bleeding and a tendency to bruise easily.

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

Berger W. Incidence of severe side effects during therapy with sulfonylureas and biguanides. Horm Metab Res Suppl. 1985;15:111-115.

Carpentier JL, Bury J, Luyckx A, Lefebvre P. Vitamin B12 and folic acid serum levels in diabetics under various therapeutic regimens. Diabetes Metab. 1976;2(4):187-190.

Cashman K, Flynn A. Optimal nutrition: calcium, magnesium and phosphorus. Proc Nutr Soc. 1999;58:477-487.

Conly, J. and Stein, K. Reduction of vitamin K2 concentrations in human liver associated with the use of broad spectrum antimicrobials. Clin Invest Med. 1994;17(6):531-539.

Covington T, ed. Nonprescription Drug Therapy Guiding Patient Self-Care. St Louis, MO: Facts and Comparisons; 1999:467-545.

Cummings JH and Macfarland G. Role of intestinal bacteria in nutrient metabolism. J. Parenter. Enteral. Nutr. 21(6):357-365, 1997.

Fauci A. ed. et. al. Harrison's Principles of Internal Medicine. Fourteenth Edition. New York, Mc-Graw-Hill Companies Health Professional Division, 1998.

Galland L. The Four Pillars of Healing. New York, NY: Random House; 1997:186-199.

International Life Sciences Institute, Present Knowledge in Nutrition. Seventh Edition. Washington, DC, ILSI Press, 1996.

Kaplan NM. The dietary guideline for sodium: should we shake it up? NAm J Clin Nutr. 2000;71:1020-1026.

Kirschmann G. and Kirschmann, J. Nutrition Almanac. Fourth Edition. McGraw-Hill, 1996.

National Research Council. Recommended Dietary Allowances. 10^th ed. Washington, DC: National Academy Press; 1989.

Potts JT. Diseases of the parathyroid gland and other hyper- and hypocalcemic disorders. In: Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14^th ed. New York: McGraw-Hill Companies Health Professional Division; 1998:2241.

Roe DA. Drug-Induced Nutritional Deficiencies. Second Ed. Westport, CT, Avi Publishing, pp. 155-158, 1985.

Shahani KM. and Ayelo, AD. Rise of dietary Lactobacilli in gastrointestinal microecology. Am J Clin Nutr. 1980;33:2448-2457.

Singer GG, Brenner BM. Fluid and electrolyte disturbances. In: Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York: McGraw-Hill Companies Health Professional Division; 1998:269.

Stevens CE and Hume ID. Contributions of microbes in vertebrate gastrointestinal tract to production and conservation of nutrients. Physiol. Rev. 78(2):393-427, 1998.