ARBs. Angiotensin Receptor Blockers
Common brand names: Olmesartan (Benicar), Losartan (Cozaar), Valsartan (Diovan), Telmisartan (Micardis)
Three nutrients listed against this medication. The most severe is marked moderate.
At a glance
One of the three is marked well documented. The other two carry their own evidence levels.
At a glance
- ZincModerate · Well documented
- Coenzyme Q10 (CoQ10)Mild · Traditionally cited, limited evidence
- MagnesiumMild · Traditionally cited, limited evidence
Color shows how serious each listed effect is. The label beside it shows how strong the evidence is. The cards below explain each one and show its evidence.
Nutrients it can lower
Mechanism, ARBs, like ACE inhibitors, interact with the renin-angiotensin-aldosterone system (RAAS). Long-term RAAS blockade alters zinc homeostasis. Zinc is a cofactor in the ACE enzyme and ARB use has been associated with reduced serum zinc in observational Research that watches what people already do rather than assigning a treatment. It can show that two things travel together, not that one causes the other. studies.
Common signs, Immune dysfunction, impaired wound healing, taste alterations, reduced testosterone in men
Koren-Michowitz et al. (Am J Hypertens, 2005; PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 15797654): losartan increased urinary zinc excretion and induced zinc deficiency in hypertensive patients; magnesium was unaffected.
Zinc 15–25 mg daily, taken away from meals, is a range in common use, not from a trial cited on this row. The cited paper measured magnesium, zinc and nitric oxide metabolism on losartan and tested no repletion dose, form or timing. Food does reduce zinc absorption; the size of that effect is not established by anything cited here.
Mechanism, ARBs lower blood pressure by blocking the renin-angiotensin-aldosterone system, a pathway with no established link to CoQ10 synthesis. The concern on this row is extrapolated from patients taking an antihypertensive alongside a statin, and it is the statin that has the CoQ10 mechanism. No ARB-specific CoQ10 study exists.
Common signs, Fatigue, reduced exercise tolerance, muscle weakness, especially if co-prescribed with statins
No ARB-specific CoQ10 study exists; the concern is extrapolated from polypharmacy. Speculative.
CoQ10 100 to 200 mg daily is a range in common use, not from a trial cited on this row. No trial on this site establishes that one form outperforms the other, and the heart-failure outcome trials used ubiquinone.
Mechanism, Patients on antihypertensives, including ARBs, often present with low magnesium, particularly if also on a diuretic (common combination). Magnesium deficiency independently raises blood pressure, potentially reducing drug efficacy.
Common signs, Muscle cramps, poor sleep, elevated blood pressure despite medication, anxiety, constipation
Houston (J Clin Hypertens, 2011): a review of magnesium in hypertension and cardiovascular disease. The data concern baseline magnesium deficiency in hypertensive patients, not ARB-caused depletion; a clamp study found magnesium unaffected by losartan.
Magnesium glycinate was used at 200–400 mg/day, the form least likely to cause loose stools, taken in the evening. On a potassium-sparing diuretic this is discussed with the prescriber.
For your next appointment
It prints or saves as a single page. Whether to add a supplement for a nutrient this medication may lower is a decision for your prescriber.
Disclosure
These statements have not been evaluated by the Food and Drug Administration. Any grade on this page describes the strength of published human trial evidence in the populations studied. It is not a recommendation for any individual and is not medical advice. Starting, stopping or changing any supplement or medication is a decision for your physician.
Grades move when new trials publish. A free monthly email lists every grade EBL moved, with the reason and the trial behind it: the sign-up is on the Evidence Log →