ARBs — Angiotensin Receptor Blockers: What It Depletes and How to Replenish

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 studies.

Golik et al. (1998) — RAAS-acting drugs associated with zinc depletion; Ripa et al. (1995) — zinc depletion observed with antihypertensive therapy

Immune dysfunction, impaired wound healing, taste alterations, reduced testosterone in men

ARBs lower blood pressure via RAAS blockade. Some research suggests antihypertensive medications broadly affect mitochondrial bioenergetics and CoQ10 status, particularly in patients also on statins (common co-prescription).

Mortensen et al. — antihypertensive polypharmacy associated with lower CoQ10 in cardiac patients; mechanistic concern especially in statin co-users

Fatigue, reduced exercise tolerance, muscle weakness — especially if co-prescribed with statins

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.

Houston (2011) — magnesium deficiency is an underrecognized contributor to resistant hypertension; Guerrero-Romero & Rodriguez-Moran (2009)

Muscle cramps, poor sleep, elevated blood pressure despite medication, anxiety, constipation