Phosphates

Phosphorus/Nutrient Depletion:

  • ACE inhibitorsACE inhibitors: According to secondary sources, ACE inhibitors may decrease blood levels of phosphorus.
  • AlcoholAlcohol: According to secondary sources, alcohol (ethanol) may increase urinary phosphorus. Wine may enhance absorption of phosphorus (as well as calcium and magnesium).
  • AntacidsAntacids: According to secondary sources, antacids containing aluminum, calcium, or magnesium may bind phosphate in the gut and prevent its absorption, potentially leading to hypophosphatemia when used chronically.
  • AnticonvulsantsAnticonvulsants: According to secondary sources, some anticonvulsants (including phenobarbital and carbamazepine) may lower phosphorus levels and increase levels of alkaline phosphatase.
  • AntidiabeticsAntidiabetics: High doses of insulin may lower blood levels of phosphorus in diabetic ketoacidosis patients (23).
  • Bile acid sequestrantsBile acid sequestrants: According to secondary sources, bile acid sequestrants such as cholestyramine (Questran?) and colestipol (Colestid?) may decrease oral absorption of phosphate. Therefore, oral phosphate supplements should be administered at least one hour before or four hours after these agents.
  • CalcimimeticsCalcimimetics: In a meta-analysis, calcimimetic therapy decreased blood levels of phosphorus (24).
  • CalciumCalcium: In women, increased calcium may decrease phosphorus absorption (28).
  • CorticosteroidsCorticosteroids: According to secondary sources, corticosteroids may increase urinary phosphorus levels.
  • Electrolyte modulatorsElectrolyte modulators: According to secondary sources, excessive intake of phosphates may cause electrolyte disturbances, including hypocalcemia. According to secondary sources, phosphates may increase fecal levels of calcium in some assays, cause a false decrease in some serum and urine test results (by inhibiting emission in some flame methods and by competing with EDTA for calcium), decrease urine magnesium levels, and decrease serum levels of potassium.
  • EstrogensEstrogens: In women, estradiol had phosphaturic properties (25).
  • FructoseFructose: In laboratory and human research, high fructose intake has been associated with decreased serum phosphorus and increased urinary loss of phosphorus (30).
  • High-phosphate beverages, cola drinksHigh-phosphate beverages, cola drinks: In hemodialysis and chronic kidney disease patients, salivary phosphate secretion was increased and was related to consumption of phosphate in beverages (31). Cola drinks contain significant amounts of phosphate; excessive intake may result in hyperphosphatemia and hypocalcemia, according to secondary sources.
  • MagnesiumMagnesium: According to secondary sources, phosphates may decrease urine magnesium levels.
  • NiacinNiacin: In patients with metabolic syndrome dyslipidemia, once-daily, extended-release niacin lowered serum phosphorus concentrations (29).
  • Phosphate bindersPhosphate binders: In a meta-analysis, use of phosphate binders decreased blood phosphate levels (26; 27).
  • PotassiumPotassium: According to secondary sources, phosphates may decrease serum levels of potassium.
  • Pumpkin seedPumpkin seed: According to secondary sources, pumpkin seed may increase urine phosphates.
  • Salt substitutesSalt substitutes: According to secondary sources, salt substitutes high in potassium may lower phosphorus levels.