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Refrigerants
Anti-inflammatories/Nutrient Depletion:
Chromium
Chromium: Based on human evidence, corticosteroids may increase urinary chromium excretion; and therefore, lead to chromium deficiency or corticosteroid-induced hyperglycemia (
10229312
).
Folate
Folate: Based on human evidence, sulfasalazine may inhibit absorption and metabolism of folic acid (
6148048
). Based on secondary sources, patients using sulfasalazine chronically may be advised to increase their dietary folate intake, and to take a supplement if they have any other condition, which could also contribute to deficiency. Biological agents used to treat rheumatoid arthritis, such as infliximab, may increase plasma folate levels (
18849561
). In vitro studies have also suggested that non-steroidal anti-inflammatory drugs (NSAIDS) may interfere with folate-coenzyme metabolism, while aspirin may exhibit this effect to a greater magnitude after its conversion to salicyclic acid (
1540135
).
Glutathione
Glutathione: Based on animal evidence, glutathione may be reduced by acetaminophen in a dose-dependent manner (
19537930
). A review discussing acetaminophen-related toxicity explains that the hepatic glutathione stores are depleted to combine with acetaminophen's toxic metabolite (
10980926
). According to the review, for such toxicity, N-acetylcysteine may be recommended and effective if given within the first 15 hours of overdose.
Iron
Iron: Current human studies are conflicting, where evidence indicates that aspirin use was not associated with reduced serum iron (
16905794
), while another study suggests an association between aspirin use and lower serum ferritin (
11470724
). A systematic review evaluating mortality associated from non-steroidal anti-inflammatory drugs (NSAIDS) or aspirin-related bleeds showed that mortality appears to increase and remains a concern that may be addressed on an individual basis (
19500343
).
Vitamin C
Vitamin C:Based on animal evidence, there may be an increased risk of developing gastric lesions with the concurrent use of vitamin C and aspirin (
307908
). Based on this study, the authors conclude that individuals should use caution when concomitantly taking large doses of vitamin C and aspirin.