{
  "name": "Verified Supplement Data — Medication × Nutrient Depletion Crosswalk v1",
  "description": "Which common medications deplete which nutrients, with severity, effect size, US users affected, mechanism, and PubMed IDs. Powers the medication-interaction pages and the supplement analyzer.",
  "license": "CC BY 4.0",
  "source": "verifiedsupplementdata.com",
  "rows": [
    {
      "medication": "Statins (HMG-CoA Reductase Inhibitors)",
      "medication_id": "statin",
      "ingredient_id": "vitamin-d",
      "ingredient_depleted": "Vitamin D",
      "relationship": "depletes",
      "severity": "low",
      "effect_size": "",
      "us_users_millions": 92,
      "mechanism": "Cholesterol pathway disruption may reduce D3 synthesis",
      "pmids": "",
      "source": "matrix.depletions",
      "source_url": "/medications/statins/"
    },
    {
      "medication": "Statins (HMG-CoA Reductase Inhibitors)",
      "medication_id": "statin",
      "ingredient_id": "coq10",
      "ingredient_depleted": "CoQ10",
      "relationship": "depletes",
      "severity": "high",
      "effect_size": "16-54% reduction",
      "us_users_millions": 92,
      "mechanism": "Mevalonate pathway inhibition blocks CoQ10 synthesis",
      "pmids": "28686047",
      "source": "matrix.depletions",
      "source_url": "/medications/statins/"
    },
    {
      "medication": "SSRIs (Selective Serotonin Reuptake Inhibitors)",
      "medication_id": "ssri",
      "ingredient_id": "vitamin-b12",
      "ingredient_depleted": "Vitamin B12",
      "relationship": "depletes",
      "severity": "moderate",
      "effect_size": "",
      "us_users_millions": 45,
      "mechanism": "Associated with lower B12 levels in long-term users",
      "pmids": "",
      "source": "matrix.depletions",
      "source_url": ""
    },
    {
      "medication": "SSRIs (Selective Serotonin Reuptake Inhibitors)",
      "medication_id": "ssri",
      "ingredient_id": "vitamin-d",
      "ingredient_depleted": "Vitamin D",
      "relationship": "depletes",
      "severity": "moderate",
      "effect_size": "",
      "us_users_millions": 45,
      "mechanism": "Low D compounds depressive symptoms SSRI is treating",
      "pmids": "",
      "source": "matrix.depletions",
      "source_url": ""
    },
    {
      "medication": "SSRIs (Selective Serotonin Reuptake Inhibitors)",
      "medication_id": "ssri",
      "ingredient_id": "coq10",
      "ingredient_depleted": "CoQ10",
      "relationship": "depletes",
      "severity": "low",
      "effect_size": "",
      "us_users_millions": 45,
      "mechanism": "Some evidence of mitochondrial effects reducing CoQ10",
      "pmids": "",
      "source": "matrix.depletions",
      "source_url": ""
    },
    {
      "medication": "SSRIs (Selective Serotonin Reuptake Inhibitors)",
      "medication_id": "ssri",
      "ingredient_id": "folate",
      "ingredient_depleted": "Folate / Methylfolate",
      "relationship": "depletes",
      "severity": "high",
      "effect_size": "",
      "us_users_millions": 45,
      "mechanism": "Folate required for serotonin synthesis; depletion reduces SSRI efficacy",
      "pmids": "22950138",
      "source": "matrix.depletions",
      "source_url": ""
    },
    {
      "medication": "Metformin",
      "medication_id": "metformin",
      "ingredient_id": "folate",
      "ingredient_depleted": "Folate / Methylfolate",
      "relationship": "depletes",
      "severity": "moderate",
      "effect_size": "",
      "us_users_millions": 37,
      "mechanism": "Secondary mechanism via B12-folate metabolic pathway",
      "pmids": "",
      "source": "matrix.depletions",
      "source_url": "/medications/metformin/"
    },
    {
      "medication": "Metformin",
      "medication_id": "metformin",
      "ingredient_id": "vitamin-b12",
      "ingredient_depleted": "Vitamin B12",
      "relationship": "depletes",
      "severity": "high",
      "effect_size": "5.8-30% deficiency rate",
      "us_users_millions": 37,
      "mechanism": "Calcium-dependent ileal absorption disruption",
      "pmids": "26900641",
      "source": "matrix.depletions",
      "source_url": "/medications/metformin/"
    },
    {
      "medication": "Proton Pump Inhibitors (PPIs)",
      "medication_id": "ppi",
      "ingredient_id": "calcium",
      "ingredient_depleted": "Calcium",
      "relationship": "depletes",
      "severity": "moderate",
      "effect_size": "RR 1.30 hip fracture",
      "us_users_millions": 33,
      "mechanism": "Acid-dependent calcium solubilization impaired",
      "pmids": "16855264",
      "source": "matrix.depletions",
      "source_url": "/medications/ppis/calcium/"
    },
    {
      "medication": "Proton Pump Inhibitors (PPIs)",
      "medication_id": "ppi",
      "ingredient_id": "iron",
      "ingredient_depleted": "Iron",
      "relationship": "depletes",
      "severity": "moderate",
      "effect_size": "RR 2.56",
      "us_users_millions": 33,
      "mechanism": "Gastric acid required for ferric-to-ferrous reduction",
      "pmids": "27155887",
      "source": "matrix.depletions",
      "source_url": "/medications/ppis/iron/"
    },
    {
      "medication": "Proton Pump Inhibitors (PPIs)",
      "medication_id": "ppi",
      "ingredient_id": "vitamin-c",
      "ingredient_depleted": "Vitamin C",
      "relationship": "depletes",
      "severity": "low",
      "effect_size": "-12.3% plasma levels",
      "us_users_millions": 33,
      "mechanism": "Reduced ascorbic acid absorption at higher pH",
      "pmids": "15080570",
      "source": "matrix.depletions",
      "source_url": "/medications/ppis/vitamin-c/"
    },
    {
      "medication": "Proton Pump Inhibitors (PPIs)",
      "medication_id": "ppi",
      "ingredient_id": "magnesium",
      "ingredient_depleted": "Magnesium",
      "relationship": "depletes",
      "severity": "high",
      "effect_size": "OR 1.71",
      "us_users_millions": 33,
      "mechanism": "TRPM6/7 channel pH-sensitivity reduces intestinal absorption",
      "pmids": "25023992",
      "source": "matrix.depletions",
      "source_url": "/medications/ppis/magnesium/"
    },
    {
      "medication": "Proton Pump Inhibitors (PPIs)",
      "medication_id": "ppi",
      "ingredient_id": "vitamin-b12",
      "ingredient_depleted": "Vitamin B12",
      "relationship": "depletes",
      "severity": "high",
      "effect_size": "OR 1.65",
      "us_users_millions": 33,
      "mechanism": "Stomach acid required for B12 release from food proteins",
      "pmids": "23325883",
      "source": "matrix.depletions",
      "source_url": "/medications/ppis/b12/"
    },
    {
      "medication": "Oral Contraceptives",
      "medication_id": "birth-control",
      "ingredient_id": "vitamin-b6",
      "ingredient_depleted": "Vitamin B6",
      "relationship": "depletes",
      "severity": "moderate",
      "effect_size": "23% increased depression risk",
      "us_users_millions": 14,
      "mechanism": "Increased tryptophan-kynurenine metabolism depletes B6",
      "pmids": "27680324",
      "source": "matrix.depletions",
      "source_url": "/medications/birth-control/"
    },
    {
      "medication": "Oral Contraceptives",
      "medication_id": "birth-control",
      "ingredient_id": "vitamin-b12",
      "ingredient_depleted": "Vitamin B12",
      "relationship": "depletes",
      "severity": "moderate",
      "effect_size": "",
      "us_users_millions": 14,
      "mechanism": "Altered binding protein levels reduce available B12",
      "pmids": "",
      "source": "matrix.depletions",
      "source_url": "/medications/birth-control/"
    },
    {
      "medication": "Oral Contraceptives",
      "medication_id": "birth-control",
      "ingredient_id": "magnesium",
      "ingredient_depleted": "Magnesium",
      "relationship": "depletes",
      "severity": "moderate",
      "effect_size": "",
      "us_users_millions": 14,
      "mechanism": "Increased urinary magnesium excretion",
      "pmids": "",
      "source": "matrix.depletions",
      "source_url": "/medications/birth-control/"
    },
    {
      "medication": "Oral Contraceptives",
      "medication_id": "birth-control",
      "ingredient_id": "zinc",
      "ingredient_depleted": "Zinc",
      "relationship": "depletes",
      "severity": "moderate",
      "effect_size": "",
      "us_users_millions": 14,
      "mechanism": "Copper-zinc antagonism shifts toward copper dominance",
      "pmids": "",
      "source": "matrix.depletions",
      "source_url": "/medications/birth-control/"
    },
    {
      "medication": "Oral Contraceptives",
      "medication_id": "birth-control",
      "ingredient_id": "folate",
      "ingredient_depleted": "Folate / Methylfolate",
      "relationship": "depletes",
      "severity": "high",
      "effect_size": "",
      "us_users_millions": 14,
      "mechanism": "Impaired folate metabolism; critical if pregnancy follows",
      "pmids": "",
      "source": "matrix.depletions",
      "source_url": "/medications/birth-control/"
    },
    {
      "medication": "birth-control + ssri",
      "medication_id": "birth-control+ssri",
      "ingredient_id": "folate",
      "ingredient_depleted": "Folate / Methylfolate",
      "relationship": "drug-drug-compounded",
      "severity": "",
      "effect_size": "Both deplete folate via different mechanisms — compounding risk for depression",
      "us_users_millions": "",
      "mechanism": "",
      "pmids": "",
      "source": "matrix.compound_interactions",
      "source_url": ""
    },
    {
      "medication": "metformin + ppi",
      "medication_id": "metformin+ppi",
      "ingredient_id": "vitamin-b12",
      "ingredient_depleted": "Vitamin B12",
      "relationship": "drug-drug-compounded",
      "severity": "",
      "effect_size": "34% greater B12 reduction than either alone",
      "us_users_millions": "",
      "mechanism": "",
      "pmids": "26900641",
      "source": "matrix.compound_interactions",
      "source_url": ""
    },
    {
      "medication": "statin + ppi",
      "medication_id": "statin+ppi",
      "ingredient_id": "coq10",
      "ingredient_depleted": "CoQ10",
      "relationship": "drug-drug-compounded",
      "severity": "",
      "effect_size": "Statin depletes CoQ10; PPI may reduce absorption of CoQ10 supplements",
      "us_users_millions": "",
      "mechanism": "",
      "pmids": "",
      "source": "matrix.compound_interactions",
      "source_url": ""
    }
  ]
}