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Excedrin PM
Depletes
Prolonged use of Excedrin PM can impact 8 essential nutrients.
Zinc
Studies indicate that medications like aspirin can increase zinc loss through urine. Zinc plays a vital role in wound healing, protein synthesis, cell reproduction, immunity, and vision. If you take aspirin regularly, consider monitoring zinc levels and supplementation may be beneficial to prevent a deficiency.
Replace with Zinc Bisglycinate (12.5 mg)
Research:
Folic Acid
Regular aspirin use, even at therapeutic doses, can lead to lower-than-normal levels of folate in the blood (serum folate). Additionally, aspirin might slightly increase the amount of folate excreted in urine, potentially disrupting the body's folate balance. For those taking regular aspirin therapy, folic acid supplementation should be considered to prevent a deficiency.
Replace with Folate (.2mg as L-5-Methylfolate) (0.34 DFE)
Research:
Vitamin C
Research suggests that taking Vitamin C alongside Acetaminophen might prolong the medication's presence in the bloodstream. This could potentially allow for lower Acetaminophen doses, thereby reducing the risk of side effects.
Replace with Vitamin C Ascorbic Acid (200 mg)
Research: COQ 10 (as Ubiquinone)
Vitamin B12
Research found that individuals hospitalized with heart disease and a history of aspirin use were nearly twice as likely to have low or borderline vitamin B12 levels compared to non-aspirin users. While this doesn't definitively prove aspirin causes B12 deficiency, it raises a potential link. Aspirin can irritate the stomach lining in some individuals. This is concerning because the stomach plays a crucial role in vitamin B12 absorption by producing hydrochloric acid and intrinsic factor. Both are essential for proper B12 uptake.
Replace with Vitamin B12 Methylcobalamin (0.2 mg)
Research: van Oijen MG, Laheij RJ, Peters WH, Jansen JB, Verheugt FW; BACH study. Association of aspirin use with vitamin B12...
Milk Thistle
Milk thistle (Silybum marianum) contains a group of complex flavonoids called silymarin. This natural compound has been shown to increase glutathione levels in the liver. Acetaminophen, a widely used pain reliever and fever reducer, can be harmful to the liver in high doses or for people with certain risk factors. Research suggests that silymarin may help elevate glutathione levels within the liver. Glutathione is an important antioxidant that the body uses to combat damage, and its depletion is believed to play a role in how acetaminophen harms the liver.
Replace with Milk Thistle (Silybum marianum) (seed) Standardized 80% Silymarin Flavonoids) (200 mg)
Research: Abdilkerim Oyman, et al. Protective Effects of Silymarin on Acetaminophen-Induced Toxic Hepatitis. EJMA 2022;2(1):1–6. Noor...
Niacinamide
Acetaminophen, a common pain reliever and fever reducer, is generally safe at recommended doses. However, overdosing can lead to severe oxidative stress, a cellular imbalance that damages the liver and can cause acute liver failure. Niacinamide, a form of vitamin B3, has been shown to be effective in mitigating many conditions caused by oxidative stress. Recent research specifically investigated its ability to protect the liver from acetaminophen damage. The study found that niacinamide offered both preventive (prophylactic) and treatment (therapeutic) benefits.
Replace with Niacinamide (100 mg)
Research: Mahmoud YI, Mahmoud AA. Role of nicotinamide (vitamin B3) in acetaminophen-induced changes in rat liver: Nicotinamide effect...
NAC
Studies suggest that acetaminophen may cause liver damage in high doses or with certain risk factors. N-acetylcysteine (NAC) has been shown to offer protective benefits for the liver against the potential toxic effects of acetaminophen.
Replace with N-Acetylcysteine (200 mg)
Research: Hendrickson RG. What is the most appropriate dose of N-acetylcysteine after massive acetaminophen overdose? Clin Toxicol...
Also Benefits From:
Omega 3
Omega-3 fatty acids offer promise for managing pain associated with osteoarthritis (OA). Research suggests they may work by reducing inflammation, a key contributor to OA pain and stiffness. Studies involving over 2000 patients with OA showed that omega-3 supplementation significantly lessened joint pain compared to a placebo. This improvement was accompanied by increased joint function, suggesting omega-3s might help people with OA move more easily and comfortably.
Research: Kuszewski JC, Wong RHX, Howe PRC. Fish oil supplementation reduces osteoarthritis-specific pain in older adults with...
Health Impact
Excedrin PM-induced nutrient depletion can lead to a range of health problems
Weakened Immune Response
Classic dermatology and immunology literature shows that zinc deficiency causes lymphopenia and reduced immune capacity; more recent work links marginal deficiency to impaired inflammatory and anti-microbial responses.
Research: Fraker PJ et al. The dynamic link between the integrity of the immune system and zinc status. JAMA Dermatol....
Slow Skin & Wound Healing
Experimental and clinical studies demonstrate that zinc deficiency is associated with skin lesions, delayed wound closure and abnormal inflammatory responses, while zinc repletion can improve healing outcomes in selected populations.
Research: Lin PH, Sermersheim M et al. Zinc in wound healing modulation. Nutrients. 2017;9(1):16.; News-Medical. The role of zinc in...
High Homocysteine & Vascular Risk
Meta-analyses of randomized trials show that folic acid supplementation lowers homocysteine and modestly reduces stroke and overall cardiovascular disease risk in some populations, especially where baseline folate status is low, highlighting the adverse vascular profile of folate deficiency.
Research: Li Y et al. Folic acid supplementation and the risk of cardiovascular diseases: a meta-analysis of randomized controlled...
Folate-Related Megaloblastic Anemia
Hematology and nutrition reviews describe folate deficiency as a classic cause of megaloblastic anemia and mucosal abnormalities, frequently exacerbated by medications that antagonize folate metabolism.
Research: O’Leary F, Samman S. Vitamin B12 in health and disease. Nutrients. 2010;2(3):299-316. (discussion of folate and B12 in...
Scurvy & Fragile Blood Vessels
Modern case reports and re-analyses of classic scurvy trials show that vitamin C deficiency causes defective collagen and capillary integrity, with slow recovery of scar strength even after repletion if deficiency is prolonged.
Research: Gandhi M et al. Scurvy: rediscovering a forgotten disease. Clin Case Rep. 2023;11(6):e10296835.; Hujoel PP, Hujoel MLA....
Delayed Wound Healing & Fatigue
Systematic reviews report improved healing of chronic wounds with vitamin C supplementation in deficient or high-need states, supporting the clinical impact of inadequate ascorbate on tissue repair.
Research: Bechara N et al. The role of vitamin C in tissue repair and wound healing: a systematic review. Int Wound J....
B12-Related Megaloblastic Anemia
Clinical reviews identify vitamin B12 deficiency as a common cause of megaloblastic anemia; hematologic abnormalities often improve with replacement, underscoring the hematopoietic consequences of depletion.
Research: Langan RC, Zawistoski KJ. Update on vitamin B12 deficiency. Am Fam Physician. 2017;96(6):384-389.; Green R. Vitamin B12...
Side Effects
Common side effects of Excedrin PM, some of which may be related to nutrient depletion
Review
Some side effects of Excedrin PM, which contains a combination of acetaminophen, aspirin, and diphenhydramine, may include:
1. Nausea and vomiting
2. Dizziness
3. Drowsiness
4. Constipation
5. Dry mouth
6. Blurred vision
7. Headaches
8. Insomnia
9. Nervousness or anxiety
10. Rapid heartbeat
It is important to note that everyone may react differently to medications, so some individuals may experience side effects not listed here. Additionally, combining Excedrin PM with other medications or alcohol may increase the likelihood of side effects. If you experience any severe or persistent side effects, it is important to contact a healthcare professional.
1. Nausea and vomiting
2. Dizziness
3. Drowsiness
4. Constipation
5. Dry mouth
6. Blurred vision
7. Headaches
8. Insomnia
9. Nervousness or anxiety
10. Rapid heartbeat
It is important to note that everyone may react differently to medications, so some individuals may experience side effects not listed here. Additionally, combining Excedrin PM with other medications or alcohol may increase the likelihood of side effects. If you experience any severe or persistent side effects, it is important to contact a healthcare professional.
Get Support
We've developed a formula to replenish the nutrients depleted by Excedrin PM.
Shop Third-Party Supplements
Vitamin B12 Methylcobalamin
by Pure Encapsulations
Pure Encapsulations' Vitamin B12 supplement provides a high-quality, bioavailable form of vitamin B12 to support energy production, neurological function, and overall health.
Strength: 0.2 mg
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Niacinamide
by Pure Encapsulations
The Niacinamide supplement by Pure Encapsulations is a high-quality, hypoallergenic dietary supplement designed to support healthy skin, joints, and overall cellular function by providing a bioavailable form of vitamin B3.
Strength: 100 mg
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Zinc Bisglycinate
by Pure Encapsulations
The Zinc supplement by Pure Encapsulations is a dietary supplement designed to support immune function and overall health, featuring highly bioavailable zinc in a hypoallergenic, vegetarian capsule.
Strength: 15 mg
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Vitamin C (Ascorbic Acid)
by Pure Encapsulations
Pure Encapsulations' Vitamin C supplement is a high-quality, hypoallergenic product designed to support immune function, collagen production, and antioxidant protection.
Strength: 200 mcg
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Folate
by Pure Encapsulations
Pure Encapsulations' Folic Acid supplement provides a high-quality, bioavailable form of folic acid to support healthy fetal development, cardiovascular health, and overall cellular function.
Strength: 800 mcg
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N-Acetyl-L-Cysteine
by Pure Encapsulations
The NAC supplement by Pure Encapsulations provides N-Acetyl-L-Cysteine, an antioxidant that supports cellular health, detoxification, and immune function.
Strength: 600 mg
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Milk Thistle (Silybum marianum) (seed) Standardized 80% Silymarin Flavonoids)
by Pure Encapsulations
The Milk Thistle supplement by Pure Encapsulations is a dietary supplement designed to support liver health and detoxification, made with high-quality, standardized milk thistle extract.
Strength: 250 mg
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Milk Thistle (Silybum marianum) (seed) Standardized 80% Silymarin Flavonoids)
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