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Regarding drug-induced nutritional changes, methotrexate, an inhibitor of folate metabolism, can cause DNA hypomethylation and NTDs [87]
[11] In vitro permeation studies show the vehicle allows gradual partitioning of tretinoin into viable epidermis while retaining azelaic acid predominantly in follicles and niacinamide in the upper corneal layers, mirroring their desired sites of action
13(1): Chakravorty S, Malvi A, Chaturvedi A et al
however it is actually a vitamin-like nutrient, similar in structure to the B Vitamins
[PMID: 24283226 DOI: 10.1056/NEJMra1208707] [DOI] [PubMed] [Google Scholar] 44.Griffiths MJD, Evans TW