| Do you take any of the following medications? | Yes | No |
| Laxatives |
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| Cholesterol-lowering drugs (cholestyramine, fibrates, etc.) |
|
|
| Steroidal drugs (prednisone, methylprednisolone, cortisone) |
|
|
| Hormonal Replacement Therapy (estrogen, progesterone) |
|
|
| Antibiotics |
|
|
| Antidepressants |
|
|
| Nicotine |
|
|
| Anti-gout agents (colchicine, allopurinol, febuxostat) |
|
|
| Levothyroxine |
|
|
| Levo-Dopa |
|
|
| Anticonvulsants |
|
|
| Aspirin |
|
|
| Non-Steroidal Anti-Inflammatory Drugs (Naproxen, Ibuprofen, Diclofenac) |
|
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| Caffeine |
|
|
| Antihypertensive drugs |
|
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| Statin drugs (atorvastatin, simvastatin) |
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|