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After entering the cochlea, cisplatin is taken up into cells by diffusive and passive transport, copper transporter protein 1 (Ctr1) and organic cation transporter protein 2 (OCT2), endocytosis, and toxicity through DNA adduct formation, oxidative stress, mitochondrial dysfunction, inflammatory response, and ferroptosis ( 2.1 Cisplatin-induced DNA damage and apoptosis Once cisplatin enters the cell it can be hydrolyzed to form toxic aqua-cisplatin complexes and form intra-and interstrand crosslinks with DNA (Mukherjea et al., 2011)

The best results seem to come with doses around 2,000 mg per day among overweight and obese individuals, and the effects typically appear over 12 to 24 weeks , with weight loss plateauing after a few months in most studies

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Individuals taking certain medications that include nicotinic acid, theophylline, bile acid-binding resins, methotrexate, and L-dopa all interact with folate and may increase risk for folate deficiency

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