For example, use of the DHFR inhibitormethotrexate in patients with IBD can deplete folate and causehyperhomocysteinemia.8,9 Sulfasalazineimpairs folate absorption and can cause hemolytic anemia.4,10,11Corticosteroids increase net protein loss.3 Due to the high prevalence of clinical and subclinical nutrientdeficiencies in this population, routine monitoring of nutrient status,mineral and multivitamin supplementation, and increased protein intake arerecommended.2,3. Here, DHFR is linked to inflammatory bowel disease.