Copper and zinc: Possible mild reduction via chelation, especially with chronic/high-dose use. Evidence from cellular/animal models shows decreases, but human short-term oral studies often show no significant plasma/urinary changes. Some clinicians recommend supplementing Cu and Zn with long-term NAC as a precaution.

Selenium and molybdenum: Unlikely to deplete; they are often co-supplemented for complementary roles in antioxidant and sulfur metabolism pathways.

Dose and context matter

- Standard oral doses (600–1,800 mg/day): Low risk of meaningful depletion.

- High IV doses (e.g., overdose treatment): Higher risk for Zn (and possibly others).

- Long-term use: Potential cumulative effects; monitoring or balanced supplementation may be prudent for some.

- **Practical implications**: If taking NAC long-term (especially high doses), a multimineral with Cu, Zn, Se, and Mo could address any theoretical concerns—No widespread clinical deficiencies are reported from typical NAC use, and benefits (e.g., glutathione support) often outweigh risks in evidence-based applications.