For this present study, UChicago Research Bangladesh (URB) study staff will work to identify patients who meet our inclusion and exclusion criteria from our established HEALS cohort study during which the URB staff will obtain informed consent. The inclusion criteria for the study are:  HEALS cohort members age 18-70 consistently high urine arsenic levels (≥ 200 µg/g creatinine) based on 15-20 years of follow-up data existing data on genetic information regarding the AS3MT variants that classify them as being an inefficient or efficient arsenic metabolizer.  The exclusion criteria for this study would be HEALS members who are  missing baseline urine samples missing the latest follow-up urine samples.  There will be a total of 300 subjects enrolled,100 for the intervention 1 group, 100 for the intervention 2 group and 100 for the control group.