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A deficiency or lack of Vitamin B12 is quite common in the over 65s, those diagnosed with pernicious anaemia, and in anyone who follows a vegan, strict vegetarian, or extreme/fad/restricted diet for a long time without taking a B12 supplement or eating fortified foods

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Combined treatment of metformin and PINK1/Mfn2 overexpression significantly reduced ROS production and apoptosis, inhibited -myosin heavy chain (-MHC) expression, increased mitochondrial MMP, and improved myocardial injury

Rather than increasing medication on a fixed schedule, Nooms physician-designed protocol adjusts dosing based on each patients individual progress and response

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Therefore, one of the most important approaches in melasma management and potentially mitigating its progression is photoprotection