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Melasma: a comprehensive update Part I, II J Am Acad Dermatol

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and patients with glutathione-S-transferase M1 (proinflammatory-cytokine producer macrophages) null and M1 and T1 (Type 1 helper CD4 + lymphocytes) double null polymorphisms had increased mortality suggesting that antioxidant therapy becomes fundamental for those patients (109)

Therefore, even though B12 may come in more concentrated dosages with oral administration, the IM shots still provide the best way to correct B12 deficiency