Reduced GSH decreases GPX4 expression/activity, promoting Fe 2+ and ROS accumulation
Additionally, certain variants in genes related to antioxidant response, such as the catalase (CAT) gene and the glutathione peroxidase (GPX) gene, have been associated with increased susceptibility to vitiligo.67,69,70 Furthermore, vitiligo has been associated with defective recycling of tetrahydrobiopterin (6BH4), essential for melanin formation, leading to an excess of 7BH4 and inhibition of phenylalanine hydroxylase (PAH)
Symptoms of the patients is diverse from no symptom to severe pain and dysphasia
One possibility may be the acute improvement of glycemic control by tirzepatide
In the UK, hydroxocobalamin is the preferred injectable form, with cyanocobalamin rarely used in NHS practice
Glutathione is an antioxidant that the body produces naturally to fight free radicals, which can damage cells and increase the risk for a wide range of diseases (x)