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For naturally occurring B12 in food, the presence of gastric acid, pepsin, and intrinsic factor is essential for liberation and absorption

Additionally, diabetic patients are more susceptible to severe complications, such as secondary bacterial infections and postherpetic neuralgia, following episodes of herpes zoster [14]

High level of Cortisol hormone The fluctuation of Cortisol, the stress hormone in the body, might affect the elastic fibers of the skin as cortisol could convert to cortisone and affect the elasticity

This seems obvious, but it trips up patients who switch between medications without properly discontinuing the previous one