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The risk may persist over several years, with one study indicating weight gain in 41% of cases

Epidermal PIH may resolve better and faster than dermal PIH where melanin accumulates in long-lived melanophages [27]. Melasma is also a chronic acquired hypermelanosis which involves increased melanin levels in the epidermis and/or dermis [28,29,30]. It manifests as bilateral dark or grayish-brown macules, more particularly located on the face

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In addition the the B12, there is also Vitamin B6 for healthy red blood cell production and an extra boost of energy

Two main causes often emerge then: Autoimmune gastric problems (such as anti-parietal cell antibodies and intrinsic factor antibodies) An infection with Helicobacter pylori Both can interfere with vitamin B12 and iron absorption and lead to long-term symptoms