These include diet, lack of sleep, stress, genetics, and especially exposure to the damaging rays of sunlight that have been reviewed in detail elsewhere and will be presented, in brief, below [10, 14, 16]
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The groups most likely to develop B12-related hair and skin changes are the same ones at risk for deficiency generally: vegans and vegetarians, adults over 50, people on long-term metformin or proton pump inhibitors, anyone who's had bariatric surgery, and people on GLP-1 protocols whose reduced appetite has significantly lowered their overall nutrient intake for an extended period