The epidemiology of coexisting iodine and selenium deficiencies in central Africa, but not in China, has been linked to myxedematous cretinism, a severe form of congenital hypothyroidism accompanied by mental and physical retardation
Therefore, the first visible change is radiance
10.1038/s41413-024-00336-6 14 ChenH.XieC.ChenQ.ZhuangS
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)
While our livers naturally produce it, factors like UV exposure, city pollution in areas like Chicago or Des Plaines, and general aging deplete our stores