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Acral vitiliginous lesions, located on the wrist, hand, ankle, and foot, are often resistant to medical therapies, probably due to their lower content of melanocytes and hair follicles, which harbor melanocyte stem cells
Patients often ask a smarter question than it first appears: do GLP-1 medications reduce inflammation, or do they mainly help with weight loss and blood sugar while inflammation improves as a side effect
Conversely, in cells where NADPH-consuming reactions are active (e.g., fatty acid synthesis, antioxidant defense), the cytosolic concentration of NADPH decreases, while NADP + increases
The dual mechanism problem There are actually two separate mechanisms at play when you combine tirzepatide with levothyroxine, and both push in the same direction