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Hormonal Changes : Conditions like pregnancy or the use of certain medications can cause hormonal imbalances that lead to pigmentation changes in the skin

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Deficiencies in B12 can directly lead to nerve damage and worsen symptoms of diabetic neuropathy.65 While most people can get adequate B12 through diet (meat, fish, dairy, fortified cereals), certain medications including metformin and proton pump inhibitors can impair absorption and raise the risk of deficiency

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