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The affected endothelial cells undergo apoptosis

Additional risk factors include: Chronic kidney disease : Reduced renal clearance may impair B12 excretion Liver disease : Hepatic dysfunction can disrupt B12 metabolism and storage Myeloproliferative disorders : Certain blood cancers increase B12-binding proteins Concurrent medication use : Some drugs may interact with B12 metabolism, including metformin, proton pump inhibitors, and H2 antagonists Patients with these conditions should have B12 supplementation carefully monitored by their healthcare team

Thoracic outlet syndrome (TOS) Symptoms: Achy neck/shoulder, numbness/tingling in the arm/hand, sometimes color or temperature changes

Aging causes sagging and loose skin that wrinkles more easily

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