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doi:10.1016/j.rdc.2015.08.002 29Williams DM

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Intracellular glutathione levels, within a cell or cells, appear to be a sensitive indicator of the cells overall health and its ability to resist toxic challenges

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This is one reason why dark spots may become more noticeable after sun exposure, acne, irritation, or melasma

Severe B12 deficiency is widely reported and leads to pernicious anemia since your body needs B12 to make red blood cells, and a deficiency limits its capabilities to build them