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In the second step reaction (Figure 3(b)), compound I is reduced through redox reactions by a two-electron transfer from an electron donor (the second molecule of hydrogen peroxide) to produce the free enzyme, oxygen, and water [10]

These might include: Persistent fatigue that seems disproportionate to liver disease severity Glossitis (sore, red tongue) or mouth ulcers Shortness of breath and palpitations due to anaemia Difficulty concentrating or 'brain fog' Mood disturbances including irritability or depression It is crucial to recognise that some symptomsparticularly fatigue and cognitive changesare common in both fatty liver disease and B12 deficiency, potentially leading to delayed diagnosis

A Systematic Review of Nutraceutical Interventions for Mitochondrial Dysfunctions in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Retinoids Melasma or skin pigmentation is often caused by sun exposure