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15 Histological features The features are subtle, comprising slight hyperkeratosis, variable acanthosis and elongation of the epidermal ridges, accompanied by increased pigmentation in the basal region (Figs 25.2225.24)

If these symptoms are present, they may point to the medication as the cause of your fatigue

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Our healthcare providers may suggest B12 injections to help you experience increased energy levels, as vitamin B12 plays a key role in converting food into glucose, the essential fuel your body needs for daily activities