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One of the main external causes of glutathione deficiency and oxidative skin ageing is urban pollution

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These findings reinforce the importance of continued monitoring, early detection, and intervention strategies to possibly mitigate the growing burden of vitamin B12 deficiency in both public and private healthcare settings (23)

Clinician Perspective The ADA Standards of Care 2024 state directly: "Routine supplementation with antioxidants, such as vitamins E and C and carotene, is not advised because of lack of evidence of efficacy and concern related to long-term safety." [6] Glutathione is not explicitly addressed in this language, but the guidance reflects a broader evidentiary standard the ADA applies to antioxidant supplements in diabetes management