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Order related labs such as: o Complete Blood Count (CBC) o Liver enzymes (AST, ALT, bilirubin) o Kidney function tests (creatinine, eGFR) o Methylmalonic acid (MMA) and homocysteine to check B12 activity

Genetic predisposition can modulate cellular sensitivity to apoptosis, and multiple regulatory factors are involved, including inflammatory mediators (IFN-, IL-2, IL-1), TSH, and anti-TPO antibodies