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[1] Causes of generalised hyperpigmentation include excessive sun exposure, drugs, Addisons disease and nutritional disorder such as Vitamin B12 deficiency
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Krugliak Cleveland et al., 2022)
However, anecdotal reports from online forums cited in a 2025 systematic review included anxiety and panic attacks, depression and anhedonia, insomnia, heart palpitations, fatigue and weakness, and loss of appetite
