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Several systemic diseases, including Addisons disease, PeutzJeghers syndrome, McCuneAlbright syndrome, Cowden syndrome, neurofibromatosis, acquired immunodeficiency syndrome, haemochromatosis, and hyperthyroidism, as well as uncommon conditions such as Nelsons syndrome, polyostotic fibrous dysplasia syndrome, LaugierHunziker syndrome, and the Carney complex, may feature oral melanotic macules [1, 26, 27]

Specific vitamins and minerals warrant attention during tirzepatide therapy due to their roles in metabolic health and potential for deficiency with reduced dietary intake

Enzymatic Antioxidants Hydrogen water differs fundamentally from enzymatic antioxidants like SOD in mechanism, bioavailability, and tissue penetration, making it a potentially superior option for whole-body oxidative stress protection

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