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Males mainly restore fecal butyrate levels and inhibit the expression of TNF- in the ascending colonic mucosa, whereas females focus on repairing intestinal epithelial tight-junction proteins (TJPs) and inhibiting myeloperoxidase (MPO) activity

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The most common symptoms patients experience are chronic pruritus and eczematous lesions, which can adversely impact the quality of life for individuals afflicted by this disease [84]

In this situation, it can be challenging to demonstrate B12 deficiency even when there are typical symptoms (including neuropathy-like paraesthesia and numbness), as serum B12 concentrations may be just within, or sometimes above, the normal range due to the oral supplementation