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In the epidermis of vitiligo lesions, a marked decrease in the expression of c-kit, the stem cell factor receptor, and the MITF transcription factor (microphthalmia-associated transcription factor) has been detected, along with a reduction in endothelin B receptor.40 A marked reduction in microRNA-211 expression has also been observed, associated with a lower oxygen consumption rate, aberrant mitochondrial complexes, alterations in lipid metabolism, and an increase in reactive oxygen species

This may be because of the slow motility (constipation) causing the gas to become trapped in the GI tract for longer compared to the more diarrhea-dominant form of SIBO

Upper body strength work maintains overall conditioning

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