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Management of the refractory vitiligo patient: current therapeutic strategies and future options

9.1 Integrated discussion on mechanistic evidence strength, gaps, and confounding factors (1) Strength ranking of core mechanistic evidence and prioritization for clinical translation Based on a systematic analysis of each nutrient's regulatory pathway, the mechanisms with the strongest evidence for clinical translation are prioritized as follows: Omega-3 polyunsaturated fatty acids (EPA/DHA) anti-inflammatory pathway: Supported by human RCTs (65, 69), which show that EPA/DHA supplementation reduces the levels of pro-inflammatory cytokines (IL-1, IL-6) and improves depressive symptoms

Vitamin B-12 status differs among pregnant, lactating, and control women with equivalent nutrient intakes. The Journal of Nutrition 145.7 (2015): 1507-1514

On the other hand, dose-response relationships for these peptides are often biphasic or bell-shaped, meaning that more is not better and that higher concentrations can lose the effect or even reverse it