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I would say that is very similar to the Skin If you have blackheads or acne read

Vitamin B12: How Frequently Should I Get It
That is a reasonable estimate after decades of the slow, 1%-per-year background erosion

95-97 Melatonin Melatonin is a hormone that regulates circadian rhythms in the body and has antioxidant and anti-aging properties

J Pharmacol Exp Ther 279(1):194199 Norenberg MD, Jayakumar AR, Rama Rao KV (2004) Oxidative stress in the pathogenesis of hepatic encephalopathy

This raises the question of whether mitochondrial dysfunction could be a factor that causes the disease to progress
