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Common triggers include sun exposure, hormonal changes, inflammation, acne, vitamin D deficiency, and certain skin disorders

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Alkaline phosphatase of the brush border of the intestines, which participates in thiamine transport (Figure 2), plays protective roles against pathogenic infection (191) and bacterial toxins (LPS) in the gut, and may counteract inflammation (192)

Reactions that warrant attention include persistent swelling or redness lasting more than 24 hours, significant pain beyond the initial injection moment, the development of hard nodules that do not resolve within a day or two, fever or systemic symptoms following injection, or any sign of infection at the injection site including warmth, pus, or spreading redness