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A multicenter RCT, the PIVENS 262 trial, randomized 247 nondiabetic patients treated with MASH into the pioglitazone, vitamin E, and placebo groups for 96 weeks

Skin lightening with the use of glutathione occurs because this compound can change eumelanin (dark pigment) into pheomelanin (two true pigments of light)

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The result is a smoother, more luminous complexion with improved tone and texture

And another thing that you had mentioned is most of us don't have the right gut microbiome to make this, which is really unfortunate with so many of us not having very healthy guts, not diverse, different quality of microbes in our gut, even if you are eating a lot of these foods and vegetables or these pomegranates and nuts, you're just probably not making any urolithin A to get a benefit at all