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Summary: Vitamin B12 supplements can trigger acne in some susceptible individuals, particularly at high doses, by altering skin bacteria behaviour and inflammatory responses

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pmid:34140279FREE Full TextGoogle Scholar Metformin and reduced vitamin B12 levels: new advice for monitoring patients at risk

Additionally, recent studies have identified bacterial DNA in human and mouse adipose tissues 20,21

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This is because there are few vegan foods that contain B12 and also because the body finds it significantly more difficult to absorb B12 from the few vegan sources that have it