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B12 And Acne

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Vitamin B12 provides only general benefits for acne sufferers but may actually trigger acne breakouts. Find out how.

What is Vitamin B12?

Vitamin B12 or Cobalamin is one of the B vitamins. It is a water-soluble vitamin that is essential for the formation of blood, functioning of the nervous system, production of fatty acid, synthesis of DNA and energy production.

Vitamin B12 is the most complex vitamin and the only one to contain cobalt, which is a rare element.

It is commonly supplied in supplements as cyanocobalamin but the forms of the vitamin which are useful in humans is methylcobalamin and adenosylcobalamin.

The recommended daily intake of vitamin B12 is 2 - 3 micrograms per day. However, because of the low toxicity of this vitamin, that dose can be exceeded with no side effects.

Vitamin B12 is mostly produced by bacteria. Therefore, plant and animal sources of the vitamin are usually taken from the parts where bacteria mostly grow. For animals, this part is the gut.

Animal liver can also serve as a good dietary source of vitamin B12 since it is the organ responsible for converting cyanocobalamin to hydroxocobalamin and the bioactive forms of the vitamin: methylcobalamin and adenosylcobalamin.

Other excellent sources of Cobalamin are eggs, milk, and dairy products, fish, shellfish and poultry. Vitamin B12 can also be obtained from fortified foods.

Vitamin B12 deficiency is usually caused by anemia and mostly produces extensive damage to the brain and nervous system. Symptoms of vitamin B12 and vitamin B9 deficiencies overlap because they are caused by pernicious anemia.

Therefore, vitamin B12 supplements are usually given to treat this deficiency. The hydroxocobalamin form is also used to treat cyanide poison since it is simply converted to harmless cyanocobalamin when it chelates cyanide.

Ironically, the most common bacteria used in the industrial synthesis of vitamin B12 supplements are from Propionibacterium species. Some strains of Propionibacterium (for example, P. acnes) are known to cause acne.

How Vitamin B12 Treats Acne

Vitamin B12 has no direct effect on acne treatment. Instead, it is included in supplements for treating acne to improve general health including skin health.

Because vitamin B12 is involved in a number of biochemical processes including cellular metabolism, DNA synthesis, and regulation as well as the production of fatty acids, it is possible that it can help strengthen the immune system and promote hormonal balance in the body.

Hormonal imbalance, especially the increased production of male sex hormones, is one of the main causes of acne. When these hormones are produced in high amounts, they stimulate the production of excess sebum, and this promotes bacterial colonization of the skin.

However, it is unlikely that vitamin B12 produces any markedly significant effect on its own. Instead, it can improve the absorption and usage of other vitamins and minerals which can improve acne symptoms.

Like most vitamins, vitamin B12 can also serve a supportive role in detoxifying the body, regenerating skin cells and increasing the production of proteins and fatty acids need to preserve the structural integrity of the skin.

Does Vitamin B12 Cause Acne?

Vitamin B12 has been reported to cause acne breakouts. This effect is experienced especially when used along with vitamin B6.

In one study, 100 micrograms/day of vitamin B12 and 100 mg/day of vitamin B6 caused acne breakouts. This acne attack stopped when both vitamins were withdrawn and resumed even when the supplements were recommenced but at half the earlier doses.

It should be mentioned that most studies only linked acne and supplementation with high doses of vitamin B12. In one report 5 – 10 mg/week of vitamin B12 injection caused inflammatory acne lesions which cleared off after a week without the supplement.

Statistical evaluation of reports of acne caused by vitamin B12 in WHO database showed that of the two commercially sold forms of the vitamin, hydroxocobalamin caused more acne breakouts than cyanocobalamin.

How Vitamin B12 Can Cause Acne

The exact mechanism by which vitamin B12 causes acne and acne-like dermatitis is still unknown. However, there are a few theories being put forward.

One researcher suggests that there are components of hormonal, vascular, and immunological factors in the appearance of acne lesion following vitamin B12 supplementation.

Considering that the most common acne lesions reported were pimples and papules covering the face and shoulder, it is possible that there is a local inflammatory response in the skin caused by high levels of vitamin B12.

Whichever enzymatic activities are overstimulated as a result of B12 megadoses, the result seems to lead to increased sebum production and the appearance of inflammatory acne lesion.

Why Vitamin B12 Megadoses May Cause Acne
Hyperactivity of enzymes and biochemical reactions depending on vitamin B12 leading to increased sebum production or hormonal imbalance
Irritation of the skin following increased elimination of excess vitamin B12 from the skin pores
Impurities/Contaminants in Hydroxocobalamin injections
Bacterial contamination of vitamin B12 during production

Yet another theory put forward is that there is an increased and prolonged excretion of vitamin B12 via the skin following megadoses of the vitamin.

This would most likely cause an irritation of the follicular epithelium which will be interpreted as an injury by the immune system.

Therefore, the immune cells sent to the site of the injury may be responsible for the inflammatory skin reaction which is part of the effects produced by these cells.

Because most of the acne breakouts experienced with vitamin B12 are produced after the administration of hydroxocobalamin, some are arguing that the skin reaction is caused by contaminants in the injectable form of the vitamin.

Sorbitol and iodine are sometimes found in ampoules of hydroxocobalamin and it is possible that they can trigger inflammatory skin reactions.

The hydroxocobalamin link can be extended further. Although rarely mentioned (and for good reasons), it is possible that vitamin B12 may introduce strains of Propionibacterium to the body.

Bacteria are responsible for both natural and industrial production of vitamin B12 and the form of the vitamin that these microorganisms produce is hydroxocobalamin.

Furthermore, Propionibacterium, the species to which acne-causing bacteria belong, is the FDA-preferred microbe for the industrial production of vitamin B12.

This last theory is rather far-fetched for two major reasons. First, Propionibacterium is generally regarded as safe (or GRAS by FDA standards) because it produces no endotoxins and exotoxins which may contaminate the final vitamin product.

Secondly, even if a few Propionibacterium cells or their toxin contaminates the final vitamin B12 product, it is very unlikely that they can find their way out of the body up to the skin surface where they can trigger acne breakouts.

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