Vitamin B12 is the most chemically complex vitamin on earth, and an essential nutrient used for manufacturing haemoglobin, producing the myelin sheath that protects nerves in the brain, converting food into glucose for energy, and producing nucleic acids (e.g., DNA), the body’s genetic material.
It’s essential for preventing heart disease, depression, and brain disorders. It’s so healthy that John F Kennedy claimed that he would never have become president without vitamin B12.
B12 is also one of the most popular vitamin supplements on earth, uniquely in the form of injections (B12 shots) rather than pills. It all started in the 1950s when the emergence of Confined Animal Feeding Operations (CAFOs) led to vegan and vegetarian movements becoming wildly popular.
As you might know, only animal foods such as meat, fish, eggs and organs like liver contain vitamin B12. Actually, neither animals nor plants have the necessary enzymes to manufacture vitamin B12, only bacteria does, but animal products contain plenty of those bacteria. Certain strains of your gut bacteria can also manufacture vitamin B12 but in nearly every human being alive this is nowhere near sufficient.
Hence it’s smarter to eat a big juicy slice of steak to get B12, but originally, vegan leaders decided that they could get enough through plants such as seaweed, spirulina, and fermented soybeans. Uniquely for a water soluble vitamin, the human body can actually store vitamin B12 for up to two years and recycles up to 75% of the vitamin B12 it uses. Hence, many vegans and vegetarians got along excellently for a while.
However, it turned out that plant sources of vitamin B12 contain only B12 analogs called cobamides that actually block the uptake of real vitamin B12. A study in 1974 dealt the first blow; American research found that 92 percent of vegans, 64 percent of lactovegetarians, and 20 percent of semi-vegetarians had blood levels of b12 below normal. Since then, usage of high dose B12 shots has been rampant among the vegan community and mainstream vegan outlets now encourage it.
The trend hasn’t halted there; as numerous studies flood out about vitamin B12’s widespread deficiency in the world, and its health benefits such as a happier mood, improved sleep, and protection against heart disease, many ordinary people are jumping aboard the B12 train as well. American doctors gave out 1.5 million prescriptions for vitamin B12 shots in 2008 alone.
Why is this medical trend relevant on a website devoted to clearing acne?
Simply because no other vitamin is as associated with as many monstrous acne outbreaks in as many studies and for as many years as vitamin B12 has been.
Vitamin B12 causes acne in countless studies!
The 1960s was the early era of vitamin B12 shots and numerous studies from back then spoke of acne following high doses. The bouncing ball of truth hasn’t stopped since then either.
Since the 1960s, we firstly have this 1979 study which concluded that acne springs up rapidly after vitamin B12 injections.
Secondly, an even more fascinating study was this one from 2014 published in the Indian Journal of Dermatology which had the stated aim “to compare vitamin B12 and folic acid levels in patients with moderate and severe acne vulgaris with those of the healthy control group”.
Hence, Dr Hilal Gökalp and his team of scientists gathered two groups of volunteers; one group of 120 acne patients (98 women, 22 men; mean age, 20 years; age range, 18-40 years) who completed 6 months of isotretinoin therapy and another group of 100 acne-free people (79 women, 21 men; mean age, 21 years; age range, 18-40 years).
The scientists measured the blood levels of vitamin B12 and folic acid of the acne-prone group both before the six month Accutane trial and after it, while the healthy group’s levels were only measured once.
The conclusion was very interesting. The results showed that the 120 acne patients had significantly higher vitamin B12 levels in the bloodstream before the Accutane than the healthy volunteers. The levels were 30% higher. Here’s what the scientists said: “pre-treatment vitamin B12 values of the patient group were found to be statistically significantly higher”. The effect was limited to vitamin B12; folic acid (vitamin B9) was no different between the groups.
Last but not least, we have this fresh and extremely interesting study that according to some pundits, puts the final nail in the coffin of vitamin B12 for acne patients.
In an experiment conducted in 2015, scientists led by Dr D Kang wanted to test the effect of vitamin B12 supplementation on p.acnes bacteria; hence they supplemented healthy volunteers with vitamin B12 and performed a detailed examination of their skin microbiota (microorganisms). The scientists did not discover that vitamin B12 encouraged the p.acnes to grow or multiply or get stronger in the face of topical acne treatments; nothing that simple.
Instead, B12 increased the amount of metabolic waste products produced by B12. In its daily activities, P.acnes bacteria uses the amino acid l-glutamine to make either vitamin B12 or peptides called porphyrins. If p.acnes is already equipped with more B12, less will be made and the conveyor belt of porphyrin will accelerate instead.
You’re probably guessed the end to this tale; porphyrins have previously been placed under suspicion of causing acne. They are known experts in irritating the skin, this study from 1988 found that p.acnes-derived porphyrins are actually big contributors to squalene oxidation, or sebum oxidation. The scientists said that “porphyrins were confirmed to be highly efficient catalytic factors in the squalene oxidation process”.
If you’re an expert on the science behind acne then you’ll know that oxidation of squalene produces the highly comedogenic compound squalene peroxide, which is actually a bigger cause of acne than p.acnes bacteria itself.
In this earlier article on seasonal acne, we discussed how the improvement in acne during summer which many people enjoy is due to natural sunlight’s ability to destroy these porphyrins. Notably, this study from 2015 discovered that acne-prone skin contains more porphyrins than skin without acne. The scientists also directly fed vitamin B12 to p.acnes bacteria in a petri dish and observed a spike in porphyrin production of 39%.
Vitamin B12 and acne – nobody is safe!
The scientists in the study administered vitamin B12 injections to 10 participants with clear skin, and observed that 1 of them developed acne a one week later. Upon analysis of the bacteria on the patient’s skin, Dr Kang and his scientists discovered that the p.acnes had mutated into a more aggressive form exclusively found on the skin of acne patients.
It’s well established that the bacteria on the skin of acne patients is more aggressive; it churns out more porphyrins and greater amounts of other inflammatory metabolic waste products. B12 somehow has the dangerous power to turn friendly skin bacteria into a more villainous variety for acne. The results were not staggering; only 1 out of 10 clear skinned people developed acne. But still, those who already had acne got far worse.
The role that vitamin B12 plays in acne has been a mystery ever since the 1960s, but it’s now certain that metabolites churned out by p.acnes bacteria are the missing link scientists have long been hunting for.
One other plausible mechanism is that excessive doses of vitamin B12 can convert the toxic heavy metal mercury into methylmercury, a far more toxic form that can contribute to inflammation behind acne. This study found that high dose vitamin B12 shots were linked to greater accumulation of methylmercury in the brain and hence damage.
So is this the end of vitamin B12 for us acne patients or do these results not translate into the real world where science and diet is far more complicated? After all, iodine is another nutrient that has been blamed for acne since the 1960s and we mostly exonerated it in this article.
The reality is that with a thorough scouring of the acne-sphere and well-designed scientific studies, you can see clearly that there’s a ton of bad stories. In fact, I’ve never seen so many horror stories for one nutrient:
- I never ONCE had acne before and after doctor put me on 10,000mcg B12 shots 3 times a week, I have patches of pimples on my nose, temples, and chest! Horrible!
- I decided to supplement with vitamin B12 a few months ago but ended up taking way too much. Ever since I’ve had terrible acne and it’s not going away.
- I’ve been taking B12 shots twice a week and have horrible acne on my back, neck, face and chest.
- I have been taking vitamin B12 supplements since August every other day. The dosage was 5,000 mcg as an oral pill. I developed severe acne all over my cheeks and neck and basically everywhere. I have never looked like this before – it’s horrible!
- Someone who had started a course of B12 shots, and felt generally healthier on them, said that “the acne came on overnight practically and is all over my chin and neck. It’s also slowly creeping up my cheeks towards my forehead”.
It’s pretty clear that vitamin B12 at least has the power to cause acne, whether it’s via porphyrins or an undiscovered mechanism. However, the truth of the matter is very different…
Vitamin B12 also has benefits for acne
The dosage in the biggest and most damning study was truly enormous; the volunteers were injected with 1000mcg, which is 5000% of the recommended daily allowance for adults, which is 2.4mcg. Typical B12 shots prescribed by doctors contain 500-1000mcg with instructions to be injected 2 times per day.
What we have is evidence that massive doses of B12 can cause acne, just like with iodine. But the only piece of evidence that dietary intake of vitamin B12 can trigger acne is the study showing that acne patients had 30% higher levels in their blood than average. Furthermore, another study on female acne patients concluded that blood B12 levels were no different to healthy volunteers.
Here’s the truth: vitamin B12 deficiency is not just rampant in vegans. People who shun meat are very deficient themselves; studies generally suggest that 50% of vegetarians and 80% of vegans need more vitamin B12. However, one study also discovered that 40 percent of all people between the ages of 26 and 83 have plasma B12 levels in the low to normal range – a range at which neurological symptoms start kicking in. 9 percent had an outright deficiency and 16 percent were at “near deficiency”. Separately, B12 deficiency has been estimated to affect about 40% of people over 60 years of age.
Many factors in the modern lifestyle deplete vitamin B12 levels. Firstly, heavy alcohol intake massively impairs the absorption of vitamin B12 into the gastrointestinal tract. Secondly, many of us have impaired nutrient absorption anyway due to too much grains, sugar, and low intakes of other nutrients. Finally, low levels of the antioxidant glutathione are an epidemic due to it being depleted in the detoxification of toxins. Glutathione is needed to protect vitamin B12 molecules and keep them functional.
If you eat plenty of meat and organs then you’re home and dry when it comes to vitamin B12. The best sources in the world, in order, are…
-Lamb liver – (1501% per 100 grams).
-Lamb kidney. (873%).
As you can see, organs are by far the best, but the regular meat of those animals is not far behind. A 200 gram lamb steak contains 86% of the RDA for instance. A medium sized egg also contains 10%.
If you’re eating only a small amount of animal foods, perhaps by trying to eat less steak or lamb chops after seeing the reports on red meat causing cancer in the news, then you are likely to be deficient in vitamin B12.
What happens then? Well firstly, your levels of oxidative stress will be substantially higher. That means your skin will have more acne-causing free radicals and less acne antioxidants to protect against those free radicals.
Vitamin B12 is needed to restrain levels of homocysteine, an amino acid used as a marker for heart disease. High homocysteine levels result in endothelial dysfunction, a narrowing of the arteries, and oxidative damage to cholesterol. But elevated homocysteine also has a strong link to oxidative stress; this study applied homocysteine to cells and found that it increased oxidative stress by inhibiting a compound called tetrabiopterin by 80%. This study was more direct; it found that homocysteine increases production of a compound called PAR-4, which itself led to far more free radicals being generated by the body.
This study on 149 patients with heart disease found that the risks to cardiovascular health posed by homocysteine were due in large part to increasing oxidative stress, which thus winds up causing acne as well. Finally, this study again discussed the cardiovascular risks and said that oxidative stress was to blame.
Obviously, a malfunctioning heart can only affect acne extremely indirectly, but oxidative stress is one of the two root causes of acne, alongside chronic inflammation.
Not only that, but vitamin B12 can improve a wide range of bodily conditions that lead to acne indirectly, most notably including sleep deprivation. There’s a vast catalogue of studies analysing vitamin B12’s effect on sleep but this one stands out. Read the extract:
- Two adolescent patients suffering from persistent sleep-wake schedule disorders appear to have responded to treatment with vitamin B12 (methylcobalamin). Neither patient showed any laboratory or clinical evidence of vitamin B12 deficiency or hypothyroidism. The improvement of the sleep-wake rhythm disorders appeared immediately after administration of 3,000 micrograms/day of methylcobalamin.
The link to the study is here. Other studies have found that B12 improves sleep deprivation resulting jet lag and shift work. Studies on rats have also shown benefits. It fits very logically that vitamin B12 can cause sleep deprivation, given its numerous effects on depression and neurotransmitters (see below).
This study found that vitamin B12 improved areas of sleep such as “sleep quality,” “concentration,” and “feeling refreshed” by directly influencing melatonin. This study found that patients with delayed deep-phase sleep syndrome benefitted from vitamin B12; sleep onset came forward from 2am to midnight.
Possibly the most interesting benefit of higher vitamin B12 is defence against the deadly heavy arsenic.
In this article we discussed how arsenic found in rice and fruit juice causes hyperkeratosis, an overgrowth of the skin protein keratin which binds dead skin cells together into pore-blocking clumps that cause acne.
Good news; this study found that supplementation with vitamin B12 led to increased clearance of vitamin B12 through urine, and this study found that vitamin B12 prevented an increase in oxidative stress caused by arsenic.
There’s also evidence that vitamin B12 protects against mycotoxins from toxic moulds. It’s possible that vitamin B12 plays a role in detoxifying harmful contaminants more widely across the body.
Health benefits of vitamin B12
Firstly, Taiwan researchers found that the cardiovascular problems resulting from elevated homocysteine levels could be avoided by getting more vitamin B12. Secondly, B12 is linked to depression, with roughly 30% of patients being deficient according to one study. This makes sense because vitamin B12 has the ability to activate a compound called tetrahydrobiopterin, which itself activates the happiness hormone serotonin, and dopamine.
Another study examined the brain function of children who had been fed a vegan diet and hence had low levels of vitamin B12. Apparently, there was a significant association between B12 status and performance on tests measuring fluid intelligence, spatial ability and short-term memory, with formerly vegan children scoring lower than normal omnivorous kids for each test.
Vitamin B12 is also a potent way to treat anaemia as it’s used to manufacture the haemoglobin cells which transport iron throughout the bloodstream. In fact, the road to the B12 discovery began in 1929 when scientist George Whipple was conducting experiments in which he induced anemia in dogs by bleeding them, then fed them various foods to observe which diets produced the fastest recovery from the newly produced anaemia.
His results showed that ingesting large amounts of liver seemed to cure anaemia most effectively. Hence, he hypothesised that liver might cure pernicious anaemia, aenimia where there’s enough iron but the iron isn’t being utilised correctly.
He found signs of success, and later, in 1948, a different team of scientists including Dr Falkers and Dr Todd isolated, identified, and named the compound in liver responsible – vitamin B12.
If you’ve got the symptoms of anaemia like fatigue, weakness, dizziness, and shortness of breath but are also getting plenty of iron, then vitamin B12 might well be the solution.
Vitamin B12 may supercharge your energy levels, as it’s used to extract energy from food. Finally, vitamin B12 is famous for strengthening the myelin sheath, a protective coating like the plastic on a wire which keeps neurons intact and well-functioning.
The truth about vitamin B12 is that at high doses of 1000mcg, it almost certainly does cause acne.
There are plenty of well-designed studies suggesting it, the case studies on acne patients taking B12 shots are overwhelmingly negative, and scientists have identified a specific and plausible mechanism involving bacterial metabolites.
However, I definitely do not recommend that you minimise B12 in your diet because low levels can increase oxidative stress and cause sleep deprivation, and put you at risk of depression and brain problems. The two takeaways from this article are to 1) not take vitamin B12 shots, and 2) get plenty of vitamin B12 from food. If you’re an omnivore then simply eat more animal based foods, especially liver and other organs. Two eggs for breakfast each day will give you about 20% of the RDA, if you’re a vegetarian.
If you’re a vegan then you face the age-old conundrum, since plant sources like spirulina are not absorbed properly. However, there are now effective vitamin B12 supplements available which aren’t in the form of injections and aren’t in colossal acne-causing doses.
That’s why this Garden of Life Organic B-12 Spray supplement is truly excellent. It’s completely organic, well-sourced and vegan friendly, in the methylcobalamin form, and contains 140 servings. It’s in a spray form, so you bypass a potentially weak digestive system through direct absorption into the bloodstream. Furthermore, you don’t even need 500mcg per day. At most, you need to spray your body once every two days. Hence the bottle will last you 280 days, or over 9 months. The supplement is excellent value for money, and you can buy it here.
It’s especially critical for vitamin B12 that you buy the most efficient methylcobalamin form rather than cyanocobalamin. In Europe and Japan, scientists have recognised that methylcobalamin is the best absorbed form of vitamin B12 in humans and use it exclusively in prescriptions, but America remains stuck in the dark ages.
If you fear the supplement is secretly derived from animals then don’t worry; vitamin B12 supplements are manufactured by the fermentation of microorganisms such as Streptomyces griseus, Pseudomonas denitrificans and Propionibacterium freudenreichii subsp. shermanii. After all, it’s the bacteria in animals which manufactures B12 rather than the animals themselves.
Overall, vitamin B12 is another iodine; suspicious in high doses, but perfectly safe for acne at normal dietary intakes.
Thanks for reading!