Vitamin B12 and Acne
I was hoping this day would never come – the day that I had to admit there might be some potential side effects to vitamin B12 supplements!
I have heard from a few people over the years that they had a reaction to vitamin B12 supplements. In those cases, it was not clear whether it was the actual vitamin B12 or possibly another chemical that was included in the supplement preparation.
But in June of 2010, someone wrote me saying that there had been some discussion on a German Blog that several people started getting “bad” skin after taking b12 supplements. As I am not a reader of German, I noted it but did not research further.
Then, on October 27, someone commented on the Will a Multivitamin Cover B12 Needs? post, saying they had developed acne after supplementing with vitamin B12.
I did some more research and found some cases in the scientific literature in which vitamin B6 and/or vitamin B12 was thought to be the cause of acne and rosacea. I have added the page Side Effects of B12 Supplements to Vitamin B12: Are You Getting It? in order to alert people to this possibility.
It would be good to know what sort of dose could typically cause this problem, how much of a culprit vitamin B12 is compared to vitamin B6, and if all forms of vitamin B12 are implicated. I found very little on it and the most recent report was from 2001, so it is not an area of much study at this point.
Of course, if you suspect high doses of vitamin B12 to be causing a problem for you, opt for smaller doses more often (see Recommendations).
November 10th, 2011 at 2:13 pm
I think small daily doses have got to be better than large weekly doses, as large doses have been known to cause side effects such as skin rashes, hives and inflammatory issues.
The regular form of B12 (cobalamin) used in supplements is cyanocobalamin – which is an inactive form of B12 bound to cyanide. This is broken down by metabolism into methylcobalamin and cyanide. While cyanide is a poison it is assumed to be tolerable at these small doses except for people who exhibit cyanide sensitivities.
So it would be interesting to know whether high doses were involved and what form of B12 was implicated.
November 10th, 2011 at 2:51 pm
Mark,
If you didn’t already click through to the Side Effects of B12 Supplements article, you can see there that one of the case reports was with only 20 micrograms of B12. It’s hard to believe such a small amount could have caused the problem so I’m wondering if it wasn’t more the vitamin B6 she was taking. I would assume that an amount that small was cyanocobalamin. I’m afraid I don’t know details of any of the other reports.
The amount of cyanide in cyanocobalamin is one of the next issues I plan to tackle.
November 10th, 2011 at 3:19 pm
Sorry – hadn’t clicked through yet – B12 dose seems reasonable but the B6 dose seems a high. With such a small number of cases its hard to rule out confounding factors.
I’m interested in what you find out about cyanocobalamin.
November 11th, 2011 at 8:30 am
If you still have the German link and need to know what it says, I could read it and summarize it in English.
November 11th, 2011 at 8:40 am
I haven’t noticed much difference after I started taking supplements. I have always had some acne, and after we started taking 1000 mcg twice weekly nothing has changed. My husband has perfect skin and it stayed the same. I don’t recall him getting more acne.
November 11th, 2011 at 9:54 am
Lisa,
I hope people don’t think I was suggesting that everyone will get acne upon taking high dose B12 supplements – most people will not get acne.
November 11th, 2011 at 9:56 am
Arcadio,
I just checked the email and the person didn’t include a link. I don’t think it’s worth asking him to dig up, but thanks for offering.
November 11th, 2011 at 10:27 am
I never suffered from acne in my life but have recently been suffering with awful skin and have been unable to pin down a cause! Now that you posted this, I have realised that the acne only appeared after I began taking vitamin supplements (I have tried various but currently buy the Vegan Society’s Veg 1 supplement).
I guess I will stop taking the supplement and see what happens!
November 11th, 2011 at 2:47 pm
Of course I meant *haven’t* been able to pin down the cause!
Also, if it does turn out that supplements are causing my acne… what are my options?
November 11th, 2011 at 3:22 pm
Nikki,
How much have you been taking?
November 11th, 2011 at 6:35 pm
Just one a day of the Veg1 supplement and whatever is in the fortified foods I happen to eat on that day…
November 11th, 2011 at 6:36 pm
Nikki,
How much B12 is in one of the supplements? I couldn’t find the amount on the Vegan Society page.
Jack
November 11th, 2011 at 6:41 pm
Just went and checked the bottle… it says each tablet provides 10 micrograms of B12.
November 11th, 2011 at 6:53 pm
Well that’s not very much and very hard to believe it could be causing your acne. Most of it isn’t going to be absorbed – at 10 micrograms you’re hardly going to absorb much more than what’s in a serving of fortified foods. See if your skin clears up and let me know and we could go from there. It could be something else in the supplement.
November 11th, 2011 at 6:53 pm
This in from another dietitian:
Just as quick non documented personal report, I have had two cases in my office where patients reported the occurence of acne after receiving vitamin B12 injections prescribed by a medical doctor (but never with oral doses).
November 11th, 2011 at 6:56 pm
I know it’s not likely to be the supplement but I figure it’s worth a try seeing as I can’t seem to pin anything else down. My face is so sore and itchy.
I will let you know if I notice any difference.
November 11th, 2011 at 7:02 pm
Nikki, Good luck – I hope it clears up!
November 14th, 2011 at 12:51 pm
I have had acne just about my entire adult life (which I control through using beta hydroxy acid and benzoyl peroxide on a daily basis. HOWEVER: I will ALWAYS break out if I take –> any <— kind of b vitamin supplement; I figured this out a few years ago, and it remains true today. So, I only take b-12 supplements that are exclusively b-12, and I only take the methyl b-12 (but only because I have heard that this form is more easily absorbed — though I have no idea if this is true); when I only take b-12, I don't have skin problems.
Which is to say: for me, there IS some (mysterious) B vitamin that wreaks havoc on my skin.
November 14th, 2011 at 2:28 pm
> but only because I have heard that this form is more easily absorbed — though I have no idea if this is true
I’ve seen no evidence that this is true.
November 23rd, 2011 at 9:12 am
hydrocobalamin has many reports of people breaking out from scalp,face and body…..if you’re getting injections of the active form of b12..methylcobalamin, and you or the pharmacy let light get to it, it will degrade to hydrocobalamin…..
cyanocabalamin has been known to cause blindness in some people who carry the gene for leber’s……
November 29th, 2011 at 7:23 pm
I recently correlated my cystic acne breakouts with a daily 1000mcg B-12 supplement. I am nearly 40 and never broke out like this until I chose strictly B-12 and not a multi-B vitamin. My cousin experienced the same reaction. I realize everyone is different, just sharing the information.
December 16th, 2011 at 6:02 pm
I have been informed that a teenage vegan I know stopped taking large B12 supplements for 3 weeks and her skin has mostly cleared up.
December 16th, 2011 at 6:17 pm
I haven’t noticed a particular improvement in my skin since I stopped taking the multivitamin… the search for a cause continues… *sigh*
May 4th, 2012 at 4:44 am
Vitamin B12 does not cause facial Acne. The rancid fatty acids in some Vitamin B12 supplements do. Methyl-B12 from jarrow formulas causes no problems at all.
Acne is Low Estrogen/High DHT which is caused by a Vitamin D deficiency.
Vitashine Vegan D3.
May 4th, 2012 at 5:17 pm
Cobalamin,
Interesting theory, but how can you possibly know this? And is it from the rancid fatty acids or from vitamin D deficiency?
May 5th, 2012 at 1:21 am
Hello Jack,
From your “Side Effects of B12 Supplements” page:
A 1991 case report from North Carolina says “This case illustrates an eruption “RESEMBLING” acne rosacea that was temporally associated with daily ingestion of high-dose B vitamin supplement. The eruption “failed” to respond to the usual treatment regimens for rosacea, but promptly improved when use of the vitamin supplement was discontinued.”
Source: http://veganhealth.org/b12/toxicity
There is a big difference between “resembling” and actual Acne.
Actual Acne is caused by a Vitamin D deficiency and the Acne-like condition caused by the supplements is either from those rancid fatty acids or maybe a hidden toxic ingredient. Its not actually Acne but can easily be mistaken for it. Its just red small dots with oily skin.
These supplements gave me an Acne-like condition on the forehead about a year ago and gave me toxicity symptoms after the second dose; this is a very toxic product: http://www.solgar.com/SolgarProducts/Vitamin-D3-Cholecalciferol-2200-IU-Vegetable-Capsules.htm
The only ingredient that stands out and can cause oily skin is the Vegetable Magnesium Stearate(stearic acid).
In reality, we shouldn’t be blaming Vitamin B12 but simply certain supplement manufacturers for using expired and/or toxic molecules.
As for Acne. It is well known in the literature that high androgen hormones, especially DHT cause excess sebum to be released which plugs up the pore.
Estrogen balances out the androgen hormones.
Vitamin D deficiency causes low estrogen levels; estrogen keeps the skin healthy and beautiful. This is why Vitamin D deficienct men tend to get back acne and very few women do. Hence women naturally have higher estrogen levels than men.
Source: http://www.hopkinsmedicine.org/news/media/releases/Heart_and_Bone_Damage_From_Low_Vitamin_D_Tied_to_Declines_in_Sex_Hormones_
Source: http://www.livestrong.com/article/91209-estrogen-acne/
May 5th, 2012 at 7:33 pm
Cobalamin,
While I’m sympathetic to the idea that the B12 molecule is not to blame in these skin outbreaks, it’s harder for me to believe there is enough rancid fatty acids in a 1,000 µg B12 supplement to cause a skin outbreak.
Thanks for the links, they were interesting. However, the one on vitamin D and estrogen didn’t indicate that vitamin D deficiency causes low estrogen levels.
July 7th, 2012 at 12:39 pm
Hi Jack Norris RD
OMG! I am so glad I came across this site! I have been having some issues with my skin for a while now and could not figure out why. I’m thinking back and I think it has something to do with the vitamins I have been taking. I began to take daily vitamins to help with my energy level due to fatigue. Then, I started to take B12 ( not sure exactly how much mcg) and a daily vitamin to help with fatigue and managing my weight. I believe this is when I began to notice some breaking out on my face. Never really paid it much attention thinking it would go away with some acne products like it usually does. Did not notice any changes. I got a dog and noticed my face was getting worst. I began to purchase acne products to treat what I thought was acne and irritated my face even more. I was still taking a daily vitamin and B12 at the time. It took me a while before going to see a dermatologist who diagnosed me with eczema, which I never had in the past. I ended up getting rid of my dog thinking I’m on my way to my clear skin again and began to take some prescriptions to help with the restoration. I noticed some improvement. I think around that time I may have ran out of vitamins and B12 so I noticed some improvement since I wasn’t taking them at the time. I eventually purchased some more daily vitamins and B12, this time it was B12 1000 mcg (not knowing about the amount and the effects). At my follow up appointment the dermatologist said It looked like I had a combination of eczema and acne and gave me some samples of epiduo to put on my face. Now I was taking Prednisone 5mg tablet once a week, Loratadine 10mg tablet twice a day, applying Fluocinonide .05% ointment twice a day and applying epiduo gel. I was hoping the epiduo would help and still not much improvement. I just slowed down on the other prescriptions to see if I noticed a difference and still nothing. Mind you, I’m still taking my daily vitamin and B12 1000 mcg just about every day. I just discontinued everything a couple days ago. I was doing some research on eczema and acne when I saw a link that connected breakouts with B 12 and thats when my research went the other way. I have read some information that connects B12 with acne and others had no connection until I clicked on this link and began to read. I will not be taking anything at all for the next couple weeks to see if anything changes. I am in need of some help immediately cause some of that information scared me a little with the excessive amount I’ve been taking. I can’t talk to my doctor till monday so I will call first thing monday morning and ask her what she recommends. Until then I will not be popping anything down my throat.
It seems maybe my acne wasn’t so bad with the smaller amount of B12 in the beginning.
Then its clear an allergic reaction caused me to catch eczema and made it worst with the irritating acne prroducts. If it was even eczema!
Then I began to take B12 1000 mcg and continued to break out.
So if there is any information that will help, please let me know. I feel like I’m about to lose it!
Do you think it is a good idea to discontinue everything for now?
Will a daily vitamin cause acne breakouts?
Do you think the dermatologist may have mis-diagnosed me with eczema? Could it have been a reaction because of the B 12 1000 mcg and the daily vitamin along with me irritating my face with acne products?
I’m sorry for all the information and questions, but you know what you’re talking about and I would really appreciate your help. It’s clear that everyone may not have the same reaction but I am. One last thing, I notice some breaking all over my body since I began taking the B12 1000 mcg, but smaller bumps that look like pimples, not so noticeable. I’m guessing it is the B12 1000 mcg? Is there any way to flush this out of my system?
Hope to get a response soon.
Thank you
July 7th, 2012 at 3:14 pm
Zakiya,
> Do you think it is a good idea to discontinue everything for now?
I cannot speak to your medications as I am not a doctor, but there should be no harm in discontinuing vitamin B12 supplements for a few days. If too much vitamin B12 is the cause, then the acne-like symptoms should abate over the course of a few weeks. If you are vegan, you should find a different way to get B12. A multivitamin would be another way, but you would need to monitor to see if it caused the acne to come back.
Good luck!
July 8th, 2012 at 4:19 pm
Thanks for the feedback.
January 30th, 2013 at 9:25 pm
Oh, yes, methylcobalamin (jarrow sub-linguals and injectable) caused cystic acne in me. Undoubtedly.
February 1st, 2013 at 4:58 am
Leah, that’s the same brand/kind that caused me to have a HORRIBLE acne outbreak! (I wonder why?).
February 12th, 2013 at 2:21 pm
Nikki, I am curious to know did you continue to stay off B12 ? Have you still got acne? I became a vegetarian (now vegan) and was told to take B12 and within a few months i was breaking out (which has never happened before) really bad around my chin and the side of my forehead. I couldn’t figure out why this was happening so i got blood tests done as it was really getting me down. It turns out I am double what i should be in B12 which my doctor then told me can cause acne. I looked at the back of the bottle and it was 1000% of my RDA. I stopped taking the B12 vitamin immediately about 2 / 3 weeks ago now and i haven’t noticed much change in the acne yet. I’m just wondering anybody else who went through this, did you have to wait a long time before it went away? Thanks!
February 13th, 2013 at 3:15 am
Ava, when I have breakouts from b-12 (or b complex — both cause problems), the acne breakout starts almost immediately. It doesn’t take weeks. But acne is slow to go away. You say it started “within a few months,” so I wouldn’t be completely convinced that b-12 is the problem — though I am no medical expert.
February 13th, 2013 at 7:55 am
Thanks for your advice Dustin, i really appreciate it.
It’s very hard to be sure why it is happening. I started taking B12 everyday from June 2012 and by November i was covered in spots, some being cyst like ones. The B12 is the only link i have as to why the acne has mysteriously taken over. I was sure it was it as my doctor said so and doing research on the internet pointed towards it but it seems like it should be at least clearing up a little bit by now but it’s still the same
February 13th, 2013 at 8:05 am
Hi Ava,
Yes, mine was very bad too — also cystic. I had completely clear skin beforehand.
I cannot take any kind of multi-vitamin or anything with B vitamins. I have to rely on soymilk and other foods that are supplemented. For some reason, they don’t make my skin react.
I’d also suggest being extremely gentle with your skin, especially until it clears. I’d use products that are fragrance free and very basic. Maybe try a little benzoyl peroxide. Have you heard of acne.org? They have a great regimen and line of effective, basic products that produce quick results (they’re all vegan, too).
Acne seems to take a life of its own after it starts, and it may require more than simply quitting the supplements to get it under control.
February 13th, 2013 at 8:17 am
You know what? Now you mention it my skin is much clearer and I’ve either not been able to afford or been bad at remembering to take my vitamins lately…
February 13th, 2013 at 8:21 am
Thanks Dustin. I just looked at it as black and white but i will certainly look at the acne.org site again. My doctor prescribed ‘Duac’ to speed things along, i just looked at the label and it has benzoyl peroxide in it . It doesn’t seem to do much for me as yet but maybe patients is the key! Thanks again for your advice
February 13th, 2013 at 8:47 am
That’s really interesting Nikki, it’s a possibility that it is just time! Judging by your previous posts, It’s been around 3 months since you started cutting back on the vitamins so maybe it does simply take a while for it to take effect?
February 21st, 2013 at 11:44 pm
I tried both oral and sublingual cyanocobalamin and within two days of starting both of them, I had nasty cystic acne break out. I also got headaches and racing heart from the sublingual.
I take daily supplements that contain 60mcgs (1000% RDA) methylcobalamin, and my skin is fine-great even.
I will not go near cyanocobalamin again. It does not agree with my body at all. It is also the synthetic b12, and I’m sure that is part of the problem.
February 21st, 2013 at 11:54 pm
…oh, and the oral cyanocobalamin that made me break out in cysts was in a b complex tablet supplement. The oral was cyano. only. Therefore, two separate attempts at ingesting cyano. in two different forms produced the same cystic acne results.
The daily methyl that I now take is in NowFoods Thyroid support forumula, and my skin is nice.
I’ve been taking these thyroid supplements (along with iron) to address slightly slow thyroid and slightly low homoglobin. My skin is nice as long as i stay away from the cyano. I have always been acne prone though.
March 21st, 2013 at 4:49 am
If you take b12 injection & b12 supplement then you will have acne as well as pimples which is a good sign. It flushes the homocystiene (toxic in blood) from blood in the form of acne,rashes & pimples.Homocystiene causes B12 deficiency as well as it causes stroke & heart attack. So if you take b12 injection then acne, rashes & pimples will appear which is good sign. No need to worry. source http://www.b12d.org
March 21st, 2013 at 11:39 am
Indiansoft,
This is definitely the first I’ve heard that B12 supplements will cause homocysteine to be excreted through the skin in the form of pimples. I was so intrigued that I went to the site to see what it had to say:
http://www.b12d.org/b12-deficiency-5-basic-processes
“Without B12 a person builds up homocystein which makes them depressed and irritable (yes, I know a few of those!). It also creates skin problems such as acne, eczma, rashes, which is the body trying to get rid of the extra homocystein. We had a case where someone developed pimples (fatty nodules) all over his arms, back and chest which were the fat trying to form encasements around the homocystein to stop it poisoning the body.”
This does not make sense to me because B12 helps the body convert homocysteine back into methionine and so when you take a B12 supplement, your body would have *less* need to rid itself of homocysteine.
Reading more on the site, I found:
http://www.b12d.org/4-removing-toxins
“This is the most immediate thing that B12 does – it gets from the small intestine (ileum) into the blood stream, and it’s in an active state. It is designed to attach to anything that may poison the body, wrap itself around that substance, and then excrete that substance in the urine – at the same time sacrificing itself….Environmental toxins include Cyanide as mentioned above, also Lead, Arsenic, and the heavy metals and keep them away from the delicate biochemistry of the body.”
I have never heard of B12 wrapping itself around a substance to prevent it from harming the body. B12 can be used to detoxify cyanide (in cases of cyanide poisoning) as cobalamin has a strong affinity for cyanide, so if you give someone with high levels of cyanide a non-cyano form of B12, the cyanide will attach to the cobalamin and then be urinated out. But I have never heard of this being done for metals or any other substance.
I did a quick PubMed search to see if I could find anything on this stuff and I could not, nor does the Linus Pauling Institute mention it: http://lpi.oregonstate.edu/infocenter/vitamins/vitaminB12/
My sense is that this website if a mixture of fact and fiction. But I’m always happy to be proven wrong.
April 15th, 2013 at 6:11 pm
I am proof that b12 DOES cause acne. I have been taking larger doses of b’s for fatigue for one month. The fatigue has been GREATLY helped but the acne (which I never even had this badly when I was TEENAGER…laugh!) is maddening and directly began upon supplementing with the b 12. I am taking methylcobalamin in sublingual form (only a miniscule amount of b 12 your body actually gets after the b goes through the digestive tract). The cyanocabalamin is synthetic and not very usable by the body since it needs to be converted to be worthwhile, therefore is the poorest choice of b12 to take. I am also taking hydroxycobalamin and adenosylcobalamin, both better forms of b than cyanocobalamin.
My daughter with chronic fatigue/fibromyalgia ish stuff is taking all of these too with well above 15 mg per day, and is not experiencing any acne issues. Like with so many supplements, people’s bodies respond differently.
worth a read explaining methylcobalamin
http://www.nationalnutrition.ca/detail.aspx?ID=1901
April 22nd, 2013 at 7:50 pm
evy,
Hydroxocobalamin also has to be turned into methyl- or adenosyl- to be used by the body. I would be skeptical of anything written by a supplement company about methylcobalamin.
> The cyanocabalamin is synthetic and not very usable by the body since it needs to be converted to be worthwhile,
Cyanocobalamin is more stable in supplement form and possibly requires less than if you are taking methylcobalamin.