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In a randomized, double-blind, placebo-controlled trial in 2,919 participants (65 years) with elevated blood concentrations of homocysteine, supplementation with vitamin B 12 (500 g/day) and folic acid (400 g/day) for two years did not decrease the risk of osteoporotic fracture despite reductions in homocysteine (120, 121)

Theoretical concerns regarding growth factor modulation and potential cancer interactions remain unsubstantiated by clinical evidence

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How Vitamin B12 May Affect Your Skin The proposed mechanism by which vitamin B12 influences acne development involves the skin microbiome, particularly the bacterium Cutibacterium acnes (formerly Propionibacterium acnes ), which naturally resides in hair follicles and sebaceous glands