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The United Kingdom National Quality Assessment Scheme for Haematinic Assays warns against false B12 results and the risk of neurological damage: In the event of any discordance between clinical findings of B12 deficiency and a normal B12 laboratory result, then treatment should not be delayed

Excess B12 may influence both bacterial activity and inflammation, which are key factors in acne development

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Mechanism of Action Inhibits Nicotinamide N-Methyltransferase (NNMT) Increases intracellular nicotinamide and NAD levels Improves mitochondrial efficiency and energy metabolism Supports lipolysis and fat oxidation Reduces adipocyte (fat cell) growth and proliferation Modulates inflammatory pathways and insulin signaling These effects may lead to enhanced fat metabolism, better blood sugar regulation, improved endurance, and a general increase in metabolic flexibility