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In contrast, congenital pernicious anemia, often caused by mutations in the GIF gene, which encodes intrinsic factor, manifests in infancy or early childhood with profound vitamin B12 malabsorption, leading to severe megaloblastic anemia and developmental delays

refrigerate at 2-8C after reconstitution

As a result, the acne bacteria could concentrate instead on using their cellular machinery to churn out more compounds to attack our face and induce inflammation in acne. Indeed, as you can see here and at 3:53 in my video , without excess B12 on the skin (with B12 shown in green), the bacteria have to make most of it on their own at the expense of porphyrins (shown in red), which can trigger acne inflammation