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In the latter study, the researchers hypothesized that vitamin B12 may activate an inflammatory process in bacteria that normally lives on the skin, but which can promote acne when inflamed, according to Live Science

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A study from The Netherlands (Riphagen, 2020) found that after 8.5 years of follow-up of an older cohort (median baseline age=65), a doubling of baseline MMA levels was associated with an increased risk of mortality (HR 11.48, CI 3.3239.64)