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How Vitamin B12 Deficiency Affects Skin

How Vitamin B12 Deficiency Affects Skin

Vitamin B12 deficiency affects more people than you think. Extreme cases lead to anemia and neurological symptoms (like peripheral neuropathy), but even minor deficiencies can profoundly affect your health… and your skin. If you’re struggling with skin issues, this article is for you. Vitamin B12 may be the missing link on your healing journey.

“If you’re struggling with skin issues, this article is for you. Vitamin B12 may be the missing link on your healing journey.”

Keep reading to learn about vitamin B12 deficiency, who’s at risk, and how symptoms can show up on the skin.

Vitamin B12 Deficiency

Vitamin B12 (cobalamin) is in the family of B vitamins. It’s a cofactor for two key enzymes affecting metabolic health in every cell of the body. B12 is required for:

  • Nervous system health
  • Synthesis of red blood cells
  • Cardiovascular health
  • Skin health (Source 1)

Vitamin B12 deficiency is common in the U.S., affecting 3 to 6% of adults, with another 15% experiencing marginal depletion of this essential nutrient. (Source 2)

Vitamin B12 deficiency occurs because of these possible factors:

  1. Inadequate intake of vitamin B12. Adults need at least 2.4 mcg of vitamin B12 daily from animal products, dairy products, and fortified cereals. Not eating enough leads to deficiency. Vegetarians and vegans are at higher risk. (Source 1, 3)
  2. Malabsorption. Absorption of vitamin B12 requires good stomach acid, intrinsic factor, and gastrointestinal health. Absorption declines with age, and GI issues like celiac disease lead to low levels of vitamin B12. Pernicious anemia is an autoimmune condition that decreases vitamin B12 absorption. (Source 1)
  3. Vitamin B12 depletion. Medications like metformin decrease vitamin B12 levels, potentially leading to deficiency. (Source 4)

Regardless of the root cause, when your body needs more vitamin B12 than you have, you may develop megaloblastic anemia, where red blood cells are enlarged and don’t function properly. Megaloblastic anemia can also be caused by folate deficiency, since vitamin B12 and folate work together in the methylation cycle required for red blood cell production. In blood tests, low vitamin B12 is also associated with high homocysteine levels.


Dermatologic conditions can indicate nutrient deficiencies, including vitamin B12, because nutrition plays a critical role in skin health.

“Dermatologic conditions can indicate nutrient deficiencies, including vitamin B12, because nutrition plays a critical role in skin health.”

Cutaneous conditions where vitamin B12 deficiency is a potential root cause include:

  • Hyperpigmentation. Hyperpigmentation occurs when skin cells produce more skin pigment (melanin), causing dark areas of the skin. Research suggests vitamin B12 deficiency disrupts the homeostasis of melanocytes, the cells that produce melanin, leading to hyperpigmentation. (Source 5)
  • Glossitis. Glossitis is tongue inflammation, and vitamin B12 plays an important role in the skin, including the skin of the tongue. Over 68% of glossitis patients have an underlying vitamin B12 deficiency. (Source 6)
  • Atopic dermatitis. Skin inflammation, like eczema, is a highly prevalent skin condition. A meta-analysis of studies suggests supplementing with vitamin B12 may help improve eczema and skin health. (Source 7)

Other skin conditions like vitiligo and skin lesions may also correlate with a vitamin deficiency, but more research is needed. Please work with your dermatologist or other healthcare provider to explore connections between nutrition status and skin health.

Vitamin B12 Supplements

An effective way to correct vitamin B12 deficiency is with supplementation. Vitamin B12 supplementation helps those who don’t get enough in their diet or whose daily needs are more significant. For those with poor absorption, choose a liquid version that absorbs through the mouth and bypasses the gastrointestinal tract.

Core Med Science Liposomal B12 Folate TMG Liquid Spray is a liposomal supplement with superior bioavailability. Spray it directly into the mouth for direct absorption. The physician-created formula contains active forms of vitamin B12 and folate (not synthetic folic acid) for optimal benefits.

Skin conditions might be a sign you need more vitamin B12, and Core Med Science has you covered with this effective liposomal product.



1. National Institutes of Health Office of Dietary Supplements. Vitamin B12: Fact Sheet for Health Professionals. Accessed 1/18/24 at

2. Shipton, M. J., & Thachil, J. (2015). Vitamin B12 deficiency - A 21st century perspective . Clinical medicine (London, England), 15(2), 145–150. Full text:

3. Rizzo, G., Laganà, A. S., Rapisarda, A. M., La Ferrera, G. M., Buscema, M., Rossetti, P., Nigro, A., Muscia, V., Valenti, G., Sapia, F., Sarpietro, G., Zigarelli, M., & Vitale, S. G. (2016). Vitamin B12 among Vegetarians: Status, Assessment and Supplementation. Nutrients, 8(12), 767. Full text:

4. Miller J. W. (2018). Proton Pump Inhibitors, H2-Receptor Antagonists, Metformin, and Vitamin B-12 Deficiency: Clinical Implications. Advances in nutrition (Bethesda, Md.), 9(4), 511S–518S. Full text:

5. Rzepka, Z., Respondek, M., Rok, J., Beberok, A., Ó Proinsias, K., Gryko, D., & Wrześniok, D. (2018). Vitamin B12 Deficiency Induces Imbalance in Melanocytes Homeostasis-A Cellular Basis of Hypocobalaminemia Pigmentary Manifestations. International journal of molecular sciences, 19(9), 2845. Full text:

6. Chen, G. Y., Tang, Z. Q., & Bao, Z. X. (2022). Vitamin B12 deficiency may play an etiological role in atrophic glossitis and its grading: A clinical case-control study. BMC oral health, 22(1), 456. Full text:

7. Zhu, Z., Yang, Z., Wang, C., & Liu, H. (2019). Assessment of the Effectiveness of Vitamin Supplement in Treating Eczema: A Systematic Review and Meta-Analysis. Evidence-based complementary and alternative medicine : eCAM, 2019, 6956034. Full text:

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