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Abdulghani, AA, Sherr S, Shirin S, Solodkina G, Tapia EM, Gottlieb AB
Inborn errors of metabolism (e.g., vitamin B6-dependent convulsions or B6-responsive anemia)
This includes people with: Pernicious anaemia (autoimmune destruction of intrinsic factor-producing cells), typically requiring lifelong IM injections Crohn's disease or surgical resection affecting the terminal ileum Coeliac disease causing malabsorption (may improve with gluten-free diet) Chronic pancreatitis reducing enzyme availability needed for B12 release Vegans and strict vegetarians need reliable B12 sources through fortified foods or supplements, as plant-based diets contain negligible amounts of active B12
Expected Timelines 4-8 Weeks Subtle changes in skin texture and firmness 8-12 Weeks Visible improvements in wrinkles and skin quality 12+ Weeks Optimal results with continued use Clinical evidence includes 12-week studies showing improved skin laxity, clarity, and reduced wrinkles, outperforming vitamin C and retinoic acid in comparative trials with 70% increase in skin elasticity after 12 weeks
