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Also, high-dose B12 has been linked to acneiform eruptions in some case reports and reviews (Bahbouhi et al., 2023) as described in the PubMed record

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A primary focus of research involving this compound is its interaction with the enzyme nicotinamide N-methyltransferase (NNMT)

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Disorders of cobalamin (vitamin B12) metabolism: emerging concepts in pathophysiology, diagnosis and treatment