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Vitamin B12-related acne tends to occur only in dosages in excess of 5 to 10 mg per week. Thats 5,000 to 10,000 micrograms a week, which is well in excess of the 50 micrograms a day or, alternately, the 2,000-microgram single weekly dose that I recommend

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Other documented adverse effects include decreased appetite (which contributes to the therapeutic effect), fatigue, injection site reactions, dizziness, and modest increases in heart rate (typically 2-4 beats per minute)