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2017 Mar 20;9(3)

References Tejero J, Lazure F, Gomes AP

Homocysteine can act directly on glomerular cells inducing sclerosis, and it can initiate renal injury by reducing plasma and tissue level of adenosine

To overcome these constraints, we propose that future prospective studies implement three key strategies: (1)Systematic collection of dietary and supplemental B12 data using standardized instruments such as food frequency questionnaires

The use of B12 injections by healthcare professionals is generally considered safe

I know you didn't mention that as an issue, but I feel there is some link between B12, cystic acne, mast cell dysfunction, gastroparesis and probably many other symptoms