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European journal of neurology : the official journal of the European Federation of Neurological Societies

Treatments might include injections or high-dose oral supplements to restore B12 levels

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No IGF-1 or Growth Hormone Receptor Activation Full-length growth hormone produces complex metabolic effects including appetite stimulation through IGF-1 (insulin-like growth factor-1) production and direct growth hormone receptor activation

Supplementing with Betaine with Pepsin can help improve ones digestion, and you can read more about that here

Relative Deficiency of Other B Vitamins The emergence of acne through vitamin B12 can possibly be mitigated through the combination of other vitamins although no conclusive experimental investigations on this phenomenon have been carried out so far