Vitamin B12 and Eczema

Vitamin B12 has been shown to have anti-inflammatory effects by suppressing the production of certain cytokines involved in the inflammation process. It can also enhance immune regulation by supporting the activity of regulatory T-cells.

Vitamin B12 deficiency has also been associated with secondary folate deficiency, which can impact the immune response. High-dose folic acid supplementation (160 mg/d to 10 mg/d) has been shown to reduce inflammation in mice with allergic dermatitis by suppressing T cell proliferation and the secretion of proinflammatory Th2 cytokines (Makino et al. 2019).

Italian doctors from the University of Verona published an interesting case study in 2020. They described an 18-year-old patient who had been suffering from severe atopic dermatitis (AD) since the age of 15. In addition, the patient had allergic rhinitis since the age of 10, with sensitivities to pollen, molds, and house dust mites.

To manage his condition, he had to continuously use topical steroid creams and undergo 5-6 cycles of different oral steroid medications each year. He had skin lesions on his eyelids, scalp, neck, elbow folds, and under the knees (82 SCORAD points). The patient was also diagnosed with chronic gastritis, which was probably the cause of his anemia and vitamin B12 deficiency.

At the time the study authors assessed the patient, he had been off topical steroids for 2 weeks and systemic steroids for 5 weeks. Blood tests confirmed anemia and severe vitamin B12 deficiency (46 pmol/l, while normal values are 133-675 pmol/l), but excluded vitamin D deficiency.

Four months later, the patient's SCORAD had decreased from 82 to 10, and he reported no need for topical or oral steroids. The serum vitamin B12 level was 213 pmol/L. Doctors recommended stopping supplementation and taking vitamin B12 only in the form of food products.

3 months later, the patient returned to the medical center due to an exacerbation of eczema (SCORAD 50). At the same time, his vitamin B12 level dropped to 97 pmol/L, with normal vitamin D levels again noted. Vitamin B12 oral supplementation at a greater dose (cyanocobalamin 500 mcg/day) was also administered, along with a one-week topical steroid treatment.