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Though its primary effect was hormonal, the reduction in colonic inflammation and diarrhea suggests indirect effects on microbiotagut interactions through neuroimmune modulation

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Others acknowledge that individual variations in MMP expression, copper metabolism, and skin sensitivity can create unexpected reactions

Silencing of ANGPTL 3 (angiopoietin-like protein 3) in human hepatocytes results in decreased expression of gluconeogenic genes and reduced triacylglycerol-rich VLDL secretion upon insulin stimulation

Acneiform or skin changes have been reported with high-dose or frequent B12 administration, though the mechanism remains unclear