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NICE recommends considering surgical options when non-surgical measures have been unsuccessful

To Sleep Better and Regulate Mood Getting enough B12 helps your sleep-wake rhythm and allows your body to handle stress better

Common Symptoms of Low Vitamin B12 Symptoms of low vitamin B12 include fatigue, weakness, tingling in hands and feet, and difficulty concentrating

It also plays a role in protecting B12 from being destroyed by stomach acid, such as in the stomach and intestines.[ref] TCN2 (transcobalamin II, TCN2 gene): TCN2 is a B12 transport protein that moves vitamin B12 from the bloodstream into cells throughout the body

I have read that a mega dose of b12 apparently changes the 'friendly' skin bacteria to bad bacteria which causes the acne eruptions