Does B12 Help with HS?: Unpacking the Role of Vitamin B12 in Managing Hidradenitis Suppurativa

October 27, 2025 •

4 min read

Research suggests that people with hidradenitis suppurativa (HS) are at a higher risk of deficiencies in certain key micronutrients, including vitamin B12, zinc, and vitamin D. This raises the question: Does B12 help with HS, and what role does this essential vitamin play in managing this chronic inflammatory condition?

Quick Summary

This article examines the link between vitamin B12 and hidradenitis suppurativa (HS), focusing on how B12's anti-inflammatory properties may influence HS symptoms. It explores current research, dietary sources, and the role of supplementation as a complementary strategy for HS patients.

Key Points

Inflammation Management: Vitamin B12 helps regulate homocysteine levels, which are linked to increased inflammation in HS.
Potential Immune Modulation: B12-dependent enzymes are involved in immune regulation, and supplementing might improve inflammatory responses in HS.
Complementary, Not Curative: B12 is considered a complementary therapy and should not replace standard HS treatments prescribed by a healthcare provider.
Evidence is Limited: While case studies exist showing promise, more randomized controlled trials are needed to fully understand B12's effects on HS.
Holistic Approach: B12 is one piece of a broader nutritional strategy, which includes a balanced, anti-inflammatory diet and addressing other potential deficiencies like zinc and vitamin D.
Consult a Professional: Always talk to your doctor or a dietitian before starting any supplement, especially B12, to determine if it's appropriate for your situation.

The Connection Between Vitamin B12 and Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition characterized by painful nodules, abscesses, and sinus tracts. While its exact cause is unknown, diet and nutrition are increasingly recognized as factors that can influence disease activity. Vitamin B12, an essential nutrient, has been investigated for its potential role in managing HS, primarily due to its anti-inflammatory and metabolic functions.

Vitamin B12's Role in Inflammation

Vitamin B12 is crucial for various physiological processes, including DNA synthesis and the metabolism of homocysteine. Studies show that elevated plasma levels of homocysteine are correlated with the severity of HS symptoms because homocysteine promotes pro-inflammatory effects. Vitamin B12 helps regulate these homocysteine levels, suggesting that supplementation could potentially reduce inflammation and, consequently, its pro-inflammatory effects in HS. Furthermore, a recent study published in the Journal of the Science of Food and Agriculture linked higher circulating vitamin B12 with lower levels of inflammatory markers like IL-6 and CRP in humans, further supporting its anti-inflammatory potential.

B12 and Immune Modulation

Chronic inflammation in HS may lead to lower levels of S-adenosyl-L-methionine (SAMe) and low methionine synthase activity, both of which are vitamin B12-dependent enzymes. Researchers have theorized that B12 supplementation might help improve elevated tumor necrosis factor (TNF) levels, a key driver of inflammation in HS. While more rigorous research is needed, this provides a plausible mechanism for how B12 could support HS treatment by modulating the immune system.

Evidence from Case Studies

While large-scale randomized controlled trials on B12 supplementation for HS are currently lacking, some promising case series exist. For instance, a few reports described the complete resolution of HS lesions in patients with concurrent Crohn’s disease after B12 supplementation. It is important to note that these cases involved patients with other inflammatory conditions, but they provide anecdotal evidence for B12's potential efficacy as an adjunctive therapy.

Dietary Sources of Vitamin B12

For those without severe deficiency, increasing dietary intake of B12-rich foods is a safe and beneficial strategy. Here are some excellent sources:

Animal Products: Meat, especially beef liver, poultry, fish (like salmon, tuna, and sardines), and eggs are all rich in B12.
Dairy: Milk, cheese, and yogurt provide a good source of B12.
Fortified Foods: Many plant-based milks, nutritional yeast, and breakfast cereals are fortified with B12, making them viable options for vegetarians and vegans.

Comparison of Key Nutrients for HS Management


Nutrient	Primary Function for HS	Strength of Evidence	Recommended Approach
Vitamin B12	Regulates inflammatory homocysteine levels, potential immune modulation.	Promising, but primarily from case studies; more research needed.	Dietary increase and supplementation, especially if deficient.
Zinc	Antioxidant properties, modulates inflammation; low levels associated with more lesions.	Mounting evidence suggests beneficial effects; supplementation shows promise.	Consult doctor for supplementation based on blood levels.
Vitamin D	Modulates inflammation; high rates of deficiency observed in HS patients.	Strong evidence for deficiency link; supplementation can improve outcomes.	Check blood levels and supplement under medical guidance.
Omega-3 Fatty Acids	Strong anti-inflammatory properties, a cornerstone of the Mediterranean diet.	Well-supported for general anti-inflammatory benefits; beneficial for HS.	Increase intake through fatty fish, seeds, and nuts.

A Broader Nutritional Approach for HS

Beyond specific supplements, a holistic dietary strategy is essential for managing HS. An anti-inflammatory diet, such as the Mediterranean diet, focusing on whole, unprocessed foods, can help reduce symptoms. It is also beneficial to identify and potentially eliminate specific food triggers. Common culprits include:

Dairy Products: Elimination has shown symptom improvement in some observational studies.
High-Glycemic Foods: Foods that cause rapid blood sugar spikes can increase inflammation.
Brewer's Yeast: Found in beer, bread, and fermented items, this has been identified as a potential trigger.

Adopting a healthy, balanced diet not only helps manage inflammation but also supports overall well-being, which is critical for living with a chronic condition like HS.

Conclusion

While research on the specific link between vitamin B12 and HS is still in its early stages, available evidence suggests a promising connection. By regulating inflammatory pathways and potentially modulating immune responses, B12 holds promise as a complementary therapy. However, it is not a standalone cure and should be part of a comprehensive management plan supervised by a healthcare provider. Prior to initiating any new supplement, individuals with HS should have their B12 levels checked and discuss the best course of action with a dermatologist or registered dietitian. A balanced, anti-inflammatory diet rich in B12 and other key nutrients, coupled with standard medical treatments, offers the most effective strategy for managing symptoms and improving quality of life.

For more information on dietary management for HS, please refer to the American Academy of Dermatology's guidance on the topic.

Frequently Asked Questions

For most people, a balanced diet that includes meat, fish, dairy, and fortified foods can provide sufficient B12. However, if you are at higher risk for deficiency (e.g., vegan, older adult) or have chronic inflammation, supplementation might be necessary under a doctor's guidance.

Yes, many people with HS find that adopting an anti-inflammatory diet, like the Mediterranean diet, helps manage symptoms. Limiting processed foods, sugar, dairy, and brewer's yeast is also often beneficial.

Symptoms of B12 deficiency can include fatigue, weakness, numbness or tingling, and memory issues. HS patients are at a higher risk of being deficient. A doctor can perform a blood test to check your B12 levels and determine if supplementation is needed.

Supplements can sometimes interact with medications. It is crucial to consult your healthcare provider before adding any supplements, including B12, to your routine to ensure it is safe and won't interfere with your current treatment plan.

There is no official, standardized dosage of B12 specifically for HS due to limited research. The appropriate amount would need to be determined in consultation with a doctor, especially if you have a confirmed deficiency.

Evidence suggests that supplements like zinc and vitamin D may also have beneficial effects for HS patients, particularly those who are deficient. Omega-3 fatty acids, known for their anti-inflammatory properties, are also often recommended.

There is no evidence suggesting that B12 causes HS flares. In fact, the anti-inflammatory effects of B12 are theorized to potentially reduce them. However, individual reactions to supplements can vary, so it is always best to monitor your symptoms and discuss any concerns with your doctor.