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Large doses of B12 can trigger acne-like symptoms in a small percentage of people

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Calcium acts as a trigger for AMPK activation through calcium/calmodulin-dependent protein kinase kinase-2 (also known as CaMKKβ) for phosphorylation of AMPK at Thr 172 of the α subunit in some tissues (Desjardins and Steinberg, 2018)