Vitamin B

Background and uses:

Some of the B vitamins are very popular these days. And, with good reason. There are eight types of B vitamins: they are necessary to human functioning. Some give us more energy; some help our immunity; some help our hair grow, some help our neurologic function and our memory. 

Our body does not make B vitamins (although may convert tryptophan to vitamin B3). So, it is important to get them through proper nutrition and from supplements. There are eight B vitamins:

B1 (Thiamin)

B2 (Riboflavin)

B3 (Niacin)

B5 (Pantothenic acid)

B6 (Pyrodoxine)

B7 (Biotin)

B9 (Folate - also called folic acid when it is contained in a supplement)

B12 (Cobalamin)

(The numbers of the B vitamins skip - for example B3 skips to B5 above -because there were some substances researchers originally thought were B vitamins but they were not so they dropped them out).

What body functions are B vitamins responsible for? Where do the B vitamins come from? When you take too much, do those vitamins accumulate in your body producing toxicity? Or, does your body eliminate them? How can you tell if you take too much? How can you tell if you take too little?

B1 (THIAMINE)

Benefits of vitamin B1 

Thiamine converts food to energy

Cardiovascular: Helps with normal cardiac function

Musculoskeletal: helps maintain proper muscle function

Glucose: Thiamine helps metabolize glucose

Neurologic: Helps with proper nerve function; may help preserve and support cognitive function

Mental Health: May help preserve emotional health

Signs and Symptoms of Excess: Stomach ache, nausea, constipation and diarrhea, hair loss, rashes, and nerve damageor neuropathy(tingling of hands and feet), bright yellow urine

Signs and Symptoms of Deficiency: Loss of appetite, weight loss, fatigue, irritability, decreased reflexes, numbness and/or tingling of the extremities, weakness, abdominal discomfort, thinking problems, memory loss, insomnia, hallucinations, delirium, vision problems (blurry and/or double vision), nausea, vomiting, palpitations/tachycardia, shortness of breath, lower leg edema (swelling), heart failure, involuntary eye movement, paralysis, Wernicke-Korsakoff syndrome and Wernicke encephalopathy (brain damage from excessive alcohol use)

Factors That Can Cause Vitamin B1 Deficiency

• Poor diet

• Alcohol dependence This is a very common deficiency in alcoholics (beri-beri)

• Old age

• HIV/AIDS

• Diabetes

• Starvation

• Bariatric surgery

• Kidney disease

• Dialysis

• High-dose diuretic ("water pill") use

• Excessive nausea and vomiting in pregnancy

• Hyperthyroidism

• Prolonged diarrhea

Sources of Thiamine: Black Beans, lentils, seeds, lean pork, salmon, whole grains, cereals, as well as in yeast, beef, nuts, cauliflower, green peas, asparagus, vegetables  liver, oranges, eggs, potatoes, asparagus, and kale, firm tofu, brown rice, acorn squash, mussels.

B2 (RIBOFLAVIN)

Benefits of vitamin B2:

Like nearly all B vitamins, vitamin B2 is not made by the body: It is obtained through nutrients and supplements. Riboflavin helps break down carbohydrates, fats and proteins so they can be used for energy. It also enhances absorption and metabolism of iron, folic acid (B9) and other B vitamins (B1, B3, and B6)

Eyes: Riboflavin helps prevent cataracts

Musculoskeletal: B2 helps keep muscles healthy

Gastrointestinal: Helps maintain the mucous membranes in the digestive system and helps maintain healthy liver

Skin: Helps maintain healthy skin

Cancer: Anti-tumor effects

Neurologic: Vitamin B2 helps maintain healthy nervous system

Endocrine: Supports hormone production by the adrenal glands

Signs and Symptoms of Excess: The body does not store Vitamin B2. It eliminates it in the urine so excess stores are very rare. Excess B2 might make your urine appear bright yellow urine.

Signs and Symptoms of Deficiency: Skin disorders, hyperemia (excess blood) and swelling of the mouth and throat, cracks in the lips, dark coloration of lips and tongue, sore tongue, angular stomatitis (lesions at the corners of the mouth), cheilosis (swollen, cracked lips), hair loss, reproductive problems, sore throat, itchy and/or red eyes, degeneration of liver and nerves, anemia, and seborrheic patches (red, scaly patches around the nose, mouth, eyes, ears and the pubic area) may indicate a B2 deficiency.

Factors That Can Cause a Vitamin B2 Deficiency: Some factors that cause a riboflavin deficiency are celiac disease and other malabsorption syndromes, liver disease, alcoholism, dialysis, and chronic (ongoing) barbiturate use (like phenobarbital and Fiorcet).

Sources: Some good sources of riboflavin include grain products, eggs, asparagus, avocados, spinach and other green vegetables; milk, beef, pork, cheese, liver (beef or pork), fish, mushrooms, almonds, and fortified cereals.

B3 (NIACIN)(NICOTINIC ACID)

Benefits of Vitamin B3

Vitamin B3 plays a major role in maintaining the body's energy. It is also antioxidant properties that help protect cells and organs from damage.

Cardiovascular: B3 may help prevent heart disease, and decrease atherosclerosis. It may help reduce high blood pressure.

Eyes: B3 Can help reduce the risk for cataracts

Neurologic: B3 enhances brain function, and may reduce the risk of Alzheimer's

Musculoskeletal: May help with symptoms of arthritis

Skin: Improves skin and may help reduce acne

Cholesterol: Increases HDL cholesterol, lowers LDL, lowers triglycerides (Niacin has been used since the 1950s to treat high cholesterol)

Glucose: Vitamin B3 may help treat type 1 diabetes.

Male/Female: Suggested to help improve some cases of erectile dysfunction

Neurologic: May help with vertigo, migraines, motion sickness and enhance brain function

Mental Health: ADHD, depression, schizophrenia

Other: May help reduce diarrhea in cholera, and may enhance athletic performance

Signs and Symptoms of Excess: Can cause significant flushing (redness, itching, burning of skin) as a side effect so often taken at night with a baby aspirin. GI upset, gas, dizziness, mouth pain. Headaches, increased liver function tests, increased blood sugar, gastrointestinal ulcers, change and/or loss of vision, gout flares, blood sugar, lower blood pressure, irregular heartbeat among others. Some of these symptoms explain why people do not use niacin (B3) much high cholesterol.

B3 is not stored in the body: It is eliminated in the urine. This also causes bright yellow urine sometimes.

Signs and Symptoms of B3 Deficiency: This deficiency can cause many symptoms: Thick brownish/discolored areas of the skin that has been exposed to sunlight; photosensitivity, vomiting, diarrhea, fatigue, headache, depression, anxiety, poor concentration, a disease "pellegra" (dermatitis, stomach problems, neurologic problems) dementia, glossitis (inflammation of tongue), constipation, mouth lesions, peripheral neuropathy (loss of sensation of extremities) alopecia (hair loss)and others.

Sources: Calves liver, pork and calves canned tuna, chicken, turkey, salmon, or other lean meats, lean pork chops, nuts, dried fruit, portabella/crimini mushrooms, peanuts and peanut butter,  brown rice, avocados, asparagus, green peas, spinach, sweet potatoes, asparagus, fortified cereals, omega-3 oils, coffee, tea. There are over the counter brands of Niacin and there are also prescription brands which tend to be higher dose. The prescription brands are usually prescribed for high cholesterol and triglycerides.

Factors That Can Cause Vitamin B3 Deficiency:

Malnutrition

Genetics

Malabsorption (inability to absorb Vitamin B)

IBS

Chronic diarrhea

Medication interaction

Alcohol use

Malignancy

Caution: A few medications bind with B3 so the vitamin cannot be used by the body efficiently (isoniazid). Vitamin B3 can also increase the action of certain medicines: B3 may cause an increase in bleeding with some blood thinners; should be used with caution with cholesterol lowering medications, clonidine, tegretal, colchicine, guanfacine, some blood pressure medicine, diabetes, gout, unstable angina (chest pain), history of heart attack, alcoholism, severe liver disease and others.

B5 (PANTOTHENIC ACID)

Benefits of Vitamin B5: B5 is important in converting protein, carbohydrates and proteins into energy. While many of the following actions have not yet been supported by scientific evidence, (needing more research), it has been suggested that B5 is helpful for certain functions of the body:

Cardiovascular: Helps lower blood pressure

Eyes: Eye infections

Respiratory: Allergies

Gastrointestinal: Colitis

Musculoskeletal: Arthritis, muscle cramps, carpal tunnel, rheumatoid arthritis

Skin: Skin healing and skin health, hair loss

Glucose: Helps lower blood sugar

Cholesterol: Helps lower LDL and increases HDL

Immunity: Boosts immunity

Genitourinary: Premenstrual syndrome, may help build sex hormones

Neurologic: Headaches, Parkinson's, neuropathy (nerve Pain), multiple sclerosis, restless legs, insomnia

Psychologic: Irritability, anxiety, ADHD

Other: Helps create red blood cells, helps in the processing of other vitamins, may help alcohol dependence/recovery, chronic fatigue, and possibly athletic performance

Signs and Symptoms of Excess: Like other B vitamins, this vitamin does not normally build up in your body; it is eliminated in the urine. So, symptoms of excess are typically few. However, if there is excess, digestive issues like vomiting and diarrhea may occur. Excessive pantothenic acid can also increase the risk for bleeding.

Signs and Symptoms of Deficiency: Fatigue, insomnia, depression, irritability, depression, stomach pain, vomiting, more frequent respiratory infections,

Sources: Mushrooms (esp. button and shitake), fish, avocados, eggs, lean chicken, beef, pork, sunflower seeds, milk, sweet potatoes, and lentils, milk, brewer's yeast, corn, cauliflower, kale, tomatoes, split peas, peanuts, soybeans, lobster and salmon, broccoli, fortified cereals, organ meats

B6 (PYRODOXINE)

Benefits of Vitamin B6:

Vitamin B6 is important in converting food to energy; it is essential in the formation of red blood cells and other cells (i.e. DNA synthesis) and helps for optimal nerve functioning.

Neurologic: B6 may help with memory and prevent dementia in old age, aids in cognition

Mental Health: Vitamin B6 helps prevent depression - it is a necessary building block of serotonin and dopamine - the "happy", motivating neurotransmitters in your brain, among other things.

Immunity: B6 helps build immunity

Genitourinary: Helps with PMS (premenstral syndrome) symptoms

Cancer: Reportedly decreases cancer risks - anti-tumor effects

Neurological: May help decrease risk and cognitive decline

Other: Improves circulation and helps create hemoglobin, the oxygen carrying part of the red blood cells that circulate to give your cells oxygen to function.

Signs and Symptoms of Excess: Nausea, vomiting, diarrhea, loss of appetite, heartburn, loss of muscle control, photosensitivity, headaches, fatigue, loss of sensation and/or inability to sense temperatures, neuropathy, and painful skin lesions, among others. Excess B6 is excreted in the urine so excess is not common.

Signs and Symptoms of Deficiency: Deficiency in B6 is not common (but does tend to be more frequent in alcoholics). When levels are low, a person can develop peripheral neuropathy (numbness, pain of extremities), confusion, depression, anemia, poor immunity, seborrheic dermatitis, tongue swelling, cracking lips, cheilosis, confusion, depression, frequent illness, increased PMS symptoms, and mouth sores, among others.

Causes of Vitamin B6 Deficiency: Malabsorption, hypothyroidism, diabetes, kidney disease, some medications including corticosteroids, estrogen, anticonvulsants, Crohn's disease, celiac disease, ulcerative colitis, and alcoholism.

Caution: Use with certain chemotherapies, barbiturates, anti-seizure medicines, Levodopa, Isoniazid, and others

Sources of Vitamin B6: Green leafy vegetables, root vegetables, non-citrus fruits (like bananas), watermelon, avocado, legumes, watermelon, fish, lean meat, poultry, chick peas, onion, spinach, potatoes, tofu, salmon, turkey, ground beef, bulger wheat, cottage cheese, rice, raisins, and others.

B7 (BIOTIN) (VITAMIN H)

Benefits of Vitamin B7:

Vitamin B7 (biotin) helps metabolize carbohydrates, and fats for energy and plays an essential role in the formation of protein: the building blocks of our body.

GI: B7 helps liver function

Glucose: May help maintain normal glucose levels

Skin: Promotes healthy skin, strengthens nails and hair, may prevent hair loss, may help with hair regrowth

Neuro: Helps with nervous system functioning; may help with neuropathic pain

Signs and Symptoms of Excess: This is rare because because excess is eliminated in the urine however there are rare cases which may cause a rash, flushing, itching, stomach upset and possibly kidney problems (among others).

Signs and Symptoms of Deficiency: This is generally pretty rare but symptoms of B 7 deficiency may include thinning hair/hair loss, scaly facial rashes around the eyes, nose and/or mouth and brittle nails, cracking in the corners of lips. appetite loss, neurologic symptoms (if chronic).

Causes of B7 Deficiency: Excess alcohol intake, raw eggs in the diet (binds with B7), inborn metabolic problems, certain antibiotics, inflammatory bowel disease, some anti-seizure medications, smokers, Accutane use, and severe malnutrition,among others.

Side Effects in Normal Doses: Bad taste in mouth, nausea, loss of appetite, irritability, confusion and sleep disturbance. In allergy: Possible rash, itching, shortness of breath

Sources of Vitamin B7: Beef liver, fish, cooked eggs, salmon, nuts, seeds, spinach, avocado, pork, sweet potatoes, cereals, mushrooms, rice

Caution: May cause false lab results in blood levels of vitamin D, triponin (enzyme used to measure possible heart attack). Others include T4, TSH level (labs which measures thyroid functions), hormones (false testosterone level, FSH, LH) and parathyroid hormone, PSA (prostate levels), vitamin B12, folate, some antibodies (i.e. hepatitis A, B and C).

B9 (FOLATE) (FOLIC ACID)

Benefits of B9 (folic acid): Like the other B vitamins, folic acid (B9) also supports integral functions of the body. It helps in the formation of red blood cells, helps in processing of proteins and tissue growth; especially in the formatioren of DNA and nervous system function, among others. 

Folic acid is also essential in the proper development of a fetuses neural tube (brain and spinal cord development): Without enough folate, babies can be born with spina bifida - a problem with spinal nerve development which, depending on the severity, can result in disability. 

Currently, there is some research focused on the off-label use of folic acid for autism. It  will be interesting to see the results.

Eyes: May slow macular degeneration in the elderly (when taken with B12)

Ears: Possibly reduces age-related hearing loss

Cardiac: Decreases the risk of heart disease

Skin: May slow aging skin

Cancer: May protect against certain cancers:

Mental Health: Depression and other mood problems

Neurological: Helps nervous system functioning, possibly helps decrease risk of dementia, may help decrease nervous tics.

Other: Certain anemias

Signs and symptoms of Excess: Nausea, vomiting, diarrhea, stomach upset, bloating, gas, bad taste in mouth, dermatitis (skin irritation)behavior changes, confusion, excitation, seizures, may accelerate cognitive decline in elderly, may increase of cancer recurrence, sleep disturbance

Signs and Symptoms of Deficiency:

Inflammation of the tongue (redness) and/or gums, sores in the corners of the lips (angular cheilitis), mouth sores, poor growth, appetite loss, nausea, vomiting, abdominal pain, diarrhea, shortness of breath, irritability, earing loss, tinnitus, memory loss, concentration problems, mental sluggishness

Causes of vitamin B9 Deficiency: Alcoholism, absorption problems (i.e.inflammatory bowel disease), celiac disease, hemolytic anemia, decrease in estrogen during menopause, decreased intake, use of trimethoprim, use of methotrexate and others.

Sources of Vitamin B9:

Dark leafy greens, broccoli, brussels sprouts, asparagus, peas, avocado, oranges, whole grains/whole wheat products, wheat germ, bulgur wheat, beef liver, salmon, asparagus, turnips, beets, beans (lima, soy, kidney, white, lima, mung, lentils, garbanzo beans), milk

Caution: Kidney disease/dialysis, seizure disorder; liver disease, pernicious or hemolytic anemia, infection, alcoholism, concurrent use of certain drugs, barbiturates, anticonvulsants, methotrexate, and anti-malaria medication pyrimethamine, nitrofurantoin, tetracycline

B12 (COBALAMIN)

Benefits of B12: Vitamin B12 supplements seem to be the rage these days because they are instrumental in supporting our much sought after energy. B12 does help convert food into energy; it aids in neurotranssion and nerve function, including mood maintenance. It helps convert food to energy; is instrumental in DNA synthesis, red blood cell formation and breaks down homocysteine - a cause of heart disease.

Eyes: Dry eyes, macular degeneration

Ears: B12 injections may help ringing in the ears

Cardiovascular: Reduces homocysteine - an amino acid that , in normal levels is good but in excessive levels can cause cardiovascular damage, stroke and blood clots if it is too high.

Skin: If related to a vitamin B12 deficiency, B12 help with vitiligo, hyperpigmentation, and tongue inflammation (smooth, sore tongue)

Cancer: Decreases risks for some cancers

Mental Health: Helps concentration, enhances memory

Neurologic: Helps nerve function and prevents nerve damage. May help periheral neuropathy

Others: Contributes to red blood cell production

Signs and symptoms of Excess: Acne, rosacea, muscle weakness, fatigue, headaches,mental changes (depression, irritability), palpitations, stomach issues (nausea, vomiting,diarrhea). Excessive vitamin B12 eliminated in the urine: It is not stored in the body. Therefore excess is not common but can happen.

Signs and Symptoms of deficiency: Some of these are similar to symptoms of B12 excess. Weakness, fatigue, depression, confusion, decreased memory and concentration, appetite loss, weight loss, pallor, heart palpitations, infertility, numbness/tingling of the extremities/neuropathy, imbalance, depression, moodiness, headaches, and soreness of the mouth, tongue, or mouth sores.

Causes of deficiency: Malabsorption: Over 50 (change in acidic content of the stomach causes less absorption), atrophic gastritis, pernicious anemia, intestinal surgery - including bariatric surgery to lose weight; intestinal problems like celiac disease, Crohn; vegans and vegetarians, use of metformin and or protein pump inhibitors (PPI's-like omeprazole [Prilosec], Nexium, pantoprazole [Protonix],  Lansoprazole  [Prevacid], and Aciphex).

Risk for Vitamin B12 deficiency:  Aging (less absorption); other absorption problems (i.e.  Crohn's) people on metformin or taking PPIs (protein pump inhibitors) for GERD, Celiac, vegans and vegetarians, some immune disorders (i.e. lupus), pernicious anemia and alcoholics.

Sources: Eggs, cheese, milk, fish, shellfish, cured ham, soy, beef liver, red meat, poultry, lamb, pork, chicken, clams, mussels, oysters, nutritional yeast, fortified cereals

Note: Vitamin B12 levels can be evaluated through simple blood tests (which can also be done at home).