IV Vitamin Center | 703-844-0184 | Fairfax, Va 22306 | B Vitamins | IV Ketamine Treatment Center | Ketamine for Depression and Pain | Loudon Va Ketamine | 703-844-0184 Call for an appointment

IV Vitamin Center | 703-844-0184 | Fairfax, Va 22306 | B Vitamins | IV Ketamine Treatment Center | Ketamine for Depression and Pain | Loudon Va Ketamine | 703-844-0184 Call for an appointment

 

B vitamins

 

  • Thiamine or B1’s major role is to act as a coenzyme (helps catalyse a reaction) involved in the breakdown of sugars and amino acids. Found most readily in whole grains.
  • Riboflavin or B2 acts as coenzyme and plays a major role in the production of ATP, the bodies “energy currency.” Liver, milk, mushrooms, spinach and almonds are all rich sources of riboflavin.
  • Niacin is the most common form of vitamin B3, with nicotinamide being another common form. As with riboflavin, both niacin and nicotinamide play an important role in the generation of ATP, but are also important in the break down of dietary fats, carbohydrates and proteins. Turkey, chicken breast and peanuts are all high in Niacin.
  • Pantothenic acid or B5 is a cofactor used in the synthesis of coenzyme A, which is important in the synthesis of fatty acids and the generation of ATP. As the “pan” in its name would suggest, pantothenic acid is found in nearly every food, in part because it is so vital to life.
  • Pyridoxine or B6 is vital in the synthesis of amino acids and important neurotransmitters such as serotonin, dopamine and GABA. Through the AOC1 gene, B6 is also a cofactor for the production of diamine oxidase, the enzyme that breaks down histamine in the gut.
  • Biotin or B7 helps to maintain healthy blood sugar level. Biotin is commonly recommended as a dietary supplement for the strengthening of nails and hair. Leafy greens, nuts and egg yolks are all rich in biotin.
  • Found in leafy greens, Vitamin B9 is perhaps the most famous of all the B vitamins due to its importance role in pregnancy and early infancy.
  • Hydroxocobalamin or B12 has many essential functions, but it seems to also play an important role in the maintenance of adult neurological tissue in the brain. Animal proteins and foods have the highest B12.
  1. A vitamin must be an organic compound, very simply this means it must contain at least one carbon atom.
  2. Vitamins must be vital to life, i.e. without it a person could not survive.
  3. They are required in limited amounts, this definition is the most woolly as there is no hard description of what “limited” refers to.
  4. Finally, vitamins cannot be synthesized by a person in sufficient quantities, i.e. they must come from the diet.

What are vitamins?

We’ll start with iron. Whilst it ticks the latter three points, iron falls at the first hurdle as it doesn’t contain a carbon atom. A compound containing both iron and carbon (such as iron carbonate) passes this check, but then fails on the vital to life aspect, as whilst iron is vital to life, iron carbonate is not.

OK, let’s pick something a bit more complex. Glucose is a simple carbohydrate, is definitely vital to life, and since it contains six carbon atoms it passes that point as well. But it falls down on the other two points, firstly because it can be synthesised in the body from the longer complex carbohydrates and fats that we eat, and secondly because it is required in large amounts to provide energy.

Let’s try one more example, ascorbic acid or Vitamin C, a very famous vitamin indeed. Containing six carbon atoms it passes the first point, it is defiantly vital to life as it plays a key role in tissue maintenance and repair. Indeed, diseases such as scurvy, characterised by breakdown of the bodies tissues, rapidly appear in the absence of ascorbic acid.The exact amount required isn’t known but estimates range from 60-100 mg per day.Finally, ascorbic acid cannot be synthesised directly by humans, rather we must obtain it from food (citrus fruits and tomatoes are especially rich) or via supplements. It ticks all the boxes and so is classed as a vitamin. Interestingly, most plants and animals on the planet can synthesise ascorbic acid, whereas humans and a few other species can’t. So, whilst ascorbic acid is a vitamin for us, it isn’t for most other species.There are currently thirteen recognized vitamins. Vitamin A, C, D, E and K and 8 types of B vitamin. The functions of these vitamins is very diverse, for example vitamin C is important in tissue repair, whereas vitamin D  is important for regulating bone mineral metabolism.

The B Vitamins

B vitamins are a class of water (as opposed to fat) soluble vitamins which play an important role in many cellular processes. When present in supplements individually, B vitamins are referred to by their individual name, for example, vitamin B1. When all are present they are often termed “vitamin B complex.”

Below is a quick summary table of the B vitamins, but I’ll give more info about the role of each, the potential harmful effects arising from a lack of each, and where available, information about the recommended daily amount of each.

Vitamin Alternative Name Brief Function
B1 Thiamine Breakdown of sugars and amino acids
B2 Riboflavin DNA repair, ATP (the energy currency of the body) generation
B3 Niacin ATP generation
B5 Pantothenic acid Breakdown of sugars and amino acids, synthesis of fatty acids and amino acids
B6 Pyridoxine Synthesis of amino acids
B7 Biotin Fatty acid synthesis, break down of sugars
B9 Folic acid DNA synthesis and repair, important for rapid cell division
B12 Hydroxocobalamin DNA synthesis and repair, fatty acid and amino acid synthesis

 

Vitamin B1 – Thiamine

Thiamine’s major role is to act as a coenzyme (helps catalyse a reaction) involved in the breakdown of sugars and amino acids into their constituent parts. These are then available to be used to make other molecules required by the body.

As such, a severe deficiency in thiamine can prove fatal with symptoms including weight loss, loss of sensory perception, weakness, pain, increased heart rate, and shortness of breath. These symptoms are sometimes taken together and classed as Beriberi disease, although it is also commonly referred to as thiamine deficiency. Whilst very severe cases are rapidly identified, low level occurrences of these symptoms can pass un-noticed for many years or often be misdiagnosed [1].

However, a relatively simple blood test is possible.

Thiamine is readily available in many foods, including numerous food containing yeast based products or cereal grains, in particular those containing the wholegrain. Other rich food sources include asparagus, kale, liver and eggs. For adults the Recommended Dietary Allowances (RDA) are 1.2 mg in men and 1.0 mg in women, rising to 1.4 mg during pregnancy and breastfeeding.

A Review of the Biochemistry, Metabolism and Clinical Benefits of Thiamine

Thiamin in Clinical Practice

Nutritional Status of Bariatric Surgery Candidates

Nutrition in Pregnancy Following Bariatric Surgery

 

Vitamin B2 – Riboflavin

Riboflavin acts as coenzyme and plays a major role in the production of ATP, the bodies “energy currency”. Deficiencies in riboflavin are uncommon in the West as many of our foods are enriched during their processing. However, when Riboflavin deficiency is present, symptoms can include inflammation of the skin, especially around the lips and the mouth, light sensitivity and anaemia. In very severe cases there is a severe lack of energy which eventually leads to the collapse of the bodies systems. However, this is incredibly rare and often associated with severe malnutrition [2].

Outside of the widely available fortified foods, liver, milk, mushrooms, spinach and almonds are all rich sources of riboflavin. The RDA for men over the age of 14 is 1.3 mg per day and 1.0 mg per day in women rising to 1.4 mg during pregnancy and 1.6 mg during breastfeeding.

Interestingly, when added to a B complex formula or a multivitamin, B2 seems to have a protective effect against an increased cancer risk associated with high doses of certain B vitamins.

Vitamin B3 – Niacin

Niacin is the most common form of vitamin B3, with nicotinamide being another common form. As with riboflavin, both niacin and nicotinamide play an important role in the generation of ATP, but are also important in the break down of dietary fats, carbohydrates and proteins and the synthesis of carbohydrates and fatty acids.

As with riboflavin, deficiency of niacin leads to the development of inflammatory disorders, but also similarly to riboflavin this is now incredibly rare in the West due to fortification of foods [3].

One interesting usage of niacin, but not nicotinamide, is as a lipid-lowering medication. Acting to reduce the amount of low-density lipoproteins and increase the amount of high-density lipoproteins.

Foods rich in niacin include liver, tuna, salmon, avocados, leafy vegetables, dates and wholegrain cereals. The RDA for men is 16 mg per day and 14 mg per day for women with an upper limit of 35 mg per day for each. At doses exceeding this there are some mild side-effects including facial flushing whereby blood rushes to the face causing a redness and tingling.

Vitamin B5 – Pantothenic acid

Pantothenic acid is a cofactor used in the synthesis of coenzyme A, which is important in the synthesis of fatty acids and the generation of ATP. As the “pan” in its name would suggest, pantothenic acid is found in nearly every food, in part because it is so vital to life.

Deficiency in pantothenic acid is virtually unheard of as it is so prevalent in the diet, although some small trials have described similar effects to those seen with other B vitamin deficiencies [5].

The RDA for pantothenic acid has been set at 5 mg per day for men and women, increasing to 7 mg per day for pregnant and breastfeeding women. No upper limit or side effects have been described.

Vitamin B6 – Pyridoxine

Pyridoxine is vital in the synthesis of amino acids and important neurotransmitters such as serotonin, dopamine and GABA. Deficiency of pyridoxine gives rise to similar symptoms described above including inflammation and a lack of energy or confusion. Although severe deficiency is uncommon low level deficiency can be relatively common and as with other B vitamin deficiencies can be missed or misdiagnosed.

Foods rich in pyridoxine include chick peas, bananas, pork and beef. The RDA for pyridoxine is 1.7 mg per day for men and women rising to 2.0 mg per day for pregnant and breast feeding women. As with all B vitamins pyridoxine is water soluble meaning that excessive doses are often passed out in urine. However, continued very high doses of pyridoxine are associated with very severe side effects including the development of heart arrhythmia and neurological damage. Confusingly, the maximum recommended dose varies quite widely, set at 10 mg per day in the UK, 25 mg per day by the EU and 100 mg per day in the US.

Vitamin B5 – Pantothenic acid

Pantothenic acid is a cofactor used in the synthesis of coenzyme A, which is important in the synthesis of fatty acids and the generation of ATP. As the “pan” in its name would suggest, pantothenic acid is found in nearly every food, in part because it is so vital to life.

Deficiency in pantothenic acid is virtually unheard of as it is so prevalent in the diet, although some small trials have described similar effects to those seen with other B vitamin deficiencies [5].

The RDA for pantothenic acid has been set at 5 mg per day for men and women, increasing to 7 mg per day for pregnant and breastfeeding women. No upper limit or side effects have been described.

Vitamin B6 – Pyridoxine

Pyridoxine is vital in the synthesis of amino acids and important neurotransmitters such as serotonin, dopamine and GABA. Deficiency of pyridoxine gives rise to similar symptoms described above including inflammation and a lack of energy or confusion. Although severe deficiency is uncommon low level deficiency can be relatively common and as with other B vitamin deficiencies can be missed or misdiagnosed.

Foods rich in pyridoxine include chick peas, bananas, pork and beef. The RDA for pyridoxine is 1.7 mg per day for men and women rising to 2.0 mg per day for pregnant and breast feeding women. As with all B vitamins pyridoxine is water soluble meaning that excessive doses are often passed out in urine. However, continued very high doses of pyridoxine are associated with very severe side effects including the development of heart arrhythmia and neurological damage. Confusingly, the maximum recommended dose varies quite widely, set at 10 mg per day in the UK, 25 mg per day by the EU and 100 mg per day in the US.

 

Vitamin B7 – Biotin

Biotin is required for the production of fatty acids, and the break down of sugars, potentially to maintain blood sugar level. Biotin is commonly recommended as a dietary supplement for the strengthening of nails and hair. These claims arise from the fact that these symptoms arise when biotin is deficient, as well as other more common B vitamin deficiencies including inflammation of the skin. However, data supporting a beneficial effect in those already obtaining the required amount of dietary biotin is weak [6,7].

Whilst severe deficiency is rare, mild deficiency may be relatively common due to dietary deficiencies. Rich dietary sources include leafy green vegetables, nuts and egg yolks (but not the whites which contain avidin which neutralises biotin). Importantly there is no current RDA for biotin, rather there are “Adequate Intakes” which are meant to act as a guide until better information is available. These are currently set at 30 μg per day for both men and women.

Vitamin B9 – Folic acid

Vitamin B9 is perhaps the most famous of all the B vitamins due to its importance role in pregnancy and early infancy. Folic acid is converted into tetrahydrofolic acid which acts as a cofactor in many cellular reactions, but especially the synthesis of amino acids and nucleic acids, vital for rapid cell division. Times when rapid cell division is important? During pregnancy and early infancy, and also in the production of red blood cells which have a rapid turnover within the body.

As you can imagine a deficiency of folic acid is associated with some poor health effects. In pregnancy a lack of folic acid was linked with the risk of neural tube and congenital heart defects which are a major causes of miscarriage and early infant death [8,9]. As such folic acid supplementation is strongly recommended before and during pregnancy and also in the babies diet after birth.

Outside of pregnancy folate deficiency can lead to a variety of symptoms including depression, confusion, anaemia and fatigue [10]. Anaemia caused by a lack of red-blood cell production may be the major symptom here driving the development of the other symptoms such as depression and fatigue as the brain is not being supplied with sufficient energy.

Foods rich in folic acid include leafy green vegetables such as spinach or kale as well as citrus fruits and many cereals. Fortified bread The RDA for folic acid varies by age and sex. For those over 14 years old a dose of 400 μg (micro-gram) per day is recommended, increasing to 600 in pregnant women and 500 in breastfeeding women. An upper limit of 1,000 μg per day has been recommended although no harmful effects have been associated with high levels of consumption. Interestingly there is some suggestion that high intakes of folic acid can mask vitamin B12deficiency which can be much more serious, although no in-depth study has yet been performed [11].

Vitamin B12 – Hydroxocobalamin

Finally, to hydroxocobalamin. The most important role of hydroxocobalamin is in the synthesis of DNA in a similar fashion to folic acid, hence why it is possible for an excess of folic acid to mask a deficiency of hydroxocobalamin. Whilst there is a large overlap in function between the two hydroxocobalamin seems to also play an important role in the maintenance of adult neurological tissue in the brain. As such a deficiency can lead to several severe neurological disorders such as a loss of sensation, dementia and other neurological conditions, which unlike other vitamin B deficiencies may not be reversible [12,13].

Most animal derived foods including fish, meat, poultry and eggs is rich in hydroxocobalamin meaning vegetarians of vegans are strongly recommended to supplement their diet. A RDA of 2.4 μg per day for men and women has been set, rising to 2.8 μg per day in pregnant and breastfeeding women. No adverse effects have been associated with excess vitamin B12 intake from food or supplements in healthy individuals.

Vitamin B12 dosing

To begin, Vitamin B12 seems to be the most popular B vitamin to supplement with, and the market has responded with mega dose supplements everywhere. These supplements usually list their doses in terms of micrograms. You’ll most commonly see 1,000 and 5,000 mcg doses. This converts to 1 mg and 5 mg respectively.

Tying this back into the JAMA study, we see that a 1 mg dose is more than double the 0.4 mg dose of B12 that was associated with an increased risk of cancer in the Norwegian population. 1 mg of B12 represents 16,667% of your daily B12 intake. So, in the world of B12 supplements, we want a product that offers methylcobalamin (the quality form of B12) and a dose of 500 mcg or less.

Good luck.

Most of the products on the market are made with at least 1,000 mcg.

This B12 product by Nature’s Way is made with only 500 mcg, but Nature’s Way uses cyanocobalamin, which is cheap B12 that we want to avoid.

Then you have products like this one from Jarrow, which uses 5000 mcg of methylcobalamin, which is way too large of a dose for regular use.

Now let’s turn our attention to B complex products. That’s probably where we want to play anyway because of the potential protective effect of B2.

Good B Complex products

It is important to keep in mind that you may not need a B vitamin supplement at all. Although many who have MTHFRmutations feel better on a methyl folate supplement, side effects are also common. be sure to discuss the pros and cons of taking B vitamins with your doctor before starting with any of these products.

Pure Encapsulations B Complex Plus

Pure Encapsulations B Complex Plus is one of my favorites. It has a relatively conservative dose of a high quality B12 (methylcobalamin) at 400 mcg, and also offers 400 mcg of folate (methylfolate), which cuts the 0.8 mg dose of folic acid from the JAMA study in half. Pure also adds B2 to the formula which, based on the data, we have theorized could be protective.

Thorne Research Stress B Complex

However, as much as we like the Pure B Complex, Thorne Research makes my favorite B complex supplement because the dosing is so conservative, even more so than the Pure product. If you want to “push the envelope” in a safe way, Pure is a good option, but if you want to supplement with B vitamins and play it very safe, I would opt for Thorne.

The B12 dose (methylcobalamin) is only 100 mcg, which I love, and the folate dose is 334 mcg, again well below the dose used in the JAMA study. Thorne adds B2 to the formula, but the one thing I don’t like about the Thorne product is the high dose of B6 which comes in at 28.4 mg. This is a very large dose that I would not take for extended periods of time. The Thorne B complex, like most B complex supplements, should be cycled on and off.

Take home message

 

 

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