Vitamin B

The biochemical actions of the Bs are truly multifarious, affecting every organ system and all aspects of our health - Pamela Weintraub

Vitamin B

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In the constellation of vitamins, D has been the rising star. Many doctors now accept the D deficit as a cause of bone loss, fatigue, increased risk of heart disease and even cancer, and they routinely test and treat their patients for this deficiency.

Amid the D mania, though, a quieter movement has emerged: An increasingly vocal group of nutritionists and integrative practitioners argue that B vitamins play a critical role in heart health and immunity, and also provide widely effective treatments for headache, fatigue, mood, stress and menstrual disorders.

“B vitamins are real multitaskers and are involved in so many critical processes,” says Kathie Swift, MS, RD, LDN, nutrition director for Food As Medicine, a professional training program at The Center for Mind–Body Medicine (CMBM) in Washington, D.C. “They are sparkplugs in everything from energy metabolism to detoxification to mood to immunity and gut health.”

Despite all this versatility, there’s plenty of debate in the medical community — especially between conventional and integrative practitioners — about how much vitamin B we actually need to stay healthy. And, even among those who agree that the Bs are vital to our well-being, there are wide variations in how they are integrated into a treatment regimen. What we do know, however, is how the Bs work in our body, and that can help us make better decisions should we find ourselves needing to ramp up our daily dosage down the road.

Given how critical B vitamins are to our health and well-being, it’s clear we need to guard against running too low. But, in terms of how common various B deficiencies actually are, the medical community has been embroiled in a bit of a dispute.

Brent Bauer, MD, director of the Department of Internal Medicine’s Complementary and Integrative Medicine Program at the Mayo Clinic in Rochester, Minn., points to three especially high-risk groups who are prone to B deficiency:

  • Those over age 65, who are less efficient at absorbing vitamin B-12 through ordinary digestion because of a decrease in the acidity of the stomach.
  • Vegetarians, who often miss out on major sources of B-12 in their daily meals.
  • Smokers and drinkers, who may find themselves deficient in B-6.

These people often need supplements for better health. Yet, outside of these special groups, many conventional doctors assert, the recommended daily allowance (RDA) is adequate for most of us. Other practitioners, however, vehemently disagree. They argue that B deficits are far more widespread — and that chronic, low-grade deficiencies pose a serious threat to public health.

Tom Petrie, BS, CDN, nutritionist at the Schachter Center for Complementary Medicine in Suffern, N.Y., for example, says that people under life stress are at risk, as are adolescents feasting on junk food. James Gordon, MD, clinical professor of psychiatry at Georgetown Medical School and author of Unstuck: Your Guide to the Seven-Stage Journey Out of Depression (Penguin, 2008), agrees: “With all our processed food, up to 60 percent of Americans have a B-vitamin deficit.”

Burt Berkson, PhD, MD, director of the Integrative Medicine Center of New Mexico in Las Cruces and coauthor of User’s Guide to the B-Complex Vitamins (Basic Health Publications, 2005), agrees that most of us are woefully deficient. “Most Americans could probably benefit from taking up to three times — or more — of the RDAs for many of the B vitamins,” he writes.

So why the big debate? It may be a matter of perspective: Is the practitioner aiming to cure a disease or boost and achieve an optimal level of health? “The RDA values were calculated more than 60 years ago during World War II,” writes Berkson, “and their original purpose was not to maximize health and nutrition, but to provide the minimum amounts necessary to avoid flagrant disease.”

For physicians like Gordon, who rely on B vitamins to enhance energy and optimize mood, blood levels deemed adequate by mainstream doctors often turn out to be seriously low. Keeping a steady supply of B vitamins in the body requires ingesting them daily, because unlike fat-soluble A and D vitamins, water-soluble Bs are not stored by the body. Any Bs not promptly absorbed are washed away.

Long ago, B vitamins were considered a single vitamin — just as vitamins C and D are today. But now scientists understand the Bs as a complex of chemically distinct vitamins often found in the same foods and frequently functioning together as a group.

The biochemical actions of the Bs are truly multifarious, affecting every organ system and all aspects of our health. But a few roles stand out: Bs are crucial to methylation, the process by which protein and DNA are produced and sustained in the body; they can lower levels of the amino acid homocysteine, helping us with heart health; and they are pivotal in creating neurotransmitters responsible for brain function and mood...

The story behind the Bs is nothing if not complex, starting with which nutrients fall into the B category at all.

“The vitamin B-complex consists of 11 nutrients that have similar roles in acting as coenzymes in production of energy and in the metabolism of proteins, fats and carbohydrates,” explains Tom Petrie, BS, CDN, nutritionist at the Schachter Center for Complementary Medicine in Suffern, N.Y. But, those 11 nutrients are divided between the eight classic Bs — B-1, B-2, B-3, B-5, B-6, B-7, B-9 and B-12 — and the three nutrients that are considered honorary B vitamins because they meet some but not all of the requirements of a classic B: para-amino benzoic acid (PABA), inositol and choline...

We know the B vitamins are critical to our health and well-being, but is it possible to overdo them? Take a look at the list below to find out.

B-1, Thiamin: No known adverse reactions to higher doses recorded in the literature.

B-2, Riboflavin: Intake many times higher than the RDA causes no known adverse reactions, but possible reactions to much higher doses include numbness, itching, burning/prickling sensations and dark yellow urine.

B-3, Niacin: If you buy your B-3 over the counter and treat yourself, you’re unlikely to have side effects with daily intake below 50mg. If you require more, make sure you are under a doctor’s supervision, because side effects, especially facial flushing, may result. If you are on niacin therapy, be sure to monitor liver enzymes.

B-5, Pantothenic acid: No known adverse reactions to moderate doses. However, larger doses may cause diarrhea and actually inhibit the absorption of B-7, Biotin.

B-6, Pyridoxine: Large doses of over 100 mg daily, taken over long periods of time, may cause nerve damage.

B-7, Biotin: Biotin is not known to be toxic. Oral biotin supplementation has been well tolerated in doses up to 200,000 mcg/day in people with hereditary disorders of biotin metabolism. In people without disorders of biotin metabolism, doses of up to 5,000 mcg/day for two years were not associated with adverse effects.

B-9, Folate or folic acid: High doses of B-9 can mask a B-12 deficiency, allowing associated nerve and cognitive deterioration to proceed unchecked. This can be remedied by taking a supplement that contains 100 percent of the Recommended Daily Allowance of both B-9 and B-12.

B-12, Cyano-cobalamin: No known adverse reactions to higher doses.

PABA: Can damage the liver at high doses. Also associated with nausea, vomiting and allergic-type reactions. Can block action of sulfa-containing antibiotics.

Inositol: High doses may result in diarrhea.

Choline: High doses (10 to 16 grams/day) have been associated with a fishy body odor, vomiting, salivation and increased sweating.

Source: Pamela Weintraub, Excerpt from All About B Vitamins, Experience Life, September 2010.

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Last Updated : Thursday, December 17, 2020