B Vitamins - You May Be Deficient and Not Know It.

Article by Zoltan Rona, MD, MSc author of Vitamin D and other great health books.
While not as glamorous as ginkgo biloba, ginseng or St. John’s wort, the B vitamins are far more important for the optimal functioning of the brain, spinal cord and the nervous system than any other nutrient or herbal remedy.

While glucosamine sulfate, chondroitin sulfate and shark’s cartilage are grabbing the headlines in osteoarthritis reversal, we often forget that equally exciting (and less expensive) results can be achieved in osteoarthritis with high doses of several B vitamins, including niacinamide and vitamin B12. And, did you know that the often overlooked B vitamin, biotin, can not only help prevent hair loss, fragile nails and certain types of dermatitis but that it can also fight yeast or fungal infections?

The B-complex vitamins are a group of similarly structured water-soluble compounds that are not stored in the body and must be supplied on a daily basis from the diet or through supplementation. They consist of B1 (thiamine), B-2 (riboflavin), B-3 (niacin, niacinamide), B-5 (pantothenic acid), B-6 (pyridoxine), B-7 (biotin), B-12 (cobalamin), and folic acid (B-9, folate or folacin). PABA, inositol and choline are often included as part of the B complex. The B-complex of vitamins are used in the proper formation of every cell in your body - particularly the heart, liver and nerve cells.

B-complex vitamin deficiencies occur far more easily and frequently than has been generally assumed, especially in people on weight loss diets, fasts, high daily intakes of sugar, refined and processed foods as well as caffeine, saccharine and alcohol. People under stress or on a long list of medications, especially antibiotics, diuretics, chemotherapy, the birth control pill, hormone replacement therapy and others may be at high risk to develop B vitamin deficiencies.

B-complex vitamins are commonly found together in foods and have similar coenzyme (catalysts for enzyme reactions) functions, often needing each other to perform specific metabolic tasks. Some of the B vitamins (B-12 and biotin) can also be made in the body by the friendly microbes (bacteria, yeast, fungi, molds) in the large intestine. The majority of the B vitamins, however, are obtained from food and then absorbed into the blood, mainly from the small intestine. If we consume too many B vitamins, the excess is excreted through the urine and the skin (perspiration). These excesses, with rare exceptions like B-3 (niacin), are quite harmless and often helpful, especially for those suffering from various suboptimal mental processes.

SUMMARY
B vitamins are vital for: health of the skin, bones, hair and muscle; health of the mucosal membranes, particularly around the mouth; intestinal health and bowel function; optimal blood sugar control; relief of moodiness, restlessness, irritability, insomnia, and fatigue; improved liver and cardiovascular system; health brain cell function and health; relief from skin problems, including dry and itchy skin and rashes; and relief from PMS, nausea, muscular weakness and sore or dry mouth and tongue.

The B vitamins are found in many foods, occurring together, never in isolation. While the richest natural source of B vitamins is brewer's yeast, or nutritional yeast, this is not necessarily an ideal food for many hypersensitive people. Other good sources of the B vitamins are the germ and bran of cereal grains, green vegetables, beans, peas, liver, most animal foods and nuts.

The B vitamins function primarily as coenzymes that catalyze many biochemical reactions in just about every cell in the body. They create energy by converting carbohydrates to glucose and also are important in fat and protein/amino acid metabolism. The B complex vitamins are very important for the normal functioning of the nervous system, their anti-stress effects and energy boosting properties. They are also important for the health of the liver, heart, skin, hair, eyes and the mucosal linings, especially in and around the mouth. The B vitamins are also vital for the general muscle tone of the gastrointestinal tract, which allows the bowels to function at their best.

Single B vitamin supplementation is not generally recommended because the functions of the B vitamins are so interrelated. In therapeutic dosages, they are best taken as a B-complex to relieve stress, fatigue, anxiety, nervousness, insomnia, hyperactivity, many kinds of skin problems, especially dry or itchy dermatitis rashes, or cracks at the corners of the mouth. Isolated B vitamin supplements may be therapeutically useful for conditions such as vitiligo, which may be helped by higher dosages of PABA (3000 mg. or more daily) in addition to a balanced B-complex supplement. Similarly, High doses of B-6 for PMS and B-1 for alcohol-induced organ damage are therapeutically helpful.

Practically all the B-complex vitamins are involved in the treatment of anxiety and depression. The most important of these are B1, B3, B6, B12 and inositol. When using high doses of individual B vitamins, they must always be in conjunction with all the other B vitamins in relatively high doses to prevent or reduce side effects as well as deficiencies in those B vitamins not supplemented. For example, if using vitamin B1 in doses of 1000 mg. daily, take a B complex of at least 100 mg of most of the other Bs at the same time.

ANXIETY, DEPRESSION AND B-COMPLEX VITAMINS
B1 (Thiamine)–(500 –3000 mg. daily) reduces or eliminates irritability, disordered thinking and mental confusion in otherwise healthy people. Clinically indicated in Alzheimer’s disease, depression, insomnia, memory loss, alcoholism and all anxiety disorders.

B3 (Niacin) –(500 –3000 mg. daily) - is recommended for circulatory problems and lowering triglycerides and cholesterol. Niacinamide does not work in this fashion and is more applicable to anxiety, nervousness and irritability. Niacinamide is effective treatment for anxiety, insomnia, depression and other nervous system problems commonly seen in people who suffer from hypoglycemia and/or diabetes. Dementia, irritability, headaches, mental confusion, attention deficit disorder, hallucinations, amnesia, certain forms of schizophrenia and severe depression can all be signs or symptoms of B3 deficiency.

Adverse Effects and Toxicity: hepatitis has been observed with the time released form of niacin; Inositol hexa-nicotinate (contains 6 molecules of niacin and 1 molecule of inositol) does not cause flushing or hepatitis. Caution when taking more than 1000 mg. Of niacin per day as it may elevate liver enzymes, which should be monitored during niacin therapy - if elevated, cut back on dosage.

Nausea is first sign of toxicity with both niacin and niacinamide. Flushing occurs with niacin, so it’s best taken with food. Other adverse effects of high dose niacin are gastritis, elevated uric acid levels and reactivated peptic ulcers, the latter of which can be prevented by taking L-glutamine (4000 mg. with each dose) to repair any gastrointestinal damage.

B6 (Pyridoxine) –(100 –1000 mg. daily) –is clinically effective in practically all anxiety and depression related psychiatric illnesses including anorexia nervosa, attention deficit disorder, autism, bipolar disorder, PMS, chronic fatigue syndrome, fibromyalgia, hyperactivity and dementia. Caution should be taken as some reports of peripheral neuropathy (numbness, tingling, loss of sensation) have been reported with large doses of vitamin B6. This can be reversed by either lowering the dose of B6 or increasing the relative doses of the other B-complex vitamins.

Vitamin B12 (Cobalamin) –(1000 –3000 mcg. daily). B12 goes by many names: Cyanocobalamin - oral, sublingual, or intranasal administration of B12 is only rarely effective; Hydroxycobalamin - injectable - is longer acting and achieves higher B12 levels than cyanocobalamin; Methylcobalamin –oral lozenges - brain active form especially useful for mercury toxicity and other neurological problems (M.S., chronic pain syndromes). The most spectacular benefits of B12 are seen with depression, chronic fatigue, memory loss, neuropathy and bipolar disorder. Although effective against anxiety, other B vitamins, especially B3 in high doses appears to be most effective.

Inositol –(1000 –6000 mg. daily) has been reported in recent psychiatric journals to be as effective as prescription anti-depressant and anti-anxietydrugs without the side effects. The powdered form is most effective but also the costliest (equivalent in price to most commonly prescribed anti-depressants). One side benefit in large doses is that it helps remove fat from the liver.

References
Gaby, A.R., M.D., Wright, J.V., M.D.; Nutritional Therapy in Medical Practice, Reference Manual and Study Guide2000 Edition; Wright/Gaby Seminars; Kent, WA; 2000.
Levine, J. Controlled trials of inositol in psychiatryEur Neuropsychopharmacol, 1997 May, 7:2, 147-55

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