B Vitamin Deficiency: Are You at Risk?

By Dr. Linda J. Dobberstein, DC, Board Certified in Clinical Nutrition

October 26, 2015

B Vitamin Deficiency: Are You at Risk?
Are you at risk for a B vitamin deficiency? The answer is undoubtedly yes. B vitamins are essential nutrients that must be obtained from the daily diet. Healthy gut bacteria like Lactobacillus help with the production of vitamin B12 and folate, but dietary intake must meet the needs and demands of all the others. Low B vitamin intake affects every facet of health and function in the body.

A myriad of health concerns and disorders are related to B vitamin insufficiency. Stress, caffeine, alcohol, sugar, digestive problems, numerous medications and more deplete B vitamins. Replenishment of these fundamental B vitamins is essential and critical to good health. Researchers continue to delve into understanding the vast functions of B vitamins. There are some surprising insights into just how important B vitamins truly are.

Vitamin B1, Thiamin

A modern diet filled with high carbohydrate intake, especially simple sugars, depletes the critical, often forgotten about B vitamin, thiamin. Depletion of thiamin can cause muscle soreness from lactic acid accumulation, muscle weakness and loss of muscle, trouble focusing eyes, swelling in the legs, loss of balance, and frequently bumping into things. Thiamin plays a fundamental role in heart function, rhythm and cardiac energy production. Fatigue, memory and and focus problems, problems with appetite, and increased pain sensitivity may occur due to insufficient intake of thiamin.

In addition, there may be concerns with anemia, PMS, bone loss, blood sugar issues, anorexia, constipation, digestive problems, and sound/noise sensitivity. Thiamin deficiency is more prevalent now than the previous several decades because of dietary habits with the sheer amount of carbohydrates and nutrient poor foods consumed today. Alcohol intake depletes thiamin along with several other B vitamins.

Thiamin diphosphate is the active coenzyme form of thiamin, which by-passes activation processes required by synthetic thiamin HCl. Thiamin works together with vitamins B2 and B3. Several cardiac, blood pressure, diuretics/water pills, and hormone replacement therapy (HRT) meds deplete thiamin.

Vitamin B2, Riboflavin

Riboflavin, or vitamin B2, helps thiamin with the production of energy. Riboflavin-5-phosphate is the active, coenzyme form of vitamin B2. Riboflavin HCl is the common non-active form. Vitamin B2 is needed to process amino acids and fats and activates vitamin B6 and folic acid. It is essential for converting carbohydrates into ATP or energy.

Lack of riboflavin is linked with alopecia or hair loss, anemia, blurred vision, cataracts, cracks on the corner’s of the mouth and chapped lips, poor mood, dry skin w/ greasy scales, dizziness, eyes that are red, itchy, and burn, tongue inflammation, impaired growth, migraines, and light sensitivity. Vitamin B2 is involved with numerous steps with energy production, redox balance (powerful antioxidant agents) and diverse regulation throughout the body. Numerous medications like HRT or birth control meds, antibiotics, and anti-depressants deplete vitamin B2.

Leaky Gut Syndrome, Diminished Glutathione

Recent animal studies show that lack of riboflavin creates a negative change within the digestive tract and immune system. Most specifically, the structural integrity of the gut is compromised and inflammation occurs with insufficient vitamin B2, i.e. a breakdown in the epithelial layer and tight junctions in the gut lining occur which is leaky gut syndrome.

This same study showed that insufficient riboflavin led to decreased levels of glutathione. Glutathione is the master antioxidant of the body and needs B2 and several other nutrients to be made by the body. This means that a simple lack of vitamin B2 can create the rate limiting step on energy production and antioxidant status with mitochondria and glutathione. Research shows that insufficient vitamin B2 also plays a primary role in the development of several neurological and neuromuscular disorders.

Vitamin B3, Niacin

Niacin, or vitamin B3, is used to help make energy from carbohydrate intake. It is also needed to process alcohol. Deficiency is associated with anorexia and nausea, canker sores, confusion, poor mood, dermatitis with scaly, dark patches on the skin, diarrhea, and emotional lability or unstable, quick to change emotions, fatigue, bad breath, headaches, indigestion, insomnia, pain in arms and legs, poor leg circulation, memory trouble, muscle weakness, PMS, skin breakouts, acne and skin inflammation. The typical triad of symptoms related to insufficient niacin is dermatitis, diarrhea, and dementia also known as pellagra. Niacin works together with several other B vitamins to help with serotonin production.

Niacin is directly involved with cell signaling and DNA repair. The brain, gut, and skin are the most sensitive to insufficient niacin. Niacin is also involved with cholesterol management and heart health and has been shown to be a potent anti-candida nutrient. Inositol hexanicotinate is a biologically activated form of niacin. Several medications deplete niacin including HRT, antibiotics, birth control pills, Parkinson’s and tuberculosis drugs.

Gene Stability, DNA Repair, LPS, and Lungs

Insufficient niacin is related with other problems. Niacin metabolites are directly involved with over 400 mechanisms potentially influencing every metabolic act in the body. Inadequate niacin has been linked with gene instability, impairment of cell life cycle management, delayed DNA repair, and erosion or shortening of telomeres.

Animal studies have also indicated that niacin provides remarkable protection against acute severe lung inflammation caused by shock and bleeding. Another animal study showed that niacin remarkably reduced lung injury from the bacterial toxin LPS. Niacin reduced high levels of TNF-alpha and other immune inflammatory compounds induced by the LPS thus protecting the air sacs and immune cells of the lungs.

Vitamin B5, Pantethine

Vitamin B5 or pantethine is known for many different activities. Pantethine, which is the active, coenzyme form of pantothenic acid, is nick-named the “clear head pill” at Wellness Resources. Pantethine is a major precursor to Acetyl Coenzyme A (CoA) that drives energy production from metabolism of fats and carbohydrates. Acetyl CoA is involved with function of the memory neurotransmitter acetylcholine. Pantethine also clears aldehyde toxins from the brain. Insufficient brain energy and toxins contribute to brain fatigue and brain fog; pantethine is one powerful nutrient that helps to energize and repair the brain.

Classical symptoms of vitamin B5 deficiency are hair loss and alopecia, burning feet, problems with coordination, eczema, feeling faint or fainting, fatigue, low blood pressure, infections, insomnia, irritability, muscle spasms, nausea and vomiting, anxiety or nervousness, and weakness.

Gut Inflammation, Cholesterol, and Autism

Insufficient vitamin B5 is linked with abdominal pain and leaky gut syndrome in animal studies. Adequate intake of vitamin B5 in this study showed marked reduction in gut inflammatory markers like TNF-a and NF kappa B, support several antioxidant enzyme systems related with SOD and glutathione, and helped protect tight junctions within the intestinal lining.

Pantethine is used to help lower cholesterol and improve LDL/HDL. High fat diets and exercise together has been shown in animal studies to increase the requirements of pantethine. Fat burning and physical energy production requires adequate CoA which is derived from pantethine. Make sure the athletes in your family get enough pantethine to help with energy production and recovery. Recent research shows that autistic children were deficient in several nutrients, including vitamin B6.

Vitamin B6, Pyridoxal-5-phosphate

Pyridoxal-5-phosphate, is the non-toxic, active form of vitamin B6. Pyridoxal HCl is the synthetic form of B6 that can cause nerve injury if taken in high amounts. The active form of vitamin B6 does not have this risk. Insufficient vitamin B6 is linked with acne, hair loss or alopecia, anemia, anorexia and nausea, arthritis, carpal tunnel syndrome, cracks at the corners of the mouth and chapped lips, eye inflammation, depression, dizziness, facial oiliness, fatigue, sore tongue, diminished wound healing, irritability, morning sickness, PMS, nervousness, pins and needles, numbness, or electric shock sensations, neuropathy, seizures, sleepiness, poor growth, or inflammation around the mouth and lips like a canker sore or other irritation, and weakness.

Birth control pills are notorious for depleting vitamin B6, B2, and B12. Numerous other cardiac, HRT, antibiotics, steroids, and psychiatric meds rob the body of vitamin B6. Vitamin B6 is needed to make serotonin, dopamine, and melatonin.

Vitamin B7, Biotin

Biotin acts as cofactor in the metabolism of protein, fats, and carbohydrates. It works with folate, pantethine, and vitamin B12. Several anti-seizure and nerve pain meds like gabapentin strip biotin from the body. Insufficient biotin is linked with hair loss, anemia, anorexia and nausea, depression, fatigue, elevated cholesterol, elevated blood sugar, insomnia, muscle pain and weakness, dry, gray colored skin, and a pale smooth tongue. Biotin has also been shown to be helpful with brittle nails, type 1 and 2 diabetes, pregnancy and postpartum support and nerve pain. Take a look again, nerve pain medications deplete biotin. Biotin is essential to help nerve pain. What’s wrong with this picture?

Biotin is also involved with immune system regulation and inflammation management of the skin. It plays fundamental roles in blood sugar, fatty acids, and amino acid management. Insufficient biotin leads to increased levels of the pro-inflammatory compound NF-kappa B and immune inflammation.

Vitamin B9, Folate

Folate is the active form of vitamin B9 as found in foods and coenzyme supplements. Most importantly, it refers to the methylated form. This is often seen in quality supplements as Quatrefolic, which is 10 times more bioavailable than regular, non-active folic acid. Folate is needed for cell replication and growth, forms the building blocks of DNA (genetic information) and RNA (protein synthesis in all cells). Rapidly growing cells or cells that rapidly regenerate have a very high need for folage, i.e. the unborn, red blood cells, and immune cells.

Insufficient folate is associated with anemia, anorexia, apathy, diarrhea, digestive problems, shortness of breath, fatigue, tongue inflammation, impaired growth, headaches, insomnia, memory and cognitive problems, paranoia, and weakness. Numerous medications like antacids, aspirin and other pain relieving meds, cholesterol lowering, HRT, antibiotics, diuretics, diabetes meds, inhalers, antibiotics, inflammatory bowel disease meds and more deplete folate.

Aging and Telomeres

Telomere length has been a topic of interest for slowing the rate of biological aging. A telomere is a repeated DNA sequence found at the end of chromosomes. Each time the cell replicates, the telomere is shortened. If the telomere is long, the lifespan of the cell is long.

A study published just a few weeks ago, found that suboptimal B vitamin status, i.e.insufficient folate and vitamin B12 caused elevated homocysteine levels. This led to altered DNA methylation and shortened telomere length. This means that simple nutrients have the power of affecting core anti-aging structures in cells and are vital to keeping vital DNA genetic material stable.

Vitamin B12, Cobalamin

A case history from the New England Journal of Medicine provides an example of what the lack of just one B vitamin can cause. In this example, the NEJM described a 62-year-old man who over the course of two months developed numbness and tingling in his hands, had trouble walking and became short of breath. He also experienced jaundice, anemia, and weight loss.

The diagnosis was a vitamin B12 deficiency. Had the vitamin B12 deficiency worsened, there would be additional symptoms of trouble walking or loss of balance, a sore, swollen tongue, trouble thinking and memory problems, depression, paranoia, hallucinations, weakness, loss of taste and smell, incontinence, and fatigue. Other signs of insufficient vitamin B12 are lack of stomach acid, constipation, headaches, and neuropathy.

The coenzyme, activated forms of vitamin B12 are adenosylcobalamin, methylcobalamin, and hydroxycobalamin. The common form of B12, cyanocobalamin is a low quality, non-active form of B12 that requires the body to cleave off and detoxify small amounts of cyanide. Cyano-cobalamin is in reference to cyanide.

Vitamins B6, B12, and Folate (B9)

Vitamins B6, B12, and folate play integral interconnected roles with methylation and homocysteine management. These nutrients are often studied together in this context with a common focus of neurodegenerative diseases, stroke, heart disease, and cholesterol management. Lab tests that reveal elevated homocysteine or methylmalonic acid (MMA) provide insight into B6, B12, and folate status.

Insufficient intake of these nutrients causes elevated homocysteine and MMA levels. This is an exciting arena with a wealth of information related to genetic function and risks being identified. Beside methylation and homocysteine, B6, B12, and folate have their own individual impact.

Medications that Deplete B Vitamins

Here is a list of medications known to deplete B vitamins in general from the body. Aspirin, AZT, Bumetanide, Carbamazepine, Carbidopa, Carbidopa-Levodopa, Cimetidine, Clofibrate, Colchicine, Cortisone, Cycloserine, Desogestrel-Ethinyl Estradiol, Dexamethasone, Doxorubicin, Erythromycin, Ethinyl Estradiol and Levonorgestrel, Ethinyl Estradiol and Norethindrone, Ethinyl Estradiol and Norgestimate, Ethinyl Estradiol and Norgestrel Famotidine, Felbamate, Furosemide, Gabapentin, Hydralazine, Isoniazid, Lansoprazole, Levetiracetam, Levonorgestrel, Levonorgestrel-Ethinyl Estrad, Mestranol and Norethindrone, Metformin, Methyldopa, Methylprednisolone, Neomycin, Nizatidine, Norgestimate-Ethinyl Estradiol, Omeprazole, Oxcarbazepine, Penicillamine, Phenelzine, Phenobarbital, Phenytoin, Prednisolone, Prednisone, Primidone, Ranitidine, Sulfamethoxazole, Tetracycline, Theophylline, Topiramate,Torsemide, Trimethoprim,Valproate, and Zonisamide. This is not an all-inclusive list.

There is no doubt B vitamins are critical to the function of the body. Without these essential nutrients, health is elusive. B vitamins work together in harmony with metabolism, protecting DNA/RNA, energy production, methylation, antioxidant production, detoxification, aging, neurotransmitters production, inflammation regulation, skin, hair, nail, gut, brain, nerves, blood, bones, pancreas, liver, immune system, heart, and lungs. Every organ and tissue in our body is dependent upon B vitamin status. Numerous medications, insufficient diets, genetic defects, poor gut health, and stressful lifestyles interfere and increase the need for these nutrients. The question “to B or not to B” should be answered as “Yes, I need my B’s!”

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