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Vitamin of the Month- Vitamin B

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History of B Vitamins*B graphic

B vitamins are a family of water-soluble nutrients that were discovered together at the beginning of the 20th century, initially thought simply to be “vitamin B.” As nutrition advanced, however, it was learned that they are in fact a family of compounds, each with a distinct role to play in promoting health. B vitamins are now known to play critical roles in modulating biochemistry and metabolism, and represent the most common vitamins utilized by the body as cofactors for facilitating enzymatic function. The modern refined diet, high in sugar, alcohol, and devitalized foods, leads to lower levels of B vitamins. Many medications and stress may lower B vitamin levels. While B vitamins have been for the most part researched individually, they also have therapeutic power when taken together. For example, a B complex supplement can relieve nocturnal leg cramps in the elderly.1

 

Thiamin or Vitamin B1

Vitamin B1 is needed for energy production, heart function, and the health of the brain and nervous system. B1 also helps remove lead from the body. Fifty milligrams of B1 was given to sixty women for two months, and increased levels of B1 made these women feel more clearheaded, composed and energetic.2 Fifty milligrams of B1 per day improved mental wellness in epileptics.3 Twenty-five milligrams of thiamin with 50 mg of B6 leads to significantly reduced symptoms in patients with diabetic neuropathy.4   Deficiencies of vitamin B1 manifest primarily as disorders of the neuromuscular, intestinal, and cardiovascular systems.

 

 

vitamin B deficiencyDeficiency symptoms include: [19]

  • Depression
  • Edema
  • Rapid pulse rate
  • Heart palpitation
  • Irritability
  • Memory Loss
  • Mental confusion
  • Indigestion
  • Weight loss
  • Anorexia
  • Muscular weakness
  • Sore calf muscles
  • Fatigue
  • Loss of reflexes in the legs
  • Nerve inflammation
  • Defective muscular coordination

 

Niacinamide: Antioxidant Aiding Glucose Control and Osteoarthritis

Niacinamide is needed to metabolize food (carbohydrates, fats, and proteins) into energy. Niacinamide is converted into the coenzymes nicotinamide adenine dinucleotide (NAD) and NADP, which function in oxidation-reduction reactions. The liver can convert niacin into niacinamide by adding an amine group.  Biological responses to niacin, nicotinic acid and niacinamide are virtually equivalent when taken in common doses. When taken in supra physiological doses they act differently (e.g. 500 mg niacin for stabilizing lipids). Clinical signs of early niacinamide deficiency include lack of appetite, muscular fatigue, indigestion, depression, insomnia, headaches, glossitis, and skin lesions. Severe deficiency may lead to pellagra, with dermatitis, dementia, diarrhea (the “3 D’s of pellagra), tremors and sore (black) tongue. Niacinamide may help those with osteoarthritis. One recent study of 72 osteoarthritis patients showed that niacinamide can improve joint flexibility, reduce inflammation, and allow for reduction in standard anti-inflammatory medications.6 Some people feel more relaxed when taking niacinamide. Niacinamide (also known as nicotinamide) has been shown in research to protect and even regenerate islet cells of the pancreas and may be helpful for prevention and control of Type 1 Diabetes.7, 8

 

Riboflavin (B2): Antioxidant and Migraine Preventer

B2, also known as riboflavin, is another B vitamin that helps the body turn food into energy. B2 is also a powerful antioxidant. Riboflavin supplementation may help prevent migraine headaches.5 Patients with low thyroid function may have an increased need for vitamin B2, particularly in the activated form known as riboflavin-5-phosphate. Taking riboflavin imparts a yellow color to the urine which is harmless.  Vitamin B2 deficiencies affect primarily the skin, eyes, and mucous membranes of the intestinal tract.

 

Deficiency symptoms may include: [19]

  • Chelosis
  • Inflamed mucous membranes
  • Soreness and burning of the lips, mouth, and tonguefatigue
  • Reddening, tearing, burning, and itching of the eyes
  • Eyes tiring easily
  • Dry, itchy, scaly skin
  • Scaling eczema of the face and genitals

 

Vitamin B12

Vitamin B12 has been found useful as a treatment for asthma, depression, and for promoting mental wellness. Vegetarians are particularly susceptible to low B12 levels, as B12 is the only B vitamin found exclusively in animal products. Pregnant vegans in particular need to supplement months prior to pregnancy, for pregnancy increases B12 requirements. Mothers undersupplied with B12 can have babies with neurological problems. Older adults are often low in vitamin B12.  Vitamin B12 is also available in activated forms such as methylcobalamin. Sixty milligrams of methylcobalamin was given every day for 6 months to 6 patients with chronic progressive MS. This led to improvement in abnormalities in both the visual and brainstem nerve function.14 Methylcobalamin may also be useful in the treatment of diabetic neuropathy, Bell’s Palsy,15 and sleep-wake disorders.

 

Vitamin B12 Depletion

Vitamin B12 deficiencies manifest primarily as anemia and neurologic changes. Vitamin B12 deficiency inhibits DNA synthesis, which affects the growth and repair of all cells.  The symptoms of vitamin B12 deficiency include:

  • Tongue and mouth irregularities
  • Macrocytic anemia (abnormally enlarged red blood cells)
  • Depression, confusion and memory loss (especially in the elderly)
  • Poor blood clotting and easy bruising
  • Dermatitis and skin sensitivity
  • Loss of appetite
  • Nausea
  • Vomiting
  • Fatigue
  • Peripheral neuropathy

 

elderlyAnemia is the first symptom of vitamin B12 deficiency.  Pernicious anemia results from either inadequate vitamin B12 intake or reduced gastric secretion of intrinsic factor, which inhibits absorption.

 

The elderly are most susceptible to vitamin B12 deficiency due to atrophy of gastric parental cells causing inadequate production of intrinsic factor.  Deficiencies in the elderly often cause varying degrees of neuropsychiatric symptoms such as moodiness, confusion, abnormal gait, memory loss, agitation, delusions, dizziness, dementia, and hallucinations.

 

Numerous drugs inhibit vitamin B12 absorption and, when taken chronically, can lead to nutrient depletion.  These include oral contraceptives, potassium medications, histamine-2 blockers (AxidÒ, Pepcid®, Tagamet®, Zantac®), proton pump inhibitors (Prevacid®, Prilosec™), and phenytoin (Dilantin®).

 

Overview of Vitamin B12  Cobalamin is the generic name of vitamin B12 because it contains the heavy metal cobalt.  Vitamin B12 is an essential growth factor and plays a vital role in the metabolism of all cells, especially those of the gastrointestinal tract, bone marrow, and nervous tissue.

 

Vitamin B6: Pyridoxine

Vitamin B6 plays an important role in vital life processes, which include amino acid metabolism, hemoglobin production, the efficient functioning of the nervous and immune systems and the modulation of blood sugar.9 B6 supports overall female hormonal balance and is very useful in the management of PMS,10 as well as nausea and vomiting that may accompany pregnancy.11 The depression some experience on oral contraceptives can be helped with 40 mg per day of

B6.12 A five month study with 76 asthmatics showed that 200 mg per day of B6 led to a reduction in the need for bronchodilators and asthmatic medications.13  Vitamin B6 has several forms, namely: pyridoxine, pyridoxal, pyridoxamine, and the phosphorylated versions of these forms.

 

Deficiency symptoms include: [19]

  • Depression
  • Sleep disturbances
  • Nerve inflammation
  • PMS
  • Lethargy
  • Decreased alertness
  • Anemia
  • Altered mobility
  • Elevated homocysteine levels
  • Nausea
  • Vomiting
  • Seborrheic dermatitis

 

Folate: For Wellness

Folates are essential cofactors in one carbon metabolism and their deficiency is associated with health risks such as neural tube defects, cancers and perhomocysteinemia.

“Folic acid” and “folate” are often used interchangeably, but more appropriately, folic acid refers to the fully oxidized synthetic compound (pteroylmonoglutamic acid) used in dietary supplements and in food fortification, while folate refers to the various tetrahydrofolate derivatives naturally present in foods.  It seems that since the mandatory folic acid fortification of cereal-grain products in the USA in 1998, many breakfast cereals are over-fortified with folic acid.  Consumption of cereal along with other folic acid-containing beverages and dietary supplements could result in chronically high intake of synthetic folic acid.  The appearance of unmetabolized folic acid in the bloodstream following intake of as low as 400 micrograms per day of folic acid from fortified foods or supplements caused many scientists to be concerned with the potential health risk of unmetabolized folic acid since it is thought to aggravate pre-existing cancers.

 

 

Biotin: Strengthening Nails and Balancing Blood Sugar

Biotin can help strengthen nails in humans by 25% in those with weak or brittle nails.16 A high intake of biotin can improve blood sugar control in animal models nailsof type II diabetes. By helping keep blood sugar and insulin lower, biotin may support weight loss.17 Biotin may also help patients with diabetic neuropathy.18

 

Vitamin B5: Pantothenic Acid ‘For Stress and Wound Healing’

Pantothenic acid, previously known as vitamin B5, is a member of the B complex family that helps immune function, energy generation, and the body’s production of stress hormones. Pantothenic acid may help those with rheumatoid arthritis, though more research is needed.

 

B Vitamin Contraindications

  • Niacin and Niacinamide: Avoid both of these forms in high doses if you have jaundice, heart conditions including angina and rheumatic heart disease, ulcers, gastritis, renal failure, or gout.
  • Vitamin B6: Do not take B6 with the drug levodopa, as it can inactivate it. Lactating women should not take more than 50 mg of B6 per day, as higher doses may suppress lactation.
  • Folate: Avoid folate and folic acid supplements when taking the drug methotrexate for cancer.

 

Recommended Daily Allowance for B Vitamins

B1, or thiamine, is part of the B-complex vitamins and is water soluble. The RDA is 1 to 1.4 mg, and the DOI is 15 to 30 mg.
B2, or riboflavin, a B vitamin, has an RDA of 1.6mg and a DOI of 5 to 15 mg.
B3, or niacin, is also a B vitamin. The RDA is 13 to 18 mg, and the DOI is 100mg.
B5, or pantothenic acid, also part of the B group, has an RDA of 4 to 7 mg and a DOI of 100 to 1,000 mg.
B6, or pyridoxine, another B vitamin, has an RDA of 2 to 2.2 mg and a DOI of 35 to 50 mg.
B12, or cobalamin, also a B vitamin, has an RDA of 3 mcg (micrograms) and a DOI of 100 to 300 mcg.
Biotin, also a B vitamin, has an RDA of 100 to 200 mcg and a DOI of 300 mcg.
Choline, part of the B family, has no RDA, but the DOI is 25 to 300 mg.
Folate, or folic acid, a B vitamin, has an RDA of 400 mcg for adults and a DOI of 400 to 2,000 mcg.
Inositol, another B vitamin, has no RDA, but the DOI is 25 to 300 mg.

 

 

*Statements have not been evaluated by the FDA. Products not meant to diagnose, treat, cure or prevent any disease. Consult with your healthcare provider prior to beginning any diet, exercise or nutritional program. Consultation with the pharmacist is not to be deemed in place of or equal to a thorough review and check by your physician. Nothing herein is intended to replace or influence the independent judgment of any licensed professional.     

 

References

  1. Chan, P., et al., Randomized, double-blind, placebo-controlled study of the safety and efficacy of vitamin B complex in the treatment of nocturnal leg cramps in elderly patients with hypertension. J Clin Pharmacol, 1998.

38(12): p. 1151-4.

  1. Benton, D., R. Griffiths, and J. Haller, Thiamine supplementation mood and cognitive functioning. Psychopharmacology (Berl), 1997. 129(1): p. 66-71.
  2. Botez, M.I., et al., Thiamine and folate treatment of chronic epileptic patients: a controlled study with the Wechsler IQ scale. Epilepsy Res, 1993. 16(2): p. 157-63.
  3. Abbas, Z.G. and A.B. Swai, Evaluation of the efficacy of thiamine and pyridoxine in the treatment of symptomatic diabetic peripheral neuropathy. East Afr Med J, 1997. 74(12): p.803-8.
  4. Schoenen, J., M. Lenaerts, and E. Bastings, High-dose riboflavin as a prophylactic treatment of migraine: results of an open pilot study. Cephalalgia, 1994. 14(5): p. 328-9.
  5. Jonas, W.B., C.P. Rapoza, and W.F. Blair, The effect of niacinamide on osteoarthritis: a pilot study. Inflamm Res, 1996. 45(7): p. 330-4.
  6. Polo, V., A. Saibene, and A.E. Pontiroli, Nicotinamide improves insulin secretion and metabolic control in lean type 2 diabetic patients with secondary failure to sulphonylureas. Acta Diabetol, 1998. 35(1): p. 61-4.
  7. Kishore A, et al., Antidiabetic effect through islet cell protection in streptozotocin diabetes: a preliminary assessment of two thiazolidin-4-ones in Swiss albino mice. Chem Biol Interact. 2009 Feb 12;177(3):242-6.
  8. Bender DA. Nutritional biochemistry of the vitamins. Cambridge (UK): Cambridge University Press; 2003.
  9. Sharma P. et al., Role of bromocriptine and pyridoxine in premenstrual tension syndrome. Indian J Physiol Pharmacol. 2007. 51(4):368-74.
  10. Sahakian V., et al., Vitamin B6 is effective therapy for nausea and vomiting of pregnancy: a randomized, double-blind placebo-controlled study. Obstet Gynecol. 1991. 78(1):33-6.
  11. Bermond, P., Therapy of side effects of oral contraceptive agents with vitamin B6. Acta Vitaminol Enzymol, 1982. 4(1-2): p. 45-54.
  12. Collipp, P.J., et al., Pyridoxine treatment of childhood bronchial asthma. Ann Allergy, 1975. 35(2): p. 93-7.
  13. Kira, J., S. Tobimatsu, and I. Goto, Vitamin B12 metabolism and massive-dose methyl vitamin B12 therapy in Japanese patients with multiple sclerosis. Intern Med, 1994. 33(2):p. 82-6.
  14. Jalaludin, M.A., Methylcobalamin treatment of Bell’s palsy. Methods Find Exp Clin Pharmacol, 1995. 17(8): p. 539-44.
  15. Hochman, L.G., R.K. Scher, and M.S. Meyerson, Brittle nails: response to daily biotin supplementation. Cutis, 1993. 51(4): p. 303-5.
  16. McCarty, M.F., High-dose biotin, an inducer of glucokinase expression, may synergize with chromium picolinate to enable a definitive nutritional therapy for type II diabetes. Med Hypotheses, 1999. 52(5): p. 401-6.
  17. Koutsikos, D., B. Agroyannis, and H. Tzanatos-Exarchou, Biotin for diabetic peripheral neuropathy. Biomed Pharmacother, 1990. 44(10): p. 511-4.
  18. Pelton, R.Ph., Ross, and James LaValle, R.Ph. the Nutritional Cost of Drugs. 2nd ed. Englewood, CO: Morton Publishing Company, 2000.

 

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*Products not intended to diagnose, treat, cure or prevent any disease. Statements have not been evaluated by the FDA.