The Optimal DX Research Blog

B Vitamin Applications in Natural Medicine

Written by ODX Research | Aug 14, 2024 5:13:00 PM

B vitamins include a group of eight essential water-soluble vitamins that must be consumed regularly from food, including animal-based protein, dairy products, leafy greens, and legumes.

The B vitamins include:

  • B1 Thiamine
  • B2 Riboflavin
  • B3 Niacin
  • B5 Pantothenic acid
  • B6 Pyridoxine
  • B7 Biotin
  • B9 Folate
  • B12 Cobalamin

B vitamins participate in several metabolic functions, including:

  • Energy generation via the citric acid cycle and electron transport chain
  • Mitochondrial processing of glucose, amino acids, fatty acid
  • Axonal transport
  • Neurotransmitter synthesis
  • Cellular metabolism
  • RNA and DNA synthesis
  • Central nervous system function

B vitamin deficiencies affect a broad range of metabolic functions and can manifest as:

  • Anemia
  • Behavioral changes
  • Cardiovascular dysfunction
  • Cataracts
  • Fatigue
  • Headaches
  • Impaired stress response
  • Nervous system impairment
  • Psychiatric disorders
  • Skin disorders
  • Sleep disturbances

B vitamin functions and deficiencies

Vitamin form and food sources

Bioactive form

Risk factors for deficiency

Symptoms of insufficiency/ deficiency

B1

Thiamine

Fish

Fortified foods, e.g., cereals, breads, dairy products

Pork

Whole grains

Yeast

Thiamine is found naturally in many foods and added to processed foods via fortification.

Thiamine pyrophosphate (TPP)

TPP production is magnesium-dependent.

TPP is required for acetylcholine and myelin production.

TPP is essential to maintaining aspartate, glutamate, and GABA levels and avoiding delirium and neuronal excitation due to their deficiency.

Alcohol inhibits the phosphorylation of thiamine and the production of TPP.

Alcoholism

Carbohydrate loading, high-carb diet

Decreased intake

Diarrhea

Hemodialysis

Hyperthyroidism

Impaired absorption

Increased utilization

Increased losses

Malnutrition due to pathology, chemotherapy, etc.

Pregnancy

Refeeding syndrome

Use of: diuretics, 5-fluorouracil

Anorexia

Arrhythmias

Beriberi: wet beriberi (characterized by edema, cardiomyopathy, heart failure, pleural effusion) and dry beriberi (characterized by peripheral nervous system complications, paresthesia, foot drop, muscle wasting, numbness, and absence of ankle reflexes)

Confusion

Endocarditis

Fatigue

Impaired stress reaction

Irritability

Mitochondrial dysfunction, decreased energy production

Oxidative stress

Peripheral neuropathy

Sleep disturbances

Sudden death

Wernicke-Korsakoff syndrome (characterized by altered mental status, ataxia, ophthalmoplegia, delirium, and permanent memory loss).

B2

Riboflavin

Almonds

Dairy products

Eggs

Green vegetables

Meat

Mushrooms

Riboflavin is added to processed foods via fortification.

Flavoproteins utilized in redox reactions:

Flavin adenine dinucleotide (FAD)

Flavin mononucleotide (FMN)

The active form of riboflavin is required to metabolize niacin, folate, B6, and heme proteins; convert carbohydrates, fats, and protein into glucose for energy; cellular respiration; and immune system function.

Anorexia nervosa

Barbiturate use

Hemodialysis

Diarrhea

Liver disease

Malabsorptive syndromes

Pregnancy

Use of: anticonvulsants, anticholinergics, contraceptive pills, tricyclic antidepressants, antipsychotics, and tetracyclines

Anemia

Cataracts

Cheilitis

Depression

Dermatitis

Eye irritation

Fatigue

Glossitis

Hair loss

Liver dysfunction

Migraine

Nervous system complications

Personality changes

Sore throat

Stomatitis

B3

Niacin

Grains

Legumes

Nuts

Seeds

Soy

Niacin is found in many animal and plant-based foods and is added to processed foods via fortification.

Tryptophan is converted to niacin in the body.

Nicotinamide adenine dinucleotide (NAD)

and

nicotinamide adenine dinucleotide phosphate (NADP)

NAD and NADP are required for cholesterol synthesis and DNA repair

The conversion of tryptophan to niacin depends on adequate iron, riboflavin, and B6.

Alcohol use

Carcinoid syndrome

Hartnup disease

High-corn diet

Low tryptophan intake

Use of azathioprine, isoniazid, nicotine patches, 5-fluorouracil, 6-mercaptopurine

Anxiety

Apathy

Burning and twitching in extremities

Depression

Disorientation

Fatigue

Memory loss

Pellagra (the 4 Ds: dementia, dermatitis, diarrhea, and death)

Photodermatitis, scaly rash on skin exposed to the sun

Psychotic symptoms

Swollen mouth

Vomiting

B5

Pantothenic acid

Avocados

Beef

Chicken

Eggs

Fish

Lentils

Mushrooms

Pork

Sunflower seeds

Sweet potato

Coenzyme A

Acyl-CoA is essential to acetylcholine, cholesterol, and fatty acid synthesis.

Use of antibiotics (especially tetracyclines), cholinesterase inhibitors, and memantine.

Isolated pantothenic acid deficiency is rare and usually associated with other B vitamin insufficiencies.

Arthritic pain

Behavioral changes

Demyelination

Dermatitis

Diarrhea

Encephalopathy

Fatigue

Gastrointestinal complications

Headaches

Insomnia

Irritability

Numbness, burning sensations

B6

Pyridoxine

Beef

Fortified cereals

Poultry

Starchy vegetables

Non-citrus fruits

Pyridoxal 5′-phosphate (P5P)

P5P supports immune function and brain health; metabolism of carbohydrates, fats, and protein; synthesis of serotonin and dopamine; and maintenance of normal homocysteine levels.

Alcoholism

Autoimmune disorders

Malabsorptive states, e.g., IBD, celiac, and bariatric surgery

Obesity

Pregnancy, preeclampsia, eclampsia

Renal insufficiency

Rheumatoid arthritis

Use of levodopa, penicillamine, hydralazine, isoniazid, cycloserine, and some anticonvulsants (e.g., valproic acid, carbamazepine, phenytoin)

Cheilosis

Cognitive impairment

Confusion

Convulsions

Dermatitis

Depression

EEG abnormalities

Glossitis

Idiopathic carpal tunnel syndrome (possibly)

Immune insufficiency

Irritability

Microcytic anemia

Peripheral neuropathy

B7

Biotin

Eggs

Fish

Nuts

Organ meats

Seeds

Soybeans

Biotin

Catalyzes the metabolism of glucose, fatty acids, and amino acids and is essential to gene regulation, cell signaling, and cell replication

Alcoholism

Biotinidase deficiency

Epileptic medications

Pregnancy or breastfeeding

Use of anticonvulsants.

Note: high-dose biotin can interfere with thyroid function, and 25-OH vitamin D tests

Ataxia

Depression

Dermatitis

Hair thinning

Lethargy

Nail changes

Paresthesia, tingling in extremities

Scaly rash around eyes, nose, mouth

Seizures

Skin infections

B9

Folate

Beans

Brussels sprouts

Dairy products

Dark leafy greens

Grains

Nuts

Poultry

Vegetables

Methyltetrahydrofolate

Methyltetrahydrofolate is essential to RBC production, nucleic acid synthesis, and conversion of homocysteine to methionine.

Individuals with the MTHFR gene variants should be supplemented with L-methylfolate (5-MTHF) instead of synthetic folic acid. B12 insufficiency must be ruled out before supplementing with folate.

Genetic polymorphism MTHFR C667T

Hemodialysis

Hemolysis

Malabsorption

Poor intake

Use of methotrexate, metformin, cholestyramine, sulfasalazine, antibiotics, and antiepileptics e.g., gabapentin

Affective disorders

Behavioral changes

Birth defects

Dementia

Headaches

Megaloblastic anemia

Oral ulcerations

Palpitations

Peripheral neuropathy

Poor concentration

Psychosis

Skin, hair, and fingernail changes

Spinal cord lesions

B12

Cobalamin

Animal-based protein foods

Fortified foods

Methylcobalamin and

5’-deoxyadenosylcobalamin

Cobalamin is required for myelin synthesis, neurological function, RBC production, RNA and DNA synthesis, and hormone, lipid, and protein synthesis and metabolism.

Intrinsic factor deficiency

Gastrointestinal surgery

Malabsorption (e.g., gastric bypass, celiac, and Crohn’s disease)

Poor oral intake

Vegan diet

Use of antacids, antibiotics, and colchicine

Decreased appetite

Irreversible neurological damage

Fatigue

Megaloblastic anemia

Neuropsychiatric disorders

Pernicious anemia

Many symptoms are the same as folate deficiency symptoms.

Note:

Excessively high doses of vitamins can cause toxicity, so supplementation should be initiated and monitored accordingly.

Optimal Takeaways

B vitamins are essential to health and should be consumed daily as they are not stored in significant amounts. The B vitamins work closely together in a number of metabolic functions.

Insufficiencies should be identified early to prevent progressive loss of function and potentially irreversible damage.

B vitamin supplementation should be individualized depending on genetic factors, diet, and health history.

B vitamins participate in:

  • Brain and nervous system health
  • Energy generation
  • Enzyme cofactor activities
  • Gastrointestinal health
  • Mood stabilization
  • Neurotransmitter synthesis
  • Red blood cell production
  • RNA and DNA metabolism
  • Skin and eye integrity

Reference

Hanna, Mary et al. “B Vitamins: Functions and Uses in Medicine.” The Permanente journal vol. 26,2 (2022): 89-97. doi:10.7812/TPP/21.204