Articles > B Vitamins And Their CoEnzymes

A B vitamin supplement is the cheapest, safest, and most reliable way to improve your wellbeing and overall mental abilities. I recommend the Bs to those who wish to improve their mood, mental clarity, and energy. The effects of the B vitamins are subtle, especially in the young who normally have adequate dietary intake of these nutrients. Improvements in cognitive functions from the B vitamins are particularly noticeable in middle age individuals and the elderly.

In addition to discussing the B vitamins, this chapter will review coenzymes—the new, more activated forms of the B vitamins—and make recommendations on how to reduce levels of homocysteine, an amino acid derivative that can be harmful to the cardiovascular and neurological system when present in excess.

Benefits of B Vitamins
Since B vitamins and their coenzymes play important metabolic roles in numerous biochemical reactions throughout the body, they can influence just about every aspect of brain and physical health. As a rule, individuals who take B vitamins notice improvements in:

Mood and energy
Alertness
Learning and memory
Speed of thinking
Verbal fluency
Concentration and focus
Visual clarity
Which Clinical Conditions Do the Bs Benefit?

Because of their wide range of effects, B vitamins and their coenzymes can potentially be helpful in:

Depression
Age related cognitive decline
Anxiety disorders
Addiction disorders
Chronic fatigue
Alzheimer’s disease
Parkinson’s disease

The Bs in the Brain Get an A
B vitamins help in energy production and deficiencies lead to fatigue and poor mental functioning. The increased consumption of refined foods has decreased the amounts of B vitamins present in our diet. However, on the positive note, small amounts of B vitamins are regularly added to some food products, such as cereals.

The question of whether B vitamin supplementation is necessary in healthy individuals who have a normal diet has been debated ever since vitamins were discovered. The results of several studies over the past few years have influenced my decision in favor of low dose supplementation. There can be cognitive improvements from taking B vitamins. Back in 1995, Dr. D. Benton and colleagues, from the University College Swansea, in Great Britain, gave ten times the recommended daily allowance of nine vitamins (mostly the B vitamins) to healthy college students (Benton 1995). The study lasted for one year. The students reported improvement in mood and feeling more agreeable. There was also an improvement in cognitive functioning, especially in regards to concentration. Many of my patients consistently report that B vitamin supplementation improves their energy, concentration and mood while helping them handle everyday stress better.

For otherwise healthy individuals, supplementation with one to three times the recommended daily allowance of the B vitamins is suggested. Higher dosages may be required for individuals with medical, psychiatric, or neurological disorders.

Understanding Coenzymes
In the past few years, many of the B vitamins have become available in their more activated forms known as coenzymes. For instance, the B vitamin niacin is now available in a coenzyme form known as NADH. An enzyme is basically a protein that promotes chemical changes in other substances, itself remaining unchanged in the process. A coenzyme is a substance that facilitates or is necessary for the action of an enzyme.

The brain, just like a car, needs fuel. Our primary source of fuel is through fats, proteins, and carbohydrates in the diet. After digestion in the stomach, foodstuffs are absorbed into the bloodstream and circulate to various tissues and cells where they are broken down into even smaller particles. One of these particles is a two-carbon molecule known as acetyl. Enzymes help break down these fats, proteins, and carbohydrates into acetyl and they then help extract the final energy from acetyl through a process called the Krebs cycle, named after the German biochemist who defined it. This energy is in the form of ATP (adenosine triphosphate). Enzymes also need helpers, and these helpers are called coenzymes. Most of the coenzymes in the body are partly made from vitamins, such as vitamins E, C, lipoic acid, and riboflavin (vitamin B2).

The coenzyme form of a B vitamin often has a significantly more powerful effect than a regular B vitamin. The coenzyme forms of the B vitamins are an exiting addition to the field of nutrition. It is quite possible that the elderly or certain individuals with a particular biochemical deficiency may not be able to make adequate amounts of the coenzyme forms of the B vitamins despite adequate intakes of the individual B vitamins. Hence, the coenzyme forms should be seriously considered in those who do not respond to the regular B vitamins. Some companies include most of the Bs in their coenzyme form together in one pill. I think these products deserve serious consideration, especially for their use in the middle aged and the elderly.

The Individual B Vitamins and Their Coenzymes:
Thiamin (B1) is necessary for the metabolism of carbohydrates and amino acids to adenosine triphosphate (ATP), the primary source of energy in the human body. Thiamin is found in good amounts in milk, lean pork, legumes, rice bran, and the germ of cereal grains, but is lost during food processing and cooking. The current recommended daily allowance (RDA) by government advisory panels is about 1.5 mg.

Studies indicate that supplementation with thiamin provides cognitive benefits. Dr. Benton and colleagues gave 50 mg of thiamin daily to young adult females for a period of two months (Benton 1997). The women reported being more clearheaded, composed, and energetic. The taking of thiamin had no influence on memory but reaction times were faster following supplementation. Prior to taking the thiamin, the women had normal blood levels of this vitamin.

Researchers at Princess Margaret Hospital in Christchurch, New Zealand, measured thiamin levels in elderly individuals before giving them 10 mg of the vitamin a day (Wilkinson 1997). Only the subjects with low thiamin concentrations showed benefits. They had an improvement in quality of life with more energy and deeper sleep, along with decreased blood pressure and weight.

Thiamin is now sold in its coenzyme form called cocarboxylase or thiamin pyrophosphate (TPP). Human studies giving TPP to evaluate cognitive functioning have not yet been published.

Riboflavin (B2) is a yellow-colored nutrient involved in dozens of metabolic pathways leading to energy production and the making of fatty acids and sterols. Good sources are lean meats, eggs, milk, some vegetables and enriched cereals. The recommended daily intake is about 1.5 mg. You may notice your urine turning a deeper yellow color after taking riboflavin.

Riboflavin is part of two larger activated coenzymes known as flavin adenine dinucleotide (FAD) and flavin mononucleotide (FMN). FMN is now available as a supplement. One product contains 25 mg of FMN per pill. Human studies giving FAD or FMN in order to evaluate cognitive functioning have not yet been published.

Niacin (B3), also known as nicotinamide and nicotinic acid, plays essential roles in a large number of energy pathways. Perhaps as many as 200 enzymes are dependent on this nutrient.

Nicotinamide is part of the coenzyme known as nicotinamide adenine dinucleotide (NADH), which is sold as a supplement. I will discuss NADH later in this chapter since several studies have been published regarding this coenzyme. Good sources of niacin are meats, legumes, fish, and some nuts and cereals. The recommended daily intake is about 15 to 20 mg.

Niacin for diabetics
People with diabetes often have high cholesterol and triglyceride levels. They also have low HDL (the good cholesterol) levels. Niacin, a B vitamin, reduces concentrations of triglycerides and raises levels of HDL cholesterol. However, the use of niacin in patients with diabetes has been discouraged because high doses can sometimes worsen blood sugar control. Researchers at the University of Texas Southwestern Medical Center evaluated the use and safety of once-daily extended-release niacin in diabetic patients with triglyceride problems. During a 16-week, double-blind, placebo-controlled trial, 148 patients were randomized to placebo or 1000 mg a day of niacin. Many patients were also receiving therapy with statins. Patients taking niacin had an average increase in HDL by about 20 percent and reductions in triglyceride levels by about 20 percent compared to the placebo group. Rates of adverse event rates other than flushing were similar for the niacin and placebo groups. Four patients discontinued participation owing to flushing. No harm to the liver or muscles was observed. Blood sugar levels on average rose only minimally. The researchers conclude that niacin is a treatment option for patients with type 2 diabetes who have high triglyceride and low HDL levels.

Dr. Sahelian says: Some diabetics may get benefits with a lower dose of niacin, such as 200 to 500 mg a day, which would reduce the incidence of flushing. An extended release form of niacin seems to be a good option.

Pyridoxine (B6), also known as pyridoxal, is widely available in most foods including vegetables, legumes, nuts, seeds, and animal products. The coenzyme form of pyridoxine is pyridoxal phosphate (PLP) and at least 100 different metabolic reactions are helped by PLP. PLP is a necessary co-enzyme in the production of brain chemicals: It helps the conversion of 5-HTP into serotonin, tyrosine into dopamine and norepinephrine, and the production of other neurotransmitters such as histamine and GABA. The recommended daily intake is about 1.5 mg. Deficiencies in B6 can lead to low mood.

Human studies with PLP in mood disorders and depression have not yet been published. PLP is available in pills ranging from 5 to 20 mg. Some individuals notice the difference between regular B6 and the coenzyme form. Joan, a 53-year old patient from Beverly Hills, California, says, "I've taken good quality B vitamins for a few years. Recently I tried the pyridoxal phosphate form of B6. It really has increased my energy, mood, and alertness."

Pantothenic acid (B5) is essential for biological reactions involving acetylation and energy production. This vitamin helps in the formation of acetylcholine, the metabolism of fatty acids, and the incorporation of fatty acids into cell membrane phospholipids. Pantothenic acid is also involved in making steroid hormones, vitamin A, vitamin D, and cholesterol. Good sources are egg yolk and fresh vegetables. The recommended daily intake is about 5 mg. Pantothenic acid is sold over the counter in dosages ranging from 5 to 250 mg.

My patients report that pantothenic acid helps improve their mood and energy. Personally, I notice an improvement in alertness, concentration, energy, and visual clarity with dosages ranging from 100 to 250 mg. I do experience insomnia, though, when I take more than 250 mg, even if I take it in the morning. Benita von Klingspor, a nutritionist in Marina Del Rey, California, says, "Pantothenic acid is one of my favorite nutrients. I know the effects of this nutrient extremely well since I’ve been taking 100 to 250 mg most mornings for more than thirty years. I often recommend it to many clients with low energy. Pantothenic acid increases their alertness and focus, improves their mood, and enhances their joy in life. They begin to have more interest in whatever they’re doing. However, if people take too much pantothenic acid, they can become overstimulated, wired, and easily aggravated."

Pantothenic acid is available in its activated form known as pantethine. Pantethine, itself, is part of coenzyme A, a very important substance that participates in the metabolism of carbohydrates, amino acids, fatty acids and dozens of other important chemical reactions. Cognitive effects of oral pantethine administration to humans have not been published. Pantethene is sold over the counter in dosages ranging from 5 to 50 mg. In my experience, a lower dosage of pantethine provides similar effects as a higher dosage of pantothenic acid.

Folic acid, also known as folate, generally functions in cooperation with vitamin B12 in many metabolic reactions, including the synthesis of DNA. Folic acid helps reduce levels of homocysteine, a substance that can increase the risk for atherosclerosis (discussed later in this chapter). This vitamin functions as a methyl donor. Folic acid is found in almost all foods and the recommended daily intake is about 400 micrograms. The coenzyme form of folate is called tetrahydrofolate.

Cobalamin (B12), or cyanocobalamin, has a number of important roles in metabolism, including the synthesis of DNA. This function is particularly crucial when it comes to making new red blood cells. Hence, a deficiency of B12 leads to anemia. The formation of myelin—the white sheath surrounding nerves—is partly dependent of B12. Deficiencies in B12 intake lead to nerve damage, memory loss, poor coordination, low mood, and mental slowness. This nutrient, along with folic acid and B6, helps lower levels of homocysteine. High homocysteine levels are suspected in being one of the factors causing hardening of the arteries.

The recommended daily intake of B12 is about 3 micrograms, but much higher dosages are well tolerated. B12 is found mostly in meats and fish. Vegetarians can become deficient in this vitamin if they don’t take supplements. B12 deficiency can occur in the elderly due to malabsorption from the intestinal tract. If you have gastritis, absorption problems, autoimmune disorders, insulin dependent diabetes, certain thyroid disorders, or take antacids and other medicines that reduce stomach acid, you could have problems in maintaining adequate B12 levels. Hence, monthly B12 shots, in a dose of 1mg (1,000 micrograms), could well provide you with positive cognitive benefits. Sublingual forms of B12 are also available.

There are two coenzyme forms of B12, adenosylcobalamin and methylcobalamin. Adenosylcobalamin is sold over the counter as dibencozide, in a dose of 10,000 micrograms, which is a large dose. Human studies evaluating its role in cognitive disorders have not been published. It’s quite possible that with age, nutritional deficiencies, or enzyme deficiencies, some individuals may not be able to convert B12 into its coenzyme forms.

Biotin is involved in the metabolism of carbohydrates and fats. It is widely available in foods, particularly egg yolk, soybeans, cereal, legumes, and nuts. Bacteria in the gut also make it. The RDA ranges from 30 to 100 micrograms.

Recommendations
All of the B vitamins are important and supplementation would probably benefit most everyone. For healthy individuals, taking one to three times the RDA of the Bs would be sufficient. You will find B complex supplements that say B50 or B100 on the label. This means that many of the B vitamins, such as thiamin and riboflavin, are found in dosages of 50 or 100 mg per pill. The RDA for thiamin and riboflavin is about 1.5 mg. The average, healthy person does not need to take these high dosages. However, biochemical individuality certainly does exist. Dr. David Benton, Ph.D., who researches the influence of B vitamins on cognition says, "There can be enormous differences in the needs of vitamins. It wouldn’t be unusual for some individuals requiring 20 times the amount of a particular vitamin compared to others in a similar age group."

Vitamin B12 deficiency can often be treated with oral supplements instead of giving an injection. B12 deficiency is common in patients with reduced acid secretion because acid is required to release cobalamin from food. But these patients can absorb oral supplements because the cobalamin is in the crystalline form and not bound to food. Treatment of pernicious anemia can be done with oral B!2 at 1000 mcg per day.

A Daily Dose of B Vitamins Keeps the Cardiologist Away
Scientists at the University of Michigan in Ann Arbor say that people might live longer if they take daily multivitamins containing recommended doses of folic acid and B12.

Both nutrients help lower blood levels of homocysteine - a common substance found in the body that can harm blood vessel walls and encourage blood clotting and hardening of the arteries. Up to 10% of all heart deaths are thought to be associated with high levels of homocysteine. Clinical trials have not yet demonstrated precisely how much benefit can be derived from lowering levels of the substance, but even a small amount of benefit would make it worth taking vitamins. A computer analysis looked at the hypothetical balance between cost and benefit under several different scenarios, based on what is known about homocysteine and the effects of folic acid and vitamin B12. One scenario assumed that reducing homocysteine levels could reduce heart disease risk linked to the substance by 40%. The team found that in this situation about eight life-years could be saved per 1,000 men, and almost four life-years per 1,000 women.

It did not matter if vitamins were given to all at-risk people, or just those with elevated homocysteine blood levels. Dr. Sahelian says: Homocysteine is gradually becoming accepted as another risk factor similar to high cholesterol levels in causing hardening of the arteries. A daily dose of folic acid and B12, in amounts normally found in a multivitamin supplement, can make a significant impact in reducing a person’s risk from heart disease.

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