Articles > Vitamin B Deficiencies

The B complex is an extremely important group of nutrients that the body must acquire through the diet or produce via the intestinal flora to enable it to transform food into energy, maintain a strong immune system, balance many of the body's hormones, and perform a wide variety of other tasks.

The B vitamins work together as a complex and are dependent upon each other to perform their individual tasks in the body. The insufficient intake of one B vitamin can create imbalances and deficiencies in others and impair the body's ability to assimilate and metabolize them. If a depletion or excess of one over the other occurs for a period of any duration, there will be a problem in the entire complex. Because of this relationship between the B vitamins, an isolated deficiency of only one B vitamin is rarely seen. This is another good reason for taking the B vitamins as a complex, a whole, and not separately.

It is important to note that while the B vitamins must always be taken as a complex, in cases where there is a condition or problem caused by the deficiency of a particular B vitamin, the single B vitamin may be taken in a therapeutic dosage for a short time. However, the B complex must be taken as well. Robert Crayhon of Designs for Health advises that the therapeutic dose of the single B vitamin should be taken at a different time during the day than the B complex to realize maximum benefit.

Using a whole food, B complex in which all enzymes, nutrients, and co-factors are intact, is the best way to supplement long term. This will build nutritionally. If it is necessary, a separate supplement of a particular synthetic vitamin may be taken for a time to aid in improving a particular condition or deficiency. This is something that generally should not be done for long periods of time due to the fact that with overuse, the synthetic vitamins may cause problems such as nutrient depletion and toxicity.

Another disadvantage is that they can never build nutritionally. The effect synthetic vitamins will have is pharmaceutical not nutritional. The pharmaceutical effect is not always a bad thing and may be beneficial in some cases, as we will see. Synthetic vitamins should not be the main source of supplementation, however. Our bodies were made to recognize and use vitamins and minerals as they exist in food, not chemical versions of them.

Let's look at some of the things that may contribute to vitamin B deficiencies. Consumption of sugar, white flour products, processed foods (lack nutrients and may contain many additives), conventionally grown produce (lack nutrients and are contaminated with toxins such as pesticides), alcohol, stress, environmental pollution, inadequate digestion, malnutrition, illness, and a vegetarian or vegan diet can all contribute.

Due to the fact that a good percentage of the U.S. population consumes vitamin-deficient foods along with a combination of one or more of the aforementioned problems, vitamin B deficiencies have become commonplace.

Judith DeCava, Ph.D, in the article "Vitamin B Complex in Human Nutrition," lists many possible symptoms of a B complex deficiency:

Mild to severe depression
Forgetfulness
Vague fears
Uneasiness to panic
Mood swings
Rage
Morbid thoughts
Hostility
Restlessness
Apprehension
Constant feeling that something dreadful is going to happen
Suspicions
Instability
Anxiety
Mental confusion
Noise sensitivity
Inability to handle stress
Hearing noises, voices, etc.
Loss of ability to concentrate
Impaired intellect
Loss of memory
Nervousness
Weakness
Fatigue
Lightheadedness or dizziness
Digestive problems
Hypochlorhydria (insufficient stomach acid production)
Constipation or diarrhea
Stomach pains
Decreased or increased appetite
Craving for sweets
Heart palpitations
Chest pains
Neuralgia to neuritis
Muscular soreness
Pain, tingling or achiness
Cold hands and feet
Heightened sensitivity to touch and/or pain
Menstrual complaints
Soreness of the mouth
Dermatitis
Acne
Burning or itching eyes
Difficulty swallowing
Sore throat
Hypochondria
Headaches
Insomnia or sleep disturbances

According to Dr. Richard Murray, "A classical symptom of B complex deficiency, which has reached cronicity, is a constant feeling that something dreadful is about to happen. However, the first and most common complaint, especially among women, is depression and the tendency to cry without any particular reason."

The consumption of B vitamins particularly B-12, B-6, folic acid, biotin and niacin may reverse memory problems. Research conducted at Tufts suggests that blood levels of various B vitamins that fall at the lower end of the "normal" range can interfere with mental dexterity. A severe deficiency does not have to be present for memory impairment to occur.

Studies comparing the mental capacity of individuals taking B vitamin supplements to those receiving placebos demonstrated significant improvements in memory. Specifically, they were given 10 times the RDA of the B vitamins mentioned above for a period of one year.

A vitamin B complex deficiency puts a tremendous level of stress on the adrenal glands and often those deficient in the B's will also need adrenal support. Lying down and resting for five minutes, taking your blood pressure, then standing immediately and taking the blood pressure again can assess low adrenal function. The higher number of the blood pressure measurement should read at least ten points greater upon standing, than it was when lying down. If your blood pressure is not 10 points greater or if it goes down when you stand up, reduced adrenal function is suspect. The degree of hypoadrenalism is often proportionate to the degree the blood pressure drops (Balch, 1997: 91, 92).

Let's look at the B vitamins separately to determine what each one does in the body and what the individual deficiency symptoms look like.

B-1 (thiamin) is a powerful antioxidant that is necessary for regulating and normalizing the conversion of glucose into energy. It provides the neurons (nerve cells) with important building blocks needed for energy production and increases blood flow in memory tissue. B-1 is important for detoxification, heart function, muscle tone of the intestines, stomach, and heart, and the overall health of the nervous system.

The body requires higher amounts of B-1 when increased calories are consumed, particularly starches and sugars.

Deficiency Symptoms
In the most severe form, B-1 deficiency results in beriberi. This is relatively uncommon except in alcoholics. A less severe deficiency can result in symptoms ranging from fatigue, depression, constipation, edema, enlarged liver, forgetfulness, gastrointestinal disturbances, loss of appetite, and atrophy of muscle tissue, to numbness of the legs, or tingling sensations. It is interesting to note that 30% of those entering psychiatric wards are deficient in thiamin (Murray, 1996: 83).

Food Sources
The richest food sources of B-1 are brewer’s or nutritional yeast, brown rice, egg yolks, fish, legumes, liver, nuts, peas, poultry, rice bran, dulse, kelp, spirulina, wheat germ and whole grains. A high carbohydrate diet will increase the need for thiamin and the use of antibiotics, sulfa drugs, and oral contraceptives may decrease the body's thiamin level.

Dosage Range
Generally a daily dosage of 50 to 100 milligrams is adequate. For those suffering from age related mental decline or Alzheimer's disease, the therapeutic dose is 3-8 grams daily (with the whole B complex being taken at some other point during the day).

In fact, synthetic isolates will draw the accessory nutrients needed to

Note: if you take true whole food vitamins the dosage ranges will not apply. I have included the dosage ranges for all the B vitamins, as a guide, for those that want or need to take synthetic supplements, particularly in therapeutic doses.

Contraindications
Excessive B-1 can deplete other B vitamins and disrupt insulin and thyroid production.

B-2 (riboflavin) is needed for energy production, anti-body production, the production of red blood cells, healthy eyes and skin, and growth. It aids in the metabolism of carbohydrates, fats, and proteins, and is important in the prevention and treatment of cataracts. B-2 regenerates glutathione, a powerful antioxidant that is one of the main protectors of the body's cells against free-radical damage.

Deficiency Symptoms
Indications of a riboflavin deficiency include cracking of the lips and corners of the mouth, an inflamed tongue, loss of visual perception and sensitivity to light, cataracts, and burning and/or itching of the eyes, lips, mouth, and tongue. Other possible symptoms include dizziness, hair loss, insomnia, poor digestion, and slowed mental response.

Though severe deficiencies of riboflavin are not prevalent, moderate deficiencies are found quite often and are most common among the elderly population. Low dietary levels of riboflavin have been linked to certain esophageal cancers (Murray, 1996:85).

Food Sources
The foods providing the highest levels of B-2 are brewer's or nutritional yeast, almonds, wheat germ, wild rice, egg yolks, legumes, liver, fish, and poultry.

Dosage Range
5 to 10 milligrams daily is sufficient for general health.

Vitamin B-3 is important to the proper functioning of the nervous system and aids in the metabolism of carbohydrates, fats and proteins. It also plays a role in the production of hydrochloric acid and is involved in the normal secretion of bile and digestive fluids.

B-3 is available in two forms, niacin and niacinamide. The body's need for B-3 is satisfied by either form, but in doses larger than those obtained from food, they have very different effects in the body.

Niacin lowers LDL cholesterol and triglycerides, increases beneficial HDL cholesterol, increases circulation, improves brain function by enhancing the oxygen carrying ability of the red blood cells, regulates blood flow in memory tissue, and has the ability to mobilize fat from cells into the blood. Niacin also strengthens GABA, which is a calming neurotransmitter.

Niacin can cause a somewhat irritating but harmless flushing when first taking a dose of 50 milligrams or more. A no-flush variety, inositol hexanicotinate is the only form of time release niacin that is recommended; other forms of time-release niacin are a liver irritant and should not be consumed.

Niacinamide does not cause flushing, will not lower cholesterol or improve circulation, but has other benefits. It has been used since the 1940's to reduce insulin requirements of diabetics and has been found to be very effective in the treatment of osteoarthritis.

Deficiency Symptoms
A severe deficiency of B-3 and the amino acid tryptophan will result in Pellagra, which manifests itself in marked dermatitis, dementia, and diarrhea. A moderate deficiency can cause these symptoms to a lesser degree.

Food Sources
Niacin is found in brewer’s or nutritional yeast, liver, broccoli, carrots, cheese, eggs, fish, raw milk, peanuts, potatoes, tomatoes, dandelion greens, and wheat germ.

Dosage Range
If using pure crystalline niacin, start with a dose of 100 milligrams three times a day and carefully increase the dosage over a period of 4 to 6 weeks to the full therapeutic dose of 1.5 to 3 grams daily in divided doses. If you are using inositol hexaniacinate, begin with 500 milligrams three times daily for 2 weeks and then increase to 1,000 milligrams. It is best to take either crystalline niacin or inositol hexaniacinate with meals (Murray, 1996: 96).

Contraindications
Those suffering from diabetes, glaucoma, gout, liver disease, or peptic ulcers should use niacin supplements cautiously. Consuming over 500 mg per day for an extended length of time may result in liver damage.

Vitamin B-5 (pantothenic acid): Every cell in the body including brain cells requires vitamin B-5. It plays and important part in synthesizing the adrenal hormones (important for those under stress), assists in forming antibodies, enhances the utilization of other vitamins, and promotes the conversion of choline to acetylcholine, an essential brain neurotransmitter. It is also essential for the normal functioning of the gastrointestinal tract, glucose metabolism, optimal energy levels, and for wound healing.

Therapeutic levels of pantothenic acid are used to support adrenal and joint function and another form, pantethine, is used as an aid in lowering blood cholesterol and triglyceride levels.

Deficiency Symptoms
Many foods contain pantothenic acid, therefore a deficiency of this nutrient is rare. The Greek word "Panthos," from which its name is derived means "everywhere." The first sign of B-5 deficiency is generally fatigue and listlessness, and in severe deficiency, the "burning foot syndrome" is the main characteristic. This would include symptoms such as numbness and shooting pains.

Food Sources
Most fresh vegetables are good sources for B-5. Brewer's and nutritional yeast, liver, eggs, mushrooms, avocados, broccoli, whole grains, bran, peanuts, cashews, legumes, and soybeans are especially high in B-5.

Dosage Range
For general supplementation 4 to 7 milligrams daily is adequate. For use in adrenal support the therapeutic dose would be 250 milligrams twice daily. 2 grams daily is the therapeutic dose for rheumatoid arthritis. The dosage of pantethine taken for the purpose of lowering cholesterol and triglycerides is 300 milligrams, three times daily.

Vitamin B-6 (pyridoxine) is involved in a myriad of bodily functions; more than almost any other single nutrient. It is needed for the production of the neurotransmitters norepinephrine, serotonin, and dopamine, which are all necessary for optimal brain function. B-6 also influences endocrine function in the brain. Pyridoxine plays and important role in the growth of red blood cells, the health of skin and mucous membranes, effective immune function, and it is required for the proper functioning of more than 60 different enzymes.

B-6 has been used for prevention and treatment of a large range of degenerative diseases including cancer and arteriosclerosis. It can be taken therapeutically for conditions such as PMS, bloating, carpal tunnel syndrome, depression, epilepsy, kidney stones, osteoporosis, cardiovascular disease, autism, immune enhancement, MSG sensitivity (those who are sensitive to MSG are often deficient in B-6), and in diabetes for the prevention of diabetic complications.

30 - 40% of the population may have problems converting B-6 into P5P (pyridoxyl-5-phosphate), its main active form in the body. Those who are afflicted with illnesses may be unable to activate B-6. For these people the activated form of B-6 (P5P) should be taken.

Diets high in protein will increase the body's requirements for B-6, as does the consumption of alcohol and oral contraceptives.

Deficiency Symptoms
Depression, convulsion, glucose intolerance, anemia, impaired nerve function, cracked lips and tongue, headaches, hair loss, seborrhea and eczema are all characteristic of a B-6 deficiency.

Food Sources
Most foods contain some B-6 but those that are the best sources include brewers or nutritional yeast, sunflower seeds, wheat germ, walnuts, carrots, legumes, soybeans, chicken, eggs, fish, organ meats, spinach, blackstrap molasses, and whole grains.

Dosage Range
For general supplementation 50 to 100 milligrams of B-6 is sufficient.

Contraindications
Excess B-6 can deplete other B vitamins, so always take it in balanced amounts No more than 2,000 milligrams of B-6 should be taken per day as it can result in symptoms of nerve toxicity. Therapeutic dosages should not be used long-term unless they are under a total of 500 milligrams daily. If taking doses larger than 50 milligrams for therapeutic benefit, the doses should be divided into 50-milligram doses, which can be taken during the course of the day. This is important because the liver is unable to handle more than a 50-milligram dose at a time.

Vitamin B-12 (cyanocobalamin) stimulates RNA synthesis in nerve cells, strengthens neurotransmitters, and increases concentration. It is necessary for myelin formation and also aids in protecting arteries in the brain by metabolizing homocysteine. B-12 is and essential nutrient for nervous system health and production of red blood cells and plays a critical role in healthy digestive function.

Absorption of vitamin B-12 is dependent on HCL (hydrochloric acid) in the stomach and the bonding to a substance called intrinsic factor within the small intestine. Intrinsic factor is secreted by the parietal cells of the stomach. These cells are also responsible for the secretion of HCL. The insufficiency or lack of intrinsic factor has been found more commonly among those of Scandinavian, English, and Irish descent.

The Schilling test is used to determine if insufficient intrinsic factor is an issue. The test involves taking a radioactive form of vitamins B-12 then measuring the level excreted in the urine. Impaired absorption due to a lack of intrinsic factor is indicated by a below normal urinary excretion of the vitamin.

It may takes years to develop a B-12 deficiency and the resulting neurological effects will be noticed before it can be detected by the usual blood tests. Testing urine levels of methylmelonic acid is the best way of assessing a B-12 deficiency and will detect it before the blood levels of B-12 will record outside the normal range. A B-12 deficiency causes slowly progressing and irreversible nerve damage. New evidence suggests that B-12 can be deficient even though pernicious anemia is not present. Even in cases where the blood does not indicate it, B-12 may be dangerously deficient and can contribute to such problems as mental deterioration, confusion, depression, and other cognitive problems.

Unlike other water-soluble B-vitamins, B-12 is stored in the liver, kidney, and other body tissues. As a result, signs and symptoms may not manifest themselves until after 5-6 years of poor dietary intake or inadequate intrinsic factor. A B-12 deficiency will effect the brain and nervous system long before pernicious anemia becomes apparent.

Therapeutic levels of vitamin B-12 are used in diseases and conditions such as AIDS, Alzheimer's disease, senility, compromised cognitive function, asthma, sulfite sensitivity, depression, diabetic neuropathy, multiple sclerosis, tinnitus, and low sperm count.

Deficiency Symptoms
Deficiencies have been associated with some forms of dementia. The symptoms associated with a B-12 deficiency are fatigue, headaches, shortness of breath, sore, beefy red, swollen tongue, digestive disorders, heart and nervous system disturbances such as numbness and tingling of the arms or legs, depression, mental confusion, and memory deficits. B-12 deficiency can mimic Alzheimer's disease. B-12 is often deficient in vegans because the predominant source of B-12 is animal products. It is also prevalent among the elderly population.

A B-12 deficiency is indicative of intestinal dysbiosis or the overgrowth of toxic bacteria and a disturbance in the balance of beneficial bacteria in the intestinal tract. Dysbiosis in turn will result in leaky gut if left untreated. Leaky gut allows large protein particles, undigested food particles, and toxins to permeate the intestinal walls and find their way into the blood stream where they cause all kinds of problems. This is the starting point of many diseases.

Dysbiosis requires supplementation with the B complex, vitamin B-12, digestive enzymes, and probiotics such as acidophilus and bifido bacterium. Zinc and glutamine are helpful in healing leaky gut. It is beneficial to use all of these supplements together to address the entire digestive tract. It is also important to keep the diet free of sugar and processed foods.

Food Sources
The largest amounts of B-12 are found in nutritional yeast, liver, clams, eggs, meats, fish, and dairy products. Some B-12 is available from sea vegetables such as dulse, kelp, kombu, and nori.

Recommended Dosage
For vegetarians, 100 micrograms of B-12 daily is recommended. Methylcobalamin, the active form of vitamin B-12, in sublingual tablets is the preferred form of synthetic B-12. The amounts recommended in deficiency states are 2,000 micrograms daily for 1 month, followed by 1,000 micrograms daily for 3 to 6 months or until the methylmelonic acid levels in the urine are normal.

NOTE: Those with impaired digestive processes or over or under active thyroid may have problems with B-12 absorption. Because of this, or if there is a serious B-12 deficiency, a separate B-12 supplement may be taken in addition to the B complex until the digestive processes and/or thyroid are normalized or the deficiency dealt with. This should be taken at a different time during the day than the B complex. For these people, it may be advisable to take the active form of B-12 (methylcobalamin) in a sublingual form. Vitamin B-12 injections are another possibility, though research has shown that this is no more efficacious than oral administration of B-12.

Biotin aids in the utilization of other B vitamins, the metabolism of carbohydrates, fats, and proteins, fatty acid production, and cell growth. It promotes healthy skin and hair, nerve tissue, and bone marrow, and helps in relieving muscle pain.

Deficiency Symptoms
Deficiency of biotin is rare because it is produced in the intestines from foods that contain the vitamin. If a deficiency does occur it can cause a wide range of symptoms including anemia, depression, hair loss, hyperglycemia, inflammation of the skin and mucous membranes, insomnia, loss of appetite, muscular pain, and nausea. Obviously, those consuming minimal amounts of biotin containing foods will have greater risk of developing a deficiency.

Food Sources
Good sources for biotin are nutritional yeast, soybeans, whole grains, egg yolks, milk, meat, poultry, and saltwater fish.

Antibiotics, sulfa drugs, and saccharin reduce the bioavailability of biotin as do rancid or oxidized fats and oils. A protein called avidin that is present in egg whites, binds with biotin in the digestive tract and can deplete the body of this important nutrient.

Choline is a B vitamin that is the precursor of the neurotransmitter acetylcholine and is essential for optimal memory function. Choline is easily absorbed through the blood brain barrier, helps control harmful levels of homocysteine, and protects and nourishes other chemicals that support memory. Choline, along with B-12, is necessary for myelin formation.

Choline also plays a role in gall bladder regulation, liver function, and lecithin formation, and aids in hormone production and in fat and cholesterol metabolism.

Food Sources
Choline is a major ingredient in lecithin and lecithin makes up about 30% of the dry weight of the brain. Lecithin provides other important nutrients including phospholipids, fats, and glycolipids. Choline is also found in egg yolks, green leafy vegetables, liver, soybeans, yeast, and wheat germ. The best supplemental source is phosphatidyl choline.

Deficiency Symptoms
Impaired brain function and memory, cardiac symptoms, gastric ulcers, high blood pressure, inability to digest fats, kidney and liver impairment, and stunted growth are all possible results of a choline deficiency.

Recommended Dosage
500 - 1,000 milligrams per day for those aged 65 and under. Those over 65 may need from 1 - 5 grams per day.

Folate (folic acid) is a nutrient that is often deficient because it is so fragile. Though folic acid is present in many foods, its content in food is greatly diminished by cooking and is progressively lower the longer food is stored after picking. Because of this folic acid deficiencies are extremely common.

Folic acid stores in the body are sufficient to sustain the body for only one to two months. Alcohol consumption impairs folic acid absorption, disrupts folic acid metabolism, and causes the body to excrete folic acid. Deficiency is common among pregnant women. Drugs such as anti-cancer drugs, drugs for epilepsy, and oral contraceptives also deplete folic acid. Folic acid deficiency will result in diarrhea and malabsorption and the same type of anemia caused by B-12 deficiency.

B-12 must always accompany folic acid supplementation to prevent the folic acid supplement from masking a vitamin B-12 deficiency. Folic acid will correct anemia associated with the B-12 deficiency but will not remedy the problems that the B-12 deficiency causes in the nervous system and brain. Folic acid is extremely important for proper fetal development and prevention of heart disease.

Folic acid works synergistically with vitamin B-12 in many of the body's processes. It is critical for proper cell division and healthy nerve tissue. A folic acid deficiency effects all cells in the body, but the rapidly dividing cells such as red blood cells and cells of the GI tract are most notably affected. Some of the symptoms caused by a folic acid deficiency are anemia, depression, insomnia, irritability, forgetfulness, loss of appetite, and fatigue.

Folic acid is available as folinic acid (5-methyl-tetra-hydrofolate). Supplementing with this form is more effective in raising levels of folic acid in the body because it relieves the body of the job of converting the folic acid into folinic acid.

Food Sources
All dark leafy greens (the foliage that folic acid is named after) are good food sources of folic acid. These include kale, spinach, beet greens, and chard. Other sources are nutritional yeast, rice germ, wheat germ, blackeye peas, beans and lentils, asparagus, liver, soybeans, wheat bran, and walnuts.

Recommended Dosage
400 - 800 micrograms daily with meals.

Contraindications
High doses of folic acid (5-10 milligrams) may cause gas, poor appetite, and stomach upset. Those with epilepsy should avoid folic acid in high doses, because it may result in increased occurrence of seizures.

If taking pancreatic enzymes, which may reduce folic acid absorption, take the two supplements four to six hours apart.

Inositol is essential for hair growth, helps prevent hardening of the arteries, and is important in the formation of lecithin and the metabolism of fat and cholesterol.

Inositol has a calming effect and has been shown to be very effective in cases where depression is an issue. Researchers at Ben Gurion University in Israel demonstrated that supplementing with inositol successfully reduced depression in patients who were unresponsive to antidepressants. Inositol is not only effective, but also safe and non-toxic.

Deficiency Symptoms
A deficiency in inositol can result in arteriosclerosis, constipation, hair loss, high blood cholesterol, irritability, mood swings, and skin eruptions.

Food sources
Whole grains, nutritional yeast, lecithin, citrus fruits, nuts, seeds, legumes, unrefined molasses, meats, and dairy.

Recommended Dose
6 - 12 grams daily, in divided doses.

As we have seen, the B complex vitamins are of extreme importance to our health and well being and they work together as a team. Deficiencies can imbalance the whole B complex and deficiencies such as B-12 can cause severe and permanent damage to the body. It is important that we take steps to supply this important complex of vitamins to our bodies, first through our diets and secondly through proper supplementation.

by Karen Railey

References
Balch, James F., M.D. and Phyllis A., C.N.C., Prescription for Nutritional Healing Avery Publishing Group, Garden City Park, N.Y., 1997
Crayhon, Robert, M.S., Nutrition Made Simple Mt. Evans and Company, Inc., New York, 1994
DeCava, Judith, The Real Truth About Vitamins and Antioxidants
Murray, Michael, N.D., Encyclopedia of Nutritional Supplements Prima Health, Rocklin, CA, 1996
Murray, Michael, N.D., and Pizzorno, Joseph, N.D., Encyclopedia of Natural Medicine Prima Publishing, Rocklin, CA, 1998
Pizzorno, Joseph, N.D., Total Wellness Prima Health, Rocklin, CA, 1998  

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