When it comes to obtaining sufficient amounts of certain micronutrients, you’re hyper vigilant. Magnesium? You’re eating spinach, throwing back magnesium glycinate, and adding Trace Mineral drops to your water. Iodine? You’re making dulse “bacon.” To bask in the holy triumvirate of vitamin K2, vitamin D3, and vitamin A, you’re willing to eat fermented cod liver oil and stinky natto. But as omnivores drawing upon a broad spectrum of plant and animal foods, Primal people tend to assume they have the B vitamins covered. It’s no wonder: punch a slab of beef chuck steak or a few ounces of liver into the USDA nutrient database and that whole B vitamin section seems to fill up.
Let’s take a look. You may be right. You may be totally fine. But it’s always nice to refresh your focus.
Vitamin B-1 (Thiamine)
Thiamine is a co-enzyme used to produce ATP, the energy currency of the body. Without adequate thiamine, your power levels drop. Wouldn’t want to be low energy, would you?
Serious thiamine deficiency leads to an often-fatal condition that affects the cardiovascular system called beriberi. This is hard to get in developed countries, or any country that fortifies its grains. “Dry beriberi” is another serious condition that affects the nervous system.
Poor sleep (thiamine is a co-factor in GABA production).
Why Might Deficiency Occur?
Avoidance of fortified grains. Most people get adequate thiamine because they’re eating diets based on refined white flour, which is fortified with the vitamin. I don’t advise this tactic, but it does work if all you care about is thiamine. Primal eaters will have to eat other stuff.
Although most health websites never mention it, pork is the single best dietary source of thiamine. It’s in the muscle meat, so any amount of lean pork will be rich in thiamine. You don’t need much, either. 100 grams of lean pork gets you almost all your daily thiamine (PDF).
After pork, various seeds (sunflower, in particular) and veggies (spinach, asparagus) are good sources.
Insufficient intake of animal foods. Not only are animal foods the best source of niacin, they’re also the best source of tryptophan, which our bodies can convert to niacin when needed. This is actually why food fortification was enacted—to make up for the lack of animal foods in many nations’ diets.
Where to Get It
Fish, especially tuna, is the single best source, followed by beef liver, pork, dairy, and poultry. Mushrooms and sunflower seeds aren’t too shabby, either.
Supplement. Niacin often causes unpleasant facial flushing—that’s how you know it’s working. Older sustained release forms of the vitamin eliminated the flushing but didn’t work as well and caused other, more dangerous side effects, like liver damage. Both instant release niacin and newer extended release niacin appear to be safe and effective at reducing cardiovascular disease, so stick with that if you’re trying to prevent heart disease. High-dose niacin of any type is more drug-like than vitamin-like, so be sure to consult a medical professional.
16 mg/day for men, 14 mg/day for women. Higher levels are safe if you can handle the flushing.
Vitamin B-4 (Choline)
Originally classified as the 4th B vitamin, choline was downgraded, but I don’t buy it. Choline is incredibly important for liver and brain health, and people aren’t eating the egg yolks and liver that provide the biggest doses of it like they once did.
Fatty liver: Without enough choline to process the fats entering it, the liver may begin to store visceral fat.
All the downstream effects of fatty liver, including insulin resistance, type 2 diabetes, cardiovascular disease, and, eventually, eternal damnation.
Brain fog, memory deficits, general mental “bleh”ness. Choline begets acetylcholine, an important neurotransmitter. Remember how a ton of nootropics purport to act via acetylcholine pathways? Choline’s the currency.
Why Might Deficiency Occur?
Liver insults: Any insult to the liver, like alcohol consumption, increases the amount of choline you need.
High-fat diet: Higher fat intakes require more choline to process the fat.
Pregnancy and lactation: Not a true deficiency, but as choline helps build baby brains and gets diverted to breast milk, both pregnancy and breastfeeding increase choline requirements.
Complete and utter starvation. An all-olive oil diet (olive oil is one of the few foods without B-5).
Where to Get It
All plant and animal foods (except for pure oils; pantothenic acid is water-soluble). Sweet potato, avocado, and mushrooms top the list of plant foods. Organ meats, shellfish, eggs, fish, and dairy top the list of animal foods.
Long-term use of medications, including oral contraceptives and NSAIDs. Both may impair B-6 metabolism or distribution.
Low B-6 intake. It’s present in a lot of foods, but not all of them.
Where to Get It
Potatoes, bananas, poultry, nuts, fish, and legumes.
Supplement. B-6 is widely available and inexpensive.
Aim for about 2 mg a day. Long term mega doses (1000 mg/day) may cause sensory neuropathy, characterized by numbness, pain, and difficulty walking.
Vitamin B-7 (Biotin)
Another fallen B-vitamin, biotin is everywhere. We can’t make it from scratch, but our gut bacteria make it for us, it’s present in many foods in our diet, and our bodies can even recycle the biotin we’ve already used for later use.
Weak, brittle nails. Biotin supplementation may improve nail strength.
Progressive multiple sclerosis (maybe). A recent pilot study found that high dose (100-300 mg a day with the recommended normal intake being just 30 micrograms) biotin supplementation helped to stop and even improve the progression of multiple sclerosis. More research is underway.
Why Might Deficiency Occur?
Biotinidase deficiency, a hereditary condition which prevents biotin from being recycled from proteins in the body or absorbed from foods. Standard newborn screening usually looks for this, and biotin supplementation effectively treats it.
Too many raw egg whites. Uncooked egg whites contain avidin, which binds to biotin and reduces absorption.
30 micrograms per day for all adults. More for pregnant women.
Vitamin B-9 (Folate)
Folate is a big one. It’s required for DNA methylation (a key component of gene expression) and synthesis of vital amino acids like methionine. Basically, if you want all the genes in your body to work and produce the proteins they’re meant to produce, you need folate.
We aren’t looking for it. As meat-eaters, we assume we’re getting plenty, and doctors don’t check for it regularly.
We aren’t absorbing the B12 in our food. Gut disorders like Crohn’s or diarrhea affect our ability to absorb nutrients, minerals, and vitamins, including vitamin B12.
We set the bar for “normal” too low. Everything could check out and look fine on paper, but the lower end of “normal” is too low and can still cause B12 deficiency symptoms. Other countries, like Japan, have higher “normal” B12 markers and fewer cases of Alzheimer’s/dementia.
Where to Get It
Animals. Liver, sardines, and salmon rank highest, with liver running away with it. There are no vegetarian sources.
Supplements. Methylcobalamin is probably the best.
If you eat animal products regularly and liver occasionally, you’ll be getting plenty of B12 in your diet. No need to supplement if you have none of the symptoms listed above. But if you have some of the symptoms, or you have a gastrointestinal disorder that may be compromising your ability to absorb vitamin B12, consider getting your levels tested during your next visit to the doctor. In that case, try 1 mg/day of sublingual methylcobalamin, which will bypass the intestinal tract and pass directly into the bloodstream.
Should you supplement?
Not everyone needs to supplement. I’d say most people reading this don’t need to supplement.
Pregnant women usually need more of everything, and the B vitamins are no exception. Standouts for pregnant ladies include B12, choline, and folate. Any decent prenatal supplement will provide ample B vitamins.
People with depression may want to throw in a B-complex, which has been shown to improve depressive symptoms across all groups (severely depressed, mildly depressed, people without clinical depression) and increase B-12 and folate status. The involvement of various B vitamins in energy generation, neurotransmitter production, antioxidant capacity, and vitamin activation suggest it’s just a good idea for depressive patients to be replete.
Heavy drinkers should probably take more B vitamins, as ethanol metabolism depletes pretty much all of them.
One way to determine your needs is to go through the list of symptoms and see what applies to you.
Another is to get your serum levels tested, particularly if you suspect a deficiency.
But seriously, folks: just eat a quarter to a half pound of ruminant liver every week. It’s the best way to ensure you’re eating adequate amounts of practically every B vitamin you need. That little dose of liver combined with an overall healthy diet rich in animal products, leafy greens, nuts, mushrooms, and other foods mentioned in the vitamin profiles from today’s post will provide plenty.
Thanks for reading, everyone, and I hope today’s post was informative!
Prefer listening to reading? Get an audio recording of this blog post, and subscribe to the Primal Blueprint Podcast on iTunes for instant access to all past, present and future episodes here.
About the Author
Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.