Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
9 Mar

Should You Be Getting More B Vitamins?

Should You Be Getting More B Vitamins FinalWhen 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?

Deficiency Symptoms

  1. 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.
  2. Carbohydrate intolerance. Thiamine, which helps regulate glucose metabolism, has a strong connection to diabetes. Diabetics consistently have low serum levels of thiamine and the severity of diabetic symptoms matches blood thiamine.
  3. Fatigue, listlessness, brain fog.
  4. Poor sleep (thiamine is a co-factor in GABA production).

Why Might Deficiency Occur?

  1. 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.
  2. Excessive alcohol consumption, which impairs thiamine absorption and increases thiamine utilization.

Where to Get It

  1. 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).
  2. After pork, various seeds (sunflower, in particular) and veggies (spinach, asparagus) are good sources.
  3. Supplement. Thiamine HCL is a common, well-tolerated form.

Dosage

Men need about 1.3 mg per day, women 1.2 (1.4 when pregnant or breastfeeding). High-dose thiamine (300 mg/day) is safe and has been used to improve glucose tolerance, fatigue after stroke, fatigue in multiple sclerosis, and fatigue in inflammatory bowel disease. In young women with adequate thiamine status, 50 mg/day improved reaction time.

Vitamin B-2 (Riboflavin)

Riboflavin is a facilitator; it helps activate other B-vitamins like folate, thiamin, and B-12. It’s also a necessary co-factor in glutathione recycling.

Deficiency Symptoms

  1. Cracked lips and skin, throat swelling and soreness, swollen tongue, scaly skin.
  2. Pre-eclampsia. Pregnant women deficient in riboflavin are almost 5 times more likely to develop pre-eclampsia than replete women.
  3. Low niacin. Riboflavin enables the conversion of tryptophan to niacin.
  4. Anemia. Adding riboflavin to an iron-folate supplement combats anemia better than iron-folate alone.
  5. High homocysteine. Certain MTHFR mutations increase the need for riboflavin.

Why Might Deficiency Occur?

  1. Poor diet. Riboflavin is present in many foods, but a monotonous, limited diet can run short.

Where to Get It

  1. Liver, dairy, meat, nuts, eggs, green vegetables.
  2. Supplement. It just goes by riboflavin or vitamin B-2.

Dosage

1.3 mg/day for men, 1.2 mg/day for women. Excess riboflavin is excreted in the urine, turning it yellow. 

Vitamin B-3 (Niacin)

Like every other B vitamin, niacin figures prominently in the energy generation process, particularly the glucose-to-ATP pathway.

Deficiency Symptoms

  1. Pellagra is a fatal condition caused by gross niacin deficiency. It doesn’t happen much anymore with widespread food fortification.
  2. Elevated blood lipids. Taking niacin can raise HDL and lower the total/HDL ratio. It even beats statins when it comes to improving blood lipids and lowering arterial plaque.
  3. Depression.
  4. Low appetite.

Why Might Deficiency Occur?

  1. Too much alcohol.
  2. 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

  1. 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.
  2. 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.

Dosage

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.

Deficiency Symptoms

  1. Fatty liver: Without enough choline to process the fats entering it, the liver may begin to store visceral fat.
  2. All the downstream effects of fatty liver, including insulin resistance, type 2 diabetes, cardiovascular disease, and, eventually, eternal damnation.
  3. 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?

  1. Liver insults: Any insult to the liver, like alcohol consumption, increases the amount of choline you need.
  2. High-fat diet: Higher fat intakes require more choline to process the fat.
  3. 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.
  4. Not enough egg yolks and liver.
  5. Inadequate folate intake: Folate is required to metabolize choline.

Where to Get It

  1. Egg yolks (120 mg/yolk), liver (426 mg/100 g), kidney (513 mg/100 g), brain (491 mg/100 g), fish roe (335 mg/100 g).
  2. Supplement. Lecithin, choline bitartrate (41% choline by weight), alpha-GPC (40% choline by weight) are all different types of choline.

Dosage

550 mg for men and pregnant women, 450 mg for women.

Vitamin B-5 (Pantothenic acid)

Pantothenic acid is present in most foods, so deficiency is really hard to attain. That doesn’t negate its importance in dozens of physiological processes.

Deficiency Symptoms

  1. Tingling and numbness in the extremities, intestinal upset, headaches, fatigue. Again, almost unheard of in humans with access to food.
  2. While outright deficiency is hard to achieve, extra B-5 may prove useful for people with acne (some researchers even think pantothenic acid deficiency presents as acne).

Why Might Deficiency Occur?

  1. Pantothenic acid is used in ethanol metabolism, so anyone drinking alcohol would be well-served with a dose or two.
  2. Complete and utter starvation. An all-olive oil diet (olive oil is one of the few foods without B-5).

Where to Get It

  1. 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.
  2. Gut bacteria manufacture pantothenic acid, which may be absorbed by the host.
  3. Supplement. Calcium pantothenate is the standard effective form.

Dosage

There is no upper limit set for pantothenic acid, a strong indicator of its innocuousness.

Vitamin B-6 (Pyridoxine)

B-6 is a co-factor in dozens of enzymatic reactions, including the synthesis of neurotransmitters and creation of proteins (like tryptophan). 

Deficiency Symptoms

  1. Depression.
  2. Morning sickness. Studies indicate that B-6 supplementation can reduce pregnancy nausea.
  3. Inflammation. Elevated CRP is more likely in people eating less than 2 mg of B-6 a day.

Why Might Deficiency Occur?

  1. Pregnancy increases B-6 requirements.
  2. Long-term use of medications, including oral contraceptives and NSAIDs. Both may impair B-6 metabolism or distribution.
  3. Low B-6 intake. It’s present in a lot of foods, but not all of them.

Where to Get It

  1. Potatoes, bananas, poultry, nuts, fish, and legumes.
  2. Supplement. B-6 is widely available and inexpensive.

Dosage

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.

Deficiency Symptoms

  1. Weak, brittle nails. Biotin supplementation may improve nail strength.
  2. 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?

  1. 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.
  2. Too many raw egg whites. Uncooked egg whites contain avidin, which binds to biotin and reduces absorption.
  3. Dairy allergy. Dairy is a common, reliable source of biotin, and some studies have shown biotin deficiency to be common in kids with milk allergy.
  4. Broad spectrum antibiotics can disrupt the bacteria that make biotin.

Where to Get It

  1. It’s all over, but the best sources are eggs, dairy, organ meats, avocado, pork, chicken, broccoli, cauliflower, and spinach.
  2. Supplement. Look for biotin.

Dosage

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.

Deficiency Symptoms

  1. High homocysteine. Since folate converts homocysteine into methionine, folate deficiency usually leads to excess homocysteine.
  2. Neural tube defects in offspring. This ins’t a true symptom since you won’t notice until it’s too late. Prenatal supplementation of folate (or an emphasis on folate-rich foods before and during pregnancy) is crucial.

Why Might Deficiency Occur?

  1. MTHFR mutations which increase requirements and impair metabolism.
  2. Insufficient intake of folate-rich foods, especially if you’re avoiding fortified grains (which most of you probably are). See below for a list. 
  3. Lack of vitamin C in the diet. Vitamin C improves folate absorption.

Where to Get It

  1. Chicken liver is the single best source of folate followed by other livers. Leafy greens, pastured eggs, asparagus, lentils, and chickpeas are also good.
  2. Supplement. Folic acid is the most common form, but people with MTHFR mutations which impair the conversion of folic acid to folate should take folate

Dosage

At least 400 micrograms a day for both men and women. 600-800 if pregnant.

Vitamin B-12

According to Chris Kresser, vitamin B12 deficiency is quite common, even among those who eat plenty of the richest source of B12: animals.

Deficiency Symptoms

  1. Lethargy.
  2. Unwanted weight loss.
  3. Dementia/Alzheimer’s-like symptoms.
  4. Anxiety and depression.
  5. Autism spectrum disorder in children.

Why Might Deficiency Occur?

  1. We aren’t looking for it. As meat-eaters, we assume we’re getting plenty, and doctors don’t check for it regularly.
  2. 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.
  3. 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

  1. Animals. Liver, sardines, and salmon rank highest, with liver running away with it. There are no vegetarian sources.
  2. Supplements. Methylcobalamin is probably the best.

Dosage

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!

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You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. Thinking about the choline and how to increase my intake of it.
    I already eat 20 eggs (free range) and ~100g liver per week but it leaves me short on weekly recommended. Any other good sources where I can get it? I do eat 1kg of pork and 2kg of herring/salmon a week but I don’t know if that gives me any choline.

    Kevin wrote on March 9th, 2016
    • Hi Kevin,

      Good sources of choline, in order of significance

      Grass-fed animal liver
      Egg yolks
      Non-GMO soy lecithin
      Avocado
      Choline, among other things, is a critical nutrient to assist your body’s detoxification.

      Hope this helps,

      Julia

      Julia wrote on March 9th, 2016
  2. “Why Might Deficiency Occur?

    1) Too much alcohol.”

    So what you’re saying is we need B vitamin enriched Tequila….right?

    Mike wrote on March 9th, 2016
    • I just spent 6 days in Mexico. Plenty of tequila, but alas, none of it was B vitamin enriched!! I did manage to eat primally while thoroughly enjoying myself at an all inclusive resort. Detailed some of the meals on my blog if any one is interested:)

      Elizabeth wrote on March 9th, 2016
      • Low carb changed many fast food restaurant routines. Now primal will change pub routines. “Bartender! Give me a shot and a draw. Oh, and a B complex tablet.”

        Rick wrote on March 9th, 2016
  3. Lack of B vitamins can decrease effectiveness of thyroid hormone. Not sure if that’s true for people with normal thyroid function, but in my case (I take desiccated thyroid) adding B-complex supps allowed me to reduce the dose.

    Energy! wrote on March 9th, 2016
    • Hi Energy, I also take theiroid hormone in Lievothyroxine form, but would like to try a natural dessicated form of it. However, my doctor will not prescribe it. I live in MD and would like to find a thyiroid knowledgeable naturopath but so far have had no luck finding one. I would appreciate your advice. I’ve been Paleo grok for last four years and am doing great health wise.

      Gina McAbee wrote on March 11th, 2016
      • Dr. Michael E. Doyle, (MD) -Stamford, Ct. He prescribes Armour Thyroid

        Joan Kasiewicz wrote on March 13th, 2016
  4. Wow, great info and love all the detail. I think I’m doing ok overall, due to my liver and egg yolk consumption! But when I am going through a particularly stressful time I supplement with a B complex. I figure it can’t hurt.

    Elizabeth wrote on March 9th, 2016
  5. Over 10 years ago I had bad pain in the liver area. Got the usual medical examinations (the ones that end with scopy). Since I take a B vitamin complex the pain is gone.

    Beatrix Willius wrote on March 9th, 2016
  6. This is probably a dumb question, but are the links with a strike-through an error, or does it mean something else? Normally a strike-through means it’s a change or a joke, but you have them quite frequently. Every time I see it, I pause and wonder if I’m supposed to take the statement seriously.

    Annie wrote on March 9th, 2016
    • I don’t know what the deal is either, but near as I can tell, based on the links, they should be taken seriously.

      b2curious wrote on March 9th, 2016
    • I have the same question. When I check the links the articles seem to support the crossed out statement, so I’m confused as well. Can someone clarify this please?

      Alicia wrote on March 9th, 2016
    • I think the Web server automatically checks all the links in an article each time it parses (assembles) a page (ie every time someone loads an article on the site). Links that no longer work are automatically struck through (the source material may have been moved or removed since the article was written).

      N N wrote on March 9th, 2016
    • Good question! Typically, the strike through is supposed to mean a link is broken. But we’ve had some occasions where links contain a strike through and are perfectly fine. But thanks for the heads up–we’ve gone in an updated some technical features of the blog, so the issue should be resolved going forward.

      Thanks for asking so we could clarify for everyone else who’s wondering!

      Worker Bee wrote on March 9th, 2016
  7. Great information. One minor correction. Folate (or folic acid) is Vitamin B-9 (not B-8). Vitamin B-8 is Inositol which is very important but technically is no longer considered a B-vitamin.

    TWC wrote on March 9th, 2016
  8. Just wondering about the “holy triumvirate” of K2, D3 and vitamin A…natto and cod liver oil would fit that bill but what of just eating grass fed, full fat yogurt or else some slices of extra hard gouda, getting plenty of optimal sunlight exposure and then eating liver or cooking with red palm oil, for instance?

    I mean, wouldn’t that achieve the same result bio-availability wise?

    bigmyc wrote on March 9th, 2016
  9. I have heard that a lot of people experience hair loss when taking B5 supplements. Is there any truth to this?

    David wrote on March 9th, 2016
    • Yes it’s true, Mark should be very careful about recommending it for acne and implying you can take as much as you want.

      There are many people that suffered hair loss as a result of this, check out this massive thread discussing it here http://www.acne.org/messageboard/index.php/topic/323948-vitamin-b5-hairloss-cured/

      Ben wrote on March 14th, 2016
      • Thanks for the link. Is the hair loss typically diffuse or can it manifest as sudden and rapid male pattern baldness? And is the problem seen even at 500mg daily?

        David wrote on March 14th, 2016
        • It’s MPB style, though there are also some women that also suffered hair loss. Yes 500mg is actually still a mega dose and can cause problems.

          If Mark is reading this I highly recommend he edits this article, we don’t want more people making this mistake.

          Ben wrote on March 15th, 2016
  10. What a coincidence! Just today my blood analysis results came back and my B12 levels were so low I have to get injections for a few months. I eat plenty of meat, though, so I’m a little worried what might be causing it. I’ve started doing more intense exercise recently, but I doubt it could drag my B12 levels so low I need injections.. I never thought I’d say this, but I’m hoping it’s parasites, the other options look way less cheerful.

    Katie wrote on March 9th, 2016
    • Katie,
      B12 needs “intrinsic factor” in order to be absorbed by your body. And THAT relies on plentiful stomach acid to be present. Do you know if you have enough stomach acid? You can’t absorb B12 (or iron) without it. Lots of folks are loading up on meat thinking they are “covered” on the B12 front but, if you can’t absorb it, you aren’t getting it, no matter how amazing your diet might be.

      Grok on!

      Julia

      Julia wrote on March 9th, 2016
  11. To summarize…. Eat more eggs/offal. Lovin’ it. And no, not McFluffin style.

    Myles wrote on March 9th, 2016
  12. Taking a b-complex in the winter is a great way to have exactly the kind of highlighter-yellow “ink” needed to “write” in the snow. Yes, I’m eight years old.

    His Dudeness wrote on March 9th, 2016
    • +1

      Julie wrote on March 9th, 2016
    • What a coincidence. I took a B-complex to compensate for over celebrating last night and today I drew a perfect Rosignol R in the snow.

      Jack Lea Mason wrote on March 9th, 2016
  13. I eat pork/chicken liver pate regularly..i’d say twice a week ( it’s about 30%pork liver, 30% chicken liver, rest is pork fat and some madeira wine for flavour I guess. ).
    I make my own “cheese sandwiches” which is proper sliced swiss cheese, pate, then covered with another slice of cheese with maybe a few slices of cucumber in between as well. ( the days I eat this, it’s my only meal. not hungry until next day ). I love it and hope that eating 500 grams of liver pate a week would cover my B vitamin needs? or do I have to cook the livers from scratch? the pate is organic and very high quality with pretty much just a few ingredients and I can pronounce them all :-)

    Jacob wrote on March 9th, 2016
  14. After reading your information on B vitamins, it sounds to me like an aging woman with high blood glucose (120 ish), MTHFR, etc., should take them all. can you suggest a good B vitamin that covers all the bases?
    Thank You
    Diann

    Diann wrote on March 9th, 2016
    • Check out “Vita-Min” by Biotech Pharmacal. Impressive multivitamin supplement with extra D3, and even K2.

      Lora wrote on March 9th, 2016
    • Thorne’s b complex. It’s amazing.

      PK wrote on March 9th, 2016
  15. Think I’m good on the b vitamins, except for maybe B-1. Even then I’m probably not deficient, just not as much as other primal eaters, pork is one of my least favorite meats. To your mention on natto though, I hate the stuff, but taking high vitamin butter oil or eating pastured liver will get sufficient k2, especially if you eat goose liver for some reason.

    barry wrote on March 9th, 2016
  16. I thought I was getting enough b vitamins by eating liverwurst and paleo, but I didn’t solve my problem with menstrual cramps until I started taking the p5p form of B6. It’s changed my life.

    PK wrote on March 9th, 2016
    • Yes, just like the mthfr defect, there is a somewhat common mutation in the gene that adds a phosphorus atom to B6 thereby activating it to do work for the body. People who have this mutation do better taking the already phosphorylation form, P5 P. Riboflavin has the same issue, but with a different gene. Taking a b complex with the active forms, like riboflavin 5 phosphate, methyl folate and p5p gets around this.

      Mims wrote on March 9th, 2016
    • It’s crazy right? I can’t thank my chiropractor enough! How else would I have known to try that!

      Coco wrote on March 10th, 2016
  17. Two things I would not recommend anyone put in their body: Fermented Cod Liver Oil, and folic acid. See Stephanie Seneff on folic acid, and Kaayla Daniel on FCLO. Otherwise, excellent recommendations.

    Gary Ogden wrote on March 9th, 2016
    • I absolutely agree gary, synthetic folic acid is evil and needs to be removed from the food supply. Unfortunately they keep adding it to more and more foods….

      Mark Sisson should re-evaluate his recommendation.

      Mims wrote on March 10th, 2016
  18. There’s GETTING the B vitamins, and there’s ABSORBING the B vitamins. Care to speak to the absorption end of things – I’d be curious to hear what you have to say about it. I myself don’t think I absorb them well.

    Martha Beddoe wrote on March 9th, 2016
  19. Hi Mark, it should be important to note that people with MTHFR mutations (or, rather, COMT mutations in my case) do not do well on Methylcobalamin B12. I get extreme panic attacks when I take a “methyl” B vitamin. Hydroxo- AND adenosyl- cobalamin are good sources for folks like me (though harder to find!).

    Maria wrote on March 9th, 2016
  20. Nutritional yeast flakes. Use them on everything!

    DLunsford wrote on March 9th, 2016
  21. Such an important post–thank you!

    Personally, I eat high-quality fish and meat (including liver) regularly, so have little to worry about. And yet, as you make clear, for many folks there are all kinds of factors that can interfere with absorption–even if they’re eating the right stuff.

    Being deficient in the various Bs is a really, really big deal for physical and mental health. For this reason, I regularly prescribe a medicinal-grade, whole-food-based B complex to patients (along with eating guidance). Will be wonderful to pass this post along too, to help explain why.

    Dr. Dana Leigh Lyons wrote on March 9th, 2016
  22. “[Niacin] even beats statins when it comes to improving blood lipids and lowering arterial plaque.”

    The reference link is a study which includes statins in all patients. There is no niacin, non-statin arm in this study to make the claim that “it beats statins”.

    From the “Study background and population” section of the reference:
    “… all patients were already taking statins, the dosage of which was determined by their own physician.”

    So how can you use this reference as a claim that niacin beats statins? You can say that niacin + statins are better than without niacin, but this study says nothing about the effects of niacin alone.

    I really like this site, but often when I investigate the supporting reference of a claim that I am a bit skeptical of, it does not seem to support the claim.

    Am I missing something here?
    As anybody else actually looking at these references?

    Travis wrote on March 9th, 2016
  23. Also, folic acid is not folate,. Folic acid is a known carcinogen, check out the Folic acid fortification data.

    Tom wrote on March 9th, 2016
  24. I had sciatica that just wouldn’t go away (over a year). My functional medicine doctor suggested I try sublingual B-12. It works well for some folks, though not all. It took several months, but the pain went away. I have taken a small dose daily ever since and it hasn’t come back.

    Grace wrote on March 9th, 2016
  25. I once read that B vitamins compete for absorption. Is there any truth to that? I take a B-complex every day (in addition to a well-rounded diet contain most of the aforementioned B-rich foods), but sometimes wonder how efficient it is to take the full spectrum all at once.

    Gracie wrote on March 10th, 2016
  26. I’m surprised this article didn’t mention Keefer as being rick in vitamin B12, B1, Vitamin K and biotin. I love Keefer, but think liver is totally yuck.

    Kelly wrote on March 10th, 2016
  27. What do you think about the claims in Orthomolecular circles about high does Niacin to treat depression? I have a loved one that struggles with it even though he eats a very clean organic paleo diet and exercises daily. Trying to find something that will help him- he takes a b complex already, but would the addition of Niacin help do you think?

    Amber wrote on March 10th, 2016
  28. typos above. Meant high dose Niacin. Also, PK, I wanted to thank you for your post about P5P and relief of menstrual issues. I am ordering some right now!!

    Amber wrote on March 10th, 2016
  29. I unwittingly had a B12 deficiency for eons, due to an inability to digest it from food. I only learned about it when it got so severe I was forced to drag my buns to a doctor for diagnosis. At that point, I had extreme insomnia, no appetite, crazy reactions to food (eating citric acid would bring on a panic attack, for instance), and a list longer than my leg of other symptoms. Methylcobalamin saved my life. If my neuropathy (limbs aching and going numb, sensations of electricity zapping and zinging in your parts, or a feeling like warm water running over your feet when there ain’t any) or breathing problems (struggling to take a full breath) start coming back, I know I haven’t been taking enough B12. Those are the first indicators for me.

    Mel wrote on March 11th, 2016
  30. Whenever I take a b complex supplement, with or without food it makes me sick-nauseous, indigestion,headache…
    I take supplements because I always seem to be low, and Alzheimer’s runs in my family-which is terrifying.
    Anyone have the same response, or know why this is happening? Opinions appreciated.

    Tootzek wrote on March 11th, 2016
  31. Thank you for this. Very helpful. I just recently found out about my MTHFR variation and just started getting my folate and B12 properly. I didn’t know about biotin and choline being demoted vitamins. Fascinating and so helpful. Amazing!

    slacker wrote on March 12th, 2016
  32. Has anyone heard anything good or bad concerning Vitamin B injections? A client of mine started doing these biweekly for about $30 a pop. He says he feels great, but I don’t like the idea of going to some place to get a needle stuck in your arm filled with a super dose of anything… I could be wrong here, but it just seems a little extreme. Any input would be greatly appreciated.

    Dan wrote on March 13th, 2016
    • As someone who has a serious deficiency in B-12, I started taking shots. My dr. switched me to cerefolin pills since I was unable to advance to doing it myself.

      There are many reasons someone may be low in B-12. Prevacid, zantac, etc (any GERD medication) will prevent you from absorbing B-12. I think many people are at least slightly deficient, so your client could be experiencing a boost due to that. It fell out of medical favor in the 50s and 60s due to people taking the shots for energy and well-being, rather than need.

      I would love to see B-12 levels tested periodically for everyone, but I don’t have that power. If someone is interested in getting additional B-12 for general health benefits, I would suggest taking the sublingual tablets once or twice a day.

      Typically, the shots are in the butt since they should go into a big muscle. HTH

      Julia wrote on March 13th, 2016
  33. In Dr. Robert Lustig lectures, he mentioned that many of the symptoms from excess fructose consumption are the similar to ethanol consumption. So I wonder if excess fructose consumption (ie. fruitarian diet) can also increase vitamin B deficiency. There are suggestions that high sugar diet depletes your vitamin B.

    dude wrote on March 14th, 2016
  34. That was quite insightful. Most people are B-12 deficient, how true is that! My doctor friend always stressed about it when I started bodybuilding last year(I am a vegetarian)

    But I have got it all covered. My diet revolves around eggs, dairy, nuts and fruits and veggies. Just to say I eat 5-6 whole eggs+10egg whites everyday. Egg yolks and superfood I suppose I get enough of all the B’s

    Shobhit Choudhary wrote on March 15th, 2016
  35. I will start taking the Thorne Research Basic B Complex (just ordere it from iHerb). My doctor recommended it to me, but at that time I didn’t know that it has such a high dose Niacin in it or that high doses of Niacin can cause flushes (140mg per capsule and I was planning to take two per day with breakfast and lunch). Has anybody tried this supplement and have they had any negative reactions? I have only ordered a bottle for now and will talk to my doctor about it when I see her again in June this year.
    Thank you.

    Cristina wrote on March 21st, 2016
  36. I took a generic B complex supplement for years, and thought I had my B vitamin bases covered. However, I was/am still struggling with infertility, anxiety, and fatigue, as well as insulin sensitivity issues. Despite the years of B supplementation, a recent micro-nutrient test showed I was low in all of the B vitamins (as well as some other things). The doctor I saw recommended, among other things, switching to Thorne Research’s Basic B Complex (since it has all of the more bio-available forms), which I did. While I’m still adjusting all of my vitamins and supplements, the switch in B-complex has made an important difference. (I am making all supplement changes slowly, one thing new or different each month, so that I can tell what is doing what.) Most notably, on two per day, breakfast and lunch, there was an almost immediate improvement in my NFP charts. I’m still adjusting everything (Two per day seemed to make me a little wired. One a day seemed like it didn’t have enough p5p for me. One a day plus extra p5p isn’t quite right either. Next adjustment attempt: two per day plus even more magnesium.), but it is clear that I needed the more bio-available forms found in the Thorne Basic B (unfortunately, not all of their B complexes have the bio-available forms). And of course, learning to like liver!

    Industrious Warrior Maiden wrote on March 30th, 2016
  37. B-12 deficiencies can definitely alter your mood and how you feel entirely. It’s important to stay on top of your intake so you don’t put yourself at risk for depression or the slew of other symptoms deficiency involves. Thanks for sharing!

    Rachel wrote on July 28th, 2016

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