The B-vitamin family contains diverse members necessary for healthy functioning of almost all body processes, which is why they are “essential” nutrients. The actions of the B vitamins cover everything from energy production in the body, to maintaining blood vessels to hormone metabolism.* Most B vitamins work together and, in many cases, provide the greatest benefit when supplemented together.

Not as well known as some B vitamins, Thiamin (B-1) and Riboflavin (B-2) are essential to good health. Both are critical for normal energy production in human cells.

Deficiency of vitamin B-1, known as beriberi, has wide-ranging symptoms including weakness, confusion, heart damage, and loss of balance.*1 Clearly vitamin B-1 is essential for many body functions. Though beriberi is rare in the U.S. today, marginal or near-deficiency may be rampant. The typical healthy adult gets between 1.05 and 1.75 mg per day (compared to the Reference Daily Intake [RDI] of 1.5 mg per day).1 Near-deficiency is particularly common among the elderly and has been shown to lead to disturbances in the nervous and musculoskeletal systems.*2

Vitamin B-1 was also linked to the health of the nervous system in another study: healthy women who took vitamin B-1 were shown to be more clear-headed and energetic as well as having faster reaction times.*3. Vitamin B-2 is necessary for the metabolism of fats, carbohydrates, and several of the other B vitamins. Higher doses can help protect normal blood flow to the brain.*4 The elderly5 and the poor6 have a high rate of marginal deficiency of this vitamin. It is unknown to what extent other people may have insufficient intake of vitamin B-2. The RDI is 1.7 mg per day.

Niacinamide is another form of vitamin B-3 with greatly reduced risk of adverse side effects. Niacinamide's actions differ significantly from those of niacin, and does not cause flushing. In particular, niacinamide does not affect cholesterol levels, but does help ensure healthy joint function.*12

One of the most multifaceted nutrients may be vitamin B-6 (or pyridoxine). This vitamin is a component of a large number of enzymes; therefore almost every body system relies on it for optimal function. Some important enzymes that require vitamin B-6 are responsible for amino acid (protein) metabolism, formation of essential fatty acids, and formation of some neurotransmitters.

Significant research has shown that vitamin B-6 is beneficial for maintaining nerve health,*13 hormonal balance in pre-menstrual women,*14 and kidney activity.*15 There is also evidence showing that vitamin B-6 supports healthy lung function.*16 It is said to work together with magnesium, particularly by improving magnesium absorption into cells. However, this potent vitamin should not be taken in amounts over 200 mg per day for more than a few days without consulting a doctor since it has been shown to cause temporary nerve problems.* Additionally, high doses of vitamin B-6 supplements could interfere with normal milk production of breast-feeding women.*17 This supplement has been shown to be safe during pregnancy, however.*18

 

Folic Acid and Vitamin B-12
Though known to doctors of natural medicine for years, one of the biggest nutritional news stories of the decade is that folic acid, vitamin B-6 and vitamin B-12 are critical for a healthy cardiovascular system.*19 High levels of the natural but toxic amino acid homocysteine cause damage to the blood vessels.*19 Getting enough folic acid, vitamin B-12 (cobalamin) and vitamin B-6 helps maintain normal homocysteine metabolism.*20

Deficiency of any of these vitamins has long been known to cause a type of anemia in which the red blood cells become enlarged. *21 Vitamin B-12 deficiency is also related to nerve and mental problems.*1 People who are vitamin B-12 deficient and take 1,000 mcg (1 mg) of folic acid, or more, per day will show an improvement in anemia but no improvement in nervous system damage. Subclinical or marginal vitamin B-12 deficiency is fairly common, particularly among the elderly.*22 B-12 deficiencies have been associated with difficulties in thinking, poor memory, low energy, low stomach acid and high homocysteine levels.*22,23,24 Low levels may also lead to a weakened immune system.*25 It has been speculated that high doses of folic acid (> 1 mg) mask proper diagnosis of B-12 deficiency, increasing the risk of permanent nerve damage.

Women who consume healthful diets and adequate amounts of folic acid daily throughout their childbearing years may reduce their risk of having a child with a neural tube defect. Such birth defects, while not widespread, are very serious. They can have many causes. Adequate amounts of folic acid can be obtained from diets rich in fruits, dark green leafy vegetables and legumes, fortified grains and cereals, or a supplement. Folic acid consumption should be limited to 1,000 mcg per day from all sources, according to the FDA.

 

Choline & Biotin
Choline facilitates the movement of fats in and out of cells. Because of this, it is essential for the health of the kidneys and liver. Choline can be synthesized in the body, and is the major component of phosphatidyl choline. There is no RDI for it, but many multiple vitamin formulas contain a small amount. Choline, as a constituent of lecithin, also plays a part in neural health. As people age, the circulation of choline to the brain may be reduced, therefore supplementation is recommended. *26

The key factor of the B vitamin family is their complex interdependence, which takes two main forms. First, some B vitamins require other B vitamins for synthesis or activation. An example would be the synthesis of vitamin B-3 from the amino acid tryptophan, which requires vitamin B-2. *30 Vitamin B-2 is also needed to turn vitamin B-6 into its active form in the body.

Second, the potential downside of high dose B vitamins are offset by other B vitamins. A good example of this is the fact that niacin may actually elevate homocysteine levels if taken alone *31 but not when combined in a B complex.* The ability of niacin to maintain normal cholesterol levels, combined with the ability of folic acid, vitamin B-6 and vitamin B-12 to modulate homocysteine levels, provides a better approach than using them separately to maintain cardiovascular health.*32 The body has little trouble getting rid of excess B vitamins because they are water-soluble, and thus B vitamins in general have almost no adverse side effects.

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References

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3. Benton D, Griffiths R, Haller J. Thiamine supplementation, mood and cognitive functioning. Psychopharmacol 1997;129:66-71.
4. Schoenen J, et al. High-dose riboflavin as a novel prophylactic antim-graine therapy: Results from a double blind, randomized, placebo-controlled trial. Cephalalgia 1997;17:244.
5. Madigan SM, Tracey F, McNulty H, et al. Riboflavin and vitamin B-6 intakes and status and biochemical response to riboflavin supplementation in free- living elderly people. Am J Clin Nutr 1998;68:389-95.
6. Lopez R, Schwartz JV, Cooperman JM. Riboflavin deficiency in an adolescent population in New York City. Am J Clin Nutri 1980;33:1283-6.
7. Drood JM, Zimetbaum PJ, Frishman WH. Nicotinic acid for the treatment of hyperlipoproteinemia. J Clin Pharmacol 1991;31:641-50
8. McKenney JM, Proctor JD, Harris S, Chinchili VM. A comparison of the efficacy and toxic effects of sustained- vs. immediate-release niacin in hypercholesterolemic patients. JAMA 1994;271:672-7.
9. Urberg M, Zemel MB. Evidence for synergism between chromium and nicotinic acid in the control of glucose tolerance in elderly humans Metabolism 1987;36:896-9.
10. El-Enein AMA, Hafez YS, Salem H, Abdel M. The role of nicotinic acid and inositol hexanicotinate as anticholesterolemic and antilipemic agents. Nutr Rep Int 1983;28;899-911.
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23. Werbach MR. Nutritional Influences on Illness, 2nd ed. Third Line Press: Tarzana, CA, 1993.
24. Carmel R. Subtle cobalamin deficiency. Ann Intern Med 1996;124:338-40 [review].
25. Tang AM, Graham NMH, Chandra RK, Saah AJ. Low serum vitamin B-12 concentrations are associated with faster human immunodeficiency virus type 1 (HIV-1) disease progression. J Nutr 1997;127:345-51.
26. Cohen B, et. al. Decreased Brain Uptake in Older Adults. JAMA 1995;274:902-907.
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