“B” In Harmony Part 2
Do you feel “stressed out” much of the time?
Do you eat on-the-run most days?
Are you more tired than you want to be?
Are you irritable, nervous, or depressed?
Do you suffer from constipation? Insomnia?
Do you have hair and/or skin problems?
Are you suffering from just “general weakness”?
If You Answered “Yes” To Most Of These
Questions, You May Need More B Vites.
TOPIC: Vitamin B Complex, Part 2
In the 20th century, the human diet began to contain a large amount of refined carbohydrates, e.g., white flour and white sugar. In nature, carbs occur with the vitamins, minerals, enzymes, protein, fat, and fiber needed to digest them. These components are removed from refined carbs. Without B vites, these energy providing carbs cannot be broken down.
“B” In Harmony
If you answered “yes” to most of the questions on the cover, you may need more B vitamins in your diet. Because stress and poor diet are rampant in the US, it is highly likely that many individuals are experiencing subclinical deficiency symptoms.
To summarize, the B vitamins are essential to the release of energy from food. Simple carbohydrates like sugar and white flour are denatured foods that need B vitamins to be metabolized.
The Bs are involved in maintaining the hair, skin, nerves, blood cells, immune system, hormone-producing glands, and digestive system. Plus, they are essential to the synthesis the genetic materials DNA and RNA.
In Part 1, we covered thiamin (B1), riboflavin (B2), niacin (B3), B6, biotin, and pantothenic acid. Be sure to read it. In this issue, we discuss folic acid, B12, and the B co-factors choline and inositol. We also cover the interactive effects of B6, B12, and folic acid.
“B” For Heart Health
Research shows that the B vitamins folic acid, B12, and B6 are effective in reducing the risk of heart disease. Why? The three Bs help to metabolize methionine, an essential amino acid. In a natural ongoing cycle, methionine is converted into homocysteine and back to methionine. Without these B vites, homocysteine levels build up in the blood (homocysteinemia), eventually damaging the blood vessels. The damage leads to vascular diseases including heart disease and stroke. Alongside poor cholesterol ratios1, smoking, and high blood pressure, elevated levels of homocysteine add to the list of preventable heart disease risk factors.
When these vitamins (in combination or individually) convert homocysteine back into methionine, homocysteine levels are lowered.
In the famous Harvard study of more than 80,000 middle-aged female nurses, those who got the most folic acid (more than 400 mcg per day) and the most vitamin B6 (more than 3 mg) from food and/or supplements suffered about half the heart attacks and coronary deaths as those who got the least.
In a study published in the American Journal of Clinical Nutrition, 132 men (30-49 years old) with high homocysteine levels participated in an intervention trial. Assigned to one of four supplement groups, one group got supplements of the three Bs; another got vitamin C, vitamin E, and beta carotene (all antioxidants); the third received the Bs in combination with the antioxidants; the fourth group received a placebo.
After eight weeks of daily supplementation, homocysteine levels were reevaluated. Men who had taken the B vitamins both with and without antioxidants showed a significant drop in their homocysteine levels. The B vitamin amounts used in the study ranged from 2.5 to 10 times the RDA.
B6 RDA Range
1.3 mg 3.25 mg – 13 mg
B12 RDA Range
2.4 mcg 6.0 mcg – 24 mcg
Folic acid RDA Range
400 mcg 1 mg – 4 mg
Many multiple vitamin formulas, vitamin B complex formulas, and special formulas for lowering homocysteine levels contain the three B vitamins in approximately these amounts.
“B” For Heart Health
1 To calculate your cholesterol ratio, divide your high-density lipoprotein (HDL, or “good”) cholesterol number into your total cholesterol number. An optimal ratio is less than 3.5-to-1. A higher ratio means a higher risk of heart disease.
The Facts About Vitamin B9
Both folic acid, the supplement form, and folate, which is the molecular structure as it occurs in food are called vitamin B9. Unless we are referring to the food form (folate), we use “folic acid” throughout this issue.
Many readers will be familiar with folic acid and its role in the prevention of NTDs, neural tube defects, in the human fetus. NTDs manifest as spinal bifida and anencephaly.2 It is because of this protective property that all women who have the potential of becoming pregnant need to ingest at least 400 mcg of folic acid and/or folate daily.
This is also the reason that enriched flour and cereals have been fortified with at least 140 mcg of folic acid per 3-ounce serving since 1998. Because fortification doesn’t depend on changing the behavior of individual women, it has made a substantial difference in reducing the occurrence of NTDs. According to the CDC at the end of 2006, NTD prevalence had decreased by 36%, from 10.8 affected infants per 10,000 population to 6.9.
Folic acid is needed for lactation and because it is depleted by the use of oral contraceptives, women on The Pill are doubly advised to supplement the vitamin.
Folic acid is essential as a key factor in making nucleic acid.3 Folic acid also –
• Synthesizes and repairs DNA and RNA.
• Aids rapid cell division and growth.
• Produces healthy red blood cells.
• Maintains healthy homocysteine levels.
• Enhances brain health.
Folic acid’s role in DNA repair is critical. Since damaged DNA is a feature of cancer, this damage needs to be kept at a minimum.
Studies show that people who either take folic acid supplements or get plenty of folate rich foods have a significantly reduced risk for cancer of the pancreas, breast, and colon. It is also necessary for the absorption of pantothenic acid, a B vitamin essential to adrenal function. (Discussed in Part 1.)
In this section, we differentiate between folic acid and folate, the two forms of vitamin B9. Folic acid is actually a component of folate. Folate is the more complex form found in whole foods, such as beef liver, leafy greens, and legumes. Folic acid is the form used in supplements. Fortified cereals and grains also contain this form.
A counter-intuitive fact is that folic acid is better absorbed by the body than folate. Only about 50 percent of folate is absorbed while the uptake of folic acid from supplements or fortified foods is about 85 percent. The 400 mcg RDA is for folic acid and is considered to be in addition to any folate an individual may ingest from fresh food.
Several cautions regarding folic acid need to be observed. Primarily, large doses can mask a B12 deficiency (the basis for pernicious anemia) and may lead to permanent nerve damage. In addition, folic acid can interfere with the action of anticonvulsant drugs.
The Facts About Vitamin B9
2 This is a condition in which the neural tube in the fetus (which should become the infant’s brain and spinal cord) fails to close. When the closure is not complete at the brain (anencephaly), it is fatal. If the opening occurs at the spine (spina bifida), the range of damage can vary.
3 Found in the nucleus of all cells, nucleic acid contains DNA (deoxyribonucleic acid and RNA (ribonucleic acid).
Let’s Delve Into B12
Nearly two-fifths of the US population may have marginal vitamin B12 deficiencies, according to the USDA. In a study with surprising results, a careful look at 3,000 men and women found 39 percent with plasma B12 levels in the “low normal” range.
Although this is above deficiency rank, because of individual needs, some people show neurological symptoms at these levels. More alarming, 16 percent of participants fell into the “danger zone” and nearly 9 percent were clinically deficient.
The two most important forms of B12 are cyanocobalamin and hydroxocobalamin. (B12b).4 Water soluble (as are all the B vites), B12 is the common term for this group of cobalt-containing compounds. B12 is used for the growth and repair of all our cells; for the development and maintenance of normal nervous system function; and for the formation of red blood cells. B12 works synergistically with folate in many body processes, including the homocysteine-methionine cycle, the synthesis of both DNA and red blood cells, and the maintenance of the myelin sheath. (This is the covering that “insulates” the nerves and speeds the conduction of nerve system signals).
Vitamin B12 is found naturally in a wide variety of animal foods. Plant foods have no vitamin B12 unless they are fortified. Liver and clams are the richest sources, followed by meat, poultry, eggs, milk and other dairy foods, and nutritional yeasts. Some breakfast cereals are fortified with B12. (Check the nutrition fact panel on the food label.) Suggestions regarding B12 for vegans follow below.
Pernicious anemia is the B12 deficiency disease. It is marked by fewer but larger red blood cells. These red blood cells carry too little hemoglobin, the life-sustaining, oxygen-carrying molecule based on iron. However, this type of anemia cannot be treated with iron supplements. In a “Catch-22” situation, iron cannot be used without B12.
Signs of a deficiency include numbness in the fingers and toes, disturbances in walking and balance, and great fatigue. Further symptoms include a loss of vibration sensation, confusion, and, in advanced cases, dementia. Also, without sufficient B12 to maintain myelin, nerves can be exposed to damage. As always with vitamins (and minerals), biochemical individuality comes into play.
Before the USDA study, concerns about B12 deficiencies had centered on seniors. Since the study involved people from 26 to 83 years old, researchers uncovered several other anomalies. One was that persons in the youngest group (26-49) had about the same B12 status as the oldest group (65 to 83). In other words, the high prevalence of low B12 levels existed across all age groups, even among the young adults.
Also, researchers found no association between plasma B12 levels and meat and fish intake among the younger adults. Researchers commented that the phenomenon was not the result of not eating enough meat but rather that what was being eaten was not being absorbed. This is usually common only among older folks who no longer secrete sufficient gastric juices for efficient digestion.
On the other hand, B12 from dairy foods appeared to be better absorbed.
The current RDA for B12 for adults is 2.4 mcg. A 3.5 ounce serving of lamb liver (nearly a quarter pound) provides 104 mcg; clams, 98 mcg; sardines have 17 mcg; salmon, 4.0; and tuna, 3.0. Eggs and dried whey are the same at 2.0 mcg for 3.5 ounces. Cheeses vary from 1.8 (Edam and Swiss) to 1.0 (cheddar, mozzarella, and cottage).
Vegans are vegetarians who eat no foods derived from animals (including no honey). Vegans can get their B12 from tempeh (a fermented soybean food), nutritional yeast, sea vegetables, and algas such as spirulina, chlorella, and Klamath Lake blue-green. Although the latter are very rich sources (some equaling beef liver ounce per ounce), bioassays show that only about 20 percent is utilized. This indicates that larger amounts than expected need to be eaten and/or the prudent vegan takes a B12 supplement.
As with the study participants, vitamin B12 deficiency typically results from malabsorption. This is caused by insufficient intrinsic factor. Intrinsic factor is a special stomach secretion that makes the absorption of B12 possible. Generally speaking, individuals lacking this secretion self-inject or are given B12 injections by their health practitioners.5 Nasal gels are equally effective, more convenient, and are available by prescription.
In the USDA study, supplement use dropped the percentage of participants in the danger zone from 20 percent to 8 percent. B12 supplements found in the health food store may be in either oral or liquid form. Oral B12 is often sublingual. This form by-passes the need for intrinsic factor for uptake. The liquid is called cobalamide, dibencozide, or co-enzyme B12. The co-enzyme is the fastest acting form. It is dispersed into the bloodstream by the liver. The use of 100-300 mcg as a supplement to insure uptake is common.
Let’s Delve Into B12
4 Another form, B12a, also exists, hydroxycobalamin.
5 In his classic Nutrition For Your Nerves, the late HL Newbold, MD, recommended the use of the hydroxocobalamin form of B12 (B12b) over cyanocobalamin, the commonly used form.
Newbold was a psychiatrist who, along with Carl Pfeiffer, MD, PhD, and Linus Pauling, PhD, pioneered the use of nutrition and supplements in treating patients. Pauling named the approach “orthomolecular medicine”.
Factor In B’s Co-Factors
Choline, inositol, and PABA are the B complex co-factors. At one time considered a part of the vitamin B complex, choline and inositol are now commonly listed as “other nutrients.” However, PABA (para-amino benzoic acid) is a part of the folic acid molecule making it a member of the B complex family.
PABA is synthesized in the intestines and helps in the assimilation of pantothenic acid. (See “‘B’ In Harmony, Part 1.”)
Although no deficiency symptoms have been reported, PABA may be important for skin, hair, and intestinal health. It is often included in MVMs and in vitamin B complex supplements. The best natural sources are liver, nutritional yeast, wheatgerm, and molasses.
Choline is essential to the manufacture of the neurotransmitter acetylcholine. Choline supplements raise levels of acetylcholine in the brain so are commonly sought as a “brain food” to improve memory, etc. Its use as a supplement is most convenient in the phophatidylcholine form. Like both folic acid and B12, choline also interacts with methionine. It is generally taken in 1 gram capsules.
Inositol is recommended as a natural antidepressant and immune booster. A bio-sugar, it is largely concentrated in the brain. It may be effective in treating depression because of its role in regulating serotonin, norepinephrine, and acetylcholine — all important brain chemicals.
Published studies have shown that inositol is deficient in the brains of depressed people. “A meta-analysis of inositol for depression and anxiety disorders” published by Human Psychopharmacology in 2014 found inositol especially helpful to women with PMDD, a particularly debilitating form of PMS.
Therapeutically, inositol must be used in high doses. Based on Levine’s double-blind study on depression (1995), the editors of Life Extension recommend 12 grams daily taken in three doses.
There is evidence for the use of inositol along with its derivative IP6 (inositol-hexaphosphate) as an immune booster which invigorates the activity of the body’s white blood cells. The combination has also been called an anti-cancer cocktail.
Vite B Brain Boosters
In a study published by the American Journal of Psychiatry (May 2000), research drawn from the Women’s Health and Aging Study revealed that older women with B12 deficiencies may be more prone to depression.
Observing 700 women aged 65 and over, researchers found those without adequate B12 were more than twice as likely to be severely depressed than women whose plasma levels were normal.
The importance of B vitamins in the preservation of neurologic and psychologic function has been recognized since the 1940s. At that time, the US food supply was fortified with B vitamins to combat an epidemic of pellagra, the niacin (B3) deficiency disease.
This disease is characterized by dementia. Although B vitamin deficiency-induced dementia is no longer a problem, 76 million aging Boomers make the maintenance of cognitive function a major concern.
Research indicating the importance of B vitamins in brain and cognitive function has been discussed by Katherine Tucker, PhD, a nutritional epidemiologist.6 Commenting on “significant cognitive declines” among the aging, Tucker said, “We believe that better intakes of B6, B12, and folic acid may help delay age-related declines in cognitive function, including changes in memory, orientation, judgment, and personality.”
Dr. Tucker has said,
“… taking a B-complex supplement or a multivitamin to get adequate B6, B12, and folic acid is advisable for everyone over the age of 50.”
(At Nutrition News, we advise that persons of all ages get adequate amounts of the B vitamins.)
Vite B Brain Boosters
6 Dr. Tucker is a nutritional epidemiologist at the University of Massachusetts, Lowell. Part of her job is to study nutritional trends among populations.
Make sure your daily multiple has at least the RDAs of the complete B complex and add more whole food sources of the B vitamins to your daily food intake.
Keep a complete B complex supplement on hand for when you are under unusual stress or indulge in refined carbohydrates. (Who doesn’t like a little birthday cake or some pita chips once in awhile?)
Again, rich sources of the Bs include liver, fish, dairy products, eggs, whole grains, all seeds, nuts, bran, wheatgerm, nutritional yeast, lentils and other beans (including soybeans), and leafy green vegetables. If you are a vegan, be sure you are getting enough vitamin B12.