B vitamins

Regular readers of Wellbeing may remember an article I wrote last year on the importance of Vitamin B12 which, together with folate is routinely tested on the NHS. This provoked more interest than any other article I’ve written. Clearly B vitamins are on people’s minds. Ok so we’ve got B12 and folate covered but what about Vitamin B1, B2, B3, B5, B6 and B7? What are they, and more importantly how crucial are they for our health and longevity and why are they so particularly important in our 21st century diet and lifestyle? The B complex vitamins are water soluble and delicate, which means they are easily destroyed by cooking and particularly by excess consumption of alcohol (that got your attention didn‘t it?!) Food processing can also reduce the amount of B vitamins in foods making white four and refined foods less nutritious because the husk has been removed. Much of our refined food has taken the part with the B vitamins out and then added it back in again, so we should be fine right? I’m not so convinced. The RDA for Vitamin B is in my mind far too low. This has been set for a long time and will prevent you getting beri beri and pellagra but there are a whole host of other deficiency symptoms before you get to those extremes. One of the problems is our body has a limited capacity to store most of the B group vitamins except Vitamin B12 and folate which are stored in the liver. A person with a poor diet may well end up with a B group vitamin deficiency, so B vitamins need to be eaten daily as part of a so called “balanced diet“. Of course we know that very few people eat a balanced diet. Add this to our stressful lifestyles, excess alcohol intake and the reduction in offal and red meat in our diet, is it not feasible that our needs might be greater now? I remember at school (back in the 1970’s) we had liver every Monday and fish on a Friday, and Bovril sandwiches after games. Fish was routinely given before exams we were told to make our brains function better. B vitamins were very much alive in my diet then, despite my loathing for liver Mondays we had to eat what we were given. Today I do not eat offal, red meat or have hot cups of Bovril. My B vitamins come from whole grains, nuts, fish and poultry. Despite my diet being exemplary I still need Vitamin B 12 injections and as anti supplements as I am, I routinely take a Vitamin B50mg complex. This is partly due to diet and partly to do with the A type personality I am, working long hours and juggling many different stressors. My point in sharing this with you, is if I can get low in B vitamins with my genuinely healthy diet can you imagine what some people might be running on? There are eight types of Vitamin B

• Thiamine B1
• Riboflavin B2
• Niacin B3
• Pantothenic acid B5
• Biotin B7
• Pyridoxine B6
• Folate B9
• Cyanocoalamin B12

Vitamin B1...

is needed to convert glucose into energy and has a role in nerve function. It is found in whole grains, sesame seeds, legumes, wheatgerm, nuts, yeast and meats. Thiamine deficiency is usually found in countries where the dietary staple is white rice, and symptoms can include confusion, irritability, lethargy, fatigue and muscular weakness. The most severe form is beriberi and this leads to a damaged nervous system or enlarged heart. Wernicke-Korsakoff syndrome is linked to excessive consumption of alcohol. Alcohol reduces thiamine absorption in the gut and symptoms can cause staggering, mental confusion and paralysis of the eye muscle.

Vitamin B2...

is primarily involved in energy production and helps vision and skin health. Good food sources include milk, yoghurt, cottage cheese, wholegrains, egg white, meat, yeast, liver and kidney. Deficiency symptoms usually occur in those that consume excess alcohol and include inflamed tongue, anxiety and photophobia.

Vitamin B3...

is essential for the body to convert carbohydrates and fat to energy. It helps maintain skin health and supports the nervous and digestive systems. Good sources include nuts, meats, fish, poultry, eggs and wholegrains. The most extreme case of deficiency is pellagra commonly referred to as the three D’s; dementia, diarrhoea and dermatitis.

Vitamin B5...

is needed to metabolise carbohydrates and fats as well as produce red blood cells and sex and stress related hormones produced in the adrenal glands which is why it is sometimes called the anti stress vitamin. Your body also needs this vitamin to synthesise cholesterol. Deficiency syndromes can include: fatigue insomnia depression, stomach pains and burning feet. Good sources include offal, meat, eggs, yeast, peanuts and legumes. In the UK it is rare but not impossible to see Beriberi or Pellagra, especially after bariatric surgery and in eating disorders and alcoholism. However there are symptoms that occur before you get that deficient and these are what I see in my clinics. Over twenty years the data I have collated speaks for itself. I have studied 750 women (I’ll come to why men were not included later) and these were the symptoms they presented with: [caption id="attachment_86493" align="alignleft" width="424"] symptoms of vitamin B deficiency[/caption] These myriad of symptoms originally thought to be hypochondriacal improved dramatically in a couple of weeks on a high dose Vitamin B complex. Bloods were tested before for all 750 women and 64% were deficient in Vitamin B1, B2, B5 and B6. The women were aged between 19 and 50 yrs old. The levels were particularly low after a course of antibiotics. One woman who had been on six courses of antibiotics, with no previous history of anxiety, had been suffering increasing anxiety after taking the antibiotics and on testing, her thiamine levels were remarkably low. Obviously these symptoms can be indicative of other illnesses and indeed can also be psychosomatic in nature, however with the back up of blood tests it certainly indicates that the other B vitamins need to be taken seriously. On the other hand there are of course people with these symptoms who have adequate levels of B vitamins when tested who can take an antibiotic and not get a deficiency. However in my opinion this is a minority of people. An average middle aged middle class woman I see in my clinic will be averaging a daily intake of three large glasses of wine a night, the equivalent of maybe 2/3 bottle, and women in their 20’s particularly are drinking far more alcohol. Excess female hormones rely on certain B vitamins to allow them to be broken down. An excess alcohol intake could lead to lower B vitamins which in turn may lead to hormone issues like PMT. From a dietary perspective many of these women had a reasonably “healthy” diet but were unknowingly avoiding the foods that contain vitamin B, i.e. yeast, eggs, red meat, offal and wholegrains. This was partly due to them suspecting food allergies and our old controversial friend Candida. Analysing their food diaries in more detail, the amount of Vitamin B was actually much lower than thought. The reason women were tested more than men was a fundamental difference between their admittance of anxiety disorders, they were more likely to be on restrictive diets, and they were far more open about discussing anxiety states than men.

What can cause lower vitamin B levels in the diet

• Alcohol
• Antibiotics e.g Trimethoprim
• Restrictive diets
• Stress
• Aspirin
• PPI’s e.g. omeprazole
• Metformin
• Asthma drugs
• Blood pressure lowering drugs
• Anti Parkinson’s drugs i.e. Sinemet
• NSAID’s i.e. anti inflammatory drugs
• Prednisolone
• Methotrexate

Most of us will tick one or more of the boxes above but this list is not to make you panic but for you to be aware that these can lower your Vitamin B levels. To a certain extent it depends how high your Vitamin B levels were in the first place. Vitamins B1, 2, 3, 5, and 6 can be tested but these are not readily available on the NHS and can only be done privately. Vitamin B 12 and folate tests are available but normal levels of these does not mean normal levels of the rest of the group. Taking a B vitamin in isolation can also cause a heap of extra trouble as B vitamins work as a group so if you are supplementing you need to supplement them all. As every one is different, has different experiences and lifestyles it is just worth checking if you are taking any of these medications long term if you need to look at your B vitamin status. For those with stressful lifestyles, and excess alcohol intake this also includes you. If you would like your B vitamins tested, please call me on 01323 737814/310532 or have any queries regarding the above.