Should You Be Getting More B Vitamins?

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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?

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-8 (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!

Filed under: Fitness