It’s All About B Vitamins – Thiamin, Riboflavin, Niacin, Pantothenic Acid, Pyridoxine, Biotin, Folic Acid, Cobalamin

The B Vitamins are a class of water-soluble vitamins which all play important roles in cellular metabolism and optimal health. But, gosh, there are just so many! How can you keep them all straight? Lucky for you, Sanesco’s clinical team created this quick and easy guide to help you remember all these important vitamins and what they do.

B Vitamins

Vitamin B₁: Thiamin

• What it does: Thiamin is essential for energy production, carb metabolism, and nerve cell function. It also mimics acetylcholine, a neurotransmitter important for memory and cognitive function.[i]
• Food sources: Soybeans, brown rice, sunflower seeds, peanuts.[ii]
• Deficiency: Depleted B₁ can be caused by excessive alcohol consumption, as well as poor nutrition. Extreme deficiency causes a syndrome called “beriberi,” which was once common in the 18^th and 19^th The symptoms are varied and may include heart disturbances, high blood pressure, fluid retention, and disrupted cognitive function.[iii],[iv]
• Forms: Thiamin is found in most supplements as thiamin hydrochloride.[v]
• Benefits: In animal models of Alzheimer’s Disease, thiamin deficiency promotes increased plaque formation and cognitive impairment.[vi] Additionally, large doses of thiamin have been found to have positive impacts on cognition in patients with Alzheimer’s.[vii]

Vitamin B₂: Riboflavin

• What it does: Riboflavin works with two important enzymes, FMN and FAD, involved in energy production.[viii]
• Food sources: Organ meats (kidney, liver, heart), almonds, mushrooms, whole grains, leafy green vegetables, soybeans.[ix]
• Deficiency: Cracking of the lips at the corners of the mouth, inflamed or itching tongue, itching of the eyes or lips, cataract formation, anemia, seborrheic dermatitis (itchy scaly rash of the scalp).[x]
• Forms: B₂ can be found as simple riboflavin or the more bioavailable form, riboflavin-5-phosphate.[xi]
• Benefits: Adequate riboflavin is needed for regenerating glutathione, and it can reduce neuroinflammation.[xii]
  • One study on migraine prevention found that after supplementing 400mg of B₂ per day for 3 months, patients had an overall improvement of 68% in their reported migraine severity score.[xiii],[xiv]
  • B₂ supplementation has also been linked to improvement in iron levels in patients with sickle cell anemia.[xv]

Vitamin B₃: Niacin

• What it does: Niacin is a coenzyme for NAD and NADP, which are enzymes involved in many chemical reactions within cells.[xvi]
  • These enzymes are involved in fat and carbohydrate metabolism, and the synthesis of adrenal hormones and sex hormones.[xvii]
• Food sources: organ meats, eggs, fish, peanuts, whole grains (not corn), milk, avocados.[xviii]
• Deficiency: When B₃ levels are severely low, it can lead to pellagra. This condition was common in 18th century Spain and Italy and is characterized by the “3 D’s”: dermatitis, dementia, and diarrhea.[xix]
• Forms: The nicotinic acid form reduces blood cholesterol, while niacinamide is helpful for arthritis and early onset type 1 diabetes.[xx] Inositol hexaniacinate) has the same effects as nicotinic acid, but is considered a safest form.[xxi]
• Benefits: Niacin is needed for cellular energy; it regulates blood sugar; it works as an antioxidant, and is involved in detox reactions.[xxii]
  • Niacin has been shown to be very effective for reducing elevated cholesterol and triglyceride levels. In fact, one study showed that niacin was comparable to Lovastatin in cholesterol reduction.[xxiii] Not only does niacin reduce overall cholesterol levels, it is considered by many to be the most effect method of increasing good cholesterol (HDL).[xxiv],[xxv],[xxvi]
• Side effects:
  • Skin flushing 20-30 min after supplementation. This is caused by histamine release[xxvii]
  • Occasional gastric irritation, nausea, liver damage[xxviii]
  • Extended-release niacin reduces flushing but is more toxic to the liver. Inositol hexaniacinate is the safest form; it has the benefits of niacin, without causing flushing or other negative side effects.[xxix],[xxx]

Vitamin B₅: Pantothenic Acid

• What it does: Vitamin B₅ is used for the synthesis of coenzyme A (CoA) and acyl carrier protein (ACP). These molecules are used to break down fats and carbohydrates for cellular energy.[xxxi] They also produce adrenal hormones and red blood cells.[xxxii]
• Food sources: organ meats, milk, fish, poultry, whole grains, legumes, sweet potatoes, broccoli, cauliflower, oranges, and strawberries.[xxxiii]
• Deficiency: Deficiency is rare in humans because many foods contain pantothenic acid. However, signs of deficiency include fatigue, and severe deficiency leads to “burning foot syndrome” which consists of pain and numbness in the feet.[xxxiv]
• Forms: Pantothenic acid most commonly found as calcium pantothenate. The most active form is pantethine.[xxxv]
• Benefits: B₅ helps support healthy adrenal function and is considered an “anti-stress” vitamin.[xxxvi]
  • It is reported that many physicians recommend pantothenic acid for allergies due to its positive effects on the adrenals.[xxxvii]
  • A randomized, double blind, placebo controlled study found that pantothenic acid supplementation reduces mild to moderate acne in adults.[xxxviii]
  • Another blinded, placebo controlled study revealed that panthethine (but not pantothenic acid) has significant cholesterol and triglyceride lowering properties.[xxxix]

Vitamin B₆: Pyridoxine

• What it does: Vitamin B₆ is extremely important for the synthesis of proteins, neurotransmitters, red blood cells, and hormones.[xl]
• Food sources: whole grains, legumes, bananas, seeds, nuts, potatoes, Brussel sprouts, and cauliflower. [xli]
• Deficiency: Low B₆ status is characterized by depression, convulsions (primarily in children), glucose intolerance, anemia, impaired nerve function, cracking of the lips and tough, eczema.[xlii]
• Forms: A common form is pyridoxine HCL. The pyridoxal-5-phosphate form is the most bioavailable.[xliii] Supplementing with P5P bypasses the necessary conversion of pyridoxine HCL to its active form.
• Benefits: Pyridoxine is one of the most intensely studied vitamins. Supplementation with pyridoxine has been evaluated in over 100 health conditions.[xliv]
  • Cardiovascular disease: B₆ deficiency is linked to atherosclerosis.[xlv],[xlvi] People with low P5P also have a greater risk of having a heart attack, independent of other risk factors.[xlvii] Additionally, a deficiency in B₆ leads to high homocysteine, which is known to be very damaging to the arteries.[xlviii] Some studies have shown that patients who supplemented with vitamin B₆ had a reduced risk of heart attack, compared with patients who did not supplement.[xlix]
  • Depression: B₆ levels are usually low in patients with depression, especially women on oral contraceptives.[l],[li] This is likely, at least in part, because serotonin synthesis is P5P-dependent.[lii],[liii]
• Side effects: This is one of the few water-soluble vitamins associated with some toxicity at high doses. Doses of more than 2g per day can cause toxicity and doses of over 500 mg per day for many months or years may also be toxic.[liv] The UL for B6 is 250mg.

Vitamin B₇: Biotin

• What it does: Biotin functions in the production and use of fats and amino acids.[lv] Biotin is made in the GI tract by the gut microbiome.[lvi]
• Food sources: Cheeses, organ meats, soybeans, cauliflower, eggs, mushrooms, nuts, peanuts, whole grains.[lvii]
• Deficiency: Dry skin, scaly skin, anorexia, seborrhea.[lviii]
• Forms: Biotin can be found as biocytin (the protein bound form) or isolated biotin.
• Benefits: Biotin promotes healthy hair and increases the hardness of nails.[lix] It also improves insulin sensitivity and metabolism in diabetics.[lx]
  • Glucokinase is the enzyme that regulates blood glucose, ketones, and triglycerides; it is regulated by biotin.[lxi]
  • One study found that biotin administration helped improve glycemic control and blood lipid levels in type 1 diabetics.[lxii]

Vitamin B₉: Folic Acid

• What it does: Folic acid is necessary for DNA synthesis and cellular division.[lxiii] It is also critical to the development of fetal nervous systems.[lxiv] Folic acid is also a methyl donor; proper methylation is crucial for the synthesis of neurotransmitters.
• Food sources: Leafy greens like kale, spinach, beet greens, and chard, as well as legumes, asparagus, broccoli, cabbage, oranges, root vegetables, and whole grains.
• Deficiency: Low folic acid is one of the most common vitamin deficiencies.[lxv] All cells are affected, but especially rapidly-dividing cells such as blood cells and the cells of the gastrointestinal tract.
  • Deficiency results in diarrhea, anemia, and gingivitis, as well as depression, insomnia, irritability, forgetfulness, and fatigue.[lxvi]
  • Folic acid deficiency in pregnancy has been linked to several birth defects, including spina bifida.[lxvii]
• Forms: Folic acid, the synthetic form, is available in foods as folate. To utilize folic acid or folate, the body must break them down into the active form, 5-methyltetrahydrofolate.[lxviii] Therefore, supplementing with 5-MTHF bypasses this conversion step, which can be compromised in people with certain genetic mutations.
• Benefits: Folic acid supplementation can help with the prevention of neural tube defects during pregnancy.[lxix],[lxx]
  • Additionally, folic acid helps prevent osteoporosis by decreasing homocysteine levels.[lxxi]
  • Folic acid supplementation is also used clinically to help prevent atherosclerosis and depression.[lxxii]

Vitamin B₁₂: Cobalamin

• What it does: Cobalamin works with folic acid to synthesize DNA, red blood cells, and the myelin sheath of nerve cells.[lxxiii]
• Food sources: B₁₂ is found in significant quantities only in animal foods. These include liver, kidney, eggs, cheese, and meat.[lxxiv]
• Deficiency: Low B₁₂ is characterized by anemia, poor nerve function (e.g. numbness, burning, or the sensation of pins-and-needles), diarrhea.[lxxv]
• Forms: The most common form is cyanocobalamin. However, cyanocobalamin must be converted into an active form for use in the body—either methylcobalamin or adenosylcobalamin.[lxxvi] Methylcobalamin is considered the best available active form.[lxxvii]
• Benefits: B₁₂ is a methyl donor; proper methylation increases energy, nervous system function and immune function.
  • Low B₁₂ status is common in HIV positive patients, and is associated with HIV disease progression.[lxxviii],[lxxix] Additionally, supplementing with vitamin B₁₂ can increase immune system function in HIV patients.[lxxx]

Low B₁₂ status is also associated with Alzheimer’s Disease and Mild Cognitive Impairment.[lxxxi],[lxxxii] High homocysteine, which can be caused by low B₁₂, is a risk factor for AD.[lxxxiii] Some studies show improved cognitive function after supplementation with B₁₂ in patients with dementia and low vitamin B₁₂ status.[i]

References:

[1] Murray, M. T. (1996). Encyclopedia of nutritional supplements. Prima Pub.

[1] Murray op. cit.

[1] Bello, S., Neri, M., Riezzo, I., Othman, M. S., Turillazzi, E., & Fineschi, V. (2011). Cardiac beriberi: morphological findings in two fatal cases. Diagnostic pathology, 6(1), 8.

[1] Murray op. cit.

[1] Ibid.

[1] Gibson, G. E., Hirsch, J. A., Cirio, R. T., Jordan, B. D., Fonzetti, P., & Elder, J. (2013). Abnormal thiamine-dependent processes in Alzheimer’s Disease. Lessons from diabetes. Molecular and Cellular Neuroscience, 55, 17-25.

[1] Murray op. cit.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Marashly, E. T., & Bohlega, S. A. (2017). Riboflavin Has Neuroprotective Potential: Focus on Parkinson’s Disease and Migraine. Frontiers in neurology, 8.

[1] Ibid.

[1] Murray op. cit.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Head, K. A. (2000). Inositol hexaniacinate: a safer alternative to niacin. TOWNSEND LETTER FOR DOCTORS AND PATIENTS, 88-92.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Head op. cit.

[1] Goldberg, R. B., & Jacobson, T. A. (2008, April). Effects of niacin on glucose control in patients with dyslipidemia. In Mayo Clinic Proceedings (Vol. 83, No. 4, pp. 470-478). Elsevier.

[1] Head op. cit.

[1] Murray op. cit.

[1] Ibid.

[1] Head op. cit.

[1] Murray op. cit.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Yang, M., Moclair, B., Hatcher, V., Kaminetsky, J., Mekas, M., Chapas, A., & Capodice, J. (2014). A randomized, double-blind, placebo-controlled study of a novel pantothenic acid-based dietary supplement in subjects with mild to moderate facial acne. Dermatology and therapy, 4(1), 93-101.

[1] Evans, M., Rumberger, J. A., Azumano, I., Napolitano, J. J., Citrolo, D., & Kamiya, T. (2014). Pantethine, a derivative of vitamin B5, favorably alters total, LDL and non-HDL cholesterol in low to moderate cardiovascular risk subjects eligible for statin therapy: a triple-blinded placebo and diet-controlled investigation. Vascular health and risk management, 10, 89.

[1] Murray op. cit.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Lotto, V., Choi, S. W., & Friso, S. (2011). Vitamin B6: a challenging link between nutrition and inflammation in CVD. British journal of nutrition, 106(2), 183-195.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Hvas, A. M., Juul, S., Bech, P., & Nexø, E. (2004). Vitamin B6 level is associated with symptoms of depression. Psychotherapy and psychosomatics, 73(6), 340-343.

[1] Murray op. cit.

[1] Ibid.

[1] Hvas op. cit.

[1] Murray op. cit.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Hemmati, M., Babaei, H., & Abdolsalehei, M. (2013). Survey of the effect of biotin on glycemic control and plasma lipid concentrations in type 1 diabetic patients in Kermanshah in Iran (2008-2009). Oman medical journal, 28(3), 195.

[1] Ibid.

[1] Murray op. cit.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Czeizel, A. E., Dudás, I., Vereczkey, A., & Bánhidy, F. (2013). Folate deficiency and folic acid supplementation: the prevention of neural-tube defects and congenital heart defects. Nutrients, 5(11), 4760-4775.

[1] Murray op. cit.

[1] Ibid.

[1] Czeizel op. cit.

[1] Bailey, R. L., Looker, A. C., Lu, Z., Fan, R., Eicher-Miller, H. A., Fakhouri, T. H., … & Mills, J. L. (2015). B-vitamin status and bone mineral density and risk of lumbar osteoporosis in older females in the United States. The American journal of clinical nutrition, 102(3), 687-694.

[1] Murray op. cit.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Ibid.

[1] Campa, A., & Baum, M. K. (2010). Micronutrients and HIV infection. Hiv Therapy, 4(4), 437-469.

[1] Ibid.

[1] Murray op. cit

[1] Werder, S. F. (2010). Cobalamin deficiency, hyperhomocysteinemia, and dementia. Neuropsychiatric disease and treatment, 6, 159.

[1] Ibid.

[1] Murray op. cit

Clinical Contributor

Marina Braine

Clinical Support Specialist at Sanesco International, Inc.

Marina Braine is a Clinical Support Specialist at Sanesco. She graduated from UNC-Asheville with her Bachelors of Science in Biology with a minor in French. She likes to keep active by hiking, running, and contra dancing around Asheville.