Many of my senior patients will get a prescription for a daily B-complex vitamin. Why? So many people are functionally low and taking these vitamins every day can change your life. Your body uses B-vitamins for hundreds of different processes, it’s really no wonder they can improve multiple symptoms and medical conditions.
Reasons You Could be Low in B-Vitamins:
Most people are low in these vitamins because they aren’t getting enough in their food, they use them up quickly, or they take a medicine, such as an acid-blocker, that reduces their ability to absorb B-vitamins. Also as you age your ability to absorb vitamin B-12 decreases, and a number of medical conditions can decrease your absorption of the other B-vitamins.
Many doctors don’t fully understand how to test for low B-vitamin levels that can be affecting their patient. Blood levels of a vitamin can be misleading, and won’t always show if a vitamin is doing its job. Typically I use a patient’s symptoms combined with several labs to understand how well they’re utilizing their B-vitamins.
Medical Conditions Helped by B-Vitamins:
Fatigue or Tiredness:
This is the number one reason patients come in. There are many causes for fatigue, but adding B-vitamins is a common starting point with many patients, while at the same time running labs to look for things like anemia, and low thyroid hormones. Often enough patients will improve with B-vitamins alone.
Neurological Conditions (Neuropathy, Neuritis, Migraine, Trigeminal Neuralgia):
Nerve cells rely on B-vitamins for maintenance and proper functioning. The cells that protect your neurons use a substance called “myelin” to wrap and protect them, much like insulation around a wire. When you’re low in B-vitamins (particularly B-12), the insulation cannot repair itself the way it normally does, which can lead to pain, numbness or tingling in the affected nerve. Increasing B-12 relieves the symptoms. In some patients, oral vitamin supplementation is not enough to help, and they may require a B-12 shot once a week to once a month.
Psychiatric Conditions (Alzheimer’s Disease, Dementia, Cognitive Decline, Depression, Anxiety, Insomnia):
Our brains use chemicals called neurotransmitters to talk to each other. There are many neurotransmitters in the brain like serotonin, melatonin, dopamine, and GABA. Some pharmaceutical drugs are made to mimic the actions of these neurotransmitters, but I’ve found often patients are low in B-vitamins that are critical in their natural production of neurotransmitters. My patients report improved sleep and mood from taking B-vitamins - sometimes in a few days, but commonly within 2-4 weeks.
Cardiovascular Conditions (Blood Clots that Cause Heart Attacks and Strokes):
It’s common for a senior patient to come into my office after having a heart attack or stroke. Generally, their primary care doctor will put them on a blood thinner, and a couple of medications to lower their blood pressure. I’m constantly surprised how few times their doctor has run a genetic test (called MTHFR) that has to do with how they process their B-vitamins. If you have this gene, your body has a decreased ability to make your B-vitamins active, and you run the risk of building up something called homocysteine in the blood. When homocysteine gets high, it increases your risk for blood clots. In my experience, 100% of patients with a history of blood clots have tested positive for having two “bad copies” of MTHFR and high homocysteine.
What to Know About Taking B-vitamins:
They will turn your urine bright yellow. Don’t worry, you’re not urinating out all the vitamins, this is normal.
Generally B-vitamins are well tolerated, and it’s very difficult to take too much.
Digestive upset, and “flushing” - a redness that results from too much B3 are the most common side effects I’ve seen in my practice, but it is advised that you check with your doctor before taking them.
Active forms of the B-vitamins seem to get the best results:
Folate in 5-MTHF, 5-Methyltetrahydrofolate, Metafolin, or Quatrafolic is best
Avoid: Folic Acid (inactive form)
B6 in Pyridoxal-5-Phosphate, or P5P form
B12 in methylcobalamin, adenosylcobalamin, hydroxocobalamin form
Avoid: cyanocobalamin (inactive form)