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B Vitamins ARE NOT Created Equal 01/28/2005 Over the last several months, I've heard from many of you asking why our Nutraceutical Sciences Institute (NSI) Vitamin-B Complex had varying amounts of the B vitamins. The simple answer is, despite their common designation, the B vitamins are all very different. Your benefits from these critically important vitamins drastically improve when you take them in the proper quantities and optimal forms. Conversely, some of them can actually do you harm when you take too much. Now I know that many of you are aware of the so-called B-50 or B-100 complex formulations. These formulas for the B vitamins use the same 50 mg or 100 mg dosage for each major B vitamin. I assure you that this is just a marketing scheme used by most vitamin companies over the last several decades to help sell their products. It has absolutely no scientific basis, and could actually cause some of you harm. By the end of this newsletter, I hope that you will understand the reasons why. The subject matter regarding the B vitamins is enormous. I could literally write a 1,000page book for you on the benefits. For the purposes of this newsletter, I'll keep the discussion tightly focused on some important information you need to know. Although many people think of the so-called "B vitamins" as one large group of vitamins, in point of fact, it is comprised of multiple individual and unique vitamins, each with amazing benefits and various recommended dosing amounts. The B vitamins include B1 (thiamine), B2 (riboflavin), B3 (niacin or niacinamide), B5 (pantothenic acid), B6 (pyridoxine), biotin, B12 (methylcobalamin is the far more potent active form), and folic acid. B1, otherwise known as thiamine, was actually the first B vitamin discovered and that is why it is called B1. It is found primarily in soybeans, brown rice and certain nuts. Thiamine is critically important for your energy production and proper nerve function. Severe thiamine deficiency is known as beriberi. This condition, which is rarely seen today, can lead to the loss of muscle mass and heart failure. Although beriberi is considered rare nowadays, thiamine deficiency is actually more common than most physicians realize. A study published several years ago in the prestigious American Journal of Medicine studied patients with congestive heart failure who were receiving long-term therapy with a diuretic called furosemide. It was found in those patients on long-term furosemide therapy that thiamine levels were depleted. A subsequent double-blinded study that treated these heart failure patients with 200 mg of thiamine daily actually improved cardiac output by 22% in only a few weeks time. Other studies have shown the benefit of thiamine for cognitive functioning, as well. This is especially important for a condition known as Wernicke Korsakoff Syndrome, which is seen primarily in alcoholics and patients with chronic renal failure. Although the RDA for thiamine is only 1.5 mg, I recommend a dose of at least 50 to 100 mg daily. In certain individuals, such as alcoholics, thousands of milligrams of thiamine should be given daily. There is no known toxicity for this nutrient. Vitamin B2, otherwise known as riboflavin, is found primarily in yeast and the organs of animals, including the liver, kidney and heart. It is also found in mushrooms, whole grains, and green vegetables. A deficiency of riboflavin can cause cracking along the sides of your lip, an inflamed tongue, and impairment of vision, along with some other nasty symptoms. Although riboflavin is important, it actually only has a few clinical benefits. There have been some studies showing that riboflavin in doses up to 400 mg daily can help with migraine headaches. It has also shown some benefit in patients with sickle cell disease. Unfortunately, taking high doses of riboflavin long-term can cause photosensitivity in the eyes and lead to an increased incidence of cataracts. It is therefore my recommendation that you take no more than approximately 10 mg - 20 mg of riboflavin daily. Vitamin B3, otherwise known as niacin, is generally found in organ meats, eggs and peanuts. It is critical for your production of energy and for regulating your blood sugar. Vitamin B3 deficiency is known as pellagra. The symptoms of pellagra are primarily skin rash, confusion, and diarrhea. Vitamin B3 is available as either niacin or niacinamide. Unfortunately, the niacin form of B3 can cause your skin to become flush when taken in doses of more than 50 mg to 75 mg. It is, therefore, generally recommended that the niacinamide form of vitamin B3 be taken. Niacinamide has been shown experimentally to prevent the development of diabetes in animals. There have been numerous studies in the medical literature indicating the benefit of niacinamide for diabetes mellitus or high blood sugar. There have also been studies showing that niacinamide has benefit as an anti-inflammatory for conditions such as rheumatoid arthritis and osteoarthritis. B3 has also proven its benefits for lowering cholesterol and triglycerides (lipids), although these benefits are typically seen in only the niacin form. I generally do not recommend taking high doses of niacin in the time-released form, since it can lead to an increased risk of liver damage. The safest form of niacin to take for the lowering of cholesterol is inositol hexanicotinate, also called no flush niacin. However, you need to take large quantities -- in the 1,500 mg range -- in order to see beneficial effects for lipid lowering. The RDA for niacin is typically 15 mg to 20 mg a day, although the recommended dose for niacinamide for general health purposes is 100 mg to 200 mg a day. As noted above, if you are taking B3 as a lipid-lowering agent, you need much larger doses, and it should be in the inositol hexanicotinate form. Even though this nutrient is considered safe in high doses, liver function tests should be performed under the supervision and guidance of your doctor. Vitamin B5, otherwise known as pantothenic acid, plays an important role in your energy production and the manufacturing of certain hormones. I recently wrote a newsletter on a form of pantothenic acid called pantethine that provides cholesterol-lowering benefits, and I refer you to that newsletter for more information. Although the RDA for pantothenic acid is only about 5 mg a day, it can safely be taken in up to thousands of milligrams daily. Vitamin B6 (pyridoxine) is an extremely important B vitamin for you. It is a co-factor in many enzymatic reactions in the body, and is involved with the formation of chemical transmitters in your nervous system, red blood cells, and other important proteins. It is also critically involved in maintaining optimal immune function and hormonal balance. Vitamin B6 is found primarily in whole grains, soybeans, nuts and yeast. Deficiencies of vitamin B6 can lead to depression, anemia, impaired nerve function, skin rash, and even convulsions, especially in children. Of all the B vitamins, I would say that B6 is clearly one of the top two or three most important nutrients for you to take in adequate doses. It has a multitude of clinical benefits, and is successfully used in patients with asthma, heart disease, peripheral nerve disease, depression, pre-menstrual syndrome, and other conditions. I routinely recommend vitamin B6, along with other nutrients, to patients who come into the office with peripheral nerve entrapment, such as carpal tunnel syndrome, or other problems with the nervous system. It is also critically involved in homocysteine reduction. As I have discussed many times in the past, homocysteine, which is an amino acid produced in the body, has been shown to have toxic effects for not only the cardiovascular system, but also as a potential toxin to the brain, which leads to confusion and dementia. Vitamin B6 taken along with vitamin B12 and folic acid has been shown in multiple clinical studies to lower this dangerous amino acid. In a recent study out of England, several patients were given either B vitamins (including 50 mg of B6) or a placebo immediately following a stroke. Within the two-week study period, it was found that those individuals in the treatment group had a statistically relevant lowering of C-reactive protein (CRP), a marker for cardiovascular and cerebrovascular disease. I have discussed CRP in a prior newsletter. The authors of this study concluded that supplementation with B vitamins immediately following a stroke may have both antioxidant and anti-inflammatory effects in stroke patients, independent of a homocysteine-lowering effect. Although B6, along with the other B vitamins, is considered water-soluble and theoretically non-toxic, in point of fact, it does have potential toxicity when taken in excess of more than 300 or 400 mg on a chronic basis. It is certainly safe to take 150 to 200 mg of B6 daily. Although the RDA for B6 is only approximately 2 mg a day, I recommend 50 - 100 mg daily. For reasons that I am not certain, biotin, which is also a B vitamin, was never designated with a number. Biotin deficiency can lead to skin rash, seborrhea (an increased discharge of sebum), and other conditions, along with potential hair loss. I see biotin as being used primarily to help with maintaining healthy hair and strong nails. It appears to have benefits for seborrheic dermatitis and diabetes mellitus, as well. The RDA for biotin is 300 mcg, but there is no known toxicity at even much higher levels. I recommend anywhere from 500 mcg - 5 mg a day (1/2 mg to 5 mg). The last two, but not least, B vitamins are B12 and folic acid. I have sung the praises of these two nutrients in many newsletters in the past. They are both miracle nutrients. Aside from reducing your risk of certain cancers, they appear to have benefits for cardiovascular disease, depression, and congenital birth defects, and provide a host of other miraculous benefits. Recent studies have even shown that folic acid can effect a modest lowering in blood pressure. As noted above, B6, B12 and folic acid are critical elements necessary in the lowering of homocysteine. I recommend a dose for folic acid that is at least 800 mcg daily, although this nutrient can be taken safely up to 5 milligrams a day with adequate B12 intake. When taking folic acid, it is critically important for you to take adequate doses of B12, as well. I recommend at least 500 mcg per day. The best and most active form, B12, is what is known as methylcobalamin. Almost all vitamins sold on the market these days utilize the extremely inexpensive and ineffective form of B12 known as cyanocobalamin. Methylcobalamin is a much more beneficial form, which can help with cognitive functioning, immunity, the nervous system, stroke, heart disease, and a host of other benefits. Another myth I would like to correct is that of the incorrect marketing schemes utilized by many vitamin companies, which claim that you must take B12 in its sublingual form; this is a total lie. In fact, B12 in the methylcobalamin form, with a higher dosage range and in a capsule form (which I recommend), actually achieves blood levels similar to B12 injections. I recommend that you use dosages of methylcobalamin in the 500 mcg to 5 mg a day range in a capsule for general health, and 2 - 5 mg per day if you have specific health concerns, as discussed above. Capsules are superior to rock hard tables, as they provide greater and quicker absorption. Having gone through this short dissertation on B vitamins, I believe you now understand the reason why the concept of a B-50 or B-100 complex makes no scientific sense. It may even cause harm to your vision. To include 50 or 100 mg/mcg amounts of all the B vitamins is scientifically illogical and does not provide optimal benefits and safety. In fact, 50 - 100 mg or more of vitamin B2 with long-term daily dosing may actually be dangerous. Although larger doses of thiamine (B1) should be utilized, only small amounts of riboflavin (B2) should be taken on a daily basis. The Vitamin-B Complex from Nutraceutical Sciences Institute (NSI) is formulated by a team of medical doctors on the NSI Scientific Advisory Board that includes myself. The Board understands the function of each of the individual B nutrients, and their specific roles and optimal doses. It is for that reason that our NSI B complex product contains varying amounts of these B vitamins in their correct forms and dosages, and is based on thousands of published scientific studies. Although we put in 250 mg of thiamine, we utilize only 10 mg of riboflavin. Likewise, the folic acid and B12 levels are considerably higher and in better forms than you would see in your typical B complex, mass-marketed vitamin product. The really amazing part is that we offer this superior product for less than 9 cents per day! We utilize the same scientific thought process in our entire Synergy multi-vitamin line of nutraceuticals, varying the dose of B vitamins correctly as the medical literature would dictate. To review all of your NSI Synergy multi-vitamin product choices, click here. As usual, it is my hope that these newsletters make you a more informed and knowledgeable vitamin consumer. Please feel free to forward these newsletters to your family and friends; you may save a life.