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Water-Soluble Vitamins

This week we break down Water Soluble Vitamins! How many of us take B complex and C Vitamins? Us too! This week we answer the common questions like What are you really taking? Is it really all good? When do you need the supplements? What are other ways to obtain them? Go and listen to the episode now, then come back here for a quick summary!

Taking vitamins will not make you live longer!





Best source of getting your required nutrients? Eating a healthy, well-balanced diet

Make sure you speak to your physician or nutritionist before taking any supplements as they can interact with other medications.


What are water soluble vitamins?

- B1 (Thiamine), B2 (Riboflavin), B3 (Niacin), B5 (Pantothenate), B6 (Pyridoxine), B7 (Biotin), B9 (Folate), B12 (Cobalamin), Vitamin C

Most of these are obtained through your diet and do not require supplementation!

Risk factors for why you may need supplements include: older age, pregnancy, dietary habits, medical conditions, genetics, alcohol use

Note: B complex supplements will contain all of the water soluble vitamins mentioned.

Recommended daily dose varies by age, gender, health status. Be advised that pregnant women would require more supplementation and infants or children would require less supplementation. Here we will discuss recommended doses for adults.

Note: All of these vitamins may all cause bright yellow urine

Don't forget to use reputable brands!


1. B1 (Thiamine)

- Food source: lamb liver, sunflower seeds, pork, hazelnuts

- Pyrophosphate - main form, found in whole foods, most abundant in our body

- Thiamine triphosphate - found in animal sourced foods

- Thiamine mononitrate - found in animal fed or processed foods

- Most commonly used in supplements? thiamine mononitrate and thiamine hydrochloride

- Deficiency? Most common cause is due to alcoholism secondary to malnutrition

Syndromes

a) Wernicke-Korsakoff syndrome: ataxia, nystagmus, confusion, paralysis of your eye muscles, confabulation, psychosis, mammillary body hemorrhage, etc.

b) Dry BeriBeri: peripheral neuropathy

c) Wet BeriBeri: high output cardiac failure, edema

Diagnosis: clinical or via transketolase (enzyme) activity

Treatment: thiamine followed by glucose and IV fluids

Recommended daily dose: Women 1.1 mg, Men 1.2 mg


2. B2 (Riboflavin)

- Antioxidant, converts active vitamin B6 and tryptophan into niacin

- Food source: lamb liver, pork liver, beef liver, goat cheese, almonds

- Deficiency? Due to malnutrition

- Symptoms: cheilosis (inflammation of lips and scaling at the corners of the mouth), corneal vascularization (new blood vessel formation), dry skin, magenta-colored tongue

- Some studies show promise in reducing migraines and heart disease in genetically susceptible people

Recommended daily dose: Women 1.1 mg, Men 1.3 mg


3. B3 (Niacin)

- Cellular signaling, metabolism, making DNA and repairing it

- Derived from tryptophan (need B2 and B6)

- Supplement forms include: nicotinic acid and nicotinamide

- Food source: lamb liver, peanuts, turkey, sunflower seeds

- High doses of nicotinic acid can cause flushing

- Deficiency? Due to diet, Hartnup disease, malignant carcinoid syndrome, isoniazid therapy

- Symptoms: glossitis, pellagra (dermatitis, diarrhea, dementia)

- Vitamin Excess: can be due to nicotinic acid that can be given as treatment for hyperlipidemia to raise HDL (good cholesterol) levels, symptoms include: facial flushing, treatment with aspirin (will alleviate the facial flushing).

Other findings include: liver damage (when you take 3-9 grams/day), hyperglycemia, high uric acid levels

- Beauty effects: restores skin cells, maintains skin moisture content, improves skin texture and reduces the appearance of fine lines and wrinkles

Recommended daily dose: 14-16 mg/day in both men and women


4. B5 (Pantothenate)

- Important for fatty acid, amino acid, steroid hormones, and cholesterol synthesis

- Food source: virtually found in all foods and rich sources can be obtained from beef liver, sunflower seeds, lamb liver, trout, portobello mushrooms

- Plant options include: root vegetables, whole grains, tomatoes, broccoli

- Deficiency? dermatitis, enteritis, alopecia, and adrenal insufficiency

- Requirements of this vitamin is higher in individuals that consume excess alcohol and those with diabetes

- Excess? (>10 grams/day) symptoms include abdominal discomfort and diarrhea

Adequate Intake: 5mg/day for both men and women


5. B6 (Pyridoxine)

- Important for creating liver enzymes, amino acid metabolism, release of glucose from glycogen, neurotransmitter and red blood cell synthesis, supports formation of white blood cells, required to create niacin

- Pyridoxine (found in food and supplements), pyridoxamine (pharmaceutical drug), pyridoxal (main type found in animal sourced foods)

- Food source: pistachios, beef liver, lamb liver, salmon, sunflower seeds

- Deficiency? Due to those taking isoniazid, OCPs, goat milk, chronic alcoholism

- Symptoms: convulsions, seizures, hyper-irritability, peripheral neuropathy, sideroblastic anemia, cheilosis, stomatitis, confusion, depression

- Deficiency associated with increased risk of cancer, more common in elderly

- Excess (>2000 mg/day): nerve damage, light sensitivity, painful skin lesions

- High intake of supplements can suppress milk production in breast feeding women

Recommended daily dose: 1.3 mg/day for both men and women


6. B7 (Biotin)

- Important for carbohydrate and fat metabolism, regulates gene expression and amino acid metabolism

- Commonly taken to strengthen hair, skin and nails, however no concrete evidence exists for this treatment modality

- Food source: organ meats, fish, yeast, egg yolk, salmon, dairy products

- Plant source: legumes, leafy greens, cauliflower, mushrooms and nuts

- Deficiency? can be caused by antibiotic use, ingestion of raw eggs, formula fed infants with low biotin, anti-seizure medications

- Symptoms: dermatitis, alopecia, enteritis, lactic acidosis

Adequate intake: 30 mcg/day for both men and women


7. B9 (Folic Acid)

- Important for DNA and RNA synthesis, cell growth, amino acid metabolism, formation of red as well as white blood cells

- Forms: folate (found naturally in foods), folic acid (added to processed foods or in supplements), L-methylfolate (active form, as a supplement is thought to be better than folic acid)

- Food source: lamb liver, edamame, peanuts, raw spinach, chickpeas

- Absorbed through your intestine, storage only lasts around 3 months

- Deficiency? most common deficiency in the United States can be caused due to diet, alcoholism, pregnancy, medications: phenytoin, methotrexate, genetic mutation of MTHFR

- Symptoms: neural tube defects in newborns of pregnant women who are deficient in B9

- Diagnosis: macrocytic and megaloblastic anemia, hypersegmented neutrophils, homocysteinemia (increased risk of DVT and atherosclerosis), normal methylmalonic acid

- Note: supplemental folic acid is given a part of the prenatal vitamins and even during pregnancy especially in those who have a history of B9 deficiency

Recommended daily dose: 400mcg/day for both men and women


8. B12 (Cobalamin)

- Maintains brain function and development, DNA production, cell division, conversion of protein and fat into energy, red blood cell development

- Several years of reserve, stored primarily in the liver, requires intrinsic factor produced by the stomach to be absorbed

- Forms: cyanocobalamin (most common, trace amounts in food, ideal form found in supplements), hydroxocobalamin (most common naturally occuring form, widely found in animal sourced foods), methylcobalamin and adenosylcobalamin (newer, supplement only forms)

- Food source: found only in animal products, clams, lamb liver, lamb kidneys, caviar, mackerel

- Deficiency? takes years to develop, can be caused by pernicious anemia, gastric bypass surgery, resection of the terminal ileum (Crohn's disease), malabsorption, celiac sprue, enteritis, bacterial overgrowth of the terminal ileum, those infected with a parasite Diphyllobothrium latum, vegan diet

- Symptoms: neurological symptoms (paresthesias, numbness, tingling, subacute combined degeneration), dementia

- Note: the longer the deficiency persists the more likely the neurological symptoms become irreversible

- Diagnosis: macrocytic megaloblastic anemia, elevated methylmalonic acid, schilling test

- Deficiency is linked to increase rates of depression and mood disturbance especially in the elderly population.

Recommended daily dose: 2.4mcg/day for both men and women


Who should take these B-complex vitamins?

- Pregnancy - demand increases for B12 and folate

- Pregnant or breast feeding women especially those who are vegan will likely need to supplement with a B-complex vitamin

- People taking proton pump inhibitors for lets say GERD would benefit from B12 supplementation

- People on metformin may have low levels of B12 and folate

- Women on oral contraceptives may be deficient in B2, B6, B12, and folate

- Benefits of B-complex vitamins are associated with reducing stress, mood booster, reduces fatigue, enhances performance on cognitive tests, reduces symptoms of anxiety and depression, enhances treatment response in patient's who are on antidepressants (specifically with those who take B6, B12, and folate)


9. Last but not least... Vitamin C

- Important as an antioxidant, collagen synthesis, creates norepinephrine by converting dopamine into norepinephrine, liver synthesis of bile acids, keeps tetrahydrofolate in reduced form

- Note: protects against nitrosylation of amides as nitrosamines and nitroamides, which are carcinogenic

- Cooking or drying food will reduce the content of vitamin C

- Food source: guava, red bell peppers, kale, kiwi, broccoli

- Deficiency? can be caused by diet lacking citrus fruits, green vegetables, infants on formula that has been boiled for too long, cigarette smoking

- Symptoms: scurvy, gum swelling, bruising, perifollicular hemorrhages, poor wound healing, glossitis, increased bleeding time

- Syndromes: Scurvy subtype: Infantile, occurs between ages 2-10 months

- Excess (>3 grams/day): diarrhea, nausea, vomiting, excess iron absorption in predisposed individuals (hemochromatosis, those that require repeat blood transfusions), kidney stones (increased risk in those taking >1000mg/day)

- Recommended daily dose:

Infants (0-12 months) require 40-50mg/day of adequate intake

Children (1-3 years old) recommended daily dose: 15mg/day

Children (4-8 years old) recommended daily dose: 25mg/day

Ages 9-13 recommended daily dose: 45mg/day

Women (14-18 years old) recommended daily dose: 65mg/day

Men (14-18 years old): 75mg/day

Women (19+) recommended daily dose: 75mg/day

Men (19+): 90mg/day

Pregnancy: 80-85mg/day

Breastfeeding Women: 115-120mg/day


With that said, this should provide you some information regarding the medical importance of these vitamins, the food sources from which to obtain them and to really assess if you require any of these vitamins as a supplement. Don't forget to speak with your physician before taking any of these supplements!


That's all for this week, don't forget to leave us feedback, rate, review, subscribe and send in your questions so we can continue to improve as well as, provide you high quality content!




Disclaimer: The Content on our podcast/website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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