Have You Had Your B12 Test?

The B-complex vitamins perform many different functions in our body and have countless benefits. Although they are water-soluble and do not accumulate in the body, taking too much of any vitamin or using it without proper knowledge can be dangerous and may cause side effects. When taking B-complex supplements, you should always consult your doctor and know which dosage is appropriate for you.

Converting food into glucose, which provides energy for our body (carbohydrate metabolism), is one of the main functions of B vitamins. B vitamins also help with fat and protein metabolism. Vitamin B1, known as thiamine, supports the immune system and helps the body stay strong in stressful situations. Vitamin B6, known as pyridoxine, plays a role in the production of certain hormones and of chemicals in the brain called neurotransmitters. It also has immune-supporting properties.  Niacin (Vitamin B3) lowers levels of "bad" cholesterol (LDL) while raising "good" cholesterol, known as HDL. This may also help prevent hardening of the arteries. However, a doctor should be consulted before using B-complex or niacin for this purpose.

Folate, one of the B-complex vitamins, helps with healthy fetal development as well as the formation of new cells in the body. Folate is necessary for the production of RNA and DNA. This vitamin also prevents anemia by enabling the production of red blood cells. Folate intake during pregnancy protects the unborn child from neural tube defects, a congenital anomaly.

Because B-complex vitamins are water-soluble compounds that are not produced in sufficient amounts in the human body, they are classified as essential nutrients. A B-complex supplement is recommended through diet or at certain times  – especially under stress or during pregnancy – when modern food sources alone may be insufficient to meet the need for B vitamins.

B vitamins are also known as "stress" vitamins, because they are vital for maintaining the health of the nervous system and the adrenal glands. The nervous system and the adrenal glands are the main elements of the body that respond to stress. We need to get enough B-complex vitamins to cope with the stresses in our lives and to maintain our physical, mental and emotional functions. B vitamins are also necessary for converting the food we eat into usable energy (metabolism). In situations of prolonged or increased stress, providing good B-complex vitamin support can make a great difference in the body's ability to endure and resist challenges.

B-complex vitamins are so important for staying healthy throughout life that their deficiencies can cause a wide range of very serious symptoms. These include congenital anomalies, neurological disorders, mental health disorders (dementia, depression), anemia, hypertension, insomnia, heart disease, inflammatory conditions and skin diseases.

The B-complex vitamins (bioactive forms) are as follows:

1. B1 Thiamine hydrochloride (HCl) or thiamine pyrophosphate
2. B2 Ribose 5-phosphate
3. B3 Niacinamide
4. B5 Pantethine
5. B6 Pyridoxal-5′-phosphate
6. B9 L-5-MTHF methylfolate
7. B12 Methylcobalamin
8. Biotin

In addition to the B-complex vitamins, inositol, PABA (Para-Aminobenzoic Acid) and choline were formerly regarded as members of this vitamin family, but they are now classified as B vitamin cofactors. Neither inositol nor PABA is an essential nutrient, because both can be synthesized in sufficient amounts by bacteria in the intestines, but long-term antibiotic use and excessive coffee consumption can cause deficiencies of them.

Choline is regarded as an essential nutrient. Although a small amount is synthesized in the liver, choline must be obtained from the diet, mainly in the form of phospholipids such as phosphatidylcholine (a lecithin compound), a component of cell walls. Choline is required in the methylation cycle and in the production of acetylcholine, the primary neurotransmitter that enables cognitive functions such as thinking, learning and memory.

Bioactivity and B-Complex Vitamins

Scientific studies have clearly shown that the body needs the bioactive forms of B vitamins, which are their usable forms. If B vitamins are not taken in bioactive form, or if they are not converted to their bioactive forms in the body, the body cannot benefit from them. Unfortunately, many of the B vitamins in standard B-complex supplements are not in bioactive form. Folic acid and cyanocobalamin are converted into their active forms in the body; the superiority of forms such as methylcobalamin has not been proven. These non-bioactive forms must be converted in the body into their coenzyme or bioactive forms. So what are the differences?

R5P (riboflavin 5′-phosphate) is the active form of vitamin B2 used in many metabolic processes, including nervous system development in the fetus,  the production of red blood cells in the body,  energy production, healthy growth and tissue repair. The inactive form of riboflavin is less effective and must be converted to the bioactive R5P form before it can be used. This is the vitamin responsible for urine turning bright yellow when we take a B-complex vitamin supplement.

Pantethine is the active form of vitamin B5 and a key component of coenzyme A. Research suggests that the pantethine form is more effective in the body than inactive pantothenic acid.

P5P (pyridoxal-5’-phosphate) is the active form of the vitamin B6 you need. Studies have shown that the rate of conversion of the inactive pyridoxine hydrochloride form to the active P5P form is low, especially in people with poor liver function or gluten allergies, in the elderly and in autistic children. This is a very important finding, because when the bioactive P5P level is low, taking the vitamin in an inactive form may not prevent deficiency.

Pyridoxine hydrochloride is the most commonly used form of vitamin B6 in dietary supplements. Since it is not found in natural sources, it must be converted to the active coenzyme P-5-P form in enterocytes (intestinal cells) and the liver before it can be used in the body.

In people with impaired liver function or enzyme defects, the conversion of pyridoxine hydrochloride to P5P may be reduced. In addition, some medications can affect this conversion pathway. Only the P5P form has active coenzyme function in the body. It plays an important role in more than 100 pathways related to neurotransmitter production, amino acid metabolism and other metabolic reactions. When P-5-P  is the 'active' form, it does not need to be converted in the body.

L-5-MTHF (methylfolate or 5-methyltetrahydrofolate) is the methylated bioactive form of vitamin B9 (folate). Folic acid is the synthetic form generally added to vitamin supplements and as a fortificant in foods. Folic acid is useless if the body cannot convert it to the L-5-MTHF form. The L-5-MTHF form performs two basic functions necessary for leading a healthy life, above all for brain health – the production of neurotransmitters in the brain and the production of SAMe (S-adenosylmethionine), an important enzyme regulator.

Methylcobalamin  is the naturally methylated form of vitamin B12. In contrast, cyanocobalamin is a cheaper synthetic form that does not occur in nature. Methylcobalamin is indispensable for red blood cell production, nerve health and brain detoxification.  Its deficiency can cause anemia and impaired brain and nervous system function.

The Methylation Cycle, B Vitamins and a Common Genetic Variation

People who carry an MTHFR variant can also use folic acid; 400 mcg per day is recommended for those planning a pregnancy.

In the simplified diagram below, you can see the interactions between the MTHFR gene, the active B vitamins 5-MTHF folate and methyl-B12, and the Methylation Cycle in the human body:

Methylation is a vital metabolic function catalyzed by different enzymes. It takes place in every cell and every tissue. Healing, energy production, DNA gene expression, neurological function, detoxification in the liver (of chemical toxins, heavy metals and hormones), glutathione production (the body's important intracellular antioxidant), immune response, cancer risk and the regulation of adrenal stress are all related to methylation.

Variations in the MTHFR gene prevent folic acid from being converted to the active folate (B9) form L-5-MTHF (or L-5-MethylTHF). A healthy methylation cycle function is also needed for the production of the other bioactive B vitamin forms, Ribose 5-Phosphate  (B2), Pyridoxal-5′-Phosphate (B6) and methylcobalamin (B12). L-5-MTHF deficiency can lead to many chronic conditions by disrupting vital methylation pathways in the body, including homocysteine regulation.

Effects of Methylation on Homocysteine Levels and Inflammation

Homocysteine metabolism requires Pyridoxal-5′-Phosphate (P5P), the active form of vitamin B6, and variations in the MTHFR gene lead to a disruption in a cycle. When methylation pathways are impaired, homocysteine levels rise and cause an increase in inflammation. Many studies have shown that homocysteine levels can be lowered by combining vitamins B6, B9 and B12. High homocysteine is a significant factor for the risk of coronary artery disease and stroke. Researchers are closely examining the relationship between high homocysteine and the many autoimmune diseases that have reached almost epidemic proportions in Western countries today. The common denominator of all these diseases is uncontrolled chronic inflammation. The rise in homocysteine that follows impairment in the methylation cycle may be the underlying cause of modern diseases in the body.

Providing our body with B-complex vitamins in an easily usable bioactive form is especially important for supporting healthy methylation, particularly in people with MTHFR gene variations. This is because nearly half of the population is at risk of impaired methylation cycles and elevated homocysteine levels due to these gene variations.  For these people, taking active B-complex vitamins is vitally important, especially during pregnancy and periods of increased stress. We can think of B vitamins as the fuel of methylation. Methylation is a biochemical process that takes place billions of times per second in our body. It is a very important mechanism that keeps us alive and rids us of toxins.

Functions, Properties, Benefits and Sources of B Vitamins

B1 (Thiamine) helps the body build healthy new cells. It has immune-protective and anti-stress properties. In a diet high in carbohydrates, this vitamin helps break down carbohydrates. Its natural form, thiamine pyrophosphate, is a coenzyme involved in the breakdown of sugars and amino acids. Thiamine is necessary for the production of the neurotransmitters acetylcholine and GABA, which are involved in nerve transmission. Whole grains, peanuts, legumes and spinach are foods rich in vitamin B1.

B2 (Riboflavin), as an antioxidant, fights free radicals, may prevent premature aging and provides protection against heart disease. Riboflavin is important for red blood cell production. There are studies showing that B2 can help prevent migraine attacks. Sunlight causes the inactivation of vitamin B2 in foods. Antibiotics increase the excretion of vitamin B2 from the body.  Almonds, milk, yogurt, eggs, Brussels sprouts, spinach and soy are rich sources.

B3 (Niacin) has the effect of raising good cholesterol (HDL) levels. B3 levels decrease in people who consume a lot of alcohol. It has an acne-improving effect. Milk, red meat, eggs, legumes and green vegetables are rich in niacin.

B5 (Pantothenic Acid) is found in small amounts in almost every food group — its name comes from the Greek pantothen,  meaning "from everywhere". In addition to breaking down fats and carbohydrates to obtain energy in the body, it is responsible for the production of sex and stress hormones, including testosterone. Studies show that B5 protects skin health and reduces signs of aging such as skin spots. Avocado, yogurt, eggs, meat and legumes are good sources of B5.

B6 (Pyridoxine), together with its relatives B12 and B9, controls the levels of an amino acid called homocysteine, a substance associated with heart disease. Pyridoxine is an important vitamin for mood and sleep patterns because it helps the body produce serotonin and melatonin. Some studies suggest that vitamin B6 can reduce inflammation in people with rheumatoid arthritis. Chicken, turkey, tuna, salmon, sunflower seeds, cheese, brown rice and carrots are rich in B6.

B7 (Biotin) is also known as the "beauty vitamin" because it is important for healthy hair, skin, mucous membranes and nails. High-dose biotin can interfere with test results; inform the laboratory before giving blood. It is an important vitamin for the baby's normal development during pregnancy. Liver, chicken, fish, potatoes, cauliflower, egg yolk and nuts are rich in biotin.

B9 (Folate) is also commonly known by the name of its synthetic form, folic acid. Most vitamin supplements contain folic acid rather than folate because it is cheap, but in order to be used in the blood and tissues, folic acid must be methylated in the intestines and liver and converted to 5-methyltetrahydrofolate. Folate is important because it is a brain-friendly vitamin in depression and memory difficulties. Its importance in pregnancy is that it prevents congenital neurological defects in babies. Dark green leafy vegetables, asparagus, beets, salmon, milk, bulgur and legumes are rich in folate.

B12 (Cobalamin) is a real team player. Cobalamin and vitamin B9 together are vitamins necessary for blood production. Since B12 is found mainly in animal foods, its deficiency is seen more often in people who do not eat meat at all. Vitamin B12 is absorbed only in the last part of the small intestine, called the ileum, and since the receptor sites there are limited in number, it can only be absorbed in small amounts. Fish, shellfish, milk, eggs and meat are sources of B12.

You can have a Checkup at Wellcare Laboratories to measure your vitamin B12 level.