B complexes
Controversies
Vitamins are substances that only have a role in preventing diseases in dietary doses.
FALSE. Vitamins play important roles at much higher pharmacological doses. Examples: niacin (B3) & dyslipidemia; B6, folate (B9) and B12 & homocysteine and, more recently, in Alzheimer's disease and cognitive decline (cerebral atrophy).
Paying dearly to turn urine yellow
Many critics argue that taking vitamins in pharmacological doses is a waste of time and money, as they are rapidly eliminated, primarily in the urine. This facetious claim, which could apply to most medications, denies the possibility of achieving an effect due to higher, pharmacologically active blood levels. Moreover, among over-the-counter prevention and treatment tools, vitamins are probably the least expensive of all.
Indications
For a very long time, doctors and pharmacists have been suggesting that their tired patients take a B complex. Penta 3B, the historically recommended product, is now widely genericized. However, it is only recently that we have been able to find published clinical studies that support several of these uses:
- Depression, anxiety and improvement of quality of life (1)
- Improved stress resistance (2); in elderly men (3)
- Mood and mental performance (4.5)
- Stress, mood, and mild psychiatric symptoms (6)
- Reduction of gray matter loss associated with cognitive decline (7)
- Reduction of homocysteine levels
- Reduction of the negative effects of overtraining (8)
- Prevention of B vitamin deficiencies and their effects (such as neural tube defects)
- Prevention of cardiovascular diseases, degenerative diseases and certain cancers (possible).
- Prevention of neurological disorders and/or megaloblastic anemia
- Prevention and adjuvant to the treatment of osteoporosis
Dosages
See the two documents in the appendix:
APPENDIX A : Upper Safe Levels of Intake for Adults: Vitamins and Minerals
APPENDIX B : Nutrient Reference Intakes
Vitamin B9 (folic acid): Prevention of fetal malformations: supplement of 0.4 mg (400 µg) per day, three months before conception (if possible) and during at least the first three months of pregnancy.
Vitamin B12 (cobalamin): Therapeutic oral intake for anemia: 1,000 mcg
Note B12 : Bergeron L, Pouliot F. Vitamin B12 deficiency, underestimated and underdiagnosed. Le Médecin du Québec 2011 February;46(2): 79-83.
- 33% of patients have serum vitamin B12 levels ranging from 150 pmol/l to 220 pmol/l.
- 18% have a level below 150 pmol/l.
- 100% of patients in the dementia-related disorders unit have a level below 185 pmol/l, of which 43% have a level below 110 pmol/l.
Precautions
- More than 50 mg of vitamin B6 decreases the therapeutic effects of levodopa (a drug for Parkinson's disease) and more than 80 mg can also affect phenytoin (for epilepsy).
- Taking vitamin B6 and amiodarone (Cordarone®, cardiac arrhythmia) at the same time may increase the risk of photosensitivity.
Side effects : Pretty much all that is reported from high dose vitamins is darker, even fluorescent, urine!
- No absolute contraindication
- Take with food. Vitamins are nutrients and are generally best absorbed with food.
Types of products available
In addition to the multivitamin products seen previously (see the Multivitamins sheet):
High-dose B-complex
- Formulas containing 50 mg or even 100 mg of each B vitamin (except folate and B12). Designed for acute, short-term, or intermittent use. Long-term use is safe, but of limited relevance.
High-dose B + C complex
- Formulas containing high doses of B vitamins combined with 500 or 1,000 mg of vitamin C. Useful in acute situations, mainly for severe fatigue, stress, etc.
References – B Complexes
1. Lewis JE, Tiozzo E, Melillo AB, Leonard S, Chen L, Mendez A, Woolger JM, Konefal J.The effect of methylated vitamin B complex on depressive and anxiety symptoms and quality of life in adults with depression . ISRN Psychiatry. 2013 Jan 21;2013:621453. doi:10.1155/2013/621453. Print 2013. PubMed PMID: 23738221; PubMed Central PMCID: PMC3658370. (full text freely accessible)
2. Stough C, Scholey A, Lloyd J, Spong J, Myers S, Downey LA. The effect of 90 day administration of a high dose vitamin B-complex on work stress . Hum Psychopharmacol. 2011 Oct;26(7):470-6. doi:10.1002/hup.1229. PubMed PMID: 21905094.
3. Harris E, Kirk J, Rowsell R, Vitetta L, Sali A, Scholey AB, Pipingas A. The effect of multivitamin supplementation on mood and stress in healthy older men . Hum Psychopharmacol. 2011 Dec;26(8):560-7. doi:10.1002/hup.1245. Epub 2011 Nov 16. PubMed PMID: 22095836.
4. Kennedy DO, Veasey R, Watson A, Dodd F, Jones E, Maggini S, Haskell CF. Effects of high-dose B vitamin complex with vitamin C and minerals on subjective mood and performance in healthy males . Psychopharmacology (Berl). 2010 Jul;211(1):55-68. doi:10.1007/s00213-010-1870-3. Epub 2010 May 8. PubMed PMID: 20454891; PubMed Central PMCID: PMC2885294. (full text freely accessible)
5. Pipingas A, Camfield DA, Stough C, Cox KH, Fogg E, Tiplady B, Sarris J, White DJ, Sali A, Wetherell MA, Scholey AB. The effects of multivitamin supplementation on mood and general well-being in healthy young adults. A laboratory and at-home mobile phone assessment. Appetite. 2013 Oct;69:123-36. doi: 10.1016/j.appet.2013.05.016. Epub 2013 May 30. PubMed PMID: 23727255.
6. Long SJ, Benton D. Effects of vitamin and mineral supplementation on stress, mild psychiatric symptoms, and mood in nonclinical samples: a meta-analysis . Psychosom Med. 2013 Feb;75(2):144-53. doi:10.1097/PSY.0b013e31827d5fbd. PubMed PMID: 23362497.
7. Douaud G, Refsum H, de Jager CA, Jacoby R, Nichols TE, Smith SM, Smith AD. Preventing Alzheimer's disease-related gray matter atrophy by B-vitamin treatment . Proc Natl Acad Sci US A. 2013 Jun 4;110(23):9523-8. doi:10.1073/pnas.1301816110. Epub 2013 May 20. PubMed PMID: 23690582; PubMed Central PMCID: PMC3677457. (full text freely accessible)
8. Li X, Huang WX, Lu JM, Yang G, Ma FL, Lan YT, Meng JH, Dou JT. Effects of a multivitamin/multimineral supplement on young males with physical overtraining: a placebo-controlled, randomized, double-blinded cross-over trial . Biomed Environ Sci. 2013 Jul;26(7):599-604. doi:10.3967/0895-3988.2013.07.012. PubMed PMID: 23895706.
Leave a comment