Category Archives: B vitamins

Neuropathy can be a cause of extreme tiredness

An underlying problem affecting a main nerve or affecting many nerves can be a cause of tingling and numbness in the hands or arms and legs. An increased feeling of heaviness of the arms or legs or feeling tired from just holding the arms up in the air may be due to problems with the nerves rather than weakness of the muscles. Autoimmune disease or some nutrient deficiencies (vitamin B12 deficiency most common) can be causes of neuropathy, or nerve damage. Other common causes are mentioned later.

Autoimmune disease itself can be very tiring and a cause of muscle cramps and diffuse chronic pain and it could make it very hard to cope with a physically demanding job. Some types of nerve damage can become permanent but may be reversible if caught early enough and the underlying causes are corrected. Vitamin B12 may be poorly absorbed by elderly people or for others with digestive problems; a monthly injection of B12, bypassing the digestive system, is a common treatment.  Dissolve in the mouth supplements of B12, cobalamin, are also used sucessfully by some people. In Parkinson’s Disease neuropathy has been seen and “perhaps we should be measuring MMA levels in these patients and treating with cobalamin supplementation to reduce MMA levels and prevent neuropathy.” [4]

Recognizing when tiredness is tiredness and when it is due to underlying nerve damage may be a step that can help prevent the nerve damage from becoming more permanent paralysis or numbness. Neuropathy can also affect gland or organ function as well as affecting motion and sensation. Poor coordination can become a problem with walking or with picking up and not dropping things because they just slipped from your fingers. Symptoms may also include feeling moments of burning or stabbing pain and bowel and bladder problems may include constipation or feeling unable to urinate. [1]

Neuropathy may affect approximately 24 million people in the United States. [1]

Neuropathy is more of a risk for people with diabetes, about 30% of the cases are associated with diabetes. Heavy alcohol use and traumatic injury can also be causes. And autoimmune celiac disease, hypothyroidism and other immune system diseases and viral infections sometimes can be a cause. Some types of antibiotics, radiation and chemotherapy treatments may cause neuropathy. Some cases of neuropathy are present at birth. [1]

Since celiac disease may be a cause of neuropathy trying a gluten free diet may be worth trying, (and hypothyroidism can also be a cause of neuropathy and for some people that may also be due to or made worse by gluten sensitivity problems).

Not overeating sugars and simple starches in general may help prevent neuropathy from developing by promoting more stable blood sugar. Elevated levels of blood sugar may be part of the cause of nerve damage which would be especially important for diabetics who are more at risk for elevated levels: [3].

Hot pepper – and it’s active ingredient capsaicin may be helpful. It is available over the counter as an active ingredient in skin ointments made for pain relief for arthritis patients and others with chronic pain. Warm showers or a bath may also help circulation and muscle relaxation. Taking care with toenail health is important as numbness becomes more extreme and minor injuries may become infected and go unnoticed until they become major infections and are more visibly discolored or swollen. [1]

Of the 16 million Americans with diabetes, approximately, about 25% have foot problems due to peripheral neuropathy.  Peripheral nerves are those extending out from the brain or spinal cord to the muscles and organs and skin. Neuropathy can progress from feeling tingling sensations of ‘pins and needles’ in the fingertips to not being able to feel sensations of hot, cold or pain. [2]

Peripheral neuropathy has been known to occur with Parkinson’s disease, possibly due to treatment with L-dopa [4], or possibly as a side effect with another commonly used treatment, dopamine hydrochloride. [5] Dopamine producing cells become dysfunctional in Parkinson’s Disease. [6] Dopamine is a brain neurostransmitter involved in movement but it is also has roles in immune system function.

Adequate levels of dopamine are involved in preventing both autoimmune disease and cancer. Research that compared the lifestyles of family members with and without Parkinson’s Disease found that siblings without the disease were more likely to have been coffee drinkers (three or more cups per day) and were more likely to have smoked tobacco cigarettes. Smoking tobacco has negative health risks but it may help boost dopamine levels and may have some protective effects on the dopamine producing cells. [7]

Smoking tobacco may have protective effects for some people but not others due to underlying differences in genetics. Coffee intake has also been associated with less risk of developing non-alcoholic fatty liver disease (NAFLD), [8] but again it may be helping those with a certain type of genetics and be a negative risk for people with other types of genes. Obesity and smoking cigarettes once a patient already has non-alcoholic fatty liver disease is associated with the disease getting progressively worse. [9] Fructose, sugar from fruit or refined in the form of high fructose corn syrup, intake has also been associated with worsening of NAFLD. [10] And non-alcoholic fatty liver disease has been associated with neuropathy risk in patients with diabetes. [15] So protecting the liver might be helping protect the nerves at the same time.

Protecting liver function may be important for protecting against cancer. The herb milk thistle has been found to have some protective affects for the liver. [12] Cirrhosis of the liver is also associated with peripheral neuropathy so protecting the liver may also help protect the nervous system and brain and help prevent neuropathy from developing. [11]

Summary of tips for protecting against neuropathy:

  1. Stable blood sugar and not developing diabetes may help protect the nerves.
  2. Regular exercise and stretching and warm baths or showers and massage and other methods for increasing circulation may help protect the nerves.
  3. Not eating excessively of fructose or simple sugars may help prevent damage caused by glycation of proteins; and by helping prevent obesity or diabetes.
  4. Moderate use of coffee may help protect the liver from non-alcoholic fatty liver disease and some types of liver disease have been associated with peripheral neuropathy.
  5. Dopamine or L-dopa when used as a medication to treat Parkinson’s Disease may be involved in development of peripheral neuropathy. Parkinson’s Disease involves dysfunctional production of dopamine so some other issue may be involved that causes peripheral neuropathy or it may be important to have adequate but not excessive levels of dopamine for health of the nerves.
  6. A deficiency of vitamin B12, also called cobalamin, can be non-reversible cause of peripheral neuropathy. [13]
  7. Smoking tobacco may have some protective affects against Parkinson’s Disease for some people but it has also been associated with worsening of non-alcoholic fatty liver disease in patients who already have the disease. It is unclear at this time what genes may be involved in why some people seem less at risk from tobacco smoking than others – overall it has been found to be associated with lung cancer. Chemicals within smoke cause blood vessels to constrict and reduces circulation. It has been associated with worsening of diabetic peripheral neuropathy so quitting smoking may be more protective of nerves. While it may help boost dopamine levels there are many other healthy ways to boost dopamine naturally. [14]
  8. Following a gluten free diet may be helpful in preventing peripheral neuropathy for some people. If hypothyroidism is also a problem then trying a strict gluten free diet may be beneficial as it may be a cause of autoimmune sensitivities. Eating less gluten in that case would still be exposing the body to the autoimmune ‘allergen’ so a trial of a gluten free diet may have to be very strict and last several months to six months before significant health benefits occur (in research on autoimmune celiac disease it took six months on a very strict gluten free diet in order for the levels of autoimmune antibodies against gluten to be reduced — and (potentially) the thyroid hormone which the gluten molecule resembles.)

More information about dopamine and cancer and natural ways to raise dopamine levels are included in the group of Tweets mentioned in this Tweet, click to view the information on that site:

 

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

  1. http://thelightmedia.com/posts/28389-neuropathy-12-ways-to-identify-and-manage-this-painful-disease
  2. http://www.foot.com/site/foot-conditions/neuropathy
  3. https://en.wikipedia.org/wiki/Glycation
  4. http://www.medscape.com/viewarticle/725699
  5. http://www.ehealthme.com/ds/dopamine%20hydrochloride/neuropathy%20peripheral/
  6. http://justneurology.com/
  7. https://www.newscientist.com/article/dn11568-do-coffee-and-cigarettes-protect-against-parkinsons/
  8. http://www.medicalnewstoday.com/articles/264995.php
  9. http://onlinelibrary.wiley.com/doi/10.1002/hep.23516/full
  10. https://www.sciencedaily.com/releases/2010/04/100427081044.htm
  11. http://www.medscape.com/viewarticle/460036
  12. http://umm.edu/health/medical/altmed/herb/milk-thistle
  13. http://www.webmd.com/a-to-z-guides/supplement-guide-vitamin-b12#1
  14. http://mentalhealthdaily.com/2015/04/17/how-to-increase-dopamine-levels/
  15. https://www.ncbi.nlm.nih.gov/pubmed/28254449

 

Elevated levels of BPA found in children with autism

Recently published research has found that children with autism had elevated levels of the plastic bisphenol A (BPA) compared to the children in the control group. [1] BPA is a contaminant in the food supply from its use in the plastic lining of cans and in other food packages such as plastic drink bottles. It may also be found on the slick surface coating of some types of register receipts.

This is a significant step compared to “we don’t know what causes it or how to stop it,” because BPA is something that could be avoided by prenatal women and people with autism. It is also good news because it may also be possible to reduce the risks of exposure to BPA by increasing intake of the plant phytoestrogen, soy genistein, or methyl donors such as vitamin B12 and folate and choline. [2]

/Disclosure: This information is provided for educational purposes and is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

Methyl Donors and BPA

Methyl donors are chemicals that can donate a methyl group which is made up of one carbon atom and three hydrogen atoms. Methyl groups on DNA signal the genes to remain unactivated, to stay in an off position. Removing the methyl groups can signal the gene to become active. A gene that has few methyl groups atttached may be more easily activated than normally.

This excerpt includes methyl donors and at least one methyl remove-er (BPA).

“Nutritional components that may influence the methylation of epigenetically susceptible loci include folic acid, vitamin B6 and 12, selenium, choline and betaine, methionine, soy genistein, bisphenol A, tocopherols, diallyl disulfide in garlic, and tea polyphenols [28]” [1]                                               *tocopherols are the vitamin E group.

Bisphenol A is not a natural component of food as I understand nutrition but BPA may be part of the plastic lining of cans and other food packages such as plastic drink bottles. It is also found on the slick coating of some types of register receipts. BPA may cause hypomethylation of DNA, fewer methyl groups on the DNA may cause activation of genes.

Bisphenyl A can act similarly to the hormone estrogen. Soy genistein is a phytoestrogen that may help block harmful effects of the estrogen mimetics. Other methyl donors that may help block the effects of BPA are the B vitamins folic acid, vitamin B6 and B12 and choline and betaine.

Avoiding the supplement forms and eating more food sources of Folate and methyl B12 may be more beneficial for people with defects in the methylation cycle.(MTHFR is one example). Taking the unmethylated supplement forms may interfere with the smaller quantities of bioactive folate and B12 that might be found in natural sources.

Adequate B vitamins prenatally may also help protect against DNA changes in the infant.

Folate or Folic Acid:

Folate is the form of the vitamin found in food and it is more bioactive than Folic acid. Folic acid is the form that is commonly available as a supplement and in fortified foods however it requires adequate supplies of vitamin B12 to be available in order to be converted into a more usable form. A genetic difference may exist in some individuals that prevent the body from being able to convert the inactive Folic acid form into Folate, the methylated bioactive form of the vitamin.

Food Sources of Folate, the bioactive natural form, include: most beans and peanuts, black eyed peas, green peas, grains, asparagus, most dark green vegetables, orange juice, citrus fruits. Fortified cereal and rice are good sources of folic acid, the supplemental form.

Vitamin B12:

Food Sources of Vitamin B12 include: shellfish, fish, meat, poultry, eggs, milk, cheese, dairy products, Nutritional or Brewer’s yeast. Vegetarians who don’t eat dairy, eggs, fish or other meat products may need a supplement or nutritional yeast, a vegan food source of vitamin B12.

Injections of B12 may be needed for better absorption of the nutrient for some individuals with stomach problems. Adequate stomach acid and a cofactor are required for normal absorption of vitamin B12. A genetic difference may be a problem for some people causing them to need the methylated active form of B12 rather than being able to benefit from the more commonly available unmethylated supplement.

Vitamin B6:

Food Sources of Vitamin B6 include: fortified cereal, barley, buckwheat, avocados, baked potato with the skin, beef, poultry, salmon, bananas, green leafy vegetables, beans, nuts, sunflower seeds.

Choline and Betaine:

Choline is also a water soluble essential nutrient that is frequently grouped with the rest of the B vitamins. Choline is found throughout the body but is particularly important within the brain. Choline as a high dose supplement may cause mood symptoms in people at risk for unstable moods. It is a precursor for the brain neurotransmitter acetylcholine. Betaine is a metabolite of choline. Spinach and beets are rich in betaine. Good sources of choline include egg yolks, soy beans, beef, poultry, seafood, green leafy vegetables and cauliflower.

/Disclosure: This information is provided for educational purposes and is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

  1. Kyung E. Rhee, et al., Early Determinants of Obesity: Genetic, Epigenetic, and In Utero Influences, International Journal of Pediatrics, Vol. 2012
  2. J. Higdon & V. Drake,  An Evidence-based Approach to Vitamins and Minerals:  Health Benefits and Intake Recommendations, 2nd Ed., (Thieme, Stuttgart / New York, 2012)
  3. “Choline” on whfoods.com: [whfoods.com]
  4. Betaine,” (Feb. 11, 2012) PubMed Health: [ncbi.nlm.nih.gov/]  *link not working, part of the information is available here: [med.nyu.edu]
  5. Rebecca J. Schmidt, et. al. , “Prenatal vitamins, one-carbon metabolism gene variants, and risk for autism,” Epidemiology. 2011 Jul; 22(4): 476–485. [ncbi.nlm.nih.gov]
  6. MTHFR C677T Mutation: Basic Protocol,” 

Pyroluria, anxiety and deficiency of B6 and zinc

(originally posted on March 18, 2013, most recent update, 4/9/2017)

Research suggests that pyroluria is a condition caused by a genetic difference that prevents the normal breakdown of pyrroles which are side products of hemoglobin breakdown. [5 , 8] The excess pyrroles are not toxic but when they aren’t broken down to smaller chemicals they instead combine with vitamin B6 and zinc and form a compound that is excreted by the kidneys. In normal metabolism zinc and B6 molecules would be recovered for reuse instead of being excreted. The daily nutrient loss can lead to a chronic deficiency of vitamin B6 and zinc and a variety of symptoms.

Physical symptoms might include white spots on the fingernails from zinc deficiency. Zinc is important for wound healing so skin infections might be more common. Stunted growth and teeth that are crooked from overcrowding may result from zinc deficiency during childhood.

Poor dream recall is a symptom of B6 deficiency. Digestion problems and skin symptoms may occur. Dry peeling lips with poorly healing cracks at the corners of the mouth may be a problem with B6 deficiency.

Migraines, seizures and joint pain may be symptoms of pyroluria. Insomnia, exhaustion and sensitivity to light and sound may be problems. Anxiety can become severe over time and the person may isolate themselves to reduce stress. Depression, mood swings and temper outbursts are possible symptoms. [3, see link for more physical signs and symptoms.]

I learned of pyroluria as a possible cause of B6 and zinc deficiency in a book by Julia Ross, MA, called The Mood Cure, The Four Step Program to Take Charge of Your Emotions – Today. It included a self test and information from a book by Joan Mathews Larson, PhD, called Depression Free Naturally. Excerpts are available on her website which include more detail about pyroluria as a treatable cause of anxiety and depression: [7] Her work has helped patients at the Health Recovery Center for years. The center uses therapies designed to restore nutrient balance and correct deficiencies that may be underlying causes of anxiety, depression or addictions. [healthrecovery.com]

Zinc and B6 are needed for production of neurotransmitters that help prevent anxiety and depression. Mental health problems caused by nutrient deficiencies would not be helped much by typically prescribed antidepressants or anti-anxiety drugs. [1]

Ten percent of people may suffer from pyroluria but the condition is not yet widely recognized in the medical field. A research study found the condition to be more prevalent in people with mental health diagnoses and in groups of violent criminals. The pyrrole chemical was present in 71% of adults charged with sudden onset criminal behavior and in 33% of youth charged for a violent crime. Evidence of pyroluria was also more commonly found in patients with OCD, Multiple Sclerosis, Parkinson’s disease or Lyme Disease. It was found  in 40% or more of people with autism, ADHD, manic depression, schizophrenia, Down’s Syndrome, epilepsy, or porphyria. [35 ]

/Speculation/ This could explain why some studies have found B6 supplements helpful for autism but others weren’t able to replicate the results. If 40-50% of the autistic patients in a study had undiagnosed pyroluria then those participants might find high dose B6 supplements very helpful while the rest of the study group might not notice any change.

The good news is that, once identified, pyroluria is very treatable with use of well absorbed forms of vitamin B6 and zinc. The bad news — the supplements have to be taken everyday because the amounts needed are more than is really possible to be found in foods. The supplements are replacing the excessive nutrient loss caused by the daily excretion of the nutrient pyrrole compounds. Deficiency symptoms may start to return after only 48 hours without the high dose zinc and B6 supplements. [3]

A few other nutrient supplements may also be needed to restore nutrient balance. Magnesium may be helpful and niacin (B3), pantothenic acid (B5) and manganese may also be deficient. [1] The essential omega 6 fatty acid, arachidonic acid, may also become deficient. [2] The nutrients, zinc and vitamin B6, are essential for enzymes active throughout the body. Deficiency of B6 may lead to digestive problems and impaired absorption of B12 and other nutrients. Zinc deficiency can also lead to excessive levels of copper which can be neurotoxic and may require chelation therapy. [3] Avoiding foods rich in copper and red and yellow food dyes may be helpful. [2]

Evening primrose oil is recommended as an additional supplement by a medical doctor in the following post. Evening primrose oil would be a good source of essential omega 6 fatty acids. More detail is included in the article about the mental health and other physical symptoms common for patients with pyroluria to experience. It also states in the article that treatment with the supplements can quickly end the negative symptoms for patients when the condition is first diagnosed and treated. [8]

I have found personally that continuing the supplements daily is an ongoing necessity. Earliest symptoms of the B6 and zinc deficiency may be experienced after only missing a few days of the supplements. For me increased anxiety and headaches may occur after only a couple days of forgetting the supplements.

Before I had discovered the problem zinc deficiency was severe enough for me to have many white spots on my fingernails and for me it also seemed to be the cause of anorexia – extreme lack of appetite. Which is a symptom that was not mentioned in the article [8] that included a long list of symptoms. See excerpt:

Here is Dr. Walsh’s list of some of the symptoms correlated with pyroluria: Poor stress control, sensitivity to bright lights and loud noises, morning nausea, tendency to delay or skip breakfast, very dry skin, pale skin, inability to tan, high irritability and temper, history of underachievement, little or no dream recall, auto immune disorders, white spots on the finger nails, poor growth, coarse eyebrow hair, stretch marks on the skin, severe anxiety and/or depression, fearfulness, obsessions with negative thoughts, delayed puberty, dark or mauve colored urine, affinity for spicy and salty foods, abnormal fat distribution, delicate facial features, extreme mood swings, history of dyslexia, severe inner tension, frequent infections, premature graying of hair, poor muscle development, spleen area pain, joint pain, poor wound healing, psoriasis, tendency to stay up very late, abnormal or absent menstrual periods. [8]

Zinc deficiency has been associated with anorexia nervosa. [9]  For me at the time, swallowing just one or two bites of food at the time would seem like a lot of work. The food felt like dry sawdust when I would try to swallow and my mood when being encouraged to eat would tend towards feelings of “how can you ask such a difficult task of me,” (eating shouldn’t promote anxiety or feel like sawdust). Once I had been on the high dose supplements for a little while my appetite normalized and I don’t get many white spots on my fingernails (an opaque white spot instead of the pinkish color of the skin under the nailbed; white spots may appear in anyone’s fingernail after a bump or some sort of injury damaged it).

Caution: Taking high dose zinc supplements can be dangerous to copper balance in people who do not have pyroluria.

Gluten intolerance and excessive use of coffee or other diuretics may increase the severity of the condition. [3] Infections or other problems that cause increased destruction of red blood cells could also exacerbate the condition. The pyrroles can be a produced during hemoglobin synthesis and also during break down of red blood cells. [6]

If white spots on fingernails seems like a normal part of life then consider reading more about pyroluria. [7] Not all physicians are familiar with the condition and lab samples need to be treated carefully or the pyrrole compound will deteriorate. One lab protects samples from oxidizing by adding ascorbic acid (vitamin C) to the collection tube and the sample is then kept out of light and is frozen until testing. [4]

More information about vitamin B6 and food sources of B6 is available here: Vitamin B6

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

  1. By Julia Ross, MA, “The Mood Cure, The Four Step Program to Take Charge of Your Emotions – Today,” (Penguin Books, 2004 ed., New York) p314-315  *This book also addresses nutrients that can help during addiction recovery in addition to other mood disorders.
  2. J. Kaslow, MD, “Pyroluria,” DrKaslow.com: [drkaslow.com] This article suggests that avoiding red and yellow food coloring may be helpful.
  3. Pyroluria, A Hidden Disorder,” Naturalinsight.hubpages.com: [naturalinsight.hubpages.com]
  4. Do I Have Pyroluria,” A self test about the condition is available on this laboratory website under the Reference Tab: [kryptopyrrole.com/]
  5. McGinnis WR, et. al., “Discerning the Mauve Factor, Part 1,” Altern Ther Health Med. 2008 Mar-Apr;14(2):40-50.  [ncbi.nlm.nih.gov] *The abstract mentions that use of B6 and zinc or the use of antibiotics helped reduce urinary excretion of hydroxyhemopyrrolin-2-one (HPL). The chemical was originally nicknamed the Mauve Factor, due to its purplish color.  Prednisone has been known to increase urinary loss of HPL and it is theorized that increased stress would also cause increased excretion of HPL possibly due to changes in intestinal permeability that affect urinary concentrations.
  6. A patient forum, braintalkcommunities.org, has a post by member, Halsgluten, which suggests that SIBO, small intestine biofilm/bacterial overgrowth, may add to pyrrole production by causing an increase in red blood cell breakdown. The pyrrole compound, HPL, can be formed during synthesis of hemoglobin or during destruction of red blood cells. *The observation that antibiotics helped in reference #5 could be due to their helping fight an underlying intestinal infection or other chronic infection that is causing destruction of red blood cells.
  7. Joan Mathews Larson, PhD, “Soothing the Anxious Brain,” includes excerpts from her book, “Depression Free Naturally,” [joanmathewslarson.com]
  8. Pyroluria, Mental Health and the Immune System, JudyTsafirMD.com,
    http://www.judytsafrirmd.com/pyroluria-mental-health-and-the-immune-system/
  9. Humphries, L., et al., Zinc deficiency and eating disorders. J Clin Psychiatry. 1989 Dec;50(12):456-9.
    https://www.ncbi.nlm.nih.gov/pubmed/2600063

Folate is essential and Folic Acid is commonly available

Folate (L-methylfolate or vitamin B9) and Folic Acid:

Copy of Food Sources of Vitamin B6 include- fortified cereal, barley, buckwheat, avocados, baked potato with the skin, beef, poultry, salmon, bananas, green leafy vegetables, beans, nuts, sunflower seeds.Food Sources of Folate, the bioactive natural form, include:
  • beans, black eyed peas, green peas,
  • peanuts and other nuts and seeds,
  • whole grains,
  • asparagus, most dark green vegetables,
  • orange juice, citrus fruits.
  • Fortified cereal and rice are good sources of folic acid, the supplemental form.

 

Folate is the natural form; Folic Acid is in supplements & fortified foods.

Folate is the form of the vitamin found in food and is more bioactive.  Folic acid is the form that is commonly available as a supplement and in fortified foods, however it is less bioactive, less able to function until methyl groups are added which requires adequate supplies of vitamin B12. A genetic difference may exist in some individuals that prevent the body from being able to convert the inactive folic acid form into folate, the methylated bioactive form of the vitamin. [More about methylation.]

Symptoms of Folate deficiency include:
  • Deficiency of folate can cause megaloblastic / macrocytic anemia which is characterized by red blood cells that are over-sized and ineffective.  Anemia symptoms include being short of breath and feeling tired and weak.  The symptoms are due to a shortage of normal red blood cells and reduced ability to transport oxygen with each breath.
  • Folate is needed for DNA synthesis and for DNA methylation which may be important for preventing cancerous changes from occurring in the DNA.
  • Lack of folate may increase heart disease risks due to less breakdown of homocysteine. Vitamin B6 and B12 are also necessary, a deficiency of any one of the three might cause an accumulation of homocysteine.
  • Folate is important during pregnancy for fetal development.  Spina bifida and cleft palate are birth defects that may be caused by folate deficiency.
  • Deficiency of several of the B vitamin group can cause changes in the appearance and surface texture of the tongue. B vitamins that can cause changes in the tongue are mentioned in the following excerpt and include “niacin (B3), riboflavin (B2), pyridoxine (B6), folic acid (folate/B9), and vitamin B12”:
  • “Deficiencies of niacin, riboflavin, pyridoxine, folic acid, or vitamin B12,  resulting from poor diet or from the administration of antagonists, may cause a sore, beefy-red tongue without a coat. In the chronic vitamin deficiency state, the tongue may become atrophic and smooth.”                   – “The Tongue – Clinical Methods – NCBI bookshelf  https://www.ncbi.nlm.nih.gov/books/NBK236/

  • See the post on Vitamin B6 for more information about how the group of B vitamins work together in energy metabolism and cell growth.
Reference used for food sources & symptoms of Folate deficiency:
Other References used for the food sources of Folate and Folic Acid:

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

Vitamin B6

Vitamin B6 (pyridoxal, pyridoxal-5-phosphate (P5P), pyridoxine, and pyridoxamine, ):

nutrient B6 (2) Food Sources of Vitamin B6 include:
  • fortified cereal, barley, buckwheat;
  • avocados, baked potato with the skin;
  • beef, poultry, salmon;
  • bananas;
  • green leafy vegetables;
  • beans;
  • nuts; sunflower and pumpkin seed kernels.
Symptoms of a B6 deficiency may include:
  • A severe deficiency of vitamin B6 may cause seizures;
  • other neurological (nervous system or brain) symptoms affecting mental health may include irritability, confusion, and/or depression;
  • the earliest signs of a B6 deficiency might be observed first in the mouth where the tongue may be swollen and painful and become smooth looking and have a bright magenta color; mouth ulcers and cracks or fissures at the corners of the mouth may also occur;
  • and a weakened immune system may occur with a deficiency of vitamin B6.
  • Three B vitamins, B6, B12 and folate, are all necessary for the breakdown of homocysteine, which at elevated levels may increase risk of heart disease. So deficiency of any one of the three B vitamins, B6, B12 and folate, may be involved with symptoms or a diagnosis of heart disease.

  • Symptoms of PMS (Pre-menstrual Syndrome) and symptoms of prenatal nausea and vomiting may be helped by supplemental B6 intake. This suggests a deficiency may be involved in the underlying cause of the symptoms or that an increased need for the nutrient occurs before menstruation and during pregnancy. All B vitamins are important during pregnancy as they are involved in the growth of new cells and are needed for converting sugar into usable energy.

The skin & GI tract have a rapid cell growth rate which requires energy.
B vitamins are involved in both cell growth & energy metabolism.

B vitamins work together as a group to help breakdown the sugar glucose into a usable form of energy.

Areas of the body that have a short life cycle for cells are the first areas affected by deficiency of B vitamins because new cells need energy to grow and the B vitamin group are also involved in other chemical reactions that are necessary for the growth of new cells. The lining of the intestinal tract can have a cell turnover rate of just one week and the tongue is part of the gastro-intestinal (GI) tract and has a similar quick rate of cell growth.

The skin at the corners of the mouth and the lips in general may also have a slightly quicker rate of cell turnover than other areas of the surface skin. Our outer skin and the lining of the GI-tract are similar and considered part of the same organ system.

“Deficiencies of niacin, riboflavin, pyridoxine, folic acid, or vitamin B12,  resulting from poor diet or from the administration of antagonists, may cause a sore, beefy-red tongue without a coat. In the chronic vitamin deficiency state, the tongue may become atrophic and smooth.”                   – “The Tongue – Clinical Methods – NCBI bookshelf  https://www.ncbi.nlm.nih.gov/books/NBK236/

Pyroluria:

Pyroluria may be a genetic problem that causes increased urinary loss of B6 and zinc for some people. For patients with the condition adequate amounts of the nutrient cannot be readily obtained from food sources and large dose supplements are needed on a daily basis of both vitamin B6 and the mineral zinc. The condition is generally not assessed for or treated by the current medical system as it is not easy to diagnose. Anxiety is a primary symptom, migraine headaches and reduced tolerance for stress may also be symptoms. This post of mine has links and sources for more information: http://transcendingsquare.com/2014/09/22/pyroluria-anxiety-and-deficiency-of-b6-and-zinc/

This post by a medical doctor discusses the mental health and other symptoms in more detail. Emily Dickinson and Charles Darwin had similar symptoms. Daily supplements of zinc and B6 and/or the more bioactive form, pyridoxal-5-phosphate, (P5P), can quickly restore more normal health: http://www.judytsafrirmd.com/pyroluria-mental-health-and-the-immune-system/

Lack of dreaming at night is a symptom of pyroluria likely due to a long term deficiency of vitamin B6. Once treatment with the large dose supplements has been underway for a while it is common for patients to report remembering dreaming at night again. Whether the deficiency of B6 is causing less time to be spent at night in the stage of sleep when dreaming is more likely to occur, or whether it interferes with the ability to remember dreams the next morning, is not known.

Reference used for food sources & symptoms of Vitamin B6 deficiency:
Other References used for the food sources of Vitamin B6:

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

Niacin

Niacin (vitamin B3, niacinamide, and nicotinic acid):

Copy of Food Sources of Vitamin B6 include- fortified cereal, barley, buckwheat, avocados, baked potato with the skin, beef, poultry, salmon, bananas, green leafy vegetables, beans, nuts, sunflower seeds. (2)Food Sources of Niacin include:
  • nutritional yeast;
  • meats, salmon and tuna;
  • beans, green peas;
  • peanuts, and seeds;
  • avocado, mushrooms, green leafy vegetables;
  • grains, nixtamal flour, & fortified cereals;
  • milk, coffee and tea.
Symptoms of Niacin (Vitamin B3) Deficiency:

Digestive symptoms of less severe niacin deficiency may include nausea and vomiting and may also be able to be seen visibly as an unusually bright red tongue. Several B vitamins can cause changes in the appearance of the tongue as the cells all along the digestive tract need to be replaced frequently with new cells. The B vitamins work together as a group and many are essential for the growth of new cells. See the excerpt in the reference section for other B vitamins necessary for maintaining a healthy tongue.

Headache, apathy, memory loss, disorientation, and/or depression may be neurological symptoms that occur if niacin deficiency continues long term. Fatigue may also be a symptom of niacin deficiency.

Severe niacin deficiency is called pellagra. Symptoms of pellagra include skin rashes, (dermatitis), diarrhea, dementia, and eventually death if adequate niacin isn’t provided to the patient.

The condition was discovered in groups of people who lived primarily on a diet of corn or sorghum.  However the condition was not common in Mexico, in Central America, or for some groups of Native Americans. Corn in those areas was first soaked in an alkaline solution of lime or wood ash before being made into a type of flour called nixtamal.  The alkaline soaking method makes more of the grain’s niacin content available for absorption in the human digestive system.

Nixtamal flour is available to the home shopper and might be called tortilla or tamale flour. The ingredient list would include lime or wood ash if the product was made with the alkaline presoaking step.

The amino acid, tryptophan, can be converted to niacin within the body if adequate B6, folate and heme are available (an iron rich enzyme cofactor).

Background history regarding nicotinic acid, niacin, and nicotine:

Nicotinic acid and nicotine from tobacco cigarettes have similar names because they are similar chemicals but are not the same chemical and don’t have the same function within the body. This is a content marketing issue, read more – including the comments in the following link.

A summary: Nicotinic acid is a chemically reasonable name for the form of the nutrient that was initially discovered, but the similarity of the word to nicotine made people fearful when it was first added to foods and food labels as a new nutrient fortification being added to help prevent and treat pellagra. The use of a different form with a name change to “niacin” may have been a move at that time towards a form with a more commercially successful name even though it is not as descriptive of the way the chemical is formed as the name “nicotinic acid.”

Warning – non-harmful “Niacin flush” may occur with Nicotinic acid:

For some people, excessive supplementation with the nicotinic acid form of vitamin B3, but not the niacin form, may cause a temporary non-life-threatening reaction that may include symptoms of itching, a temporary flushing or reddening of the skin, nausea and vomiting. The reaction may be referred to as a “niacin flush.” A holistic practitioner describes the reaction in the following article and mentions that it usually goes away after a week of taking the supplement and that drinking some extra water during the sensation might help ease symptoms. The practitioner suggests that the reaction may be helpful for multiple sclerosis.

Niacinamide is a form of niacin that does not help reduce cholesterol

Niacin can be converted to niacinamide in the body and both forms are available as supplements which could help prevent deficiency symptoms. However niacin may also be helpful with blood lipid (fats) levels. It may help reduce elevated levels of triglycerides which may help prevent high cholesterol levels. Niacinamide is a form that does not affect blood lipid levels and wouldn’t be recommended over the niacin form if the goal is protecting cardiovascular (heart & blood vessel) health.  http://www.webmd.com/vitamins-supplements/ingredientmono-924-niacin%20and%20niacinamide%20vitamin%20b3.aspx?activeingredientid=924&

B vitamins essential for health of the tongue (and Gastrointestinal tract):

Deficiency of several of the B vitamin group can cause changes in the appearance and surface texture of the tongue. B vitamins that can cause changes in the tongue are mentioned in the following excerpt and include “niacin (B3), riboflavin (B2), pyridoxine (B6), folic acid (folate/B9), and vitamin B12”:

  • “Deficiencies of niacin, riboflavin, pyridoxine, folic acid, or vitamin B12,  resulting from poor diet or from the administration of antagonists, may cause a sore, beefy-red tongue without a coat. In the chronic vitamin deficiency state, the tongue may become atrophic and smooth.”                   – “The Tongue – Clinical Methods – NCBI bookshelf  https://www.ncbi.nlm.nih.gov/books/NBK236/

  • See the post on Vitamin B6 for more information about how the group of B vitamins work together in energy metabolism and cell growth.
Reference used for food sources & symptoms of Niacin deficiency:
Other References used for the food sources of Niacin:

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

Thiamin: people with anorexia or alcoholism are more at risk for vitamin B1 deficiency

Thiamin (also called Thiamine or vitamin B1):

thiaminFood Sources of Thiamin (vitamin B1) include:
  • fortified flour or rice, whole grains;
  • lean pork, fish, eggs;
  • nutritional yeast;
  • cantaloupe;
  • acorn squash, asparagus, green vegetables;
  • beans, green peas;
  • nuts, sunflower and pumpkin seed kernels & other edible seeds including flax, sesame & chia.
Thiamin or vitamin B1 may have been the first vitamin to be discovered.

Thiamin is also known as vitamin B1. Historically it may have been the first vitamin to be discovered.  Around 2600 BC the symptoms of thiamin deficiency were described in Chinese literature.  Thiamin deficiency, or beriberi as it was commonly called, became a more frequent problem in some communities when white flour and polished rice were first introduced.  Milling brown rice removes thiamin from the grain along with the fibrous outer layer of the grains of rice.

Symptoms of Beriberi (Thiamin deficiency) can include:
  • rapid ‘fluttery’ heart rate;
  • enlarged heart;
  • edema or swelling of the extremities,
  • heart and lungs leading to breathing problems and eventually congestive heart failure; burning painful feet;
  • muscle weakness and pain;
  • Wernicke encephalopathy or Korsakoff psychosis are symptoms that may occur with more severe B1 deficiencies and which can include mental changes.
Deficiency of Thiamin is rare except with severe malnourishment or increased needs:

Chronic alcoholics and anorexic or other malnourished people are more at risk for thiamin deficiency.  Malaria and HIV may increase need for thiamin due to the infected cell’s increased use of the nutrient.  Renal patients on dialysis may need extra thiamin due to increased loss. The nutrient is fairly widely available and deficiencies are not typically found in people of average health with reasonably varied diets.

Reference used for food sources & symptoms of Thiamin deficiency:
Additional Reference used for Food Sources of Thiamin:

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

B vitamin methyl donors may help protect against risks from BPA

     Research in the field of epigenetics by a team led by Dr. Randy Jirtle, an oncologist at Duke University, found physical changes in the experimental groups to be preventable if the experimental BPA diet was also supplemented with the B vitamins, folic acid and B12.
     Mice who were fed BPA prenatally had significantly more babies develop a characteristic hair color and they were at increased risk for gaining excess weight compared to the control group of prenatal mice that did not receive any BPA. However when the mice were fed a diet with extra B vitamins prenatally along with the BPA there were fewer babies with the change in hair color and associated health risks. The addition of the soy bean phytochemical, genistein, also helped reduce the number of baby mice who developed the change in hair color pigmentation. [1,2]
    Bisphenyl A acts similarly to the hormone estrogen. Genistein is a phytoestrogen that may help block harmful effects of estrogen mimetics. The B vitamins used in the study were chosen because they can donate a methyl group which is necessary for allowing genes to remain unactivated, to stay in an off position. A gene that has few methyl groups may be more easily activated than normally.

      Two other methyl donors, choline and betaine, were used in addition to the folic acid and vitamin B12. Choline is also a water soluble essential nutrient that is frequently grouped with the rest of the B vitamins. Choline is found throughout the body but is particularly important within the brain. Betaine is a metabolite of choline. Spinach and beets are rich in betaine. Good sources of choline include egg yolks, soy beans, beef, poultry, seafood, green leafy vegetables and cauliflower. [3]

Betaine is also being marketed as a medication for helping to reduce blood levels of homocysteine in the inherited condition, homocystinuria. (Reducing elevated levels of homocysteine may also reduce the risk of developing heart disease.) [4]

A prenatal diet providing a low intake of the methyl donors folate and B12 has been associated with cardiomyopathy in the infants. [5] Infants born to mothers with a low intake of the methyl donors folate, B12 and choline were also more at risk for cardiomyopathy later in life. [6] Not taking prenatal vitamins during the three months prior to conceiving or during the first month of pregnancy has been associated with an increased risk for autism in the infants especially for women who have a genetic variation in their methylation metabolism, (MTHFR 677 TT, CBSrs234715 GT + TT). [9] People with problems in the methylation pathways may need to take a methylated form of B12 and folate rather than the more commonly available form of folic acid. [10]

A link between BPA intake and an increased risk for heart disease has been discovered. [7] The physiologic reason is not known. Tips from the article for people hoping to reduce exposure to BPA include:

  1. avoid use of foods and beverages from cans,
  2. avoid re-using plastic bottles for beverages,
  3. limit handling of store receipts or placing them in store bags with unwrapped foods. Some register receipts have a BPA coating
  4. and wash your hands after handling register receipts. [7]

Adequate B vitamin intake is essential for reducing elevated levels of homocysteine. An increased blood level of homocysteine has been associated with increased heart disease risk. The amount of calcification within coronary arteries has also been shown to be predictive of heart disease risk. [8]

It has not been conclusively proven that a diet with adequate supplies of methyl donors protects DNA from changes that may be caused by BPA but a diet providing plenty of B vitamins is also unlikely to cause harm. B vitamins are water soluble and quite safe except in such large doses that would be difficult to obtain from food sources alone. The B vitamins work together in metabolic pathways that are essential for burning and using energy sources. The B vitamins might be described as being similar to matchsticks for accessing  the stored energy and so they are important for daily energy levels and for a good mood.
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  1. Synopsis of the BPA prenatal mouse study, by Pete Myers, PhD, “Bisphenol A alters epigenetic programming in fetal mice, and the effect can be reversed by genistein, (about the BPA mouse study) (July 30, 2007): [environmentalhealthnews.org/] *link i no longer working. Excerpt: “The new findings focus on BPA’s ability to remove ‘protective molecules’ that normally prevent genes from being turned on at the wrong time or in the wrong tissue.”
  2. The full research article: by Dana C Dolinoy, Dale Huang, Randy L. Jirtle, Maternal nutrient supplementation counteracts bisphenol A-induced DNA hypomethylation in early development, PNAS, August 7, 2007, vol 104, No. 32, 13056-13061 [pnas.org] *The mice in the experimental groups were being fed a diet including 50 mg BPA/kg which was considered to be less than the known toxic dose for mice but it represents a greater amount than is assumed to be found in the average human’s daily diet.
  3. Choline” on whfoods.com: [whfoods.com]
  4. Betaine,” (Feb. 11, 2012) PubMed Health: [ncbi.nlm.nih.gov/]  *link not working, part of the information is available here: [med.nyu.edu]
  5. Garcia MM et al, “Methyl donor deficiency induces cardiomyopathy through altered methylation/acetylation of PGC-1α by PRMT1 and SIRT1.” J Pathol. 2011 Nov;225(3):324-35. doi: 10.1002/path.2881. Epub 2011 Jun 1. [ncbi.nlm.nih.gov]
  6. Joseph J, “Fattening by deprivation: methyl balance and perinatal cardiomyopathy.”   J Pathol. 2011 Nov;225(3):315-7. doi: 10.1002/path.2942. Epub 2011 Jul 7. [ncbi.nlm.nih.gov]
  7. Kathleen Doheny, “Higher BPA Levels, More Heart Disease? Researchers Find Higher BPA Levels Linked With Narrower Arteries; Industry Says Study Proves Nothing” (Aug. 15, 2012) WebMD: [webmd.com]
  8. Michael O’Riordan, “Coronary artery calcium bests other risk markers for CVD risk assessment” (Aug. 22, 2012) theheart.org: [theheart.org/article] *subscription service
  9. Rebecca J. Schmidt, et. al. , “Prenatal vitamins, one-carbon metabolism gene variants, and risk for autism,” Epidemiology. 2011 Jul; 22(4): 476–485. [ncbi.nlm.nih.gov]
  10. Folate is essential and Folic Acid is commonly available,” Aug. 21, 2013 [transcendingsquare.com]
  11. MTHFR C677T Mutation: Basic Protocol,” 

Other references regarding B vitamins:

    1. Article by Kate Geagan, MS, RD, End Your Energy Crisis With B12, (Jan. 10, 2012), The Doctor Oz Show website: [doctoroz.com/]
    2. Mood Disorders – Depression, The Vitamin Update website: [vitamin-update.com] Includes information about mental health symptoms and functions of several B vitamins and a few trace minerals.
    3. Author: Vladimir Hegyi, Dermatologic Manifestations of Pellegra, (May 15, 2012) emedicine.Medscape: [emedicine.medscape.com] (deficiency of Niacin or B3)
    4. Author: Dieu-Thu Nguyen-Khoa, BeriBeri (Thiamin Deficiency), (Dec. 13, 2011) emedicine Medscape: [emedicine.medscape.com] (B1)
    5. Author: Richard E. Frye, Pyridoxine Deficiency, (May 26, 2010) emedicine Medscape: [emedicine.medscape.com] (B6)
    6. Author: Angela Gentili, Folic Acid Deficiency, (Dec 1, 2011) emedicine Medscape: [emedicine.medscape.com]
/Disclosure: This information is provided for educational purposes and is not intended to provide individual health care. Please see a health professional for individualized health care./