I recently received a tweet from a reader named Savannah, who asked the following question:
@AncestralizeMe do you recommend a specific brand of a B vitamin complex to take?
— Savannah Smith (@savannahxolynn) August 14, 2014
I realized something that should be a simple question could actually be quite complex (no pun intended!) depending on the individual’s health needs, genetics, and stage of life.
In this article, I’ll cover the three main issues with taking just any old vitamin B complex, the 3 main populations that likely need a B-complex, and my recommendations for the best brands to take depending on your health needs.
Cheap B-Complex Issues
The biggest issue I see with the general population taking a run-of-the-mill B-Complex from the grocery store or supplement store is that most B-Complexes don’t contain the best forms of the nutrients that they provide. Some forms are just less effective, others are downright dangerous when taken in excess.
The best example of this problem is folate. While folate is a crucial nutrient for good health in all stages of life, the primary supplemental form used in both B-Complexes and fortified foods is folic acid, which is synthetic and not processed by the body in the same way as natural folate. Research shows that there are many benefits to using the natural form of folate (5-methyltetrahydrofolate) is preferable to folic acid because it is better absorbed, does not mask B12 deficiency as easily, and helps avoid the pitfalls of unmetabolized folic acid in circulation, which has been associated with an increased risk of cancer. For more about the folate versus folic acid issue, check out Chris Kresser’s comprehensive post on the topic.
Vitamin B12 has a few different forms that vary in efficacy and safety. Cyanocobalamin is the most commonly used (read: less expensive) form of the nutrient, and yet this form is not found in nature. Rather, the B12 form that is most desirable is methylcobalamin (or hydroxycobalamin for some folks, as you’ll see in a bit), which is the form found in food. This is not only because of it’s function as a methyl donor, but also because of concerns that the metabolism of cyanocobalamin may release small amounts of cyanide into the system.
While this would never be enough to cause cyanide poisoning, it’s a potential issue for people who have impaired detox due to genetic issues, nutrient deficiencies, or chronic illness. And Chris Masterjohn believes cyanocobalamin may not be effective because B12 is required to excrete cyanide from our bodies (discussed at the 18:01 mark).
There may be other quality issues with the typical B-Complex vitamins you’ll find in the grocery store (such as B6 variations), but these are the two primary ones I see most commonly, and are the primary nutrients I consider when assessing the quality of any B-Complex my clients are taking.
Not All B-Vitamins Are Represented
One would think that a B-Complex should provide adequate levels of all the important B-vitamins, right? Unfortunately, there are some nutrients that are often completely absent from the typical B-vitamin supplement.
Choline is the primary nutrient that I often see getting left out of most major B-Complexes. This may be because choline has only been recognized as a vitamin (i.e. essential) since 1998. But isn’t 16 years long enough to get with the program? I don’t quite understand why choline isn’t a regular feature in most B-Complexes, and if it is included it’s usually in a woefully inadequate amount.
While you can get choline from egg yolks and a variety of vegetables, there are some people who may have higher needs (e.g. pregnant women, alcoholics) or that cannot eat egg yolks due to intolerance or autoimmune issues. And choline may be just as important as folate and B12 for promoting a fully functioning methylation cycle, and can actually protect against deficiency symptoms of the other B-vitamins. So any B-Complex worth taking should contain at least 200 mg of choline, in my opinion!
Biotin is another nutrient that is frequently underrepresented in B-Complexes. Some don’t contain it at all, while others only provide around 1/3-1/2 of the daily value. Biotin is a great supplement for skin, hair, and nail health, and may also help improve blood sugar control. So look for a B-Complex that provides 100% of your daily needs of biotin.
The amounts of the individual vitamins frequently vary as well, and you want to be careful about how much of any specific nutrient you’re getting, especially if you’ll be taking the vitamin daily. While vitamin B12 has no established upper limit, meaning there’s no toxicity seen even at extremely high doses, other vitamins like folate and B6 can potentially be toxic or cause poor long term health outcomes if taken in excess for a long period of time. So for most people, I don’t suggest taking over 800 mcg of folate and 100 mg of B6 on a daily basis (but those with MTHFR are a different story.)
You should really read the label carefully of any B-Complex you’re buying, as some supplements (this one for example) don’t even contain B12 or folate, which I’d think are two of the B-vitamins you’d expect to see in a B-Complex. So as with any supplement, ALWAYS read the label to see exactly what you’re getting, and do the research ahead of time before you go to the store.
MTHFR and Methylation Issues
So now I’ll address the elephant in the room: MTHFR and other methylation defects. While we’ve only just discovered the role of genetics in our methylation capabilities, the amount of impact these genetic polymorphisms can have on our mental and physical wellbeing is astonishing. For this reason, I think everybody should get their genes sequenced (using 23AndMe, for example) and find out what their methylation gene status is. While 23AndMe no longer analyzes the results for you, you can input your data into GeneticGenie and get a free PDF showing your methylation and detox results. The data is somewhat uninformative unless you’re familiar with the different major methylation issues and how to manage them, which I’ll now go over very briefly.
MTHFR: The MTHFR enzyme metabolizes folic acid into 5-MTHF, needed to metabolize homocysteine and to facilitate methylation processes. With one or more defects in this gene, the enzyme works slower and thus allows homocysteine to build up, which may increase the risk for heart disease and stroke. A poorly functioning MTHFR enzyme also limits a person’s methylation capacity, decreasing the breakdown of compounds like histamine, seratonin, and dopamine, and preventing the proper regulation of gene expression. This means that an MTHFR mutation can lead to mental illness like schizophrenia, depression, and bipolar disorder, as well as autoimmune disease, ADD, autism, spina bifida, Down’s syndrome, miscarriages, and cancer. The primary treatment for this specific mutation is supplementing with high quality forms of folate, B12, B6, and choline, avoiding processed fortified foods, and making sure not to over supplement.
COMT: This is another commonly seen genetic defect that affects a person’s methylation functions, but in a much different way than the MTHFR mutation. The COMT enzyme primarily degrades catecholamines such as dopamine, epinephrine, and norepinephrine. In excess, these chemicals can be stimulating to the nervous system, promoting anxiety, mood swings, and possibly leading to disorders like schizophrenia and bipolar, or even Parkinson’s disease. People with a COMT mutation (particularly homozygous) often need to limit or avoid methyl donors, as methyl groups tend to build up and lead to overmethylation symptoms like irritability, anxiety, insomnia, migraines, nausea, and more. Those with COMT mutations should limit their intake of methylated folate, and use hydroxycobalamin rather than methylcobalamin as a supplement.
CBS: This genetic defect is one that must be addressed before starting an MTHFR treatment. The CBS enzyme converts homocysteine into cystathionine and removes sulfur containing amino acids. Thus those with a CBS mutation are sensitive to high dietary sulfur intake, as well as vitamin B6. There is a long process required to help clear excess sulfur in those with CBS issues, including dietary restrictions, and a variety supplements. I strongly recommend anyone with a homozygous CBS mutation to seek guidance from a health professional well-versed in treating this mutation, as it’s one of the more complicated defects to manage.
As you can see, defects in your methylation enzymes can have an enormous effect on your health, as well as the appropriateness of taking a B-vitamin complex, so if you’ve ever had a negative reaction to a B-Complex, consider the possibility that you have one or more of these genetic issues and get your genome tested to make sure!
Who Needs B-Vitamins?
While a whole foods diet with lots of variety (including many different types of both plant and animal foods) is usually enough to keep most people healthy, there are many reasons why someone may want – or even need – to use a B-complex on a regular basis.
The primary population that should absolutely supplement with high quality B-vitamins are women who are pregnant or looking to become pregnant. The biggest reason is to ensure adequate folate intake, which is the primary nutrient that has been shown to protect against neural tube defects (NTDs) and promote healthy neurological development. But folate isn’t the only issue when it comes to a baby’s brain health: choline and vitamin B12 are also strongly related to the risk of NTDs, and are crucial for proper fetal brain development. Deficiencies of these B-vitamins during pregnancy are also associated with insulin resistance, increased adiposity (e.g. “fatness”), and reduced cognitive function in the offspring of those mothers who were deficient.
As you can see from the previous section, anyone with a methylation defect will likely need to supplement with some type of B-vitamin, depending on the actual defect that they have. Those with the MTHFR SNP need to avoid folic acid and supplement with 5-Methyltetrahydrofolate (5-MTHF), while those with COMT should limit 5-MTHF and use hydroxycobalamin as a B12 supplement.
One last population that definitely needs a B-vitamin supplement is current or former alcoholics. Those who drink excessive amounts of alcohol are at risk for deficiencies in nearly all the B-vitamins, but thiamin (B1), B12, B6, and folate are particularly well-evidenced issues. I suggest that anyone who is currently drinking more than the recommended 1-2 alcoholic drinks per day, or who has a history of alcoholism, should take a high quality B-Complex to address any lingering nutrient deficiencies that exist and prevent some of the neurological damage that can come from long-term alcohol abuse.
Which B-Vitamins Should I Take?
Assuming you don’t have a methylation genetic defect, I really like Integrative Therapeutics Active B-Complex as a well-rounded, high quality B-vitamin supplement. It has the active forms of B12 and folate, as well as a good amount of a highly bioavailable form of B6. It contains 250 mg of choline, 100% of the daily value for biotin, and a significant amount of all the other important B-vitamins. It also can be taken in a half-dose if there are concerns about oversupplementation, as each dose is 2 pills (i.e. take 1 pill for a half dose). Integrative Therapeutics is also a fantastic brand with a hypoallergenic formulation, making it appropriate for people with food sensitivities, and there’s no magnesium stearate in it, which some people report issues with.
And remember, those with the MTHFR SNP need to avoid folic acid and supplement with 5-Methyltetrahydrofolate (5-MTHF), while those with COMT should limit 5-MTHF and use hydroxycobalamin as a B12 supplement.
I hope you have a better understanding of the thought process that goes into choosing a B-vitamin complex, and now know how to confidently choose the right vitamin that works for you and your specific health needs!
Did this article change your perspective on B-Complex supplementation? Are you planning to change the B-vitamins you use? Let us know in the comments below!