What drug should you avoid taking with vitamin C? Why could your feet be tingling? Long term use of Metamucil make you deficient in a what B vitamin? Easy bruising and bleeding could be a sign of what vitamin deficiency? What vitamin is made by bacteria?
This is Part 2 of 2 on vitamin deficiency. It covers information on vitamins B5, B6, B12, C, D,E, & K.
Vitamin B5: Pantothenic acid (B5) is used in metabolic cycles is key to the body’s production of energy, cholesterol, heme and acetylcholine. Cholesterol is used as the back bone of many hormones. Heme is used to carry oxygen in your blood. Acetylcholine is controls involuntary functions mediated by the activity of smooth muscle fibers, cardiac muscle fibers, and glands.
Some body signals that you are low in B5: burning, numbness or tingling in the feet, muscle weakness, swollen tongue (glossitis), cracks at the corner of your mouth (chilosis), recurrent upper respiratory tract infections (colds), fatigue, postural hypotension, hypochlohydria, GERD/heartburn, and depression.
Sources of B5: whole grains, broccoli, kale, cabbage family of vegetables, mushrooms, legumes & lentils, avocado, eggs, milk, poultry and organ meats.
Vitamin B6 (Pyridoxine/pyridoxyl/pyridoxamine) is involved in over 50 enzymatic reactions and potentially effects the function of cardiovascular, skin health, blood production, nerve function, healthy pregnancy, blood sugar regulation and cognitive function. Signs of deficiency include anxiety, depression, insomnia, irritability, confusion, abdominal pain, weakness, seizures, anemia, and poor immune function. There is even a rare form of B6 deficient epilepsy.
B6 requirements increase with diseases that affect absorption such as Celiac disease. The increased prevalence of hydrazine and hydrazide compounds as found in aerospace fuels, anti-toxicants in the petroleum industry, plating materials in metal manufacturing and ripening agents used on plants. B6-zapping hydrazine is also found in tobacco smoke, tartrazine (FD &C yellow food dyes). There are numerous drugs that deplete B6 and lead to common sides effects such as neuralgias, depression and anxiety. Those with Parkinson’s disease should consult a medical expert before supplementing with B6 as it can interfere with L-dopa when taken without carbidopa.
Food sources of B6 include potatoes, bananas, meat, poultry, fish and whole grains.
Vitamin B12: Methyl or Hydroxyl cobalamin. Measured via B12 serum levels. Falsely elevated B12 levels may exist in those with renal failure or hepatitis. Those with vegan diets are at increased risk of deficiency as major food sources are animal based.
Pernicious anemia is the result of loss of intrinsic factor, a protein that is excreted by the stomach and helps B12 absorption in the small intestine. If the stomach has low acidity as in long term use of proton pump inhibitors (a lot of medications ending in “-prazole”, presence of H.pylori, aging or damaged parietal cells as in autoimmune disease, or the small intestine mucosa is damaged as in Celiac or Crohn’s disease, B12 absorption will be reduced. Additionally those on long term use of psyllium (Metamucil) will be at increased risk of B12 deficiency. Large amounts of orally dosed B12 may help compensate by allowing for absorption by diffusion. Intramuscular injection (IM) of B12 (available with Dr. Laura) by passing the need for intrinsic factor. IM or intravenous B12 is also more helpful than oral supplementation for those with a defect in the transportation system of B12 to the brain or a an accelerated breakdown of B12 in the brain tissue. Signs of B12 dependency are dementia, depression, headaches, insomnia or chronic fatigue.
Vitamin C (ascorbic acid) is important in immune function, collagen formation (for skin and connective tissue), neurotransmitter formation, plays a role in fighting viruses and bacteria and is a key anti-oxidant. Scurvy is the severe form of vitamin C deficiency. Fatigue, depression and anxiety of health are acute signs preceding the diagnosis of scurvy. Signs are bleeding abnormalities due to poor connective tissue formation and possible vitamin C deficiency include bleeding nose, easy bruising, bleeding gums, bone pain, osteoporosis, arthralgias (pain stiffness and joint swelling), myalgias (muscle aches and pains), edema (swelling), and symptoms of suggestive of cardiovascular disease or mimicking peripheral vasculitis, or venus thrombosis.
Dose limiting symptoms of vitamin C are diarrhea and cramping. Vitamin C increases the absorption of non-heme iron this is good for those with low levels of iron/anemia. Vitamin C also seems to help the absorption of aluminum, which isn’t so good as it builds up in the bone, brain and liver and may contribute to the development of osteoporosis and Alzheimer’s disease. Avoid taking vitamin C at the same time as antacids, or aluminum hydroxide compounds. Chewable vitamin C may erode your dental enamel (it is an acid). Vitamin C supplementation can help or hinder the function of various medications; check with your medical practitioner for details.
Good sources of vitamin C include bell peppers, citrus fruits, cantaloupe, broccoli, Brussels sprouts, cauliflower, potatoes. Vitamin C is lost in high temperature and prolonged cooking.
Vitamin D (cholecalciferol) The body makes vitamin D when the skin is exposed to sunshine or ultraviolet light. About 20 min of unprotected exposure mid day in the summer months in Ontario will produce about 1000IU of vitamin D. Small amounts may be found in food sources such as fish, egg yolk, beef liver, however, when sunlight is inadequate (no exposure or seasonal variance), supplementation is essential.
Vitamin D helps the body absorb calcium and phosphorous, builds bone mineral matrix, helps the nerves and muscles function, boosts the immune system, and modulates autoimmune diseases. When the supplemental D3 taken with K2, vitamin D helps get calcium out of the blood stream and into the bones. Vitamin D deficiency can be suspect in multiple sclerosis, cancer, pancreatic deficiency, Crohn’s, Colitis, fibromyalgia, chronic fatigue, chronic low back pain, or severe muscle weakness. You may purchase D3+K2 drops at Forward Health.
Vitamin E: There are 8 different kinds of vitamin E – each a different type of tocopherol. Vitamin E is known as an antioxidant and the most potent, bioavailable form is alpha-tocopherol. When supplementing it is best to have a mixed or blend of tocopherols. Vitamin E is also involved in anticoagulation (inhibits platelet aggregation), is anti-inflammatory and stabilizes the cell membrane. Those with fat malabsorption issues at risk for deficiency. Vitamin E is also depleted in those with a high consumption of fatty foods, as thermally oxidized vegetable oil depletes vitamin E status. Good food sources of vitamin E include almond oil, wheat germ oil, nuts and seeds, whole grains, egg yolks and leafy green vegetables.
Vitamin K: There are actually four different kinds of Vitamin K. Vitamin K1 is what is often tracked so closely for those on warfarin because warfarin is an anticoagulant and affects the INR – the measurement we use to factor coagulation, or thickening of blood. Vitamin K1 is found in lots of leafy greens. K1 is also given to newborns to help prevent hemorrhage; a newborns’ intestinal tract is not yet making its own Vitamin K. K2 is made by some bacteria in our gastrointestinal tract, and by bacteria in some foods, like brie cheese. K2 helps Vitamin D3 get Calcium into the bones, so is useful in those suffering with osteoporosis or steroid induced bone loss and also can help lower total cholesterol in people on kidney dialysis. K3 and K4 still have much research pending. Those with Celiac disease not on a gluten free diet, chemotherapy, anticonvulsants or antibiotics may be at risk of vitamin K depletion, most likely due to the disruption in the bacteria of the gastrointestinal tract.
Good food sources of Vitamin K include dark leafy greens and to maximize absorption are best eaten with a source of fat (butter, olive oil, coconut oil, avocados). Olive oil actually is a source of vitamin K1 so it’s on double duty! Cheese, especially brie, egg yolks and fermented soy beans (natto) are also sources of Vitamin K.
Again, emphasize a diet with a full variety of fresh wholesome foods, rather than supplementation. There are cases however where supplementation for the short term, and sometimes even the long term, is necessary for optimum health status. A naturopathic doctor has the training and resources to help you decide what is best for your individual requirements.
Dr. Laura M. Brown, ND
Gaby, A. (2011) Nutritional Medicine. Fritz Perlberg Publishing. Concord, NH.