B Vitamin Deficiencies: Symptoms, Causes, and

Solutions
drjockers.com/b-vitamin-deficiencies/

August 6, 2020

If you are dealing with fatigue, concentration issues, depression, anxiety, memory
problems, weakness, skin issues, or other chronic symptoms, it may be time to check for
B vitamin deficiencies. B vitamins are a group of vitamins that are critical for your cellular
health, brain health, hormonal health, metabolism, skin health, and other areas of your
health. B vitamin deficiencies can result in an array of symptoms and serious health
issues. Thankfully, it is easy to correct these deficiencies through a nutrient-dense diet
and supplementation.

In this article, you will learn what B vitamins and B vitamin deficiencies are. I will go over
the potential reasons for vitamin B deficiencies. You will learn the role of each B vitamin. I
will discuss testing options for vitamin B deficiencies and share my recommendations for
the best vitamin B supplements. 

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What Are B Vitamins

B vitamins are a group of vitamins that are essential for your body’s cells proper and
healthy functioning. They allow your body to convert food into energy and support your
metabolism. They also help to create new blood cells, support brain cells, support cellular

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health, and maintain healthy skin among other functions. 

B vitamins include thiamin (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3),
pantothenic acid (vitamin B5), vitamin B6, biotin (vitamin B7), folate (vitamin B9), and
vitamin B12. Together, these B vitamins are called the vitamin B complex. Each of them
has their own role and function that I will go over later in this article. 

B Vitamin Deficiencies

When eating a nutrient-dense diet, meeting your vitamin B needs should be possible,
however, many people still need supplementation to avoid vitamin B deficiencies. Vitamin
B deficiencies are quite common and may develop due to a variety of reasons including a
poor diet, poor nutrient absorption, gut infections, various health conditions, and
medication use.

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Symptoms of B vitamin deficiencies may include fatigue, weakness, confusion, memory
problems, behavior changes, depression, mental health issues, pale skin, heart
palpitations, shortness of breath, digestion troubles, and more (1, 2).

Reasons For B Vitamin Deficiencies

You may develop B vitamin deficiencies due to a number of reasons. Here are the top
causes of B vitamin deficiencies and related symptoms.

Poor Diet 
Eating a poor diet can lead to a variety of vitamin and mineral deficiencies, chronic
symptoms, and related health issues. If your diet is high in sugar, grains, refined and
processed foods, and low in vegetables and meat, your risks of developing B vitamin
deficiencies increase. Meat, organ meats, fish, eggs, dark leafy greens, mushrooms,
seeds, and beans are some of the best sources of natural B vitamins. Eating a diet low in
these foods makes it impossible to meet your needs. 

Eating too much sugar, grains, processed foods, and other inflammatory foods increases
inflammation, gut flora imbalance, and poor absorption, which can deplete your body of B
vitamins and hinder your body’s ability to absorb the B vitamins that you are taking in.

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Eating a nutrient-dense diet is not only important for taking in plenty of vitamin Bs, but
also necessary for optimizing absorption. To learn about a nutrient-dense diet I
recommend, read this article.

High Stress 
Chronic and high stress can deplete your body of many B vitamins. Stress can be
physical, mental, and emotional. Job stressors, family and relationship problems, a lack of
social support, injury or illness, listening to the news, financial problems, depression,
anxiety, a negative mindset, low self-esteem, moving, personal changes, and driving in
traffic are all examples of common stressors people experience.

These issues become a problem when we are responding to them with fear, anger,
sadness, or negativity. When high stress becomes chronic, it increases inflammation,
pain, and health issues, and contributes to poor digestion, poor absorption, and the
depletion of vitamins and minerals, including B vitamins. 

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Poor Stomach Acid Levels 
Your body requires an acidic stomach to effectively absorb vitamin B12. Poor stomach
acid levels can lower vitamin B12 absorption.

Atrophic gastritic is a common condition that can affect older adults and decreases
stomach acid levels contributing to vitamin B12 malabsorption and deficiency. Taking
medications for acid reflux and heartburn long-term can also reduce your body’s ability to
absorb vitamin B12 (3, 4). 

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Gut Infections 
Gut infections and poor gut flora balance can lead to vitamin B12 and other vitamin B
deficiencies. Small intestinal bacterial overgrowth (SIBO) is one of the major causes of
acid reflux, heartburn, bloating, gas, constipation, nausea, and diarrhea. It can also lead
to B12 deficiency as all the extra bacteria overgrown in your small intestine intercepts
with the absorption of B12.

Inflammation in your gut, including inflammatory bowel diseases, such as Crohn’s disease
and colitis, gut infections, and gut problems cause by NSAIDs medication and antibiotics
can also lead to an imbalance and interfere with vitamin B12 and another vitamin B
absorption accompanies by digestion issues. Tapeworms and fungi in your gut can also
steal B vitamins from your body leading to deficiencies. 

To reduce the risk of vitamin B deficiencies, you need to address your gut infections and
you need to introduce healthy microbes, such as that are necessary for the production of
certain B vitamins. Research has, for example, shown that Lactobacillus acidophilus and
pathogens such as Mycobacterium tuberculosis and Salmonella typhimurium are
important for vitamin B2 and P. denitrificans and P. shermanii are important for B12
production (5, 6, 7).

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Medication Usage
There are a variety of medications that may deplete B vitamin levels. Some of these
medications include heartburn and acid reflux medications, including H2 receptor
blockers and proton pump inhibitors, metformin for diabetes chloramphenicol antibiotics,
colchicine for gout, ethanol, and levodopa and carbidopa for Parkinson’s disease.

If you are taking medications and dealing with vitamin B or other nutrient deficiencies, it is
important that you speak with your doctor about alternative medications and treatment
options, lifestyle changes as part of your treatment, and vitamin B supplementation (8, 9,
10).

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Genetics 
Your genetics play an important role in your health and may interfere with your vitamin B
levels and absorption. The methylenetetrahydrofolate reductase (MTHFR) gene is
necessary to make the MTHFR enzyme.

The MTHFR is essential for a variety of biochemical reactions in your body, including
methylation, which is the process of conversion folate (vitamin B9) into methyl-folate.
Methylation is critical for metabolizing B vitamins DNA cell function, detoxification,
hormonal health, repairing damaged cells, sleep, mental health, and behavioral health. 

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Genetic mutations and variations are common and MTHFR gene mutations are affecting
about half of the population. The problem is that MTHFR gene mutations can lead to
methylation issues increasing your risk of fatigue, sleep issues, depression and anxiety,
hormonal issues, allergies, food and chemical sensitivities, histamine intolerance, and
other health issues. MTHFR mutations and consequent methylation problems interfere
with your body’s ability to methylate and convert B vitamins. 

To support your body if you have MTHFR gene mutations and methylation issues, it is
important that you only take pre-methylated vitamin B supplements and take natural
sources of B vitamins through a nutrient-dense diet rich in meat and vegetables. To learn
more about MTHFR genes and enzymes, I recommend reading this article (11, 12, 13,
14). 

Role of Each B Vitamin 

Each B vitamin has its own role in your body and health. Let’s look at them one by one:

Vitamin B1: Thiamine

Vitamin B1 is also known as thiamine. It supports your adrenal function and helps to
maintain a healthy nervous system. It plays a critical role in the metabolism of
carbohydrates into energy and nerve transmission.

According to one study, supplementing with benfotiamine (S-benzoylthiamine O-

monophosphate), which is the most bioactive form of supplemental thiamine, raises blood
and tissue levels of thiamine at least five times than water-soluble salt and remained
bioavailable 3.6 times longer than thiamine salt (15). 

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A true B1 deficiency is called Beriberi and it is usually caused by poor diet or alcoholism. 
Symptoms include loss of appetite, weakness, pain in the limbs, shortness of breath, and
swollen feet or legs.  While Beriberi is quite rare in 1st world countries, you can have
subclinical deficiencies that aren’t as severe and go undetected and cause chronic health
problems.
Best food sources of thiamine include:  Fish, chicken, grass-fed meats, sunflower
seeds, black seeds, black beans, dark green vegetable, and pasture-raised eggs

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Vitamin B2: Riboflavin
Vitamin B2 is also called riboflavin. Riboflavin is critical for your metabolic functions. It is
essential for recycling glutathione, a powerful antioxidant in your body. The best form of
riboflavin is riboflavin 5’-phosphate sodium (R5P) because it is activated to perform at the
highest utilization rate in your body.

Symptoms of vitamin B2 (riboflavin) deficiency include sore throat, redness and swelling
of the lining of the mouth and throat, cracks or sores on the outsides of the lips and at the
corners of the mouth, inflammation and redness of the tongue, and a moist, scaly skin
inflammation.

Best food sources of riboflavin include: grass-fed raw cheese, almonds, grass-fed
beef and lamb, salmon and other wild-caught oily fish, dark green vegetable, and pasture-
raised eggs

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Vitamin B3: Niacin
Vitamin B3 is also known as niacin. It is essential for energy production in your body.
There are two forms of niacin: nicotinamide adenine dinucleotide (NAD) and nicotinamide
adenine dinucleotide phosphate (NADP). Both are necessary for the conversion of dietary
fats, proteins, and carbohydrates for energy. Niacin is also necessary for synthesizing
starches to be stored in your liver and muscles for energy.

When you are severely deficient in niacin, you develop a condition called Pellagra, which
is characterized by inflamed skin, diarrhea, dementia and sores in the mouth.  The areas
of the skin that are exposed to friction or sun exposure are typically impacted first.

Best food sources of niacin include: tuna, wild-caught salmon, pasture-raised chicken
and turkey, liver, and grass-fed beef

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Vitamin B5: Pantothenic Acid
Vitamin B5 is also known as pantothenic acid. It supports your body through the
incorporation into a molecule coenzyme A (CoA) which is essential for energy metabolism
and helping fats, protein, and carbohydrates being used as fuel sources.

Research has shown that vitamin B5 is critical for skin health, including reducing skin
spots, redness, and other signs of aging. It is also essential for the production of sex- and
stress-related hormones. 

Vitamin B5 deficiency is rare, but may include symptoms such as fatigue, insomnia,
depression, irritability, vomiting, stomach pains, burning feet, and upper respiratory
infections.  While a deficiency is rare, many people have sub-clinical symptoms which
lead to lower stress resilience and daytime fatigue and mental lethargy. 

Best food sources of vitamin B5 include: eggs, avocados, mushrooms, oily wild-
caught fish, such as trout and salmon, cabbage and grass-fed raw cheese

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Vitamin B6:  Pyridoxine
Vitamin B6 helps to balance sodium and potassium levels. It also allows for healthy red
blood cell production. It helps to balance hormonal changes in women and plays a critical
role in your immune system function.  The best form of supplemental vitamin B6 is
pyridoxal-5’phosphate (P5P) (16). 

It is also required for your nervous system and mental health. Deficiencies may lead to
anemia, nerve pain, skin problems, sores in the mouth, tongue soreness, fatigue, anxiety,
depression, cardiovascular issues and brain degeneration.

Best food sources of vitamin B6 include: tuna, wild-caught salmon, pasture-raised

chicken, beef liver, and chickpeas

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Vitamin B7: Biotin
Vitamin B7 is also known as biotin or vitamin H for its role in hair health. Vitamin
B7 cannot be synthesized by human cells, but it is produced by bacteria in the body, and
it is present in numerous foods.

Biotin is critical for adrenal function, a healthy nervous system, and proper metabolic
processes. It is important for healthy hair, skin, and nails, and is often called the ‘beauty
vitamin’ because of that. It helps to control high blood sugar and helps the growing baby
during pregnancy.

Signs of overt biotin deficiency include hair loss and a characteristic scaly red rash in the
face (around the eyes, nose, mouth), and in the genital area. Neurologic symptoms in
adults have included depression, lethargy, hallucination, numbness and tingling of the
extremities, and ataxia

Best food sources of biotin include: wild-caught fish, organ meats, nuts and seeds,
and pasture-raised eggs

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Vitamin B9: Folate
Vitamin B9 is also called folate. Its bioactive forms include folinic acid, calcium folinate,
and methyl-folate. Never buy folic acid as a source of vitamin B9, as synthetic folic acid is
not natural, can be toxic, and is not effective for those with MTHFR gene mutations.

Folate deficiency is one of the most common vitamin deficiencies due to intestinal
disorders, food choices, food processing, and MTHFR mutations.  I discuss more about
the importance of folate in this article.

Best food sources of folate include: asparagus, sprouting broccoli, spinach, avocados,
pasture-raised eggs, and liver

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Vitamin B12
Vitamin B12 is critical for healthy nerve function, cardiovascular function, sleep, and blood
cell formation. When supplementing with vitamin B12, always use methylcobalamin, not
cyanocobalamin, as methyl-cobalamin is the most bio-active form of supplemental vitamin
B12.

Best food sources of vitamin B12 include: wild-caught fish, grass-fed beef, pasture-
raised poultry, and pasture-raised eggs. Plant foods do not contain vitamin B12. As you
know, I do not recommend a vegan or vegetarian diet. That said if you are or you have
been vegan or vegetarian, supplementing with vitamin B12 is an absolute must. However,
vitamin B12 deficiencies are common among those who eat a diet rich in animal foods as
well, making vitamin B12 supplementation important for most people.

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Testing For B Vitamin Levels

Looking at your symptoms, diet, and lifestyle may be a good indication for vitamin B
deficiencies as a starting point. However, testing is always the best way to go to spot
vitamin B deficiencies and other potential health issues. Here are the tests I recommend
for B vitamin levels.

Blood Work 

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A Comprehensive Blood Analysis is a fantastic test that can spot all sorts of problems
in your body. For B vitamin levels, I specifically use this test to look at your homocysteine,
serum folate, and serum B12 levels. This is a simple blood test that offers a
comprehensive look at your health at an affordable price.

Organic Acid Test

Another blood test I recommend is a Comprehensive Organic Acid Test. This test can
help to determine the reasons behind your fatigue, sleep issues, mood changes,
depression, anxiety, digestion problems, joint pain, skin issues, and other symptoms.

This is a simple urine test that can tell us a lot about your health and possibly point us to
vitamin B deficiencies as well as your mitochondrial health, gut health, glutathione levels
and neurotransmitter levels.  

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Micronutrient Test
Lastly, I also recommend Micronutrient Testing. This test provides us with a
comprehensive nutritional analysis. While it can certainly spot any B vitamin deficiencies
by testing for each vitamin B level, it also looks at other vitamin and mineral levels,
amino/fatty acids, antioxidants, and metabolites to spot nutritional reasons behind your
health issues.

It can point you in the right direction to make necessary dietary changes and what kind of
supplementation to use to improve your health. 

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Best Supplemental B Vitamins

Taking B vitamin supplements is not enough. You have to make sure that your body can
absorb and use them. Taking high-quality pre-activated forms of B vitamins is important to
ensure that it integrates immediately and effectively in your body.

B vitamins are important for your body’s healthy methylation cycle, which helps your body
to function both physically and mentally and ensure healthy cardiovascular, nervous
system, immune system, and hormone function, ad detoxification. Taking methylated
forms of B vitamins is particularly important if you have MTHFR mutation, however, it is a
beneficial and important choice for al (17, 18)l. 

Here are the best B vitamin complex supplements I recommend with pre-activated
methylated forms of B vitamins: 

B Strong
One of the best supplemental B vitamin complexes I recommend is B Strong. This
supplements a necessary dose of each B vitamin using the most bioavailable forms to
ensure maximum supports for everyone. It also includes added choline for nerve and
neurological function, nerve signaling, cell membrane maintenance, and metabolic health.

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B Strong helps to support carbohydrate metabolism, blood sugar levels, cardiovascular
health, immune health, adrenal function, mood and mental health, nervous system
function, and overall well-being. Take one capsule a day for optimal results.

Liposomal Active B Complex 

Micelle Liposomal Active B Complex is another vitamin B complex supplement I
recommend. Along with all the necessary B vitamins, this supplement also offers an
essential mineral and electrolyte blend to support your body.

This liposomal delivery encapsulates the active ingredient into tiny, nano-sized micelles
which are further enveloped into liposomes. These healthy fat cells shield the tiny
micelles from the hostile environment in the human gut. The micelles are gradually
released and the B vitamins are deposited near the gut lining where it can be fully
absorbed and offer maximum support.

This supplement is designed to support your sleep, energy levels, mood, and stress
response. It is perfect if you are dealing with stress, low energy, or mental health issues. I
recommend that you take 1 tablespoon a day. For advanced use and maximum support,
you may take up to 3 tablespoons a day.

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Final Thoughts

B vitamins are important for your cellular health, brain health, hormonal health,
metabolism, skin health, and other areas of your health. B vitamin deficiencies can result
in an array of symptoms and health issues, including fatigue, concentration troubles,
depression, anxiety, memory problems, weakness, skin issues.

You can correct these deficiencies through a nutrient-dense diet and supplementation. Try
my recommendations for B vitamin supplementation to support your health and well-
being. 

If you want to work with a functional health coach, I recommend this article with tips on
how to find a great coach.  On our website, we offer long-distance functional health
coaching programs. For further support with your health goals, just reach out and our
fantastic coaches are here to support your journey.

Sources in This Article:

1. Vitamin B12: What to know. WebMD. Link Here
2. Symptoms of vitamin B deficiency. Healthline. LInk Here

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3. Vitamin B12. NIH. Link Here
4. Vitamin B12. Harvard TC Chang. Link Here
5. 4 overlooked causes of vitamin B12 deficiencies. US News. Link Here
6. Yoshii K. Vitamin B Family in the Regulation of Host Immunity. Front. Nutr., 17 April 2019. Link Here
7. Fang H, Kang J, Zhang D. Microbial production of vitamin B12: a review and future perspectives.
Microb Cell Fact. 2017 Jan 30;16(1):15. PMID: 28137297
8. Heartburn medicines and B12 deficiencies.. WebMD. Link Here
9. Medication known to reduce vitamin B levels. Link Here
10. Are your medications using nutrient deficiencies. Harvard Health. Link Here
11. Reilly, R., McNulty, H, Pentieva, K, Strain, J. J., Ward, M. (2014). MTHFR 677TT genotype and
disease risk: is there a modulating role for B-vitamins? The Proceedings of The Nutrition Society.
73(1):47-56. Link Here
12. Dean L. Methylenetetrahydrofolate Reductase Deficiency. 2012 Mar 8 [Updated 2016 Oct 27]. In:
Pratt VM, McLeod HL, Rubinstein WS, et al., editors. Medical Genetics Summaries [Internet].
Bethesda (MD): National Center for Biotechnology Information (US); 2012. Link Here
13. Liew SC, Gupta ED. Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism:
epidemiology, metabolism and the associated diseases. Eur J Med Genet. 2015;58(1):1-10. Link Here
14. Lynch B. MTHFR Mutations and Associated Conditions. Link Here
15. Loew D. Pharmacokinetics of thiamine derivatives especially of benfotiamine. Int J Clin Pharmacol
Ther. 1996 Feb;34(2): 47-50. PMID: 8929745
16. Labadarios D, Rossouw JE, McConnell JB, et al. Vitamin B6 deficiency in chronic liver disease –
evidence for increased degradation of pyridoxal-5-phosphate. Gut. 1977;18:23-27. PMID: 838399
17. Johnson AA, Akman K, Calimport SRG, et al. The role of DNA methylation in ageing, rejuvenation
and age-related disease. Rejuvenation Res 2012;15(5):483-494. Link Here
18. Crider KS, Yang TP, Berry RJ, et al. Folate and DNA methylation: a review of molecular
mechanisms and the evidence for folate’s role. Adv. Nutr 2012;3:21-38. Link Here

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