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NUTRITION
The Water-Soluble Vitamins: C and B Complex
Written by Atli Arnarson BSc, PhD on November 3, 2017
Vitamins are often categorized based on their solubility.

Most of them dissolve in water and are called water-soluble vitamins. In contrast,
there are only four fat-soluble vitamins, which dissolve in oil (liquid fat).

Nine water-soluble vitamins are found in the human diet:

Vitamin B1 (thiamine)
Vitamin B2 (riboflavin)
Vitamin B3 (niacin)
Vitamin B5 (pantothenic acid)
Vitamin B6
Vitamin B7 (biotin)
Vitamin B9
Vitamin B12 (cobalamin)
Vitamin C
Unlike the fat-soluble vitamins, water-soluble vitamins are generally not stored in the
body. For this reason, you should try to get them regularly from your diet.

This article provides a detailed overview of the water-soluble vitamins — their

functions, health benefits, dietary sources, recommended intake and more.

Thiamine (Vitamin B1)

Thiamine, also known as vitamin B1, was the first water-soluble vitamin to be
described scientifically.

Types
Many forms of thiamine exist, including:

Thiamine pyrophosphate: Also known as thiamine diphosphate, thiamine

pyrophosphate is the most abundant form of thiamine in your body. It is also the main
form found in whole foods.
Thiamine triphosphate: This form is found in animal-sourced foods, but is less
abundant than thiamine pyrophosphate. It is believed to represent less than 10% of the
total thiamine found in animal tissues.
Thiamine mononitrate: A synthetic form of thiamine often added to animal feed or
processed food.
Thiamine hydrochloride: The standard, synthetic form of thiamine used in
supplements.
Role and Function
Like the other B vitamins, thiamine serves as a coenzyme in the body. This applies to
all its active forms, but thiamine pyrophosphate is the most important one.

Coenzymes are small compounds that help enzymes trigger chemical reactions that
otherwise wouldn’t happen on their own.

Thiamine is involved in many essential chemical reactions. For instance, it helps

convert nutrients into energy and supports sugar formation.

Dietary Sources
The richest dietary sources of thiamine include nuts, seeds, whole grains, liver and
pork.

The chart below shows the thiamine content of some of the best sources (1).

In contrast, fruits, vegetables and dairy products generally do not provide much
thiamine.

Recommended Intake
The table below shows the recommended daily allowance (RDA) for thiamine.

The RDA for infants hasn’t been established. Instead, the table shows the adequate
intake, marked with an asterisk. The adequate intake is like the RDA, but based on
weaker evidence.

RDA (mg/day)
Infants 0–6 months 0.2*
7–12 months0.3*
Children 1–3 years 0.5
4–8 years 0.6
9–13 years 0.9
Women 14–18 years 1.0
19+ years 1.1
Men 14+ years 1.2
Pregnancy 1.4
Lactation 1.4
*Adequate intake

Deficiency
Deficiency is uncommon, but high blood sugar levels may increase thiamine
elimination via urine, raising its requirements and the risk of deficiency. In fact,
thiamine levels may be reduced by 75–76% in people with type 1 and type 2 diabetes
(2).
People with alcoholism are also at an increased risk for deficiency because of a poor
diet and impaired thiamine absorption (3).

Serious deficiency may lead to disorders known as beriberi and Wernicke-Korsakoff

syndrome.

These disorders are associated with a range of symptoms, including anorexia, weight
loss, impaired neural function, mental problems, muscle weakness and heart
enlargement.

Side Effects and Toxicity

Thiamine is considered safe. There are no reports of adverse effects after the intake of
high amounts of thiamine from food or supplements.

This is partly because excess thiamine is quickly excreted from the body in urine.

As a result, the tolerable upper intake level for thiamine has not been established.
However, this does not rule out possible symptoms of toxicity at very high intakes.

Benefits of Supplements
No good evidence shows that thiamine supplements benefit healthy people who get
adequate amounts from their diets.

But for those with high blood sugar levels or a poor thiamine status, high-dose
supplements may reduce blood sugar and blood pressure (4, 5).

Additionally, low thiamine intake has been associated with various other disorders,
such as glaucoma, depression and fibromyalgia. However, more research is needed
before strong conclusions can be made (6, 7, 8).

Summary of Thiamine
Thiamine, also known as vitamin B1, was the first B vitamin to be discovered.

Like the other B vitamins, thiamine acts as a coenzyme. It plays an essential role in
many metabolic processes, including those that convert nutrients into energy.

The richest dietary sources of thiamine include liver, pork, seeds and whole-grain
cereals. Deficiency is uncommon, but diabetes and excessive alcohol intake increase
the risk. Serious deficiency may result in diseases such as beriberi and Wernicke-
Korsakoff syndrome.

High-dose thiamine supplements do not seem to have any adverse effects and the
tolerable upper intake level hasn’t been established. However, supplements do not
appear to have any benefits for those who get adequate amounts from their diets.

Riboflavin (Vitamin B2)

Riboflavin is the only water-soluble vitamin used as a food coloring. In fact, it is
named for its color — the Latin word flavus means “yellow.”

Types
In addition to riboflavin, dietary substances known as flavoproteins release riboflavin
during digestion.

Two of the most common flavoproteins are flavin adenine dinucleotide and flavin
mononucleotide. They are found in a wide range of foods.

Role and Function

Riboflavin functions as a coenzyme in various chemical reactions.

Like thiamine, it is involved in the conversion of nutrients into energy. It is also

required in the conversion of vitamin B6 to its active form, and in the conversion of
tryptophan to niacin (vitamin B3).

Dietary Sources
The chart below shows the riboflavin content of some of its richest dietary sources
(1).

Yeast extract spread is also exceptionally rich in riboflavin, containing around 18 mg

in every 100 grams. Other good sources of riboflavin include eggs, leafy vegetables,
broccoli, milk, legumes, mushrooms and meat.

Additionally, riboflavin is often added to processed breakfast cereals and is used as a

yellow-orange food coloring.

Recommended Intake
The table below shows the RDA or adequate intake for riboflavin. These values
represent the daily intake sufficient to meet the requirements of most people.

RDA (mg/day)
Infants 0–6 months 0.3*
7–12 months0.4*
Children 1–3 years 0.5
4–8 years 0.6
9–13 years 0.9
Women 14–18 years 1.0
19+ years 1.1
Men 14+ years 1.3
Pregnancy 1.4
Lactation 1.6
*Adequate intake

Deficiency
Riboflavin deficiency is very rare in developed countries. However, a poor diet, old
age, lung diseases and alcoholism may increase the risk.

Severe deficiency results in a condition known as ariboflavinosis, which is

characterized by a sore throat, inflamed tongue, anemia, as well as skin and eye
problems.

It also impairs the metabolism of vitamin B6 and the conversion of tryptophan to

niacin.

Side Effects and Toxicity

High intake of dietary or supplemental riboflavin has no known effects of toxicity.

Absorption becomes less efficient at higher doses. Also, very small amounts are
stored in body tissues and excess riboflavin is flushed out of the body with urine.

As a result, the safe upper intake level of riboflavin has not been established.

Benefits of Supplements
In most cases, riboflavin supplements do not have any benefits for people who already
get enough from food.

Yet, low-dose riboflavin supplements may potentially reduce blood pressure and
lower the risk of heart disease in people who are genetically predisposed to them. It’s
thought to do this by decreasing high homocysteine levels in those with two copies of
the gene MTHFR 677TT (9, 10, 11).

Higher doses of riboflavin, such as 200 mg twice a day, may also reduce migraines
(12, 13).

Summary of Riboflavin
Riboflavin, also known vitamin B2, is a coenzyme with various essential functions.
For instance, it is required for converting nutrients to energy.

Found in various foods, its richest sources include liver, meat, dairy products, eggs,
leafy vegetables, almonds and legumes.

Deficiency is virtually unknown among healthy people in Western countries, although

diseases and poor lifestyle habits may increase the risk.
High-dose riboflavin supplements are not known to have any adverse effects, but they
usually only benefit those who are deficient. However, evidence suggests they may
reduce migraines or lower the risk of heart disease in genetically susceptible people.

Niacin (Vitamin B3)

Niacin, also known as vitamin B3, is the only B vitamin your body can produce from
another nutrient — the amino acid tryptophan.

Types
Niacin is a group of related nutrients. The most common forms are:

Nicotinic acid: The most common form in supplements. Also found in both plant- and
animal-sourced foods. High-dose nicotinic acid supplements may cause a condition
called niacin flush.
Nicotinamide (niacinamide): Found in supplements and foods.
The compound nicotinamide riboside also has vitamin B3 activity. It is found in trace
amounts in whey protein and baker’s yeast (14, 15, 16).

Role and Function

All dietary forms of niacin are eventually converted into nicotinamide adenine
dinucleotide (NAD+) or nicotinamide adenine dinucleotide phosphate (NADP+),
which act as coenzymes.

Like the other B vitamins, it functions as a coenzyme in the body, playing an essential
role in cellular function and acting as an antioxidant.

One of its most important roles is to drive a metabolic process known as glycolysis,
the extraction of energy from glucose (sugar).

Dietary Sources
Niacin is found in both plants and animals. The chart below shows the niacin content
of a few of its best sources (1).

Yeast extract spread is exceptionally rich in niacin, providing around 128 mg in every
100 grams.

Other good sources include fish, chicken, eggs, dairy products and mushrooms.
Niacin is also added to breakfast cereals and flour.

Additionally, your body can synthesize niacin from the amino acid tryptophan.
Scientists have estimated that 60 mg of tryptophan can be used to create 1 mg of
niacin (17).
Recommended Intake
The table below shows the RDA or adequate intake for niacin. These values are the
estimated amount of niacin that most people (97.5%) need to get from their diets
every day.

It also shows the tolerable upper intake limit (UL), which is the highest daily intake
considered safe for most people.

RDA (mg/day) UL (mg/day)

Infants 0–6 months 2* –
7–12 months4* –
Children 1–3 years 6 10
4–8 years 8 15
9–13 years 12 20
Women 14+ years 14 30
Men 14+ years 16 30
Pregnancy 18 30–35
Lactation 17 30–35
*Adequate intake

Deficiency
Niacin deficiency, known as pellagra, is uncommon in developed countries.

The main symptoms of pellagra include inflamed skin, mouth sores, diarrhea,
insomnia and dementia. Like all deficiency diseases, it is fatal without treatment.

Fortunately, you can easily get all the niacin you need from a varied diet.

Deficiency is much more common in developing countries where people commonly

follow diets that lack diversity.

Cereal grains are especially low in available niacin, since most of it is bound to fiber
in the form of niacytin.

However, your body can synthesize it from the amino acid tryptophan. As a result,
severe niacin deficiency can often be avoided on a high-protein diet (17).

Side Effects and Toxicity

Naturally occurring niacin from food does not appear to have any adverse effects.

However, high supplemental doses of niacin may cause niacin flush, nausea,
vomiting, stomach irritation and liver damage.

Niacin flush is a side effect of immediate-release nicotinic acid supplements. It is

characterized by a flush in the face, neck, arms and chest (18, 19).

Liver damage is associated with the long-term use of very high doses (3–9 grams per
day) of sustained-release or slow-release nicotinic acid (20, 21, 22).

Additionally, taking niacin supplements for a long time may increase insulin
resistance and raise blood sugar levels (23, 24).

Nicotinic acid may also increase the circulating levels of uric acid, worsening
symptoms in people who are predisposed to gout (25).

Benefits of Supplements
Nicotinic acid supplements at doses ranging from 1,300–2,000 mg per day are
commonly used to normalize blood lipid levels (26, 27).

They bring down high levels of “bad” low-density-lipoprotein (LDL) cholesterol,

while raising levels of “good” high-density-lipoprotein (HDL) cholesterol when they
are low. Triglyceride levels may also drop in those taking supplements.

Some studies also suggest nicotinic acid reduces heart disease risk, but its benefits are
controversial and study results have been inconsistent (28, 29).

Preliminary evidence also indicates that niacin supplements may improve cognition,
but further studies are needed before strong claims can be made (30).

Summary of Niacin
Niacin, also known as vitamin B3, is a group of two related compounds —
niacinamide and nicotinic acid. They serve many vital functions in the body.

Niacin is found in many different foods, such as liver, fish, poultry, eggs, dairy
products, sunflower seeds and peanuts, to name few. Additionally, it is commonly
added to processed food like flour and breakfast cereals.

Deficiency is rare in Western nations. People who eat low-protein diets that lack
diversity are at an increased risk.

High-dose nicotinic acid supplements are commonly used to normalize blood lipid
levels, although some scientists doubt the vitamin’s benefits for heart health.

But supplements may also have some negative side effects, such as liver damage,
reduced insulin sensitivity and niacin flush.

Pantothenic Acid (Vitamin B5)

Pantothenic acid is found in virtually all food. Appropriately, its name is derived from
the Greek word pantothen, which means “from every side.”

Types
There are multiple forms of pantothenic acid or compounds that release the active
form of the vitamin when digested. In addition to free pantothenic acid, these include:

Coenzyme A: A common source of this vitamin in foods. It releases pantothenic acid

in the digestive tract.
Acyl carrier protein: Like coenzyme A, acyl carrier protein is found in foods and
releases pantothenic acid during digestion.
Calcium pantothenate: The most common form of pantothenic acid in supplements.
Panthenol: Another form of pantothenic acid often used in supplements.
Role and Function
Pantothenic acid plays a key role in a wide range of metabolic functions.

It is required for the formation of coenzyme A, which is necessary for the synthesis of
fatty acids, amino acids, steroid hormones, neurotransmitters and various other
important compounds.

Dietary Sources
Pantothenic acid is found in virtually all food.

The chart below shows some of its best dietary sources (1).

Other rich sources include yeast extract spread, shiitake mushrooms, caviar, kidneys,
chicken, beef and egg yolks.

Several plant foods are also good sources. In addition to those mentioned above, these
include root vegetables, whole grains, tomatoes and broccoli.

Like many other B vitamins, pantothenic acid is often added to breakfast cereals.

Recommended Intake
The table below shows the adequate intake (AI) of pantothenic acid for most people.
The RDA has not been established.

AI (mg/day)
Infants 0–6 months 1.7
7–12 months1.8
Children 1–3 years 2
4–8 years 3
9–13 years 4
Adolescents 14–18 years 5
Adults 19+ years 5
Pregnancy 6
Lactation 7
Deficiency
Pantothenic acid deficiency is rare in industrialized countries. In fact, this vitamin is
so widespread in foods that deficiency is virtually unheard of, except in severe
malnutrition.

However, its requirements may be higher in people with diabetes and those who
regularly consume excessive amounts of alcohol.

Studies in animals show that pantothenic acid deficiency has an adverse impact on
most organ systems. It is associated with numerous symptoms, including numbness,
irritability, sleep disturbances, restlessness and digestive problems (31).

Side Effects and Toxicity

Pantothenic acid does not appear to have any adverse effects at high doses. The
tolerable upper limit has not been established.

However, large doses like 10 grams per day may cause digestive discomfort and
diarrhea.

In mice, the lethal dose was estimated to be around 4.5 grams for each pound of body
weight (10 grams per kg), an amount equivalent to 318 grams for a 154-pound (70-
kg) human (32).

Benefits of Supplements
Studies have not provided any good evidence of benefits from pantothenic acid
supplements in people who get adequate amounts from their diets.

While people take supplements to treat various disorders, including arthritis, dry eyes
and skin irritation, there is no strong evidence for its effectiveness in the treatment of
any of these disorders (33).

Summary of Pantothenic Acid

Pantothenic acid, also known as vitamin B5, plays various important roles in
metabolism.

Almost all food contains this vitamin. The best sources include liver, sunflower seeds,
mushrooms, root vegetables and whole grains.

Since pantothenic acid is so widespread in foods, deficiency is virtually unknown and

is usually only associated with severe malnutrition.

Supplements are safe and do not have any adverse effects. However, very high doses
may cause diarrhea and other digestive issues.

Although some people regularly take pantothenic acid supplements, there is currently
no strong evidence for their effectiveness in the treatment of diseases in those who get
adequate amounts from food.

Vitamin B6
Vitamin B6 is a group of nutrients that are required for the synthesis of pyridoxal
phosphate, a coenzyme involved in more than 100 different metabolic processes.

Types
Like the other B vitamins, vitamin B6 is a family of related compounds, such as:

Pyridoxine: This form is found in fruits, vegetables and grains, as well as

supplements. Processed foods may also contain added pyridoxine.
Pyridoxamine: Used until recently in dietary supplements in the US. However, the
FDA now considers pyridoxamine a pharmaceutical drug. Pyridoxamine phosphate is
a common form of vitamin B6 in animal-sourced foods.
Pyridoxal: Pyridoxal phosphate is the main type of vitamin B6 in animal-sourced
foods.
In the liver, all dietary forms of vitamin B6 are converted into pyridoxal 5-phosphate,
the active form of the vitamin.

Role and Function

Like other B vitamins, vitamin B6 acts as a coenzyme in numerous chemical
reactions.

It is involved in red blood cell formation as well as energy and amino acid
metabolism. It is also required for the release of glucose (sugar) from glycogen, the
molecule the body uses to store carbs.

Vitamin B6 also supports the formation of white blood cells and helps the body
synthesize several neurotransmitters.

Dietary Sources
Vitamin B6 is found in a wide variety of foods. The chart below shows some of its
richest sources and their content (1).

Other good sources include tuna, pork, turkey, bananas, chickpeas and potatoes.
Vitamin B6 is also added to breakfast cereals and soy-based meat substitutes.

The availability of this vitamin is generally higher in animal-sourced foods, compared

to plant foods (34).
Recommended Intake
The table below shows the RDA for vitamin B6. The RDA is the daily intake
estimated to be sufficient for most people.

The RDA hasn’t been established for infants, so the adequate intake (AI) is presented
instead.

RDA (mg/day) UL (mg/day)

Infants 0–6 months 0.1* –
7–12 months0.3* –
Children 1–3 years 0.5 30
4–8 years 0.6 40
9–13 years 1.0 60
Women 14–18 years 1.2 80
19–50 years 1.3 100
51+ years 1.5 100
Men 14–18 years 1.3 80
19–50 years 1.3 100
51+ years 1.7 100
Pregnancy 1.9 80–100
Lactation 2.0 80–100
*Adequate intake

Deficiency
Vitamin B6 deficiency is rare. People with alcoholism are at the greatest risk (35).

The main symptoms include anemia, skin rashes, convulsions, confusion and
depression.

Deficiency has also been associated with an increased risk of cancer (36, 37).

Side Effects and Toxicity

Naturally occurring vitamin B6 from food does not seem to have any adverse effects.

In contrast, very large supplemental doses of pyridoxine — 2,000 mg per day or more
— are linked to sensory nerve damage and skin lesions (38).

High intake of pyridoxine supplements may also suppress milk production in

breastfeeding women (39).

Benefits of Supplements
Large doses of pyridoxine have been used to treat carpal tunnel syndrome and
premenstrual syndrome.
However, its benefits are controversial. No strong evidence proves that pyridoxine
supplements are an effective treatment for these conditions (40, 41).

Because of the adverse health effects of high-dose pyridoxine supplements, they

should only be taken under medical supervision.

Summary of Vitamin B6
Vitamin B6 is a group of nutrients that are required for the formation of pyridoxal
phosphate, a coenzyme that plays a vital role in numerous metabolic pathways.

The richest dietary sources are liver, salmon, sunflower seeds and pistachio nuts, to
name a few.

Deficiency is rare, although regularly drinking high amounts of alcohol may raise the
risk.

High supplemental doses may cause nerve damage and skin lesions, but getting
vitamin B6 from food doesn’t appear to have any negative effects.

While adequate vitamin B6 intake is healthy, no good evidence demonstrates that

vitamin B6 supplements are useful in the treatment of diseases.

Biotin (Vitamin B7)

People often take biotin supplements to nourish their hair, nails and skin, although
strong evidence for these benefits is lacking. In fact, it was historically called vitamin
H after the German word haut, meaning “skin” (42).

Types
Biotin is either found in its free form or bound to proteins.

When proteins that contain biotin are digested they release a compound called
biocytin. The digestive enzyme biotinidase then breaks biocytin into free biotin and
lysine, an amino acid.

Role and Function

Same as all B vitamins, biotin functions as a coenzyme. It is required for the function
of five carboxylases, enzymes involved in several fundamental metabolic processes.

For instance, biotin serves an essential role in fatty acid synthesis, glucose formation
and amino acid metabolism.

Dietary Sources
Compared to the other B vitamins, biotin doesn’t have as much research behind its
content in food.
Animal-sourced foods rich in biotin include organ meats, fish, meat, egg yolk and
dairy products. Good plant sources include legumes, leafy greens, cauliflower,
mushrooms and nuts.

Your gut microbiota also produces small amounts of biotin.

Recommended Intake
The table below shows the adequate intake (AI) for biotin. The AI is similar to the
RDA, but is based on weaker research.

AI (mcg/day)
Infants 0–6 months 5
7–12 months6
Children 1–3 years 8
4–8 years 12
9–13 years 20
Adolescents 14–18 years 25
Adults 19+ years 30
Pregnancy 30
Lactation 35
Deficiency
Biotin deficiency is relatively uncommon.

The risk is greatest among infants who are fed formula low in biotin, people taking
antiepileptic medications, infants with Leiner’s disease or people who are genetically
predisposed to deficiency (43, 44).

Untreated biotin deficiency can cause neurological symptoms, such as seizures,

intellectual disability and loss of muscle coordination (45).

Deficiency has also been reported in animals fed high amounts of raw egg whites.
Egg whites contain a protein called avidin, which prevents the absorption of biotin
(46).

Side Effects and Toxicity

Biotin does not have any known adverse effects at high doses and the tolerable upper
limit has not been established.

Benefits of Supplements
Limited evidence suggests that biotin supplements may improve health in those who
otherwise get adequate amounts from their diets.

For instance, studies suggest biotin may improve symptoms in people with multiple
sclerosis (MS) (47, 48).

Observational studies also indicate that biotin supplements may improve brittle nails
in women. However, higher quality studies are needed before any claims can be made
(49, 50).

Summary of Biotin
Biotin, also known as vitamin B7, is a coenzyme required for many key metabolic
processes.

It is found in a wide range of foods. Good sources include organ meats, egg yolk,
meat, legumes, cauliflower, mushrooms and nuts.

Deficiency is uncommon and adverse effects are unknown, even at high supplemental
doses. Further studies need to establish the tolerable upper intake level.

Limited evidence supports the use of biotin supplements among people who already
get adequate amounts from their diets. However, a few studies suggest they may
improve the symptoms of MS and strengthen brittle nails.

Vitamin B9
Vitamin B9 was first discovered in yeast, but later isolated from spinach leaves. For
this reason, it was given the names folic acid or folate, words derived from the Latin
word folium, meaning “leaf.”

Types
Vitamin B9 comes in several different forms, including:

Folate: A family of vitamin B9 compounds that naturally occurs in foods.

Folic acid: A synthetic form commonly added to processed foods or sold as a
supplement. Some scientists are concerned that high-dose folic acid supplements may
cause harm.
L-methylfolate: Also known as 5-methyltetrahydrofolate, L-methylfolate is the active
form of vitamin B9 in the body. As a supplement, it is thought to be healthier than
folic acid.
Role and Function
Vitamin B9 acts as a coenzyme and is essential for cell growth, DNA formation and
amino acid metabolism.

It is very important during periods of rapid cell division and growth, such as in
infancy and pregnancy.

Additionally, it is required for the formation of red and white blood cells, so
deficiency may lead to anemia.
Dietary Sources
The chart below presents a few foods that are great sources of vitamin B9 (1).

Other good sources include leafy greens, legumes, sunflower seeds and asparagus.
Yeast extract spread is exceptionally rich in vitamin B9, providing around 3,786 mcg
per 100 grams.

Folic acid is also frequently added to processed food products.

Recommended Intake
The table below shows the recommended daily allowance (RDA) for vitamin B9. It
also presents the daily tolerable upper limit (UL), which is the amount considered safe
for most people.

The RDA for infants hasn’t been established. Instead, the table shows the adequate
intake values.

RDA (mcg/day) UL (mcg/day)

Infants 0–6 months 65* –
7–12 months80* –
Children 1–3 years 150 300
4–8 years 200 400
9–13 years 300 600
14–18 years 400 800
Adults 19+ years 400 1,000
Pregnancy 600 800–1,000
Lactation 500 800–1,000
*Adequate intake

Deficiency
Vitamin B9 deficiency rarely occurs on its own. It is usually associated with other
nutrient deficiencies and a poor diet.

Anemia is one of the classic symptoms of vitamin B9 deficiency. It is

indistinguishable from the anemia associated with vitamin B12 deficiency (51).

Lack of vitamin B9 may also lead to birth defects of the brain or neural chord,
collectively known as neural tube defects (52).

Side Effects and Toxicity

No serious adverse effects of high vitamin B9 intake have been reported.

Yet, studies show that high-dose supplements may mask vitamin B12 deficiency.
Some even suggest that they may worsen the neurological damage associated with
vitamin B12 deficiency (53, 54).

Additionally, some scientists are concerned that a high intake of folic acid — a
synthetic form of vitamin B9 — may cause health problems.

Benefits of Supplements
There is not much evidence that folic acid supplements benefit healthy people who
are following a balanced diet.

A few studies suggest that supplements may reduce the risk of heart disease, improve
blood sugar control and slightly reduce the symptoms of depression (55, 56, 57, 58).

However, the benefits of taking vitamin B9 supplements may only be seen in those
who are low in the vitamin to begin with.

Summary of Vitamin B9
Like all other B vitamins, vitamin B9 acts as a coenzyme. It is essential for cell
growth and various key metabolic functions.

It is found in both plants and animals. Rich sources include liver, legumes and leafy
greens.

Deficiency in vitamin B9 is uncommon. The main symptom is anemia, but in

pregnant women, low levels also raise the risk of birth defects. High intake doesn’t
have any serious adverse effects.

For those who get enough vitamin B9 from their diet, the benefits of supplements are
unclear. But studies suggest they may reduce the risk of heart disease and lower blood
sugar levels.

Vitamin B12 (Cobalamin)

Vitamin B12 is the only vitamin that contains a metallic element, namely cobalt. For
this reason, it is often referred to as cobalamin.

Types
There are four main types of vitamin B12 — cyanocobalamin, hydroxocobalamin,
adenosylcobalamin and methylcobalamin (59).

All of them can be found in supplements, although cyanocobalamin is the most

common. It is considered ideal for supplements due to its stability, but is only found
in trace amounts in food.

Hydroxocobalamin is the most common naturally occurring form of vitamin B12, and
is widely found in animal-sourced foods.

The other natural forms methylcobalamin and adenosylcobalamin have become

popular as supplements in recent years.

Role and Function

Like all other B vitamins, vitamin B12 acts as a coenzyme.

Adequate intake helps maintain brain function and development, neurological

function, and the production of red blood cells.

It is also required for converting protein and fat into energy and is essential for cell
division and DNA synthesis.

Dietary Sources
Animal-sourced foods are virtually the only dietary sources of vitamin B12. These
include meat, dairy products, seafood and eggs.

The chart below shows some of its richest sources and their content (1).

Other rich sources include other types of liver, heart, octopus, oysters, herring and
tuna.

However, tempeh and a few algae, such as nori seaweed, may also contain small
amounts of vitamin B12. Whether these foods can provide sufficient amounts on their
own is a matter of debate (60, 61, 62).

Other algae, like spirulina, contain pseudovitamin B12, a group of compounds that are
similar to vitamin B12, but unusable by the body (63).

Recommended Intake
The table below shows the RDA for vitamin B12. As usual, the RDA hasn’t been
established for infants, so the adequate intake (AI) is presented instead.

RDA (mcg/day)
Infants 0–6 months 0.4*
7–12 months0.5*
Children 1–3 years 0.9
4–8 years 1.2
9–13 years 1.8
Adolescents 14–18 years 2.4
Adults 19+ years 2.4
Pregnancy 2.6
Lactation 2.8
*Adequate intake

Deficiency
Vitamin B12 is stored in the liver, so even if you aren’t getting enough of it, it may
take a long time for deficiency symptoms to develop.

Those who are at the greatest risk of deficiency are those who never or rarely eat
animal-sourced foods. This includes vegetarians and vegans (64).

Deficiency may also develop in older people. In fact, many require regular vitamin
B12 injections.

Vitamin B12 absorption depends on a protein produced by the stomach called intrinsic
factor. As people age, the formation of intrinsic factor may reduce or stop altogether
(65).

Other risk groups include those who have had weight loss surgery or suffer from
Crohn’s disease or celiac disease (66, 67, 68, 69).

Deficiency may cause various health problems, such as anemia, appetite loss, sore
tongue, neurological problems and dementia (70).

Side Effects and Toxicity

Only a small proportion of vitamin B12 can be absorbed from the digestive tract. The
amount absorbed depends on the production of intrinsic factor in the stomach.

As a result, no adverse effects have been linked with high intake of vitamin B12 in
healthy people. The tolerable upper intake level has not been established.

Benefits of Supplements
While vitamin B12 supplements benefit people at risk of deficiency, less is known
about their effects among those who get adequate amounts from their diets.

One small study suggests that taking 1,000 mcg per day may improve verbal learning
in people recovering from strokes, but more research is needed (71).

Additionally, injections of hydroxocobalamin are used to treat cyanide poisoning,

usually in combination with sodium thiosulfate (72).

Summary of Vitamin B12

Vitamin B12 functions as a coenzyme and plays a vital role in many metabolic
pathways. It also helps maintain neurological function and the formation of red blood
cells.
It is found in virtually all animal-sourced foods, but is absent from plant foods.

As a result, vegans are at risk of deficiency or poor vitamin B12 status. Older people
are also at risk because of impaired absorption. Anemia and impaired neurological
function are classic deficiency symptoms.

High supplemental intake doesn’t have any known adverse effects. No strong
evidence shows that they have benefits either, at least not in those who get adequate
amounts from their diets.

Vitamin C
Vitamin C is the only water-soluble vitamin that doesn’t belong to the vitamin B
category. It is one of the body’s main antioxidants and is required for collagen
synthesis.

Types
Vitamin C comes in two forms, the most common of which is known as ascorbic acid.

An oxidized form of ascorbic acid called dehydroascorbic acid also has vitamin C
activity.

Role and Function

Vitamin C supports many essential body functions, including:

Antioxidant defenses: Your body uses antioxidants to protect itself against oxidative
stress. Vitamin C is one of its most important antioxidants (73).
Collagen formation: Without vitamin C, the body is unable to synthesize collagen, the
main protein in connective tissue. As a result, deficiency affects your skin, tendons,
ligaments and bones (74).
Immune function: Immune cells contain high levels of vitamin C. During an infection,
its levels are quickly depleted (75).
Unlike the B vitamins, vitamin C doesn’t act as a coenzyme, although it is a cofactor
for prolyl hydroxylase, an enzyme that serves an essential role in the formation of
collagen (76).

Dietary Sources
The main dietary sources of vitamin C are fruits and vegetables.

Cooked animal-sourced foods contain virtually no vitamin C, but low amounts can be
found in raw liver, eggs, fish roe, meat and fish (77).

The chart below provides examples of some raw fruits and vegetables that are
exceptionally rich in vitamin C (1).
Cooking or drying foods significantly reduces their vitamin C content (78, 79).

Recommended Intake
The recommended daily allowance (RDA) of vitamin C is the estimated amount of
the vitamin most people need every day.

The table below also shows the tolerable upper limit (UL), which is the highest level
of intake thought to be completely safe for most people.

No RDA has been established for infants. Instead, scientists have estimated their
adequate intake, which is similar to the RDA, but based on weaker evidence.

RDA (mg/day) UL (mg/day)

Infants 0–6 months 40* –
7–12 months50* –
Children 1–3 years 15 400
4–8 years 25 650
9–13 years 45 1,200
Women 14–18 years 65 1,800
19+ years 75 2,000
Men 14–18 years 75 1,800
19+ years 90 2,000
Pregnancy 80–85 1,800–2,000
Lactation 115–1201,800–2,000
*Adequate intake

Deficiency
Deficiency is rare in Western countries, but may develop in people who follow
restrictive diets or eat almost no fruits or vegetables. People with drug addiction or
alcoholism are also at greater risk.

It leads to a disease known as scurvy, which is characterized by the breakdown of

connective tissue (80).

The first symptoms of deficiency include fatigue and weakness. As scurvy becomes
worse, people may experience spotted skin and inflamed gums.

Advanced scurvy may cause loss of teeth, bleeding gums and skin, joint problems, dry
eyes, swelling and impaired wound healing. Like all vitamin deficiencies, scurvy is
fatal without treatment.

Side Effects and Toxicity

Most people tolerate high doses of vitamin C without any side effects.
However, very high doses exceeding 3 grams per day cause diarrhea, nausea and
abdominal cramps. This is because only a limited amount of vitamin C can be
absorbed from a single dose.

Taking high-dose supplements over 1,000 mg per day may also increase the risk of
kidney stones in predisposed people (81).

Benefits of Supplements
There is mixed evidence that vitamin C supplements benefit people who get adequate
amounts from the diet.

However, vitamin C can improve iron absorption from a meal, helping those who are
low or deficient in iron (82).

Additionally, one analysis of 29 studies concluded that supplements that provide at

least 200 mg of vitamin C per day may help you recover from the common cold (83).

While vitamin C supplements may also help lower blood pressure, there is no
evidence that they reduce the risk of heart disease (84, 85).

Studies also suggest vitamin C may reduce the risk of cognitive decline, improve
blood vessel function and reduce blood sugar levels, but high-quality studies are
needed before definite conclusions can be reached (86, 87, 88).

Summary of Vitamin C
Vitamin C is a powerful antioxidant that’s vital for the maintenance of connective
tissue.

The main dietary sources are fruits and vegetables, but low amounts can be acquired
from raw animal-sourced foods. Deficiency, known as scurvy, is rare in developed
countries.

Most people tolerate high-dose supplements without any adverse effects. However,
studies on the benefits of vitamin C supplements have had mixed results, suggesting
supplements may not be that useful for those who already get sufficient amounts from
their diets.

The Bottom Line

Most vitamins are water-soluble. These include the eight B vitamins as well as
vitamin C.

Their roles in the body range widely, but most function as coenzymes in numerous
metabolic pathways.
All the water-soluble vitamins are easy to get from a balanced diet. However, vitamin
B12 is only found in substantial amounts in animal-sourced foods. As a result, vegans
are at a high risk of deficiency and may need to take supplements or get regular
injections.

Keep in mind that your body generally doesn’t store water-soluble vitamins, except
for vitamin B12. Optimally, you should get them from your diet every day.

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