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Category: 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

Dimethylglycine (DMG) has one less methyl group than Betaine (TMG)

In the last post I mentioned that I started taking a specific form of an amino acid after I had found out that I have a genetic defect but that I didn’t really know how much might be necessary per day. The difference in my genes affects my ability to convert betaine the common name for trimethylglycine, into a more usable form called dimethylglycine. Betaine has one more methyl group than DMG. It is also called vitamin B15.  Methyl groups are important for many things including preventing cancerous changes from occurring in the genetic structure of cells. [1]

What I didn’t know was how much might be necessary for me to take for daily health. A reference suggested that two grams per day is a minimal daily goal but that up to ten grams per day may be more optimal for health – not enough information is available about that however.

Two to ten grams per day is a specific number. I was taking two 100 milligram tablets per day. Two hundred milligrams is 1800 milligrams less than two grams – so I let my fingers doing the walking and found a bulk supply which I will be able to spoon into something liquid and just drink or eat. The switch will also save me a significant amount of money.  [2]

The bottle of sixty 100 mg tablets provided 6000 milligrams / 6 grams of DMG at a price of $7.64 which I would use in one month. That seems inexpensive but it only provides 200 mg per day not 2 grams which is 2000 milligrams. At that level of use the bottle would last three days. At 10 grams per day I would need more than one bottle per day. The one kilogram bag supplies 1,000,000 milligrams for $65.96. If I use 2 grams per day the bag will last me 500 days or 100 days if I tried to use 10 grams per day. (2 grams of powder is roughly less than one teaspoon, there’s about 5 grams of liquid in a teaspoon but you would need to know the density/weight/mass of a powder to be able to calculate how many grams of a powder would fit in a teaspoon [3])

The genetic defect is in the gene that produces an enzyme that helps break down betaine/trimethylglyine into dimethylglycine and it is also involved in methionine metabolism but that is a different supplement/different topic. The gene is BHMT/1 (Call – T), and the enzyme it encodes for is Betaine-homocysteine methyltransferase (BHMT). See point #3 in the following post: Methylation Cycle Defects – in me – genetic screening “for research purposes only” . The post includes the link to the company that provides the genetic screening tests ‘for research purposes only’ (in other words: it can not be claimed to be ‘for diagnostic purposes’ legally at this stage of research and federal regulations).

The screening panel was developed to screen for defects that have been found to be more common in patients with autism. It was created by a scientist with a PhD and experience in genetics rather than an MD. The company provides nutritional information and possibly supplements but I haven’t spent enough time looking at the information to provide any review or opinion. I looked up information about my defects (11 out of 30) on my own. My notes are included in the linked post, it is not written as an essay type article with a beginning and end, it is a long list of notes for each defect*/gene allele/anomaly.

*Some gene differences are not negative as the word ‘defect’ suggests; allele is the word used in genetics for all the many known variations of one gene, there can be many slightly different forms with effects that might be good, bad, or cause no difference in health.

Nutrigenomics is an new area of science which specializes in providing individualized dietary counseling based on a person’s specific genetic structure. A person with typical genetic structure wouldn’t need to consider such a high dose of Dimethylglycine.

If the concern however is glyphosate substituting for glycine within proteins, then assuring that the body has a plentiful supply of the right kind of puzzle pieces (glycine) could help the body build more functional proteins, as repair and growth occurs every day. Glycine is an essential amino acid and and is not considered dangerous in isolation to my knowledge. (Aspartic acid and glutamate are also free amino acids and they can e dangerous in quantity to the brain as they can activate cell function and cause overwork to the point of cell death, hence the nickname excitotoxins – they are used in the food supply in a popular artificial sweetener and as a flavoring agent in substances such as MSG.)

/Disclaimer: This 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://naturalhealingretreats.com/products/essential-vitamins/vitamin-b-15-dimethylglycine-dmg/
  2. https://www.amazon.com/BulkSupplements-N-Dimethyl-Glycine-Powder-Kilogram/dp/B00GI24VNG/ref=sr_1_12_a_it?ie=UTF8&qid=1474328044&sr=8-12&keywords=dimethylglycine&th=1
  3. https://www.reference.com/food/many-grams-make-teaspoon-cfafd9ead940e296

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. 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,” 

Folate is essential and Folic Acid is commonly available

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

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 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):

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: https://jenniferdepew.net/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):

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 can 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):

Food 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, vitamin B1/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.

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