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B6, B12 and Folate
Some vitamins are meant to be taken together. B6, B12 and Folate needs to be taken as a trio. Each vitamin in this group depends on the other for support and balance. If you short your body of just one of the trio the other two vitamins will destabilize.
One sublingual tablet of TRB Health's B6, B12 and Folate will provide:
B6 50 mg
Folic Acid 800 mcg
B12 1000 mcg
60 sublingual capsules per bottle - 1 capsule per serving.
The National Institutes of Health, Office of Dietary Supplements states the following about B6, B 12 and Folate:
B6
“It performs a wide variety of functions in your body and is essential for your good health. For example, vitamin B6 is needed for more than 100 enzymes involved in protein metabolism. It is also essential for red blood cell metabolism. The nervous and immune systems need vitamin B6 to function efficiently, and it is also needed for the conversion of tryptophan (an amino acid) to niacin (a vitamin).”
“Vitamin B6 also helps maintain your blood glucose (sugar) within a normal range. When caloric intake is low your body needs vitamin B6 to help convert stored carbohydrate or other nutrients to glucose to maintain normal blood sugar levels.”
Vitamin B6 and the nervous system
“Vitamin B6 is needed for the synthesis of neurotransmitters such as serotonin and dopamine. These neurotransmitters are required for normal nerve cell communication. Researchers have been investigating the relationship between vitamin B6 status and a wide variety of neurologic conditions such as seizures, chronic pain, depression, headache, and Parkinson's disease.
Lower levels of serotonin have been found in individuals suffering from depression and migraine headaches. So far, however, vitamin B6 supplements have not proved effective for relieving these symptoms. One study found that a sugar pill was just as likely as vitamin B6 to relieve headaches and depression associated with low dose oral contraceptives.”
B 12
“Vitamin B12 helps maintain healthy nerve cells and red blood cells. It is also needed to help make DNA, the genetic material in all cells. Vitamin B12 is also called cobalamin because it contains the metal cobalt.”
“Signs, symptoms, and health problems associated with vitamin B12 deficiency:
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Characteristic signs, symptoms, and health problems associated with vitamin B12 deficiency include anemia, fatigue, weakness, constipation, loss of appetite, and weight loss.
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Deficiency also can lead to neurological changes such as numbness and tingling in the hands and feet.
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Additional symptoms of vitamin B12 deficiency are difficulty in maintaining balance, depression, confusion, dementia, poor memory, and soreness of the mouth or tongue.
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Signs of vitamin B12 deficiency in infancy include failure to thrive, movement disorders, delayed development, and megaloblastic anemia.”
Who else may need a vitamin B12 supplement to prevent a deficiency?
“Individuals with pernicious anemia or with gastrointestinal disorders may benefit from or require a vitamin B12 supplement.
Older adults and vegetarians may benefit from a vitamin B12 supplement or an increased intake of foods fortified with vitamin B12.
Some medications may decrease absorption of vitamin B12. Chronic use of those medications may result in a need for additional vitamin B12.”
Caution: Folic acid and vitamin B12 defiency
“Folic acid can correct the anemia that is caused by vitamin B12 deficiency. Unfortunately, folic acid will not correct the nerve damage also caused by vitamin B12 deficiency. Permanent nerve damage can occur if vitamin B12 deficiency is not treated. Folic acid intake from food and supplements should not exceed 1,000 ig daily in healthy individuals because large amounts of folic acid can trigger the damaging effects of vitamin B12 deficiency. Adults older than 50 years who take a folic acid supplement should ask their physician or qualified health care provider about their need for additional vitamin B12.”
Do healthy young adults need a vitamin B12 supplement?
“It is generally accepted that older adults are at greater risk of developing a vitamin B12 deficiency than younger adults. One study, however, suggests that the prevalence of vitamin B12 deficiency in young adults may be greater than previously thought. This study found that the percentage of subjects in three age groups (26-49 years, 50-64 years, and 65 years and older) with deficient blood levels of vitamin B12 was similar across all age groups but that symptoms of vitamin B12 deficiency were not as apparent in younger adults. This study also suggested that those who did not take a supplement containing vitamin B12 were twice as likely to be vitamin B12 deficient as supplement users, regardless of age group.”
Folate
“Folate is a water-soluble B vitamin that occurs naturally in food. Folic acid is the synthetic form of folate that is found in supplements and added to fortified foods.”
When can folate deficiency occur?
“A deficiency of folate can occur when an increased need for folate is not matched by an increased intake, when dietary folate intake does not meet recommended needs, and when folate excretion increases. Medications that interfere with the metabolism of folate may also increase the need for this vitamin and risk of deficiency.
Medical conditions that increase the need for folate or result in increased excretion of folate include:
- pregnancy and lactation (breastfeeding)
- alcohol abuse
- malabsorption
- kidney dialysis
- liver disease
- certain anemias
Medications that interfere with folate utilization include:
- anti-convulsant medications (such as dilantin, phenytoin and primidone)
- metformin (sometimes prescribed to control blood sugar in type 2 diabetes)
- sulfasalazine (used to control inflammation associated with Crohn's disease and ulcerative colitis)
- triamterene (a diuretic)
- methotrexate (used for cancer and other diseases such as rheumatoid arthritis)
- barbiturates (used as sedatives)”
What are some common signs and symptoms of folate deficiency?
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“Folate deficient women who become pregnant are at greater risk of giving birth to low birth weight, premature, and/or infants with neural tube defects.
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In infants and children, folate deficiency can slow overall growth rate.
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In adults, a particular type of anemia can result from long term folate deficiency.
- Other signs of folate deficiency are often subtle. Digestive disorders such as diarrhea, loss of appetite, and weight loss can occur, as can weakness, sore tongue, headaches, heart palpitations, irritability, forgetfulness, and behavioral disorders [1,20]. An elevated level of homocysteine in the blood, a risk factor for cardiovascular disease, also can result from folate deficiency.”
“Anti-convulsant medications such as dilantin increase the need for folate [26-27]. Anyone taking anti-convulsants and other medications that interfere with the body's ability to use folate should consult with a medical doctor about the need to take a folic acid supplement.”
B6 References
- Leklem JE. Vitamin B6. In: Shils ME, Olson JA, Shike M, Ross AC, ed. Modern Nutrition in Health and Disease. 9th ed. Baltimore: Williams and Wilkins, 1999: 413-421.
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- Bender DA. Novel functions of vitamin B6. Proc Nutr Soc 1994; 53:625-30.
- Chandra R and Sudhakaran L. Regulation of immune responses by Vitamin B6. NY Acad Sci 1990; 585:404-423.
- Trakatellis A, Dimitriadou A, Trakatelli M. Pyridoxine deficiency: New approaches in immunosuppression and chemotherapy. Postgrad Med J 1997; 73:617-22.
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- Leyland DM and Beynon RJ. The expression of glycogen phosphorylase in normal and dystrophic muscle. Biochem J 1991; 278:113-7.
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- U.S. Department of Agriculture, Agricultural Research Service,1999. USDA Nutrient Database for Standard Reference, Release 13. Nutrient Data Lab Home Page.
- Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. National Academy Press. Washington, DC, 1998.
- Alaimo K, McDowell M, Briefel R, Bischof A, Caughman C, Loria C, and Johnson C. Dietary intake of vitamins, minerals, and fiber of persons ages 2 months and over in the United States: Third National Health and Nutrition Examination survey, Phase 1, 1988-91. Hyattsville, MD: U.S. Department of Health and Human Services; Center for Disease Control and Prevention; National Center for Health Statistics, 1994:1-28.
- Combs G. The Vitamins: Fundamental aspects in nutrition and health. San Diego, California: Academic Press, Inc., 1992; 311-328.
- Lumeng L, Li TK. Vitamin B6 metabolism in chronic alcohol abuse. Pyridoxal phosphate levels in plasma and the effects of acetaldehyde on pyridoxal phosphate synthesis and degradation in human erythrocytes. J Clin Invest 1974; 53:693-704.
- Weir MR, Keniston RC, Enriquez JI, McNamee GA. Depression of vitamin B6 levels due to theophylline. Ann Allergy 1990; 65:59-62.
- Shimizu T, Maeda S, Mochizuki H, Tokuyama K, Morikawa A. Theophylline attenuates circulating vitamin B6 levels in children with asthma. Pharmacology 1994; 49:392-7.
- Bernstein AL. Vitamin B6 in clinical neurology. Ann N Y Acad Sci 1990;585:250-60.]
- Villegas-Salas E, Ponce de Leon R, Juarez-Perez MA, Grubb GS. Effect of vitamin B6 on the side effects of a low-dose combined oral contraceptive. Contraception 1997; 55:245-8.
- Vinik AI. Diabetic neuropathy: pathogenesis and therapy. Am J Med 1999; 107:17S-26S.
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- Selhub J, Jacques PF, Bostom AG, D'Agostino RB, Wilson PW, Belanger AJ, O'Leary DH, Wolf PA, Scaefer EJ, Rosenberg IH. Association between plasma homocysteine concentrations and extracranial carotid-artery stenosis. N Engl J Med 1995; 332:286-291.
- Rimm EB, Willett WC, Hu FB, Sampson L, Colditz GA, Manson JE, Hennekens C, Stampfer MJ. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. J Am Med Assoc 1998; 279:359-64.
- Refsum H, Ueland PM, Nygard O, Vollset SE. Homocysteine and cardiovascular disease. Annu Rev Med 1998; 49:31-62.
- Boers GH. Hyperhomocysteinaemia: A newly recognized risk factor for vascular disease. Neth J Med 1994; 45:34-41.
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- Malinow MR. Plasma homocyst(e)ine and arterial occlusive diseases: A mini-review. Clin Chem 1995; 41:173-6.
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- Siri PW, Verhoef P, Kok FJ. Vitamins B6, B12, and folate: Association with plasma total homocysteine and risk of coronary atherosclerosis. J Am Coll Nutr 1998; 17:435-41.
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B12 References
- Herbert V. Vitamin B12 in Present Knowledge in Nutrition. 17th ed. Washington, D.C.: International Life Sciences Institute Press, 1996.
- Herbert V and Das K. Vitamin B12 in Modern Nutrition in health and disease. 8th ed. Baltimore: Williams & Wilkins, 1994.
- Combs G. Vitamin B12 in The Vitamins. New York: Academic Press, Inc, 1992.
- Zittoun J and Zittoun R. Modern clinical testing strategies in cobalamin and folate deficiency. Sem Hematol 1999;36:35-46.
- U.S. Department of Agriculture, Agricultural Research Service. 2003. USDA Nutrient Database for Standard Reference, Release 16. Nutrient Data Laboratory Home Page..
- Subar AF, Krebs-Smith SM, Cook A, Kahle LL. Dietary sources of nutrients among US adults, 1989 to 1991. J Am Diet Assoc 1998;98:537-47.
- Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. National Academy Press. Washington, DC, 1998.
- Bialostosky K, Wright JD, Kennedy-Stephenson J, McDowell M, Johnson CL. Dietary intake of macronutrients, micronutrients and other dietary constituents: United States 1988-94. Vital Heath Stat. 11(245) ed: National Center for Health Statistics , 2002.
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- Carmel R. Malabsorption of food cobalamin. Baillieres Clin Haematol 1995;8:639-55.
- Sumner AE, Chin MM, Abraham JL, Gerry GT, Allen RH, Stabler SP. Elevated methylmalonic acid and total homocysteine levels show high prevalence of vitamin B12 deficiency after gastric surgery. Ann Intern Med 1996;124:469-76.
- Brolin RE, Gorman JH, Gorman RC, Petschenik A J, Bradley L J, Kenler H A, Cody R P. Are vitamin B12 and folate deficiency clinically important after roux-en-Y gastric bypass? J Gastrointest Surg 1998;2:436-42.
- Huritz A, Brady DA, Schaal SE, Samloff IM, Dedon J, Ruhl CE. Gastric acidity in older adults. J Am Med Assoc 1997;278:659-62.
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