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Mental Health & B Vitamins




My first post-graduate degree was in eating disorders & clinical nutrition at University College London. It certainly brought a fair amount of ups and downs to the table, as well as some very questionable lecturers, but one of my positive takeaways from that experience was the in-depth knowledge I gained on vitamins and minerals & their vital importance for our survival & overall wellbeing.


One of the vitamins they really hammered on the importance of were the B vitamins, especially B-12. In fact, one of my first group projects was the case study of a 14 month old with a severe B-12 deficiency due to a poorly varied diet. He had been exclusively fed breast milk until 9 months of age, at which time small quantities of dried fruit & bananas were added to his diet. Because his mother was a strict vegan, and had been for 14 years prior, she had a B12 deficiency which resulted in her breast milk not containing the necessary nutrients. That, coupled with a lack of complimentary food which is typically introduced to babies at around 6 months, quickly led to an evident developmental delay and a multitude of worrying symptoms expressed by the baby.


I remember being taken aback by the severity of the toddler's neurological and physiological symptoms, which culminated in the child being rushed to the emergency room in a comatose state. Thankfully, B-12 supplements quickly reversed the majority of the symptoms. However, the developmental delay was deemed not likely to ever be salvageable. You can read more about the case study here.


The case study, mixed with what we were taught by our lecturers, really instilled in me the importance of B vitamins in our diet, and the significant damage a poorly varied diet can do to our health. As adults, we are able to withstand the above for longer periods of time compared to infants, who - as demonstrated in the above case study - can develop severe impairment - and even die - in a matter of months if they do not have access to the foods & vitamins needed for physical and cerebral development from utero onwards. Quick disclaimer here: I'm in no way wagging my finger at those who follow a vegan diet. Rather, I'm pointing out the importance of vitamin supplementation for adults - because many choose to follow a certain diet without taking supplements because they "feel fine", until they don't - and the importance of a healthy, well-balanced diet for growing children. A plant-based diet does indeed have its benefits but it does also lack the vitamins and minerals that are found animal products. This is especially true for B-12, as it is not abundant in plant based foods. It's important to be aware of that & to incorporate the appropriate supplements.


The B vitamins are all very important & key to our different metabolic processes. They offer a huge variety of benefits, from increasing our energy levels to promoting gut health and keeping our nervous system healthy... & everything in between. As supplements, they can be taken separately or are sometimes grouped together in one vitamin named "B-Complex", because each of their roles are very inter-related. In food, they are most abundant in red meat & unprocessed carbohydrates. Because they're water soluble vitamins, much like magnesium, we end up peeing them out instead of storing them in the body. As a result, we need to replenish our bodies with the B vitamins via food or supplements.


I've found it both concerning and fascinating how something as "simple" as vitamins can have such a huge effect on our physical & mental state. Most interesting, in my opinion, is how the deficiency of so many vitamins & minerals contribute to depression and anxiety. Below I'll list all of the 8 B vitamins and a quick rundown of each, followed by a more comprehensive overview of the ones that are most important for our mental health and a few B-Complex rich recipes & supplement suggestions.



The B Vitamins


*This is not an exhaustive list of the roles of each B vitamin.


Vitamin B-1, Thiamine

Plays a very large role in breaking down nutrients & converting them into energy. Important for cognitive function.


Vitamin B-2, Riboflavin

Key for cell growth, energy production & breaking down medication, steroids & fats. It also helps reduce oxidative stress (which can lead to cell & tissue damage) & nerve inflammation.


Vitamin B-3, Niacin

Helps create and repair DNA, acts as an antioxidant and plays an important part in the creation of serotonin.


Vitamin B-5, Pantothenic Acid

A co-enzyme that helps create and break down fatty acids (& therefore may contribute to reducing cholesterol levels - this is still being researched), and plays a role in energy production. Deficiency is very rare as it's found in almost all foods.


Vitamin B-6, Pyridoxine

Helps with brain development, keeps the nervous system, the immune system and the heart healthy. Helps metabolize protein, carbohydrates and fats.


Vitamin B-7, Biotin

Assists in breaking down fats, proteins and carbohydrates. It also influences cell growth.


Vitamin B-9, Folate

Helps create DNA & RNA, promotes healthy red blood cells, helps metabolize protein, improves cognitive function and helps with fetal development. It's a super important vitamin for pregnant women to be taking - folate deficiency has been proven to be linked to birth defects such as spina bifida (spine defect) and anencelaphy (brain defect). More readily absorbed from supplements than from food.


Vitamin B-12, Cobalamin

Essential in red blood cell formation, DNA creation, nerve function and cell metabolism. It's also a key component to the development & function of our brain.



Spotlight on 3 of the Bs


Here's the deal with B vitamins. They are essential for the function of our body and brain, helping countless enzymes do their jobs (e.g. energy release, cell & DNA creation, breaking down nutrients for absorption, etc). If you aren't deficient in a B vitamin, taking a supplement won't do much of anything for you. What it boils down to is the link between certain vitamin B deficiencies & mental health.



Thiamine (B-1)


Quick note on thiamine: this is one of the first vitamins we learned about during my post-grad - appropriate, as it's also the first vitamin to have been identified - and I found the backstory to be pretty interesting. In the 1800s, the link between illness and diet hadn't been discovered, but in 1884 a Japanese Navy physician made the link between severe illness & death and thiamine deficiency. He had noticed that there was a high rate of illness & death among Japanese sailors who would spend months at sea: in one instance, out of the 376 sailors who had been at sea for over 9 months on a training mission, 169 came back severely ill and 25 had passed away.


Because their diet consisted almost exclusively of white rice, and thiamine is found in the outer layers of rice which is polished off to create white rice, it wasn't difficult for the physician to make the connection. The diet of the sailors was changed, drastically bringing down the illness and mortality rate and putting the crucial importance of thiamin on the map.


Link To Mental Health:

Thiamine deficiency has been linked to depressive symptoms numerous times. Multiple studies have shown that inpatients and outpatients seeking psychiatric help for depression also had low levels of thiamine. However, it isn't clear to me whether or not this is due to overall malnutrition as a symptom of depression, as inadequate food intake is often associated with mood disorders.


A 2011 study done on 9 patients suffering from generalized anxiety disorder found that daily injections of 100mg of thiamine greatly improved overall wellbeing, appetite and fatigue. A randomized controlled trial of 80 women in Ireland suffering from borderline thiamine deficiency were found to have regained energy and experienced less depressive symptoms once their thiamine levels were back to normal.


Thiamine is crucial for the breaking down of carbohydrates, which is the only thing the brain feeds off of. Therefore, if we lack thiamine, we can't metabolize carbohydrates properly, and our brain isn't able to function, affecting everything from our motor skills to our concentration. So, linking increased anxiety and depression to thiamine deficiency doesn't seem like too much of a stretch to me!


Signs of Deficiency:

Symptoms of mild deficiency can be unexplained weight loss, depression, memory loss & confusion, muscle weakness and lowered immunity. Severe thiamine deficiency is called beri-beri. There are two types: wet beri-beri (affects the cardiovascular system) and dry beri-beri (affects the central nervous system), which mostly affects chronic alcoholics via Wernicke-Korsakoff syndrome, a type of dry beri-beri. Symptoms include impaired motor-function, difficulty with speech, swelling & tingling of extremities, issues with balance & walking, severe wasting away of the muscles and can lead to fluid build-up in the heart & lungs. Thankfully, most of these serious symptoms are reversible through high dosage of thiamine.


Those most at risk are people suffering from alcoholism, those receiving dialysis treatment, overusing of diuretics and/or laxatives, those with malabsorption issues related to weight loss surgery or diseases like Crohn's or celiac, and people suffering from anorexia.


Where You Can Find It:

According to Mount Sinai hospital, the main dietary sources of thiamine are pork, beef, poultry and organ meats. Other sources include whole grains, wheat germ, Brewer's yeast, nuts and blackstrap molasses.



Folate (B-9)


Link To Mental Health:

Folate and B12 are the two vitamins that help break down homocysteine, an amino acid. If we're deficient in B12 and/or folate, homocysteine doesn't get broken down and metabolised, leading to high levels of it in our blood. High levels of homocysteine are linked to several neuropsychiatric disorders (more about that below).


Additionally, folate is needed to synthesize dopamine, a hormone and neurotransmitter that plays a really important role in our executive functions, namely in motivation and our reward system. Depression, OCD, Parkinson's and Schizophrenia are all associated with low dopamine levels.


Signs of Deficiency:

Folate deficiency almost always occurs with other B vitamin deficiencies, particularly B12. Megaloblastic anemia, a type of anemia charaterized by abnormally large (and few) red blood cells, is one of the first indicators of folate (and B12!) deficiency, accompanied by fatigue, shortness of breath, irritability and/or weakness. There can also be a change in hair, skin and nail pigmentation and gastrointestinal issues. As mentioned above, folate deficiency while pregnant significantly increases the risk of birth defects, developmental issues and preterm delivery.


People suffering from chronic alcoholism, pregnant women and those with malabsorption issues are at an increased risk of being deficient in folate.


Where You Can Find It:

Folate can be found in a variety of foods, particularly dark, leafy greens. The foods highest in folate are spinach, asparagus, brussel sprouts, liver and avocados. The vitamin can also be found in supplements such as B-Complex, Prenatal, Multivitamins and on its own. It's best absorbed by the body when taken without food (100%) versus with food (85%).



Cobalamin (B-12)


Link To Mental Health:

Arguable one of the most important B vitamins, B12 deficiency can cause a wide range of psychiatric issues, including depression, panic, anxiety and hallucinations.


One study found that, out of the 115 outpatients who were being treated for major depression, the ones that had been taking B12 supplements for a period of 6 months had a higher success rate in diminishing their depressive symptoms than those who had not been taking B12. A case study on a 57 year old woman who was experiencing psychiatric symptoms (lethargy, severe depression, etc) that kept worsening despite numerous treatments that included anti-depressants, anti-psychotics and electroconvulsive treatment. Want to know what they didn't check? Her B12 levels. Once they determined her deficiency and put her on supplements, she went into "complete remission of her psychiatric symptoms without recurrence".


Elevated levels of homocysteine, an amino acid, is caused by a B12 deficiency and can create neuropsychiatric issues such as major depression. The ins and outs are still unclear, but here is what we do know: homocysteine plays a crucial part in the balance of the biochemicals in the central nervous system - and too much of it throws that balance off. When elevated, homocysteine increases oxidative stress which, if chronic, damages our cells, disrupting cell signaling, thus leading to disorders such as ADHD, depression and sometimes even cancer. More than that, evidence has shown that children and adolescents who suffer from severe mental illness have elevated homocysteine levels (and, by default, low B12 & folate levels), and some studies have shown that adults suffering from depression do as well.


Signs of Deficiency:

Symptoms of mild deficiency include numbness and/or tingling in extremities, anemia, swollen tongue, difficulty concentrating, memory loss, fatigue and/or weakness. Fortunately these are easily remedied with B12 supplements. Severe B12 deficiency, on the other hand, can lead to serious symptoms such as paranoia, deep depression, loss of taste and smell, delusions and/or incontinence.


Those at risk are vegetarians and vegans, people who have undergone weight loss surgery, and those who have issues with absorption (Crohn's disease, celiac disease...). The use of heartburn medication can also affect B12 levels, as acid is needed for the absorption of the vitamin.


Where You Can Find It:

Food items high in B12 are clams, liver, lean beef, trout, salmon, canned tuna, greek yogurt, milk, ham, eggs and poultry. It cannot be found in plant-based foods. There is also an abundance of B12 vitamin supplements available over-the-counter as well as B12 shots that your doctor can prescribe for you. I've had B12 shots before & can vouch for their efficacy!




Supplements & Recipes


I've compiled a small list of B vitamin-rich recipes (both vegetarian & non-vegetarian) & some good supplements to look into:



Recipes


Beef Stew

Red meat is a vitamin B powerhouse, hosting 5 of the 8 B vitamins. This recipe has B-1 (beef, garlic, & potatoes), B-2 (beef & potatoes), B-3 (beef & potatoes), B-5 (potatoes), B-6 (beef, onions, potatoes, carrots & garlic), B-9 (potatoes) and B-12 (beef).

Shakshuka with Feta

Another recipe chock full of vitamins due to the tomatoes and eggs both bringing in a huge amount of different B vitamins: B-1 (tomatoes & garlic), B-2 (eggs & feta), B-3 (tomatoes), B-5 (tomatoes), B-6 (tomatoes, onions, garlic & red bell peppers), B-7 (tomatoes), B-9 (red bell peppers) and B-12 (eggs & feta). Whew!


Kale, Barley & Feta Salad with a Lemon Honey Vinaigrette

This salad packs a B vitamin punch: B-2 (feta), B-3 (barley), B-5 (avocado), B-6 (feta, kale & barley), B-7 (barley), B-9 (chickpeas) and B-12 (feta - yay for cheese!).


Mac & Cheese Scrambled Eggs

Offers vitamins B-1(whole wheat pasta), B-2 (eggs & turkey bacon), B-3 (turkey bacon) & B-12 (cheddar cheese).


Balsamic Ginger Soba Noodles - I love anything with ginger & sesame oil so this recipe was a total win for me!

Vitamins B-1(tofu), B-3 (soba noodles) and B-9 (edamame) can be found in this recipe.


White Wine Mussels

The mussels alone are a great source of B-2 and B-12.



Supplements

Garden of Life Raw Vitamin B Complex I love anything & everything Garden of Life. No fillers, no binders - just pure, unaltered vitamin B complex plus probiotics & enzymes for gut health and to help with the absorption of folate and B-12. If you're in Europe, you can order these on iHerb, LuckyVitamin or directly from their website. If you're in the US, Whole Foods will definitely have them.

Garden of Life MyKind Organic Vitamin B-12 Spray I really like this spray because it tastes so good! I discovered it at my cousin's home in Florida & fell in love with it then & there. As I've mentioned before, I struggle with absorption, so this liquid format has been perfect for me.


Nature Made Super B Energy Complex

This supplement is a good, budget-friendly substitute for Garden of Life's B complex. For those of you in Europe, iHerb or LuckyVitamin are the way to go. In the US, this supplement is readily available in all supermarkets.






Disclaimer: I'm not affiliated with any brands or organizations, & receive no compensation for listing them. Anything linked here is either a resource for the article or a product/service that I have tried, tested and firmly believe in.




References



Associations Between Serum Homocysteine Levels and Anxiety and Depression Among Children and Adolescents in Taiwan

Chung & al., Scientific Reports, 2017


B Vitamins and Folic Acid

United Kingdom National Health Service, 2020


Be Healthy With B12 Lawson, Psychology Today, 2004 updated 2016


Biotin - Vitamin B7

The Nutrition Source, Harvard T.H. Chan School of Public Health, Harvard University


Catatonia and Other Psychiatric Symptoms With Vitamin B12 Deficiency

Berry & al., Acta Psychiatrica Scandinavica, 2003


Folate

National Institutes of Health, Office of Dietary Supplements, updated 2020


Folate (Folic Acid) - Vitamin B9

The Nutrition Source, Harvard T.H. Chan School of Public Health, Harvard University


Folic Acid: Influence on the Outcome of Pregnancy Scholl & Johnson, The American Journal of Clinical Nutrition, 2000


Health Effects of Vegan Diets

Craig, The American Journal of Clinical Nutrition, 2009


Homocysteine and Psychiatric Disorders

da Silva & al., Journal of Inborn Errors of Metabolism and Screening, 2017


Niacin - Vitamin B3

The Nutrition Source, Harvard T.H. Chan School of Public Health, Harvard University


Nutritional Brain Bomb: Thiamine Deficiency

Deans, Psychology Today, 2012


Pantothenic Acid - Vitamin B5

The Nutrition Source, Harvard T.H. Chan School of Public Health, Harvard University


Persistence of Neurological Damage Induced By Dietary Vitamin B-12 Deficiency in Infancy

Schenck & al., Archives of Disease in Childhood, 1997


Riboflavin - Vitamin B2

The Nutrition Source, Harvard T.H. Chan School of Public Health, Harvard University


The A List of B12 Foods

Harvard Health Publishing, Harvard Medical School, 2016 updated 2018


The Effects of Vitamin B in Depression

Mikkelsen & al., College of Health and Biomedicine, Victoria University


The Impact of Thiamine Treatment on Generalized Anxiety Disorder

Luong & Nguyen, International Journal of Clinical Medicine, 2011


Thiamin - Vitamin B1

The Nutrition Source, Harvard T.H. Chan School of Public Health, Harvard University


Vitamin B1 (Thiamine)

Mount Sinai


Vitamin B6

The Nutrition Source, Harvard T.H. Chan School of Public Health, Harvard University


Vitamin B-6

Mayo Clinic, 2017


Vitamin B12

Hedaya, Psychology Today, 2012


Vitamin B12

Mayo Clinic, 2017


Vitamin B12 Deficiency Can Be Sneaky, Harmful

Skerrett, Harvard Health Publishing, Harvard Medical School, 2013 updated 2019

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