Vitamin B5 – Pantothenic Acid

In Greek 'pantos' means 'everywhere'. Utilised in the manufacture of coenzyme A (CoA) and acyl carrier protein (ACP), conversion of fats and CHO for energy production and the manufacture of adrenal hormones and red blood cells. (Murray 2001)

Deficiency Signs and Symptoms
Fatigue, burning foot syndrome, numbness or shooting pain.

Naturopathic Dosage Range
Will vary depending on what is being treated, adaquate maintenance dose is 100 mg per dose

Main Uses
Adrenal support – known as the anti stress vitamin.
Rheumatoid arthritis – often there are lower levels the worse the symptoms are, helps to alleviation of pain.
High cholesterol and triglycerides – reduces levels, and lipid lowering effect in diabetics.

Safety
No side effects reported

Vitamin B3 – Niacin

Can be converted from the amino acid tryptophan. Involved in energy production, fat, cholesterol and carbohydrate metabolism and the manufacture of compounds such as sex and adrenal hormones.

Deficiency Signs and Symptoms
Pellagra – dermatitis, dementia, diarrhoea, death

Naturopathic Dose
Maintenance 100 mg taken with meals.

Main Uses

Energy production, regulates blood sugar, antioxidant, liver detox, reduces cholesterol.
Lowers blood lipids – niacin works better, in some instances, than cholesterol lowering pharmaceuticals.
Diabetes – used under supervision instead of autoimmune drugs (prednisone), safer and effectivAe.
Arthritis – rheumatoid and osteoarthritis, high dose have been proven useful.

Safety
Skin flushing 20 – 30 min after, irritating factor not dangerous.
Gastric irritation, nausea, liver damage – avoid time release tablets.
Caution in liver damage, or elevated liver enzymes, gout or peptic ulcer.
In diabetes use under supervision of a practitioner because of impaired glucose tolerance.
Liver function tests and cholesterol tests advised during high doses.

Vitamin B2 – Riboflavin

Excess B2 results in yellow-green urine. involved in energy production.

Deficiency Signs and Symptoms
Cracking lips, sores in corner of mouth, inflamed tongue, visual disturbances – sensitive to light, loss of visual acuity, cataracts, burning and itching eyes, lips, mouth, tongue. Disorders of mucous membranes. Anaemia and seborrhoeic dermatitis.
 
naturopathic Dose
Maintenance 5 – 10 mg daily
   
Main Uses

Migraine – prevention, based on theory thatmigraines are caused by reduced energy production within mitochondria of cerebral blood vessels.
Cataracts – reduced generation of glutathione enhances formation
Sickle cell anaemia – increases iron status and glutathione levels.

Safety
No toxicity.

Vitamin B1 – Thiamin

Deficiency Signs and Symptoms
Beriberi – mental confusion, muscle wasting (dry), fluid retention (wet), high Bp, difficulty walking, heart disturbances. Can result from eating white rice rather than whole grain.
Mild deficiency – fatigue, depression, pins and needles or numbness in legs, constipation.
In alcoholics with thiamin deficiency = Wernicke-Korsakoff syndrome.

Main Uses
Prevent deficiency in diabetes, Crohn’s dx, MS, neurological diseases.
Prevent and treat impaired mental function in elderly, in Alzheimer’s it is essential for energy production in brain, severe deficiency causes psychosis. Mimics NT acetylcholine (memory),which is often low in Alzeimer’s. (Murray 2001)
Epileptics on Dilantin (phenytoin) – improves mental function.

Naturopathic Dose

100 mg daily

Cautions
None

Inositol

Is an unofficial B vitamin which functions closely with choline. It is a primary component of cell membranes, as phosphatidylinositol. (Haas 1999)

Food Sources
Citrus fruit, whole grains, nuts, seeds, legumes. Fibre component of phytic acid (inositol phosphate). Intestinal bacteria releases inositol from phytic acid.

Main Uses
Liver disorders (100 – 500 mg)
Depression and panic attacks – used in serotonin and acetylcholine, depressed patients show low levels of inositol in cerebrospinal fluid, shown to reduce depression and panic.
Diabetes – neuropathy, decreased nerve function because of loss of inositol from nerve cell.

Choline

Aids in the manufactures the neurotransmitter acetylcholine, and is the main components of our cell membranes as phosphatidylcholine (PC). Needed for proper metabolism of fats. Can be manufactured from amino acid methionine or serine. Recently become an essential nutrient. (Murray 2001)

Deficiency Signs and Symptoms
Fatty infiltration of the liver and signs of liver dysfunction.

Food sources
Grains, legumes, egg yolk as lecithin (PC), cauliflower and lettuce, liver, soy.

Main Uses
As PC:
Liver disorders (350 – 500 mg) – hepatitis, alcohol induced fatty liver, cirrhosis, diabetic fatty liver, drug induced damage.
High cholesterol – increases solubility so decreases ability to cause atherosclerosis.
Alzheimer’s disease – increases accumulation of acetylcholine, improves memory.

Safety
At high doses phosphatidylcholine may cause anorexia, nausea, abdominal bloating, gastointestinal tract pain, diarrhoea. Do not use in depression. (Murray 2001)

Biotin

Biotin is a B vitamin that functions in manufacture and utilisation of fats and amino acids. It is manufactured in intestines by gut bacteria. A vegetarian diet enhances production and absorption of biotin through changing gut bacteria. (Haas 1999)

Deficiency Signs and Symptoms
In adults – dry, scaly skin, nausea, anorexia, seborrhoea.
In infants – seborrhoeic dermatitis (cradle cap) and hair loss.

Main Uses
Promotes strong nails and healthy hair.
Seborrhoeic dermatitis – usually show deficiency.
Diabetes – enhances insulin sensitivity, can be useful for some cases of diabetic neuropathy.

Vitamin A – Retinol & Carotenes

Natural vitamin A: retinol or retinyl-palmitate.
Carotenes: beta-, beta- and alpha-, mixed carotene from palm oil (best form); carotenes are precursors to vitamin A, found in plants.

Deficiency Signs and Symptoms
Reduced immune function, alterations in lining of respiratory or gastrointestinal tract, more susceptible to infectious disease e.g. pneumonia.
Prolonged deficiency can cause night blindness, xerophthalmia and increased infection rate.

Main Uses
Visual – to improve sight and night vision.
Growth & development – as vitamin A helps to maintain epithelial tissue.
Reproduction – beta-carotene in fertility, ovulation and corpus luteum function.
Immune function (5000 I.U. for men, 2500 I.U. for women) – maintains mucosal surfaces and secretions.

Caution
Avoid high doses during pregnancy or if not on contraception.

Vitamin B9 – Folic Acid

Synthetic vs Natural
In food folate is in the form of pteroyl glutamic acid which requires complicated conversion and is unstable. The synthetic form, pteroyl monoglutamic acid, used in supplements is a stable molecule with better bioavailability. Absorption from food between 50-66% from supplements it’s double that. Small amounts produced by bacteria in intestines but mostly lost in stool. (Braun and Cohen 2005).

Deficiency Signs and Symptoms
All cells are affected, especially rapidly dividing ones such as red blood cells and gastro-intestinal tract cells.
Poor growth, diarrhoea, anaemia, gingivitis, abnormal pap smear in females. Depression, insomnia, irritability, forgetfulness, loss of appetite, fatigue, shortness of breath. Macrocytic anaemia, senility, hair loss, headache, nausea, weight loss. (Murray 2001)

Main Naturopathic Uses
Before conception and during pregnancy (dose 400 mcg) – deficiency one month before conception or during the first trimester is an independent risk factor for neural tube defects in newborns.

Deficiency from oral contraceptive use – more than five years of use can be associated with a progressive decrease in folate levels and can result in mood changes and NTD if pregnant within one mnth of stopping.

According to recent research folate aids in homocysteine reduction and cardiovascular disease protection, together with B6 and 12.

Depression – especially in psychiatric and geriatric populations. Between 15-38% of depressed people have a  deficiency (Albert and Fava 1997).
 

Nutritional Supplementation

A supplement is a product intended to supplement the diet, not to be use as a food or as a sole item of a meal or the diet. Nutritional supplementation may include vitamins, minerals, essential nutrients, accessory nutrients or neutraceuticals.

Recommended Dietary Allowance (RDA)
RDAs have been set since 1940s by various Food and Nutrition Boards; they were originally intended to reduce severe states of nutritional deficiency e.g. scurvy, rickets and beriberi. RDAs were designed to assess diets in groups of people not individuals, because individual RDAs vary depending on diet and lifestyle. “Individuals with special nutritional needs are not covered by the RDAs.” (National Research Council, Recommended Dietary Allowances, National Academy Press, DC, 1989)

Recommended Daily Intake (RDI)
RDI are “the levels of intake of essential nutrients considered, on the basis of available scientific knowledge, to be adequate to meet the needs of practically all healthy people.” (Braun & Cohen 2005). Based on preventing nutrient deficiency signs in healthy people, they do not take individual requirements into account. E.g. tannin/phytates and iron. Often known to change when new evidence emerges and can vary from country to country, so not a definitive guide. They have limited clinical use. RDAs and RDIs do not reduce the risk of developmental or degenerative diseases such as CVD or neural tube defects.

Daily Value (DV)
Food product labeling. Two sets of references: Daily Reference Values (DRV) and RDI. DRVs are a set of dietary references that apply to fat, saturated fat, cholesterol, carbohydrate, protein, fibre, sodium and potassium.

Optimum Daily Intake (ODI)
The amount of nutrients needed for vibrant health (Balch & Balch). Higher amounts than RDA. This is generally where nutritionists/naturopaths prescribe. Scientific research shows the optimal level for nutrients are much higher than RDAs. RDAs do not take into account lifestyle factors, such as smoking, where is has been ascertained (by the Food and Nutrition Board), that they require at least twice as much vit C as nonsmokers.