B Vitamins: The Essential Crew of Superheroes Keeping Your Body Running Smoothly

I was talking to someone in the medical field the other day about vitamin B12 and they commented: “Oh yes! B vitamins they are all the same aren’t they and you get them in your cereal.”

I felt deflated by this comment because B vitamins are unsung heroes that keep your body functioning at its best. It does however highlight how little awareness there is around important vitamins and nutrition generally.

The B vitamins are a dynamic group of eight vitamins working together in a beautiful symphony to ensure your energy levels are high, your brain is sharp, and your cells are healthy. But they are not all the same and the way your body absorbs them, or doesn’t in the case of those of us with Pernicious Anaemia, is also different.
Time to introduce that person who I know reads here (!) and the rest of our members and blog post readers to our Superhero character: Cobalamin! You will see and hear more of our Superhero and his friends in our social media and education and raising awareness programmes as these start to roll out later this year.

What are B Vitamins?

B vitamins are a team of eight essential nutrients, each with a slightly different role to play. Humans generally need to get them regularly from diet or from supplements if on a restricted diet. People with Pernicious Anaemia need Vitamin B12 to be replaced through injections for life because there is no (or insufficient) intrinsic factor in their body to utilise any B12 they get from food or from oral supplements.
People with Pernicious Anaemia and other B12 absorption problems may also need to supplement some of the other important B vitamins too. It is common for people with a B12 deficiency to also be deficient in folate (B9) and sometimes other nutrients like iron.

Why are the B Vitamins superstars in disguise?

• Energy Powerhouse: B vitamins help unlock energy from the food we eat. They act like a key, turning carbohydrates, fats, and proteins into fuel for our bodies.
• Brain Booster: B vitamins are crucial for healthy brain function, memory, and concentration. They help with the production of neurotransmitters, the chemical messengers in our brains.
• Happy Cells: B vitamins play a vital role in cell metabolism, ensuring our cells function properly. This contributes to healthy skin, hair, and nails.
• Nervous System Support: B vitamins are essential for maintaining a healthy nervous system. They help transmit nerve impulses throughout the body, keeping us coordinated and sharp.
• Red Blood Cell Production: B vitamins, particularly B12 and folate, are necessary to produce red blood cells, which carry oxygen throughout the body.

If you are a Pernicious Anaemia patient you will immediately recognise why symptoms like fatigue, brain fog, pins and needles in your hands or feet, anxiety, breathlessness, mood swings etc are experienced when you are insufficiently treated with B12 replacement therapy.

What do those words mean on the cereal packet?

• Vitamin B1 (thiamine): Thiamine is essential for energy metabolism and converting food into energy. It also supports cell growth, development and function.
• Vitamin B2 (riboflavin): Riboflavin also plays a role in cell development, growth and function. It also contributes to energy production and the metabolism of fats and medications.
• Vitamin B3 (niacin): Niacin is involved in more than 400 cellular metabolic processes, helping convert food into energy.
• Vitamin B5 (pantothenic acid): Pantothenic acid helps turn food into energy and metabolize fat.
• Vitamin B6 (pyridoxine): Vitamin B6 supports hundreds of metabolic reactions. It also plays a role in brain development and immune function.
• Vitamin B7 (biotin): Biotin plays a role in metabolism, gene regulation and cell signalling.
• Vitamin B9/11 (folate): Folate is crucial for DNA synthesis (the creation of new cells), amino acid metabolism and formation of red blood cells.
• Vitamin B12 (cobalamin): Cobalamin is essential for central nervous system development and function, red blood cell formation and DNA synthesis.

Getting Your Daily Dose of B Vitamins

The good news is that B vitamins are widely available in a variety of foods. Here’s a quick guide to some B vitamin-rich options:

• Thiamin (B1): Whole grains, legumes, nuts, seeds
• Riboflavin (B2): Leafy green vegetables, dairy products, eggs, lean meats
• Niacin (B3): Lean meats, poultry, fish, nuts, seeds
• Pantothenic Acid (B5): Meat, poultry, fish, whole grains, avocados
• Vitamin B6: Poultry, fish, potatoes, chickpeas, bananas
• Biotin (B7): Eggs, nuts, seeds, dairy products, avocados
• Folate (B9/11): Leafy green vegetables, beans, lentils, fortified grains
• Vitamin B12: Meat, poultry, fish, dairy products (strict vegetarians and vegans may need supplements and those with problems with absorption will need injections)

And yes! vitamins B1, B2, B3, B6 and B9 are regularly found in fortified cereal.

It is important to know that not all B vitamins are absorbed in the same way. This very difference is the reason why some people have the autoimmune condition called Pernicious Anaemia or why some people might have problems with absorbing B12.
B vitamins are a class of water-soluble vitamins and for the majority of the B vitamins the step process of how your body gets to use them is quite simple.

1. Food Breakdown: As you digest food, your stomach breaks down the B vitamin-containing components.
2. Absorption: In the small intestine, the B vitamins are further broken down and then absorbed through the intestinal wall by passive diffusion.
3. Transportation: Once absorbed, the B vitamins are transported through the bloodstream to the liver and then distributed throughout the body to the cells that need them.
4. Excess Excretion: Since they’re water-soluble, any excess B vitamins are not stored in the body and are eliminated through the urine.

And here is the really important bit….
There’s one exception to this process in terms of absorption: Vitamin B12 (cobalamin). Vitamin B12 needs stomach acid to release it from food and intrinsic factor to transport it. If you have low or no stomach acid this process will not work efficiently. If you have no or low Intrinsic Factor or anti-bodies that attack your Intrinsic Factor then you will never get enough vitamin B12 through diet or oral supplementation. You must by-pass the system that doesn’t work! And (until we find another solution that works) this means adequate injections to resolve symptoms.

Vitamin B12 needs Intrinsic Factor:

A special protein called intrinsic factor, produced by the stomach lining, rounds up and binds to the freed B12 and once this “IF B12” complex travels in the small intestine it attaches to specific receptors in the ileum which triggers absorption into the bloodstream.

Vitamin B12 needs a carrier to release it into your body. If you don’t have that Intrinsic Factor carrier, or if you have antibodies that attack your intrinsic factor then your B12 absorption is not going to work. If you don’t get sufficient B12 through replacement therapy, then your quality of life is seriously diminished. Absorption may even be non-existent, and you need B12 injections to keep you alive. This isn’t scaremongering – it is basic science that any health care professional should know.

Last week we had a member tell us that her doctor told her she “no longer had Pernicious Anaemia”. I should track down this doctor so that I can nominate them for a Nobel Prize! I imagine that if they have miraculously found a cure that hasn’t yet been found in 100 years and which over 200 medics and researchers in CluB12 are still working on they might also be able to cure me of my cynicism and, some might say, sarcasm.

You are not going to be magically cured, you are not going to be able to improve your absorption. It worries me how much mis-information there is out there on this topic not just from wellness and health gurus but also from doctors and health care professionals, nutritionists and some social media sites.

We frequently hear from our members that their doctor tells them that they are at risk of overdosing on vitamin B12 or that B12 can be toxic. Is there any truth in that? Research and 100 years of patient lived experience of B12 supplementation for people with Pernicious Anaemia will tell you that it is far, far, more damaging to not get enough B12! PAS and other patient advocacy groups have to comment all the time to patients and doctors that vitamin B12 is not toxic, it is water-soluble and excess will be eliminated through urine.

This is the science behind how B12 works in your body. There are too many myths and too much gaslighting still going on about this important and life essential vitamin.

Excessive doses of some B vitamins can cause reactions.

Vitamin B6 (Pyridoxine): Long-term high intake (over 1 gram per day) can cause nerve damage, numbness, tingling, and skin lesions.
Niacin (Nicotinic Acid): High doses (over 1-3 grams per day) can cause flushing of the skin, nausea, vomiting, liver damage, and high blood pressure.

Now I’m not a medic nor a scientist, but I am an informed patient. Ive made it my missions to try and understand as much as I can in this area, because like many patients with pernicious anaemia I have been misdiagnosed and undertreated. You should do your own research and check your own levels and symptoms and discuss with your doctor before making any radical changes to your supplementation regime or diet. It is a sensible approach to think about supplementation wisely and to consider fortification in foods and drinks which you may be consuming, and which can not only increase your daily intake but may skew blood test results especially if you are still looking for a diagnosis.

One key takeaway from this thought process, started off by an innocent remark, is that we all (as Pernicious Anaemia patients) are very used to blaming our symptoms on lack of B12. But since the symptoms often overlap with other conditions and deficiencies, it is worth also looking regularly at the other vitamins especially folate and Vitamin D and also iron levels to see if our Superhero Cobalamin also needs some additional help from his friends.