I have done a lot of reading and researching over the years on nutrition and supplements in my pursuit of helping my husband with his Parkinson’s. Nutrient deficiency can be an underlying causal factor in many chronic health issues. Most recently, I was contacted by several people with Parkinson’s regarding vitamin B-1, thiamine, deficiency. I started to do some research. Back in the early 1900’s before foods were fortified with vitamins, thiamine deficiency was known as Beri-Beri. Today most people don’t give much thought to nutrient deficiency. However, it could be a more significant issue now, because our soils are so depleted from our monocrop, large scale, depletive agricultural practices.  

Dr. Derek Lonsdale, a pediatrician from the Cleveland Clinic wrote the book Thiamine Deficiency Disease, Dysautonomia and High Calorie Malnutrition in 2017.  His work with patients had increasingly revealed that many were suffering from the consequences of the nutrient-depleted, high calorie and empty calorie Western diet.  One of his primary concerns was the depletion of B Vitamins.  B vitamins directly regulate mitochondrial metabolism.  

The B vitamins are water soluble vitamins required as coenzymes in the proper functioning of cells and the production of energy.  B vitamins are essential for properly functioning mitochondria and energy metabolism.  The loss or deficiency of any one of the B vitamins will have an impact on the mitochondria.  

The transformation of food macromolecules (carbohydrates, fats and proteins) into cellular energy in the form of ATP requires numerous micronutrients for coenzymes and cofactors in enzymatic reactions, as components of mitochondrial cytochromes and as carriers of electrons and protons in the generation of ATP in the mitochondrial respiratory chain.  

Vitamins are essential micronutrients that are important precursors to enzymes that are critical to all living cells for proper functioning.  Humans do not produce many of the critical vitamins, so they must be obtained from food or produced by bacteria in the gut.  The western diet is high in processed foods that are devoid of living organisms that can produce these vitamins.  In addition, many of the preservatives used in packaged foods and herbicides used on the plants we consume are “antibiotic” in nature and destroy the beneficial bacteria that produce key vitamins for our health.  Lactobacillus and Bifidobacteria species found in fermented foods and probiotics are the key suppliers of B vitamins in our gut.  

What are these B-vitamins?  

• Cobalamin - B-12
• Folates - B-9
• Inositol - B-8
• Biotin - B-7
• Pyrodoxine - B-6
• Panothenic acid - B-5
• Adenosine (ATP) - B-4
• Niacin - B-3
• Riboflavin - B-2
• Thiamin - B-1

Given the fact that our gut bacteria are making these essential vitamins for us, you can see how important gut health is to our overall health.  Without the right beneficial bacteria in our guts we can’t synthesize these vitamins.  

Overall B-Vitamin deficiency 

The key gut bacteria involved in synthesis of these vitamins can be found in fermented foods and probiotics.  However, it takes more than a supplement to restore your gut health if you are consistently eating a diet that is high in processed foods, high fructose corn syrup and food preservatives.  These bacteria also need the right kinds of fresh foods to break down in digestion to produce these critical nutrients. 

B-vitamin deficiency  

B vitamins are important to the daily production of both red and white blood cells.  Dr. Stasha Gominak discusses the connection between combined deficiency of the B vitamins with low Vitamin D.  She discusses the importance of quality sleep and how the restoration of vitamin production will take many months of improved sleep before you can restore a full state of health.  

If you are suffering from any of the above symptoms you might want to think about adding foods that are high in thiamine (B1) to your diet and considering additional supplementation.  You can’t restore full B vitamin production overnight by taking a probiotic and B Vitamin supplements, so you will need to supplement for some period of time until you can restore the bacteria needed to support ongoing healthy levels of vitamins.   

If you don’t like eating beef liver, there are some quality beef liver supplements that you can purchase.  Always make sure to get your beef liver or beef liver supplements from grass fed organic beef.  Most people don’t think about the connection between how the animals they eat are fed and their own health.  However, cattle are also depleted of essential trace nutrients and healthy gut bacteria when they are fed diets high in GMO corn silage and given antibiotics to put on weight more rapidly.  This will affect the quality of the nutritional profile in the meat and thus the nutrients that are available to you when you consume the meat.  

B-12 - cobalamin

B-12 is a critical nutrient in the production of healthy blood and nerve cells.  Cobalamin is also necessary for the production of new DNA molecules.  Our cells are constantly dying and we are growing new cells all the time so B-12 is very important to the renewal processes in our body.  

What are the signs and symptoms of B-12 deficiency?

• Weakness, fatigue, light-headedness
• Muscle weakness, neuropathy, trouble walking
• Thinned stomach lining leading to gastritis
• Increased risk of Crohn’s disease
• Small intestinal bacterial overgrowth (SIBO)
• Lack of skin pigmentation, paleness
• Vision loss
• Immune system disorders

Vitamin B-12 is an essential water-soluble vitamin that is commonly found in animal proteins such as fish, shellfish, meat, eggs, and dairy products, thus vegetarians and vegans often have a deficiency of B-12 due to their dietary restrictions.  

Certain medications can interfere with the production and/or absorption of B vitamins.  In particular medications for acid reflux and heartburn called proton pump inhibitors can be significant contributors if taken for long periods of time.  Most of these medications state that they should not be taken long term, however, millions of Americans are prescribed these medications and take them long term.  

If you have been taking proton pump inhibitors for a long time, consider some simple lifestyle changes like eating your last meal of the day at least two hours before bedtime, sleeping at a propped up angle, and taking digestive enzymes before meals to help with the breakdown of your meals.  

If you have gastritis or thyroid issues such as hypothyroidism or Hashimoto’s this may also connect to B-vitamin deficiency.  Chronic gastritis can contribute to malabsorption of nutrients, including the B vitamins.  Roughly 40% of hypothyroidism patients have indications of B-12 deficiency.  

B-9 - folate 

Understanding of folate metabolism and folate deficiency has increased in recent years as functional medicine and genomics has become more widely available.   People who have loss of function in the MTHFR gene have difficulty breaking down folate to the more usable forms of folate.  

Folate is essential for the production of healthy red blood cells that carry oxygen throughout our bodies. Folate refers to the category of molecules that include pterin, para-aminobenzoic acid (pABA) and glutamate molecules. Folates are required for DNA synthesis and epigenetic regulation of gene expression.  

Folate generating capacity is ubiquitous in the human microbiome, if there is a healthy gut flora.  In the linked study they were evaluating the genes and pathways of the gut bacteria. Chorismate, a key metabolite in the Shikimate pathway, acts as an intermediate for many metabolic pathways including folate and aromatic amino acid biosynthesis. In this study, the genes required to synthesize chorismate from PEP were found in 256 species of the microbiome.  

Source

Folate is used to:

• Treat Alzheimer’s disease 
• Prevent cancer
• Prevent heart disease
• Prevent certain birth defects

Foods that are high in folate include beef liver, asparagus, broccoli, avocado, oranges and legumes.  If you know that you have the MTHFR mutation and you are looking for a supplement that includes folate, make sure you look for the form 5-methyltetrahydrofolate. If you aren’t sure whether or not you have the mutation that may contribute to folate deficiency, then consider taking this form as well.  Folate, folic acid and 5-methyltetrahydrofolate are not the same.   

B-8  - inositol

Inositol is actually not a vitamin but is frequently identified as vitamin B-8.  Inositol is a sugar that is important for insulin response and hormone production.  Inositol is a free radical scavenger that is an important tool for fighting off oxidative stress. Inositol has been shown to improve mood, relieve anxiety and reduce panic disorders.   Inositol hexophosphate (IP6) is available as a supplement and it has been shown to be a mild iron chelator.   Inositol may also be helpful in the treatment of polycystic ovarian syndrome PCOS).

Inositol can be processed along two pathways and one of these is key in the regulation of intracellular calcium and the initiation of proteins.  

Symptoms of inositol deficiency are not definitive, though the following symptoms are suggested in the ongoing research:

• Alopecia
• Eczema
• Insomnia
• Constipation
• Dyslipdemias (fatty liver, fatty intestines, visceral fat, low blood lipoproteins)

Inositol is found in foods like cantaloupe, citrus fruits and fiber rich foods like legumes and wheat bran.  

B-7 - Biotin

Biotin is a water soluble vitamin that is an essential cofactor in the metabolism of fatty acids, glucose and amino acids.  While biotin deficiency is thought to be uncommon, the symptoms develop gradually over time and may be mistaken as signs of aging.  

Symptoms of biotin deficiency are:

• Thinning hair and loss of all body hair
• Scally, red rash around the eyes, mouth and perineum
• Pink eye
• keto lactic acidosis (lactate production exceeds lactate clearance)
• Aciduria (high amount of acid in the urine)
• Seizures
• Skin infections
• Brittle nails
• Fatigue
• Depression
• Hallucinations

Foods that are high in biotin include chicken and beef liver, eggs and salmon. Additionally, vegan food sources high in biotin are broccoli, sweet potatoes, mushrooms, legumes, bananas and sunflower seeds.  

B-6 - Pyridine

B-6 is another water soluble vitamin that is essential for protein metabolism.  B-6 is important for a healthy immune system, bone strength, properly functioning nerves and cardiovasculature.  B-6 is also important in the transferring of amino acids and sulfur groups.   Defects in sulfur metabolism have been reported in Parkinson’s disease for decades.  More recent research has shown the bacteria Delsulfovibrio, a sulfur metabolizing bacteria, is more prevalent in Parkinson’s disease.  Research has shown that a higher dietary intake of B-6 is associated with a reduced risk of developing Parkinson’s disease. 

Many of the symptoms associated with B-6 deficiency are involved with the skin, including rashes and cracks at the corners of the mouth.  

Foods high in B-6 are tuna, salmon, chickpeas (only buy organic), poultry and dark leafy greens.  

B-5 - Pantothenic acid

B-5 is a water soluble vitamin involved in energy production through the breakdown of carbohydrates into glucose and fats into fatty acids. B-5 is important for red blood cells and sex and stress hormones produced in the adrenal glands. Chronic stress and chronically low vitamin B-5 can lead to adrenal fatigue where the adrenal glands can no longer respond properly to stress.  

B-5 supports healthy skin, hair and nerves.  It is important in overall metabolism and supports the function of the products of fats, carbohydrates and hormones.  Panothenic acid can help prevent anxiety and depression.  

Symptoms of B-5 deficiency include:

• Fatigue
• Insomnia
• Depression
• Irritability
• Stomach pains
• Burning feet
• Upper respiratory tract infections

Mushrooms (shitake), sweet potatoes and avocados are great vegetarian sources of pantothenic acid.  Meat, products and fish are also high in vitamin B-5.  

B-4 - Adenine, choline and carnosine

B-4 is not typically discussed as a vitamin and has been associated with all three of the above compounds and the production of ATP, the essential energy for all cells in the human body.  Adenine is one of the main bases necessary for the synthesis of DNA and RNA. Adenine combined with the sugar ribose forms adenosine or ATP.  Choline must be obtained from the diet as choline or phosphatidylcholine and is essential for the integrity of cell membranes.  Carnitine is involved in energy metabolism.  Deficiency of Vitamin B-4 was noted as far back as 1938 to cause brain lesions.  

Eggs are the most choline rich food.  Keep in mind that pasture raised chickens will produce eggs that are higher in choline.  Bee pollen is the most adenine rich food and also provides the benefits of trace mineral nutrients essential for the support of B-vitamin synthesis.  Kelp, aloe vera, algae, leafy green vegetables and propolis are also high in adenine.  Smaller amounts are found in some herbs and spices such as spearmint, sage, cinnamon and ginger. 

B-3 - Niacin 

Niacin is made and used in the conversion of food into energy.  Every cell in your body needs niacin to perform at an optimum level. Vitamin B3 is the energy source for all cells as it is essential for the production of NAD+ and NADP+ in important redox reactions for the production of energy.  Parkinson’s symptoms such as fatigue, sleep dysfunction, and depression may be related to niacin deficiency.  

Niacin deficiency results in a condition called pelegra.  Key symptoms of niacin deficiency are dementia, dermatitis and diarrhea.  Those sound like pretty common symptoms in today’s day and age.  While industrialized countries assume that niacin deficiency is no longer an issue due to fortified foods, this is very likely no longer the case as our foods have become more depleted of this vitamin due to the use of glyphosate on most crops.  Niacin is produced from tryptophan through the shikimate pathway and this pathway is the target of glyphosate in both plants and bacteria, including the gut bacteria that produce niacin.   

Niacin has been shown in some studies to improve the symptoms of Parkinson’s disease (reference 1 and reference 2).  Some symptoms of Parkinson’s disease like fatigue, sleep dysfunction and mood changes may be related to a deficiency of niacin.  

Dietary sources of niacin are fish, meats, coffee, tea, nuts and grains.  Current meat processing methods can damage the NAD and NADP necessary for niacin.  In corn, niacin is covalently bound to carbohydrates thereby decreasing the bioavailability of the niacin. Therefore, cultures like ours that consume a lot of corn are particularly susceptible to niacin deficiency.  

In addition, niacin is typically absorbed in the small intestine and SIBO can affect the absorption of this and many other nutrients.  SIBO has been associated with the disruption of many processes in the digestive tract, including vitamin synthesis.  To learn more about SIBO, check out the Wheat Belly Blog and the many resources Dr. William Davis provides to understand and treat SIBO naturally.  

The liver can also synthesize niacin from tryptophan so it is also important to have sufficient tryptophan sources in your diet.  As mentioned above, foods high in glyphosate residues will impact this important pathway and the availability of tryptophan.  

B-2 - riboflavin

Riboflavin is a water soluble vitamin critical to energy metabolism.  Riboflavin is important for many redox reactions. Riboflavin is a key component of coenzymes involved in cell growth, energy production, the breakdown of fats and the handling of steroids and medications.  B2 is not stored in the body so it must be obtained daily in the diet.  The microbiome can produce some riboflavin but typically not enough for the daily requirement.  Foods that are high in Vitamin B2 are fish, animal products (liver), eggs, oysters, oily fish, dairy products, brewer’s yeast, seeds and grains. 

B-2 boosts energy, increases blood circulation and oxygenation and promotes growth and development.  B-2 helps improve mineral absorption and protects vision and the nervous system. 

B-1 - thiamine 

Symptoms of thiamine (B1) deficiency sound a lot like some of the symptoms of Parkinson’s, long Covid and other neurological diseases:

• Fatigue
• Irritability
• Nausea and vomiting
• Anxiety
• Loss of appetite
• Poor memory
• Sleep disturbance
• Changes in heart rate
• Shortness of breath
• Reduced reflexes
• Tingling 
• Muscle weakness

After doing some more research I found out that thiamine deficiency is associated with other illnesses like:

• Hypothyroid
• Parkinson’s
• Multiple sclerosis
• Dysautonomia
• ALS
• Megaloblastic anemia

Just to name a few.

Dietary sources of B-vitamins

Some foods that can help with B-vitamin production are:

• Fermented foods - sauerkraut, organic plain yogurt, kimchi, organic kefir, pickled vegetables and more - which contain both the bacteria and the foods that will help them thrive in your gut
• Beef liver, which contains copper and other essential trace minerals that are necessary for cobalamin
• Wheat germ, which contains potassium, magnesium, calcium, zinc, copper and manganese
• Sunflower seeds - high in fiber which feeds healthy gut bacteria and Vitamin E, niacin and pyridoxine
• Macadamia nuts - high in manganese and B-1
• Brazil Nuts -  energy dense and rich in healthy fats, selenium, magnesium, copper, phosphorus, manganese, thiamine, and vitamin E
• Nutritional yeast - rich in all of the B vitamins and just one tablespoon provides a rich source of essential trace minerals like zinc, selenium, manganese and molybdenum 

You might consider adding a B-Complex as you work to restore your gut bacteria for B vitamin production to improve your health. Many people don’t realize that many of the B-Vitamins are made by gut bacteria. B vitamins are very important to immunity and homeostasis in the gut. If you want to read more about the science of B vitamins in the gut from food and bacteria, you can read more here.

Remember it’s always good to "B" at your best!