Step 1: B vitamins.

What’s a catalyst? Let’s take a moment to review just what catalysts do.

When we want to start any kind of chemical reaction we sometimes have to bring a certain amount of energy to it first. If we want to light a candle it’s not enough to just get a candle and visualize it lighting. It’s better to bring an external source of energy to the task. We flick a lighter or strike a match and bring them close to the candle wick.

The energy we bring to start a chemical reaction is called the activation energy. Once the wick gets hot enough it starts burning. Once burning, the energy released by the flame’s oxidation of the candle wax keeps the reaction going until the candle is gone.

Catalysts lower the activation energy needed to start a reaction. Again, the B vitamins in our cells allow oxidation to take place at a low temperature, in a watery environment, at a controlled rate. So they’re essential to our bodies’ energy production.

It’s only stretching the point a little bit to say that B vitamins are like the sparkplugs in a car engine. They help get things going.

Why can it be hard to get enough B vitamins from food? Generally we cook it or eat too many leftovers. B vitamins turn out to be fragile critters ... they break down in heat and wash out in water. Some of them break down when exposed to air or ultraviolet light.

There are generally considered to be ten different B vitamins. They are:

B vitamins each have their own special role in the body. It’s critical to the health of our bodies and minds that we obtain all of these B vitamins on a regular basis. They’re water-soluble so the body doesn’t store any excess, excreting them instead in urine.

It’s only been a quarter of a million years since man harnessed fire. Before that time, everything we ate was raw. Our cellular machinery evolved more than a billion years before the first modern humans appeared; everything eaten by those creatures was raw too. So it’s not surprising that modern face-paced lifestyles relying on highly processed, cooked and leftover food might require B supplementation to re-create something close to the old, natural situation.

My clinical experience has been that there are few people who don’t experience more energy, optimism and mental clarity when they supplement regularly with a good B complex.

I usually recommend B-50 products. These are made by many different companies and are widely available in groceries, pharmacies and health food stores. There is no single B vitamin known as “B-50”, rather, these products are formulas made up of either 50mg or 50mcg of each of the B vitamins; roughly 8-12 times the Daily Value (DV) levels.

These products have enjoyed a surge of popularity over the last fifteen years due to a gradually dawning awareness that DV levels, being designed to prevent the onset of frank physical disease, may be inappropriately low for many people. And since the body easily rids itself of excess amounts of most B vitamins there’s little or no danger in taking these elevated levels, with a couple of caveats¹ See the footnote for these considerations.

There is, however, a substantial danger in not recognizing our bodies’ need for adequate Bs. B vitamins are frequently essential parts of the enzymes that help our digestive systems absorb Bs in the gut. Studies have shown that if mammals are deprived of adequate amounts of B vitamins for long periods they lose a portion of their ability to absorb B vitamins later, even if ordinarily adequate amounts are resupplied. This is one of the reasons for taking generous doses of Bs; the other has to do with the fact that in modern societies certain critical body areas typically experience a loss of circulatory efficiency as we age. This concern is especially relevant to physical medicine issues.² However, given increasing indications that atherosclerosis may impact blood circulation in the brain as humans age, the problem of poor circulation may also impact mental health concerns.

Resupplying B Vitamins after Their Prolonged Absence

There’s one more important observation to make here. In the clinic I’ve observed time and time again that, particularly if a patient has never had adequate vitamin supplementation, re-supplying Bs in the fairly aggressive form of a B-50 product will almost always make them feel ill. This problem doesn’t seem to appear in patients who’ve been getting even minimal amounts of B supplementation in their multi-vitamins, even if they’ve only been taking them intermittently. It does however appear frequently in folks who’ve never taken any vitamins. It’s not unusual therefore in my practice to encounter patients who tell me they can’t take vitamins because “they make me sick.”

The solution here is to start very slowly, and bring these folks up to a B-50 level of supplementation over a period of weeks if not months. The way to do this is to use a liquid B vitamin. There’s nothing particularly superior about the liquid form; it’s simply more helpful to use a liquid when we’re starting people on very low doses and gradually increasing it.

Here’s the way it works: the recommended dosage of most liquid B preparations is 1 tbsp/day (there are a few products out there that recommend 1 tsp; read the small print on the label, please.) I’ll typically start most B-deprived patients at 2 drops/day for the first week, increase them to 4 drops/day the second week, 6 drops the third, and so on up to about 10-12 drops. An eyedropper is useful; these are commonly available at pharmacies and almost all health food stores.

Once they’ve reached 10-12 drops/day most patients in otherwise decent health can start increasing their dose by four drops/day each week, up to about twenty drops/day. Going from nothing to 20 drops/day, about ½ dropperful, seems to be the tricky part. After that patients can usually go from ½ dropperful to ¾ dropperful the next week, then 1 full dropper the next, then 1 ½ droppers the next, and so on until they’ve reached the full label-recommended dose. At that point they can continue with the liquid or switch to a B-50 pill if they prefer.

There’s one notable exception to this approach: extremely elderly people in fragile health who’ve never taken vitamins. Typically these folks will present with extremely pale and pasty skin, frequently (but not always) with weight issues and very poor muscle tone overall. Typically there will be a long laundry list of health complaints. In these folks it can be critical to start with an extremely low dose of Bs, on the order of ½ or ¼ drop/day.

How does one administer a dose of ½ drop of B vitamins/day? By placing a drop in a glass of water, stirring vigorously, pouring out half the water and then drinking the rest.

The folksy way in which I explain this to patients relies on the spark plug analogy and usually goes something like this:

If B vitamins serve as catalysts for the body’s production of energy, then inadequate amounts of Bs will make the process less efficient, producing more “waste.” Imagine a car with old, worn, dirty spark plugs that no one’s bothered changing in awhile. Such a vehicle burns its fuel inefficiently and produces more pollutants and smog. It’s also going to experience more vibration and produce more noise, similar in some respects to the emotional and psychological instability poorly-nourished people sometimes experience.

(This actually isn’t too far from the truth. B vitamins are also critical parts of enzymes that disassemble neurotransmitters and other bioactive compounds after they’ve done their work. When Bs are inadequate these “wastes” are also not cleared away, resulting in a building up inappropriate molecular byproducts or “toxins”.)

Our poorly-tuned car’s engine emits more pollution discharged through the tailpipe and out into the atmosphere for the rest of us to breathe. In the case of the human body, however, the products of inefficient oxidation and incomplete metabolic reactions aren/t usually discharged through the “tailpipe” (thank god!) The body’s priority is to get these “toxins” out of the bloodstream, away from the brain, central nervous system, and internal organs. Fat tissue is the best place to put them; out of circulation, out of sight, out of mind.

As we’ve just seen the body does have mechanisms for identifying, disarming and excreting its internally-generated wastes. But these biochemical pathways require B vitamins themselves to work! So low B intake generates more waste at the same time that it keeps the body from cleansing itself of that waste.

Resupplying a B-depleted body is a delicate task because there are two steps involved in getting toxins out of the body and it’s important to take them correctly. In the first step toxins have to be mobilized from fat tissue back into the bloodstream. In the second step toxins are washed out of the bloodstream and the body. If the first step happens faster than the second step toxins back up in the bloodstream, precisely where the body doesn’t want them. We get sick. I’ve seen this happen over and over again in patients who’ve never supplemented and don’t allow enough time for their bodies to adapt to the new conditions.

Most frequently this “detox reaction” mimics the symptoms of a cold or flu. The next most common sign is gastric distress. Over the years I’ve seen everything under the sun: skin rashes, mood and behavioral disturbances and so on. One memorable and very overweight patient ignored my advice about this situation (following shortly) and kept taking his B vitamins even after he developed a fever and insomnia. One morning he woke up and felt as if someone had kicked him in stomach; he ended up in the emergency room.

To avoid these problems start with a liquid B formula and take only a few drops/day. At the first sign of any discomfort, simply stop taking the Bs. Detox symptoms are not a sign that B vitamins are not appropriate; quite the opposite. One’s potential to experience a more positive outlook and better overall health is actually greater the more prone one is at the beginning to detox symptoms—they’re a signal of how much one has to gain from the process.

Discomfort merely indicates we’ve reached our “ceiling” for how much of these resupplied nutrients one easily tolerates and it’s time to take a break. Make careful note of how many drops of Bs you were taking when you “hit the ceiling.” After a few days off the symptoms will typically pass and it’s safe to start supplementing again, typically at a dose 1 or 2 drops/day lower than the dose that precipitated the detox reaction. Again, increase slowly from there, at weekly intervals. If one bumps into the ceiling again, take another temporary break.

The situation is something like squeezing a dirty dish sponge into a sink with a clogged drain. The first few squeezes are the dirtiest; squeezing too hard too fast causes dirty water to back up in the sink. This when symptoms appear. But with each squeeze of the sponge the water coming forth becomes gradually cleaner. And, to complete the metaphor, it’s as if, as the water coming out of the dirty sponge becomes cleaner, the drain in the sink itself opens up as well.

With respect to sourcing B vitamins—I’m not so picky. There are no important manufacturing or assimilation issues of which I’m aware. If you’re going directly to a high dose because you’ve been taking lower dose Bs or a multi-vitamin fairly regularly any B-50 product will do as long as it has all of the numbered Bs (see the list above) and folic acid.

With respect to sourcing a liquid B supplement—if you haven’t taken any vitamins for a long time—be sure that you don’t purchase a product that only supplies B12. Some health food store clerks will assume that’s what you’re looking for if you ask for a liquid B product. You, too, want to be sure the formula you buy has at least all the numbered Bs and folic acid.