Hi, I’m Dr. Chad Larson, continuing our series on learning more about certain nutrients, why they’re important, and why they’re often overlooked in the standard medical system. In my view nutrition topics like micronutrients, vitamins, and minerals aren’t adequately taught in standard medical schools. The emphasis is very much on things like prescription medications. As this approach becomes ever more mainstream, I believe it makes the discussion of micronutrients and basic nutrition even more important. Many times pharmaceuticals are prescribed when the individual in question actually just has a nutrient deficiency.

We’ve covered a number of nutrients one by one in this series, but today we’re going to talk about a few nutrients as a group, which is B complex or B vitamins. Chances are you’ve heard of some of the better known B vitamins such as B-12. But they include B-1, B-2, and B-3 etc. And they also have more technical names such as thiamine, riboflavin, niacin, and cobalamin. All of these are B vitamins and they have many uses in the body.

Vitamin B complex is a finite nutrient, meaning there’s only so much B vitamin that can be in the system at once. So if we’re not repleting it regularly, replenishing those levels, then we can quite easily become deficient, or at least insufficient. I frequently test for B vitamin levels, and find that almost all of my patients are below optimal levels unless they were already on a diet that specifically provides B vitamins, or taking a supplement or a high quality multivitamin that includes the B complex. Frankly, it’s quite common to get results not just below optimal range, but below reference range.

Sometimes we can observe this in standard blood work, by looking at your CBC, your complete blood count. This is where we measure red blood cells and white blood cells. When we find that the red blood cell count is low, we understand that the individual is anemic. Most people just assume that that means they’re iron anemic, that low iron levels are resulting in low red blood cells. But the actual cause of the low red blood cell count could be an insufficiency of B vitamins.

So, we look at other markers on standard lab work, namely the MCV (mean corpuscular volume) and the MCH (mean corpuscular hemoglobin). This allows us to know whether it’s low iron or insufficient B vitamins that are contributing to anemia. If the MCV and MCH values are low, this indicates that it’s likely an iron deficiency type of anemia. But if those values are elevated out of range, this points to B vitamins.

I’m struck by how many times people have brought me their lab work from other providers and they’ve been told that everything looks fine. But I look at it and they’re anemic, and they’re anemic with one of these B vitamins. So we just put them on good, solid levels of B vitamins. Sometimes we give B vitamin injections, sometimes we do it with supplements. Or we simply adjust their diet to boost their intake of dietary B vitamins. So there’s a variety of things that we can easily do in this situation.


But what do B vitamins do in the system? They do many things. They’re important building blocks for your neurotransmitters. Neurotransmitters are biochemical messengers in the brain. They have names like serotonin, which I’m sure you’ve heard of, and GABA and dopamine. And their production depends on B vitamins such as B-6 ,B-12, and folate.

When these nutrients are insufficient, it will influence your body’s ability to synthesize neurotransmitters. In this way people can develop mood disorders just because of B vitamin deficiencies. They can have cognitive issues or memory issues. In more severe cases, they can have neurodegeneration, deterioration of the neurons, which can lead to chronic neurological conditions. And all they really needed was B vitamins. And yet these are insufficient in many people and very often overlooked in standard primary care medicine.

-Dr Chad Larson


B vitamins are also involved in liver detoxification. They’re relevant to the health of the cardiovascular system. They’re important for balancing homocysteine which is something we look at every time we run lab work for a patient. Homocysteine serves as a proxy for us to evaluate your methylation, which is an important enzymatic process in the body. You may recall that we’ve had video episodes on methylation. It’s a key process in the body, and it requires B-12 and folic acid and B-6, some very important vitamins for methylation to keep humming along. If your methylation activity drops, your homocysteine levels will go up. Therefore we can easily test for this with a basic blood test looking at homocysteine levels. This is just another way we sort of peer into your body’s needs and requirements of B vitamins.

This brings us back to the cardiovascular system. Homocysteine we know to be a kind of abrasive, inflammatory substance in the circulatory system. Elevated homocysteine levels can increase certain inflammatory processes in the bloodstream which could influence the health of your blood vessel walls. So keeping these levels normal is vital. And again, good old simple B vitamins are what help to determine this.

B vitamins are also very important for energy levels. Take the extreme example we talked about, somebody who is fully anemic. We know that when the red blood cells drop too low, the number one symptom that people experience is fatigue. Fatigue is caused by a low red blood cell count because red blood cells deliver oxygen all over the body. If oxygen isn’t able to reach the brain at maximum levels, that will influence energy production in the brain. So fatigue and energy issues are really common when B vitamin levels are off.

So these are some of the things that B vitamins do. They’re so important to general health. And that’s why we test it from multiple different angles to take out the guesswork. Then we can be much more of a sharpshooter with how we recommend certain clinical changes for people with B vitamin deficiencies and insufficiencies.

So where can we get B vitamins? You can get them from supplements, and as we’ve discussed many times before, the quality of the supplements really matters. We want high quality B vitamins, especially when it comes to folate or folic acid and vitamin B-12. We want these to be methylated because the methylated form is more usable by most people. So look for methyl B-12 and methyl folate. And there are other nutrients that also can be in these activated forms. We want activated B vitamins so the body doesn’t have to work too hard on processing these nutrients in your system.

In our office when a patient is deficient in B vitamins, we’ll sometimes use nutrient shots to bypass the GI tract completely and get right into the system. Sometimes we’ll use nutrient IVs to introduce them directly into the circulatory system. There’s a variety of ways to address this, but diet is a key strategy, too. We can get B vitamins from a healthy, anti-inflammatory diet. They’re found all over in things like leafy greens and other vegetables. We can get B vitamins even from animal proteins, and from nuts and seeds. So basically, just follow a good, healthy diet as we typically recommend. Organic and high quality food sources seem to be higher in micronutrients like B vitamins.

B vitamins are absolutely vital for general health, and it’s something I encourage you to get tested. Take some of the guesswork out. Look at things like your CBC. Have your provider look at specific B vitamin levels to understand where you’re starting from, and then make the proper changes so that you can maximize things like brain health, mood, and energy. It’s also great for something I didn’t really mention before: your hair, skin, and nails. There’s hardly an organ system that B vitamins don’t touch and influence in some way. So this has been the next in our series educating you on the importance of key micronutrients.

Let me give you another quick example. Let’s say someone is suffering from depression or anxiety. In many practices they’ll be prescribed an antidepressant medication. But you know what? Maybe it’s just that their neurotransmitters, such as serotonin, are insufficient simply because they need more of certain B vitamins. I’ve seen this clinically before and oftentimes we can just give B vitamins in these kinds of situations and the patient’s mood improves. So that’s just one example you can think about. If you suffer from anxiety or depression, or if you have some of these cardiovascular risks or energy issues, have a look at B vitamins first before your doctor prescribes a medication. Find a provider that can look at these levels in this way and take some of the guesswork out of it.

I’ll keep reading the studies and bringing you the information, Until then, keep it real.


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