B vitamins are, without question, essential for life and health. Deficiencies of various B vitamins can lead to life-threatening health complications such as:
- B1 (thiamine)—Various forms of severe neurological impairment including Wernicke’s encephalopathy, ataxia, and beriberi, situations most commonly occurring in alcoholics
- B2 (riboflavin)—Skin and mouth lesions
- B3 (niacin)—Scaly skin rash, red tongue, depression, gastrointestinal distress and diarrhea
- B5 (pantothenic acid)—Neurological impairment, gastrointestinal distress, fatigue, depression
- B6 (pyroxidine)—Anemia, skin rash, depression, confusion
- B7 (biotin)—Birth defects, hair loss, scaly skin rash
- B9 (folate)—Birth defects (e.g., spina bifida), anemia, neurological impairment
- B12 (cobalamin)—Anemia, neurological impairment, gastrointestinal distress, painful tongue and mouth
Inadequate intake of B9 or folate is especially common with profound consequences, for instance, for a pregnant mother who can deliver a child with life-threatening deformities. (For this reason, legislation mandating supplementation of folic acid in grain products such as breads and breakfast cereals was passed many years ago.) Inadequate intake of B12 or cobalamin develops in people who avoid animal products (vegans and vegetarians) or in people who are unable to absorb B12 (e.g., autoimmune gastritis from wheat/grain consumption, hypochlorhydria and atrophic gastritis from H. pylori, Crohn’s disease, celiac disease, or small intestinal bacterial overgrowth, SIBO due to failed absorption in the ileum).
Adequate intake and absorption of B vitamins is obviously not optional but a basic requirement for health. This recognition has spawned a substantial franchise in selling B vitamins as single agents, B-complex, food fortification, B12 injections, etc.
However, let’s consider this question: What B vitamins are produced by gastrointestinal (GI) microbes? B1, B2, B3, B5, B6, B7, B9, and B12—all eight B vitamins are known products of bacterial metabolism, mostly in the colon. Numerous species of Lactobacillus, Bifidobacteria, Clostridia, Ruminococcus, and Prevotella, for instance, produce B1, B9, and B12.
Are the apparent benefits of folate supplementation in pregnant females, B7 in people with thinning hair, or B3 in depression really concealing the disruption of GI microbiome composition with excessive proliferation of unhealthy non-B vitamin-producing species and a relative lack of B-vitamin-producing species? The details have not been fully sorted out. But it suggests that the real solution to lack of various B vitamins should not involve, say, fortification or supplementation, but addressing bowel flora composition to tilt the scales in favor of beneficial B-vitamin-producing microbes and away from pathogenic fecal species that have become dominant in many modern people. It does not mean supplementation with probiotics for each B-vitamin-producing species. It means:
- Eradication of SIBO—which we now accomplish with my recipe for SIBO Yogurt. (See my Super Gut book for full rationale.)
- Restoration of multiple beneficial species—With frequent consumption of fermented foods like kimchi, kefirs, yogurts, sauerkraut, kombucha, etc. If we believe the findings of Drs. Justin and Erica Sonnenburg that species diversity is greatest with consumption of fermented foods, even though the fermenting species such as Leuconostoc mesenteroides and Pediococcus pentosaceus provided by such foods are not themselves the colonizing species.
- Prebiotic fibers and related compounds—Or better, what the Sonnenburgs have labeled “microbiota-accessible carbohydrates,” or MACs. More inulin and fructooligosaccharides, for example, cause a blood in beneficial species such as Akkermansia muciniphila and Faecalibacterium prausnitzii, major producers of butyrate that yields many intestinal and extra-intestinal benefits.
My prediction: As we get better and better at rebuilding a damaged GI microbiome, B vitamin supplementation will become a relic of the past (unless, of course, you have done irreparable damage such as loss of stomach acid-producing parietal cells in the stomach due to wheat/grain consumption).