B vitamins

Natalia Poleschuk • May 6, 2025

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B-vitamin lab tests (B1, B2, B3, B6, B12, Folate) — useful for clinical evaluations of fatigue, neuropathy, mood disorders, anemia, and metabolic dysfunction.

B1 (Thiamine- transketolase activity Energy metabolism (especially carbs), nerve functionFatigue, beriberi, Wernicke’s encephalopathy (confusion, ataxia, nystagmus), peripheral neuropathy RareAlcoholism, malabsorption, high carb intake, diuretics


B2 (Riboflavin-Erythrocyte glutathione reductase activity (EGRAC)FAD coenzyme for energy, redox balanceCracked lips, glossitis, sore throat, redness of eyesNone reportedPoor diet, malabsorption, alcohol


B3 (Niacin)Indirect (measured via N-methylnicotinamide or urinary metabolites)NAD/NADP production for energy, DNA repairPellagra: "4 D's" – dermatitis, diarrhea, dementia, death Flushing, liver damage with high dosesIsoniazid use, alcoholism, corn-heavy diet


B6 (Pyridoxine)Plasma PLP (pyridoxal 5'-phosphate)Amino acid metabolism, neurotransmitter synthesis, homocysteine regulationFatigue, neuropathy, glossitis, irritability, seizures Sensory neuropathy (esp. >100 mg/day long-term)Isoniazid, alcohol, oral contraceptives, malabsorption


B12 (Cobalamin)Serum B12, MMA, homocysteineRBC production, DNA synthesis, myelin maintenanceMacrocytic anemia, fatigue, memory issues, neuropathy Rare (may cause acne-like rash)Vegan diet, pernicious anemia, metformin, PPIs


Folate (B9)Serum folate, RBC folate, homocysteineDNA/RNA synthesis, methylation, fetal developmentMacrocytic anemia, fatigue, neural tube defectsMay mask B12 deficiency symptomsAlcohol, pregnancy, poor diet, malabsorption


โœ… Best Functional Markers:

  • B6 → Plasma
  • B12 → Methylmalonic Acid (MMA)
  • Folate → RBC
  • B1 → Transketolase activity or whole blood thiamine
  • Homocysteine → Elevated in B6, B12, or folate deficiency


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๐Ÿง  Brain Estrogen, Progesterone, Testosterone, Thyroid (T3), DHEA Affects: memory, focus, mood, cognition, neurotransmitter balance Low hormones → brain fog, anxiety, depression, poor concentration, dementia risk ๐Ÿ‘๏ธ Eyes / Vision Estrogen, Thyroid (T3), Testosterone Maintains: tear production, ocular surface, visual clarity Low estrogen/T3 → dry eyes, blurry vision, light sensitivity ๐Ÿ‘„ Mouth / Saliva Estrogen, Thyroid Supports: saliva production, oral mucosa, taste Low estrogen → dry mouth, metallic taste, dental issues ๐Ÿง˜‍โ™€๏ธ Balance / Equilibrium Estrogen, Progesterone, Thyroid Regulates: inner ear function, vestibular system Decline → dizziness, vertigo, motion sensitivity ๐Ÿฅด Esophageal Sphincter (GERD / Hiatal Hernia) Progesterone, Estrogen Maintains: muscle tone of lower esophageal sphincter Low levels → increased reflux, heartburn, bloating, hernia risk ๐ŸŽ€ Breasts Estrogen, Progesterone, Testosterone Affects: tissue tone, density, cancer risk Low estrogen → sagging, tissue thinning Hormone imbalance → fibrocystic changes, higher breast cancer risk if unbalanced ๐Ÿงฌ Liver Estrogen, Thyroid, DHEA, Insulin Supports: detoxification, lipid metabolism, bile production Decline → poor detox, fat buildup, sluggish bile flow โค๏ธ Heart Estrogen, Testosterone, Thyroid, DHEA Regulates: cholesterol, blood pressure, vascular tone Low estrogen → higher LDL, plaque buildup, arrhythmias ๐ŸŒฌ๏ธ Lungs Estrogen, Progesterone Regulates: respiratory rhythm, CO2 sensitivity Decline → shortness of breath, poor oxygenation during sleep ๐Ÿฌ Pancreas / Blood Sugar Estrogen, Progesterone, DHEA, Thyroid, Testosterone Affects: insulin sensitivity, glucose metabolism Decline → insulin resistance, weight gain, prediabetes/diabetes risk ๐Ÿฝ๏ธ Gallbladder Estrogen, Progesterone Affects: bile flow, motility Low progesterone → bile stasis → risk of gallstones ๐Ÿงป Gut / Digestive Tract Estrogen, Progesterone, Thyroid, Cortisol Supports: motility, microbiome, gut lining integrity Decline → bloating, constipation, SIBO, leaky gut ๐Ÿฅš Ovaries FSH, LH, Estrogen, Progesterone, Testosterone Hormone factory pre-menopause Menopause = ovarian hormone production ceases ๐Ÿฆ‹ Thyroid TSH, T3, T4, Estrogen Affects: metabolism, temperature, hair, energy Estrogen decline may unmask hypothyroidism Low T3 → fatigue, weight gain, dry skin ๐Ÿ’ Uterus Estrogen, Progesterone Maintains: endometrial lining, muscle tone Low estrogen/progesterone → uterine atrophy, irregular bleeding Unopposed estrogen → endometrial hyperplasia/cancer risk ๐Ÿ’ช Muscles Testosterone, Estrogen, Thyroid Supports: strength, lean mass, recovery Low T → sarcopenia, loss of tone Low T3 → muscle pain, weakness ๐Ÿฆด Joints / Bones Estrogen, DHEA, Testosterone, Vitamin D Maintains: bone density, joint lubrication Decline → arthritis, joint pain, osteoporosis ๐Ÿ’‡‍โ™€๏ธ Hair Estrogen, Testosterone, Thyroid, DHEA Affects: scalp health, thickness, growth rate Imbalance → thinning, shedding, brittle hair ๐Ÿ’… Nails Thyroid, Estrogen Reflect: nutrient absorption, metabolic health Low T3 → brittle, ridged nails ๐Ÿ‘๏ธ‍๐Ÿ—จ๏ธ Vision / Eye Health Estrogen, Thyroid Dry eye, glaucoma risk increase post-menopause ๐Ÿ’ง Kidneys / Bladder Estrogen, Progesterone, Testosterone Maintains: pelvic floor tone, bladder sensitivity Low estrogen → frequent UTIs, urgency, leakage ๐Ÿง  Mood / Mental Health Estrogen, Progesterone, Testosterone, Thyroid, DHEA Modulates: serotonin, dopamine, GABA Imbalance → anxiety, depression, irritability, mood swings