B Vitamin Deficiencies: Symptoms, Causes, and Solutions

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b vitamin deficienciesB Vitamin Deficiencies: Symptoms, Causes, and Solutions

If you are dealing with fatigue, concentration issues, depression, anxiety, memory problems, weakness, skin issues, or other chronic symptoms, it may be time to check for B vitamin deficiencies. B vitamins are a group of vitamins that are critical for your cellular health, brain health, hormonal health, metabolism, skin health, and other areas of your health. B vitamin deficiencies can result in an array of symptoms and serious health issues. Thankfully, it is easy to correct these deficiencies through a nutrient-dense diet and supplementation.

In this article, you will learn what B vitamins and B vitamin deficiencies are. I will go over the potential reasons for vitamin B deficiencies. You will learn the role of each B vitamin. I will discuss testing options for vitamin B deficiencies and share my recommendations for the best vitamin B supplements. 

B Vitamin Deficiencies

What Are B Vitamins

B vitamins are a group of vitamins that are essential for your body’s cells proper and healthy functioning. They allow your body to convert food into energy and support your metabolism. They also help to create new blood cells, support brain cells, support cellular health, and maintain healthy skin among other functions. 

B vitamins include thiamin (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pantothenic acid (vitamin B5), vitamin B6, biotin (vitamin B7), folate (vitamin B9), and vitamin B12. Together, these B vitamins are called the vitamin B complex. Each of them has their own role and function that I will go over later in this article. 

B Vitamin Deficiencies

When eating a nutrient-dense diet, meeting your vitamin B needs should be possible, however, many people still need supplementation to avoid vitamin B deficiencies. Vitamin B deficiencies are quite common and may develop due to a variety of reasons including a poor diet, poor nutrient absorption, gut infections, various health conditions, and medication use.

Symptoms of B vitamin deficiencies may include fatigue, weakness, confusion, memory problems, behavior changes, depression, mental health issues, pale skin, heart palpitations, shortness of breath, digestion troubles, and more (1, 2).

Reasons For B Vitamin Deficiencies

You may develop B vitamin deficiencies due to a number of reasons. Here are the top causes of B vitamin deficiencies and related symptoms.

Poor Diet 

Eating a poor diet can lead to a variety of vitamin and mineral deficiencies, chronic symptoms, and related health issues. If your diet is high in sugar, grains, refined and processed foods, and low in vegetables and meat, your risks of developing B vitamin deficiencies increase.

Meat, organ meats, fish, eggs, dark leafy greens, mushrooms, seeds, and beans are some of the best sources of natural B vitamins. Eating a diet low in these foods makes it impossible to meet your needs. 

Eating too much sugar, grains, processed foods, and other inflammatory foods increases inflammation, gut flora imbalance, and poor absorption, which can deplete your body of B vitamins and hinder your body’s ability to absorb the B vitamins that you are taking in.

Eating a nutrient-dense diet is not only important for taking in plenty of vitamin Bs, but also necessary for optimizing absorption. To learn about a nutrient-dense diet I recommend, read this article.

High Stress 

Chronic and high stress can deplete your body of many B vitamins. Stress can be physical, mental, and emotional. Job stressors, family and relationship problems, a lack of social support, injury or illness, listening to the news, financial problems, depression, anxiety, a negative mindset, low self-esteem, moving, personal changes, and driving in traffic are all examples of common stressors people experience.

These issues become a problem when we are responding to them with fear, anger, sadness, or negativity. When high stress becomes chronic, it increases inflammation, pain, and health issues, and contributes to poor digestion, poor absorption, and the depletion of vitamins and minerals, including B vitamins. 

Poor Stomach Acid Levels 

Your body requires an acidic stomach to effectively absorb vitamin B12. Poor stomach acid levels can lower vitamin B12 absorption.

Atrophic gastritis is a common condition that can affect older adults and decreases stomach acid levels contributing to vitamin B12 malabsorption and deficiency. Taking medications for acid reflux and heartburn long-term can also reduce your body’s ability to absorb vitamin B12 (3, 4)

stomach acid

Gut Infections 

Gut infections and poor gut flora balance can lead to vitamin B12 and other vitamin B deficiencies. Small intestinal bacterial overgrowth (SIBO) is one of the major causes of acid reflux, heartburn, bloating, gas, constipation, nausea, and diarrhea. It can also lead to B12 deficiency as all the extra bacteria overgrown in your small intestine intercepts with the absorption of B12.

Inflammation in your gut, including inflammatory bowel diseases, such as Crohn’s disease and colitis, gut infections, and gut problems cause by NSAIDs medication and antibiotics can also lead to an imbalance and interfere with vitamin B12 and another vitamin B absorption accompanies by digestion issues. Tapeworms and fungi in your gut can also steal B vitamins from your body leading to deficiencies. 

To reduce the risk of vitamin B deficiencies, you need to address your gut infections and you need to introduce healthy microbes, such as that are necessary for the production of certain B vitamins. Research has, for example, shown that Lactobacillus acidophilus and pathogens such as Mycobacterium tuberculosis and Salmonella typhimurium are important for vitamin B2 and P. denitrificans and P. shermanii are important for B12 production (5, 6, 7).

Medication Usage

There are a variety of medications that may deplete B vitamin levels. Some of these medications include heartburn and acid reflux medications, including H2 receptor blockers and proton pump inhibitors, metformin for diabetes chloramphenicol antibiotics, colchicine for gout, ethanol, and levodopa and carbidopa for Parkinson’s disease.

If you are taking medications and dealing with vitamin B or other nutrient deficiencies, it is important that you speak with your doctor about alternative medications and treatment options, lifestyle changes as part of your treatment, and vitamin B supplementation (8, 9, 10).

B12 deficiency, Warning Signs of a B12 Deficiency


Your genetics play an important role in your health and may interfere with your vitamin B levels and absorption. The methylenetetrahydrofolate reductase (MTHFR) gene is necessary to make the MTHFR enzyme.

The MTHFR is essential for a variety of biochemical reactions in your body, including methylation, which is the process of conversion folate (vitamin B9) into methyl-folate. Methylation is critical for metabolizing B vitamins DNA cell function, detoxification, hormonal health, repairing damaged cells, sleep, mental health, and behavioral health. 

Genetic mutations and variations are common and MTHFR gene mutations are affecting about half of the population. The problem is that MTHFR gene mutations can lead to methylation issues increasing your risk of fatigue, sleep issues, depression and anxiety, hormonal issues, allergies, food and chemical sensitivities, histamine intolerance, and other health issues. MTHFR mutations and consequent methylation problems interfere with your body’s ability to methylate and convert B vitamins. 

To support your body if you have MTHFR gene mutations and methylation issues, it is important that you only take pre-methylated vitamin B supplements and take natural sources of B vitamins through a nutrient-dense diet rich in meat and vegetables. To learn more about MTHFR genes and enzymes, I recommend reading this article (11, 12, 13, 14)


Role of Each B Vitamin 

Each B vitamin has its own role in your body and health. Let’s look at them one by one:

Vitamin B1: Thiamine

Vitamin B1 is also known as thiamine. It supports your adrenal function and helps to maintain a healthy nervous system. It plays a critical role in the metabolism of carbohydrates into energy and nerve transmission.

According to one study, supplementing with benfotiamine (S-benzoylthiamine O-monophosphate), which is the most bioactive form of supplemental thiamine, raises blood and tissue levels of thiamine at least five times than water-soluble salt and remained bioavailable 3.6 times longer than thiamine salt (15)

A true B1 deficiency is called Beriberi and it is usually caused by poor diet or alcoholism.  Symptoms include loss of appetite, weakness, pain in the limbs, shortness of breath, and swollen feet or legs.  While Beriberi is quite rare in 1st world countries, you can have subclinical deficiencies that aren’t as severe and go undetected and cause chronic health problems.

Best food sources of thiamine include  Fish, chicken, grass-fed meats, sunflower seeds, black seeds, black beans, dark green vegetable, and pasture-raised eggs.

b vitamin deficiencies

Vitamin B2: Riboflavin

Vitamin B2 is also called riboflavin. Riboflavin is critical for your metabolic functions. It is essential for recycling glutathione, a powerful antioxidant in your body. The best form of riboflavin is riboflavin 5’-phosphate sodium (R5P) because it is activated to perform at the highest utilization rate in your body.

Symptoms of vitamin B2 (riboflavin) deficiency include sore throat, redness and swelling of the lining of the mouth and throat, cracks or sores on the outsides of the lips and at the corners of the mouth, inflammation and redness of the tongue, and a moist, scaly skin inflammation.

Best food sources of riboflavin include grass-fed raw cheese, almonds, grass-fed beef and lamb, salmon and other wild-caught oily fish, dark green vegetable, and pasture-raised eggs.

b vitamin deficiencies

Vitamin B3: Niacin

Vitamin B3 is also known as niacin. It is essential for energy production in your body. There are two forms of niacin: nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP). Both are necessary for the conversion of dietary fats, proteins, and carbohydrates for energy. Niacin is also necessary for synthesizing starches to be stored in your liver and muscles for energy.

When you are severely deficient in niacin, you develop a condition called Pellagra, which is characterized by inflamed skin, diarrhea, dementia and sores in the mouth.  The areas of the skin that are exposed to friction or sun exposure are typically impacted first.

Best food sources of niacin include: tuna, wild-caught salmon, pasture-raised chicken and turkey, liver, and grass-fed beef

B Vitamin Deficiencies

Vitamin B5: Pantothenic Acid

Vitamin B5 is also known as pantothenic acid. It supports your body through the incorporation into a molecule coenzyme A (CoA) which is essential for energy metabolism and helping fats, protein, and carbohydrates being used as fuel sources.

Research has shown that vitamin B5 is critical for skin health, including reducing skin spots, redness, and other signs of aging. It is also essential for the production of sex- and stress-related hormones. 

Vitamin B5 deficiency is rare, but may include symptoms such as fatigue, insomnia, depression, irritability, vomiting, stomach pains, burning feet, and upper respiratory infections.  While a deficiency is rare, many people have sub-clinical symptoms which lead to lower stress resilience and daytime fatigue and mental lethargy. 

Best food sources of vitamin B5 include eggs, avocados, mushrooms, oily wild-caught fish, such as trout and salmon, cabbage and grass-fed raw cheese.

b vitamin deficiencies

Vitamin B6:  Pyridoxine

Vitamin B6 helps to balance sodium and potassium levels. It also allows for healthy red blood cell production. It helps to balance hormonal changes in women and plays a critical role in your immune system function.  The best form of supplemental vitamin B6 is pyridoxal 5’phosphate (P5P) (16)

It is also required for your nervous system and mental health. Deficiencies may lead to anemia, nerve pain, skin problems, sores in the mouth, tongue soreness, fatigue, anxiety, depression, cardiovascular issues and brain degeneration.

Best food sources of vitamin B6 include tuna, wild-caught salmon, pasture-raised chicken, beef liver, and chickpeas.

Vitamin B7: Biotin

Vitamin B7 is also known as biotin or vitamin H for its role in hair health. Vitamin B7 cannot be synthesized by human cells, but it is produced by bacteria in the body, and it is present in numerous foods.

Biotin is critical for adrenal function, a healthy nervous system, and proper metabolic processes. It is important for healthy hair, skin, and nails, and is often called the ‘beauty vitamin’ because of that. It helps to control high blood sugar and helps the growing baby during pregnancy.

Signs of overt biotin deficiency include hair loss and a characteristic scaly red rash in the face (around the eyes, nose, mouth), and in the genital area. Neurologic symptoms in adults have included depression, lethargy, hallucination, numbness and tingling of the extremities, and ataxia

Best food sources of biotin include wild-caught fish, organ meats, nuts and seeds, and pasture-raised eggs.

b vitamin deficiencies

Vitamin B9: Folate

Vitamin B9 is also called folate. Its bioactive forms include folinic acid, calcium folinate, and methyl-folate. Never buy folic acid as a source of vitamin B9, as synthetic folic acid is not natural, can be toxic, and is not effective for those with MTHFR gene mutations.

Folate deficiency is one of the most common vitamin deficiencies due to intestinal disorders, food choices, food processing, and MTHFR mutations.  I discuss more about the importance of folate in this article.

Best food sources of folate include: asparagus, sprouting broccoli, spinach, avocados, pasture-raised eggs, and liver

folate, The 14 Best Folate Rich Foods

Vitamin B12

Vitamin B12 is critical for healthy nerve function, cardiovascular function, sleep, and blood cell formation. When supplementing with vitamin B12, always use methylcobalamin, not cyanocobalamin, as methyl-cobalamin is the most bio-active form of supplemental vitamin B12.

Best food sources of vitamin B12 include wild-caught fish, grass-fed beef, pasture-raised poultry, and pasture-raised eggs. Plant foods do not contain vitamin B12. As you know, I do not recommend a vegan or vegetarian diet. That said if you are or you have been vegan or vegetarian, supplementing with vitamin B12 is an absolute must.

However, vitamin B12 deficiencies are common among those who eat a diet rich in animal foods as well, making vitamin B12 supplementation important for many people.  This is due to issues with low stomach acid that causes poor B12 absorption and/or taking medications that deplete B12 levels.  

Testing For B Vitamin Levels

Looking at your symptoms, diet, and lifestyle may be a good indication for vitamin B deficiencies as a starting point. However, testing is always the best way to go to spot vitamin B deficiencies and other potential health issues. Here are the tests I recommend for B vitamin levels.

Blood Work 

A Comprehensive Blood Analysis is a fantastic test that can spot all sorts of problems in your body. For B vitamin levels, I specifically use this test to look at your homocysteine, serum folate, and serum B12 levels. This is a simple blood test that offers a comprehensive look at your health at an affordable price.

, Comprehensive Blood Analysis

Organic Acid Test

Another blood test I recommend is a Comprehensive Organic Acid Test. This test can help to determine the reasons behind your fatigue, sleep issues, mood changes, depression, anxiety, digestion problems, joint pain, skin issues, and other symptoms.

This is a simple urine test that can tell us a lot about your health and possibly point us to vitamin B deficiencies as well as your mitochondrial health, gut health, glutathione levels and neurotransmitter levels.  

organic acids, Organic Acids Test: Analyzing this Functional Health Test

Micronutrient Test

Lastly, I also recommend Micronutrient Testing. This test provides us with a comprehensive nutritional analysis. While it can certainly spot any B vitamin deficiencies by testing for each vitamin B level, it also looks at other vitamin and mineral levels, amino/fatty acids, antioxidants, and metabolites to spot nutritional reasons behind your health issues.

It can point you in the right direction to make necessary dietary changes and what kind of supplementation to use to improve your health. 

Spectracell Micronutrient, Spectracell Micronutrient Testing

Best Supplemental B Vitamins

Taking B vitamin supplements is not enough. You have to make sure that your body can absorb and use them. Taking high-quality pre-activated forms of B vitamins is important to ensure that it integrates immediately and effectively in your body.

B vitamins are important for your body’s healthy methylation cycle, which helps your body to function both physically and mentally and ensure healthy cardiovascular, nervous system, immune system, and hormone function, ad detoxification. Taking methylated forms of B vitamins is particularly important if you have MTHFR mutation, however, it is a beneficial and important choice for al (17, 18)

Here are the best B vitamin complex supplements I recommend with pre-activated methylated forms of B vitamins: 

B Strong

One of the best supplemental B vitamin complexes I recommend is B Strong. This supplements a necessary dose of each B vitamin using the most bioavailable forms to ensure maximum supports for everyone. It also includes added choline for nerve and neurological function, nerve signaling, cell membrane maintenance, and metabolic health.

B Strong helps to support carbohydrate metabolism, blood sugar levels, cardiovascular health, immune health, adrenal function, mood and mental health, nervous system function, and overall well-being. Take one capsule a day for optimal results.

B Vitamin Deficiencies

Liposomal Active B Complex 

Micelle Liposomal Active B Complex is another vitamin B complex supplement I recommend. Along with all the necessary B vitamins, this supplement also offers an essential mineral and electrolyte blend to support your body.

This liposomal delivery encapsulates the active ingredient into tiny, nano-sized micelles which are further enveloped into liposomes. These healthy fat cells shield the tiny micelles from the hostile environment in the human gut. The micelles are gradually released and the B vitamins are deposited near the gut lining where it can be fully absorbed and offer maximum support.

This supplement is designed to support your sleep, energy levels, mood, and stress response. It is perfect if you are dealing with stress, low energy, or mental health issues. I recommend that you take 1 tablespoon a day. For advanced use and maximum support, you may take up to 3 tablespoons a day.

B Vitamin Deficiencies

Final Thoughts

B vitamins are important for your cellular health, brain health, hormonal health, metabolism, skin health, and other areas of your health. B vitamin deficiencies can result in an array of symptoms and health issues, including fatigue, concentration troubles, depression, anxiety, memory problems, weakness, skin issues.

You can correct these deficiencies through a nutrient-dense diet and supplementation. Try my recommendations for B vitamin supplementation to support your health and well-being. 

If you want to work with a functional health coach, I recommend this article with tips on how to find a great coach.  On our website, we offer long-distance functional health coaching programs. For further support with your health goals, just reach out and our fantastic coaches are here to support your journey.

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Sources in This Article:

1. Vitamin B12: What to know. WebMD. Link Here
2. Symptoms of vitamin B deficiency. Healthline. LInk Here
3. Vitamin B12. NIH. Link Here
4. Vitamin B12. Harvard TC Chang. Link Here
5. 4 overlooked causes of vitamin B12 deficiencies. US News. Link Here
6. Yoshii K. Vitamin B Family in the Regulation of Host Immunity. Front. Nutr., 17 April 2019. Link Here
7. Fang H, Kang J, Zhang D. Microbial production of vitamin B12: a review and future perspectives. Microb Cell Fact. 2017 Jan 30;16(1):15. PMID: 28137297
8. Heartburn medicines and B12 deficiencies.. WebMD. Link Here
9. Medication known to reduce vitamin B levels. Link Here
10. Are your medications using nutrient deficiencies. Harvard Health. Link Here
11. Reilly, R., McNulty, H, Pentieva, K, Strain, J. J., Ward, M. (2014). MTHFR 677TT genotype and disease risk: is there a modulating role for B-vitamins? The Proceedings of The Nutrition Society. 73(1):47-56. Link Here
12. Dean L. Methylenetetrahydrofolate Reductase Deficiency. 2012 Mar 8 [Updated 2016 Oct 27]. In: Pratt VM, McLeod HL, Rubinstein WS, et al., editors. Medical Genetics Summaries [Internet]. Bethesda (MD): National Center for Biotechnology Information (US); 2012. Link Here
13. Liew SC, Gupta ED. Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism: epidemiology, metabolism and the associated diseases. Eur J Med Genet. 2015;58(1):1-10. Link Here
14. Lynch B. MTHFR Mutations and Associated Conditions. Link Here
15. Loew D. Pharmacokinetics of thiamine derivatives especially of benfotiamine. Int J Clin Pharmacol Ther. 1996 Feb;34(2): 47-50. PMID: 8929745
16. Labadarios D, Rossouw JE, McConnell JB, et al. Vitamin B6 deficiency in chronic liver disease – evidence for increased degradation of pyridoxal-5-phosphate. Gut. 1977;18:23-27. PMID: 838399
17. Johnson AA, Akman K, Calimport SRG, et al. The role of DNA methylation in ageing, rejuvenation and age-related disease. Rejuvenation Res 2012;15(5):483-494. Link Here
18. Crider KS, Yang TP, Berry RJ, et al. Folate and DNA methylation: a review of molecular mechanisms and the evidence for folate’s role. Adv. Nutr 2012;3:21-38. Link Here

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  1. Just an FYI, but when I click on a link above about the Complete Blood Analysis that page will not let me return to this one, so I have to start again, finding the Vit B article. Just something funky in the hyperlinks.

    1. The issue is actually when I click to download the sample test results. It downloads the sample twice and deletes this main article page. Since I’m seriously considering ordering all three tests as a present to myself I’d be happy to get a discount for debugging the webpage!

      1. It’s hard for me bc in beginning I had too much dopamine. With mental meds I have other issues. It’s crazy.

  2. Thanks Dr. Jockers. Excellent information with such generosity. Is bistro good available in Canada. I find it so difficult to take all the b vitamins individually. Thank you.

  3. Thank you so much, Dr. Jockers! So much precious information all in one article. I can’t imagine having to carry it all together all by myself.

  4. Hey Dr. Jockers, love your website and appreciate your commitment to helping individuals live a healthy life and become their best person! My question is about tablets/capsules vs. powder vs. liquid vitamins (sublingual). I have been told that I might not be digesting my tablet/capsule vitamins and may be better suited for liquid vitamins. What are your thoughts on the delivery systems for best absorption?

  5. Hi, thanks for another great article. I recently had a lot of blood work done, but it unfortunately lacked a lot of nutrients I’m interested in. I see you list the Comprehensive Blood Panel, Organic Acid Test, and Micronutrient Panel. Below that is a graphic titled Comprehensive Nutritional Panel, but no description of this. Is the “Comprehensive Nutritional Panel” what you get when you do all three (Blood, Acid and Micronutrient)? Or is it a separate test? I’m interested in all the Bs, A, K, zinc/copper/mag, along with most other useful info from the above tests.


  6. Great article! What are your recommendations for b vitamin complex for those of us with Alpha Galactose? I can’t ingest anything mammal. And not knowing how to get proper nutrition is taking it’s toll on my body. Chicken and turkey are mixed with fat from mammals and my food sources are limited. Anaphylaxis from a daily vitamin and toothpaste is no joke, not something I ever want to experience again! Are there recommendations for Vegan Vitamins?

  7. I have not been able to get anyone to answer questions for me. I have serious issues with my B vit deficiency and I have diarrhea again because my mag capsules are not digesting to help my body. I’ll be 75 on Oct 5th this week and desperately need some help. PLEASE!!!

  8. Is it possible for B12 shots to cause anxiety?
    Lyme and Babesia present, acute severe anxiety at the moment, which I have never had. Was wondering if my shots could be causing?

  9. What can you do for B12 if you have pernicious anemia -is there a way of reversing this so I can absorb B12 again without injections

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