The B vitamins are a group of essential nutrients that support many functions in the body, from releasing energy from food to maintaining healthy skin, nerves, and blood cells. Because they are water soluble, they are not stored in large amounts in the body, which means we need to consume them regularly through our diet. When intake is too low or the body struggles to absorb them properly, deficiencies can occur, leading to symptoms such as fatigue, weakness, skin problems, or in more severe cases, anaemia and nerve issues.

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The Role of B Vitamins in the Body

The B vitamin family includes eight nutrients: B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), B7 (biotin), B9 (folate), and B12 (cobalamin). Each has a unique role, but together they work to convert food into usable energy, support the nervous system, help form red blood cells, and maintain healthy skin and hair. Because they are found in a wide range of foods, most people with a balanced diet get enough. However, deficiencies can still develop for various reasons.

Dietary Shortfalls

One of the most common causes of vitamin B deficiency is an inadequate diet. Since B vitamins are found in wholegrains, meat, fish, eggs, dairy, leafy vegetables, beans, and fortified cereals, diets that lack variety can lead to shortfalls. Strict vegan or vegetarian diets without fortified foods or supplements are particularly at risk of vitamin B12 deficiency, as B12 is mainly found in animal-based foods. Similarly, diets high in processed foods but low in wholegrains and vegetables may lack other key B vitamins such as folate and thiamine.

Poor Absorption and Medical Conditions

Even if someone eats a diet rich in B vitamins, certain medical conditions can prevent proper absorption. For example, coeliac disease, Crohn’s disease, and chronic gastritis can interfere with how nutrients are absorbed in the digestive tract. Pernicious anaemia, an autoimmune condition, prevents the body from absorbing vitamin B12 because it affects the production of intrinsic factor, a protein needed for absorption. As people age, their ability to absorb B12 also naturally decreases, making deficiency more likely in older adults.

Alcohol and Lifestyle Factors

Excessive alcohol intake can deplete levels of many B vitamins, particularly thiamine, folate, and B6. Alcohol affects absorption and also increases the body’s demand for certain nutrients. Smoking can also have an impact on vitamin levels, as can long-term use of certain medications such as proton pump inhibitors, which reduce stomach acid needed for B12 absorption, and anticonvulsants, which can affect folate levels. Stressful lifestyles and poor dietary habits combined can further increase the risk of falling short on essential B vitamins.

Pregnancy and Increased Demands

During pregnancy, the body has a higher demand for certain B vitamins, especially folate. Folate is crucial for the development of the baby’s neural tube, which forms the brain and spinal cord. Without enough folate, there is a greater risk of neural tube defects, which is why women are advised to take folic acid supplements before and during pregnancy. Similarly, women who are breastfeeding may need more B vitamins to support both their own health and the baby’s development.

Medications That Interfere with B Vitamins

A range of common medicines can interfere with vitamin B status. For instance, long-term use of metformin, often prescribed for type 2 diabetes, is known to reduce B12 absorption. Some antibiotics and chemotherapy drugs can also affect folate levels, while diuretics can reduce thiamine levels. Anyone on long-term medication should speak to their GP about whether they need to monitor their vitamin status more closely.

Recognising and Managing Deficiency

Symptoms of B vitamin deficiencies can vary depending on which vitamin is lacking, but common signs include tiredness, weakness, irritability, pale skin, numbness or tingling in the hands and feet, and mouth ulcers. Severe deficiencies, especially of B12 and folate, can cause anaemia, nerve problems, and in rare cases, lasting damage if untreated. Diagnosis is usually confirmed with blood tests, and treatment may include dietary changes, oral supplements, or injections in the case of severe B12 deficiency.

Conclusion

Vitamin B deficiencies can be caused by poor diet, medical conditions that affect absorption, lifestyle factors such as alcohol use, pregnancy, and certain medications. Because these nutrients are essential for energy, nerve function, and blood health, maintaining adequate levels is important for overall wellbeing. Eating a varied diet and being mindful of higher risk situations can help reduce the chances of deficiency, and in some cases, a multivitamin can provide reliable support.

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