AND IN THIS SECTION I'M GOING TO BE

COVERING ALL OF THE B VITAMINS.

SO THIS SECTION IS GOING TO BE A LITTLE BIT LONGER,

AND REMEMBER THESE ARE WATER SOLUBLE VITAMINS.

WE JUST COVERED VITAMIN C

WHICH IS ALSO A WATER SOLUBLE VITAMIN.

"A," D, E AND K ARE OUR FAT SOLUBLE VITAMINS.

THE REASON I'M GOING TO TALK ABOUT ALL THE B VITAMINS

TOGETHER IS THEY WORK TOGETHER AND THEY'RE IN GENERAL PART

OF COENZYMES AND INVOLVED IN ENERGY METABOLISM

AND THAT'S WHY WE THINK OF,

OF COURSE WHEN YOU GO IN YOU SEE SUPPLEMENTATIONS OR SUPPLEMENTS,

YOU SEE A COMPLEX B OR B VITAMIN COMPLEX

BECAUSE THE B VITAMINS REALLY DO WORK TOGETHER.

THAT'S HOW I'D LIKE YOU TO THINK THEM.

THERE ARE A COUPLE B VITAMINS THAT I'M GOING TO

HIGHLIGHT AND POINT OUT FOR YOU IN PARTICULAR,

BECAUSE SOME ARE INVOLVED IN NEW CELL SYNTHESIS,

WHICH IS KIND OF AN IMPORTANT SEPARATE

ACTION OF THESE B VITAMINS.

WHEN I SAID THAT THEY ARE PART OF COENZYMES,

YOU MIGHT BE THINKING WELL, WHAT ARE THE COENZYMES?

LET'S START WITH AN ENZYME.

AN ENZYME IS ESSENTIALLY IT'S A PROTEIN,

BUT IT'S GOING TO HELP SPEED A REACTION,

WE THINK OF IT AS A CATALYST.

AND IF WE TOOK THESE TWO COMPOUNDS HERE,

AND THEY'RE SEPARATE, INDIVIDUAL COMPOUNDS,

BUT THE ENZYME IS GOING TO CONVERT

THEM INTO A SINGLE COMPOUND.

AND THIS COMPOUND MIGHT HAVE A

UNIQUE FUNCTION THAT'S NECESSARY.

THE ENZYME CAN'T DO THIS WITHOUT THE COENZYME.

AND THESE B VITAMINS ARE PART, ARE NECESSARY FOR THESE

COENZYMES TO WORK OR THEY WILL FUNCTION AS THE COENZYME.

AND IN GENERAL THAT'S HOW I WANT

YOU TO THINK ABOUT THESE B VITAMINS.

IT'S WORKING TOGETHER AS BEING COENZYMES

AND INVOLVED IN ENERGY METABOLISM.

NOW WHAT'S ENERGY METABOLISM?

YOU'RE THINKING WELL WHAT DOES THAT MEAN?

WE TAKE IN FOOD AND BREAK IT DOWN AND ABSORB IT,

AND THEN WE TAKE THOSE NUTRIENTS,

THE MACRO NUTRIENTS ONE OF OUR

THREE NUTRIENTS WE GET AS ENERGY.

THAT PROTEIN AND CARBOHYDRATE,

THOSE ARE BROKEN DOWN TO RELEASE ENERGY,

TO GIVE OUR BODY ENERGY,

TO MOVE YOUR HAND, MOVE YOUR MOUTH,

BLINK YOUR EYES, HAVE YOUR HEART BEAT.

THERE ARE OBVIOUSLY,

NUMEROUS FUNCTIONS IN OUR BODY THAT NEED CONTINUOUS ENERGY,

AND THAT'S WHERE OUR MACRO NUTRIENTS COME INTO PLAY.

THE MICRO NUTRIENTS THE B VITAMINS,

THEY DON'T ACTUALLY GIVE US ENERGY.

AND YOU'LL BE ASKED THAT ON YOUR EXAM,

DO B VITAMINS GIVE YOU ENERGY?

THEY DON'T, WE DON'T BREAK THEM DOWN TO RELEASE ENERGY.

BUT THEY'RE INVOLVED IN THAT PROCESS OF

BREAKING DOWN THOSE CARBOHYDRATES TO RELEASE

ENERGY OR THE FATTY ACIDS TO RELEASE ENERGY.

THE B VITAMINS ARE INVOLVED IN THAT PROCESS AND

NECESSARY FOR IT BECAUSE THEY ACT AS THE COENZYMES.

SO WE'RE GOING TO START WITH VITAMIN B1 WHICH IS THIAMIN.

NOW WHY IS IT B1, BECAUSE IT WAS DISCOVERED FIRST.

AND WE'LL GO THROUGH AND SEE ALL THE DIFFERENT TYPES OF VITAMIN,

B VITAMINS, AND IT WAS IN THE ORDER THAT THEY WERE DISCOVERED.

SO THIAMINE FUNCTIONS IN ENERGY METABOLISM IN THAT

ASSISTS IN METABOLISM OF CARBOHYDRATES,

AMINO ACIDS WHICH ARE THE BUILDING

BLOCKS FOR PROTEINS AND FATTY ACIDS.

NOW WHAT IF YOU DON'T GET ENOUGH THIAMIN?

WELL, THAT CAUSES A CONDITION CALLED BERIBERI,

AND THERE ARE ACTUALLY NUMEROUS

CASES OF BERIBERI BUT IN GENERAL,

CONFINEMENT IS SO IMPORTANT FOR BOTH THE NERVES AND

THE BRAIN BECAUSE THEY REQUIRE A LOT OF ENERGY.

YOUR, THESE SYMPTOMS THAT ARE SEEN

INVOLVE BOTH THE NERVES AND THE BRAIN.

SO LOSS OF SENSATION IN THE HANDS AND THE FEET,

OR WEAKNESS, EVEN ADVANCING PARALYSIS.

AND AS YOU CAN SEE HERE,

THIS GENTLEMAN IS REQUIRING CRUTCHES TO GET BY,

AND IS UNABLE TO LIFT HIS FEET UP WE DON'T SEE THIS

MUCH IN THE UNITED STATES, BECAUSE OF THIAMINE.

IT'S WIDESPREAD IN FOOD AND SO IT'S REALLY EASY

TO OBTAIN ENOUGH TO PREVENT DEFICIENCY.

SO LENTILS, BROWN RICE, WHEAT GERM, SPINACH,

AND THEN SOME OF THE MEAT SOURCES,

ANIMAL SOURCES ARE PORK.

IT IS FORTIFIED IN A LOT OF FOODS WHICH

IS ANOTHER REASON WE DON'T SEE DEFICIENCY.

BUT AGAIN ANY FOOD THAT'S GOING TO BE FORTIFIED

IS A PROCESSED GRAIN, AND I'M NOT RECOMMENDING

THAT YOU INCREASE YOUR INTAKE OF PROCESSED GRAINS.

I'D LIKE YOU TO STICK WITH WHOLE FOOD SOURCES OF,

FOR ALL YOUR NUTRIENTS.

VITAMIN B2, THIS IS RIBOFLAVIN.

RIBOFLAVIN ALSO INVOLVED AN ENERGY

METABOLISM DEFICIENCY WILL, IT'S VERY GENERALIZED JUST

BECAUSE IT'S INVOLVED IN THE ENERGY METABOLISM FOR ALL CELLS.

SO YOU SEE THE MOUTH CRACKS AND RASHES,

A RED TONGUE CALLED A MAGENTA TONGUE.

AGAIN WE DON'T SEE THIS THAT OFTEN.

RIBOFLAVIN NATURALLY OCCURS IN MILK, YOGURT,

AND THEN WE ALSO FIND IT IN GRAINS, SO IT'S IN,

WE DON'T SEE A LOT OF RIBOFLAVIN DEFICIENCY.

I DO WANT TO SPECIFICALLY POINT OUT ABOUT

RIBOFLAVIN THAT IT IS DESTROYED BY UV LIGHT.

AND BECAUSE ONE OF THE MAIN SOURCES THAT WE OBTAIN OUR

RIBOFLAVIN IS FROM MILK, WE DON'T WANT,

IF THAT'S EXPOSED TO LIGHT, IT'S GOING TO BE DESTROYED.

BUT HAVE YOU EVER NOTICED THAT ALL OF THE MILK COMES

IN THESE OPAQUE CARTONS OR THESE CARDBOARD CARTONS?

WELL, THIS IS SO THE UV LIGHT WON'T DESTROY RIBOFLAVIN.

LIKE WE'RE SEEING KIND OF A

RESURGENCE OF THIS GLASS CONTAINER.

BUT IT USUALLY HAS TO BE A UV PROTECTED GLASS IN

ORDER FOR THEM TO SELL IT, SO AS NOT TO DESTROY RIBOFLAVIN.

VITAMIN B3 IS NIACIN.

NIACIN ALSO INVOLVED IN ENERGY METABOLISM

AND DEFICIENCY RESULTS IN WHAT'S CALLED PELLAGRA.

WE CALL IT THE FOUR DS BECAUSE NIACIN DEFICIENCY

WILL EFFECT SKIN STRUCTURES AND THE DIGESTIVE TRACT.

SO THERE'S DIARRHEA,

DERMATITIS WHICH IS YOU CAN SEE HERE,

THIS SKIN CONDITION, DERMATITIS,

DEMENTIA AND EVEN DEATH WHICH CAN

BE ASSOCIATED WITH NIACIN DEFICIENCY.

I DO WANT TO POINT OUT THAT NIACIN IS ALSO

USED FOR CONTROLLING BLOOD LIPIDS,

AND WHEN YOU THINK ABOUT SOMEONE HAVING A HIGH CHOLESTEROL

THEN MAYBE THEIR LDL IS HIGH AND THEIR HDL IS LOW,

WELL NIACIN HAS HAS IN THE PAST, BEEN USED FOR THAT.

BUT I DO WANT TO POINT OUT THAT NEW RESEARCH HAS SHOWN THAT

IT'S NOT AS EFFECTIVE AS SOME OF THE OTHER DRUGS,

SO IT'S NOT BEING USED AS OFTEN.

WE CAN HAVE TOO MUCH NIACIN OR YOU'RE TAKING

NIACIN IN A PILL FORM, SO IN A SUPPLEMENT FORM,

PARTICULARLY TO CONTROL BLOOD LIPIDS,

ONE OF THE MAIN PROBLEMS THAT IS SEEN AS

WHAT'S CALLED A NIACIN FLUSH.

'CAUSE NIACIN WILL ACTUALLY OPEN UP THE BLOOD VESSELS

AND THE FACE BECOMES REALLY RED OR FLUSHED,

AND IF SOMEONE IS TAKING NIACIN,

THEY REALLY SHOULDN'T DRINK ALCOHOL WITH IT.

IF YOU'VE EVER SEEN ANYONE DO THAT, AND I HAVE,

YOU'LL NOTICE THESE BIG WELTS THAT FORM ON THE

CHIN AND THE FACE AND IT'S, PEOPLE USUALLY MAKE THAT

MISTAKE ONE TIME BECAUSE IT'S SO UNCOMFORTABLE.

SO FOOD SOURCES, NIACIN NOTICE HOW

THE MAIN FOOD SOURCES OF NIACIN ARE ANIMAL FOODS.

SO WE HAVE THE CHICKEN AND PORK AND BEEF AND TUNA.

ALTHOUGH YOU WILL FIND IT IN SOME PLANT FOODS.

POTATOES IS ONE EXAMPLE.

PYRIDOXINE, WHICH IS VITAMIN B6, IS ACTUALLY

ALTHOUGH IT DOES HAVE SOME ROLE IN ENERGY METABOLISM,

IT ACTUALLY HAS A DIVERSE RANGE OF FUNCTIONS,

IT'S INVOLVED IN OVER A HUNDRED DIFFERENT REACTIONS,

MAINLY AS A COENZYME AND SOME OF THE MAIN FUNCTIONS ARE

AN AMINO ACID CONVERSION, RELEASING STORED GLUCOSE,

IMMUNE FUNCTION AND EVEN BRAIN DEVELOPMENT,

BUT THAT'S JUST, JUST A SMALL, A SMALL PART OF THE LIFT.

I WANT YOU TO KNOW THAT I DON'T, I'M NOT HOLDING YOU

ACCOUNTABLE FOR KNOWING ALL THE FUNCTIONS OF B6,

JUST KNOW THAT IT'S VERY DIVERSE AND IS

INVOLVED IN MANY REACTIONS IN THE BODY.

NOW BECAUSE IT'S INVOLVED IN SO MANY REACTIONS IN THE BODY,

THE DEFICIENCY WILL RESULT IN THESE VERY

GENERAL SYMPTOMS OF WEAKNESS, AND FATIGUE, AND DEPRESSION.

YOU CAN GET AN ANEMIA, IRRITABILITY,

INSOMNIA, SO VERY GENERAL SYMPTOMS.

VITAMIN B6 TOXICITY IS NOT COMMON FROM FOOD.

IT CAN OCCUR WITH SUPPLEMENTATION, THOUGH.

IF YOU GO TO THE STORE AND START LOOKING AT

SOME OF THOSE COMPLEX B VITAMINS AND SUPER B,

WHAT YOU'RE GOING TO FIND IS A, SOME OF THOSE

HAVE 1,000, 2,000, 5,000 THE TIMES THE RECOMMENDED

DIETARY ALLOWANCE AND YOU REALLY DO HAVE TO BE CAREFUL

BECAUSE THERE HAVE BEEN REPORTED VITAMIN B6 TOXICITY.

SO WHERE DOES B6 COME IN?

YOU'RE GOING TO SEE THE SAME THING,

THESE ANIMAL SOURCES SUCH AS TURKEY AND PORK, BEEF LIVER,

AND YOU KNOW MOST PEOPLE DON'T EAT BEEF LIVER THESE DAYS.

BUT SOME PLANT SOURCES AS WELL SUCH AS BANANAS AND SPINACH.

VITAMIN B9, SO THIS IS FOLATE.

AND FOLATE AND THIS IS WHY I WANT YOU TO KNOW

SPECIFICALLY AND IT'S INVOLVED IN NEW CELL SYNTHESIS.

SYNTHESIS IS DNA AND OF AMINO ACIDS WHICH

IS REALLY IMPORTANT BECAUSE THERE'S THIS

FOLATE DEFICIENCY DURING AN EARLY PART OF PREGNANCY,

THEN SOMETHING CALLED A NEURO TUBE DEFECT,

MOST COMMON FORM OF A NEURO TUBE

DEFECT IS SPINA BIFIDA, WILL DEVELOP.

AND THAT'S BECAUSE THE NEURO TUBE WE THINK THIS IS JUST OUR,

YOU KNOW OUR SPINAL CODE HERE, THE VERTEBRAE.

THE NEURO TUBE DEVELOPS WITHIN THOSE FIRST FEW

WEEKS OF LIFE AND IF YOU THINK ABOUT IT,

MOST WOMEN DON'T KNOW THEY'RE PREGNANT

THOSE FIRST FEW WEEKS IT'S AFTERWARDS,

AND THAT'S WHEN THE MAIN DEVELOPMENT OCCURS.

IF THERE'S NOT ENOUGH FOLATE,

THEN WHAT'S CALLED SPINA BIFIDA THAT THIS NEURO TUBE TO PROTECT

THE SPINAL CORD DOESN'T DEVELOP AND IT ENDS UP POUCHING OUT.

THIS IS A SPINAL CORD COMING OUT OF THE BACK.

AND I CAN TELL YOU I SEE AND TREAT SOME PATIENTS

WITH SPINA BIFIDA AND IT'S A REAL RANGE OF SYMPTOMS FROM

BEING IN A WHEELCHAIR WHEN THEY'RE OLDER WHERE THEY

CAN'T WALK TO JUST USING A CANE AND HAVING DIFFICULTY

WITH WALKING SO WEAKNESS AS OPPOSED TO PARALYSIS.

BUT IT'S A PREVENTABLE CONDITION.

FORTIFICATION OF FOLATE OF OUR GRAIN

PRODUCTS STARTED IN ABOUT THE MID 1990S,

AND THIS GRAPH REPRESENTS THE INCIDENTS OF NEURO

TUBE DEFECTS AND YOU CAN SEE WITH THE RISING

INCIDENTS OF FORTIFICATION STARTED SOON AFTER THAT.

THERE WAS A DECREASE IN INCIDENT.

AND THE IDEA IS THAT YOU NEED TO FORTIFY WITH

FOLATE BECAUSE PEOPLE ARE BECOMING PREGNANT

WITHOUT KNOWING IT AND ONCE THEY FIND OUT,

TAKING THE FOLATE ISN'T GOING TO HELP,

SO IF YOU ARE IN YOUR CHILDBEARING YEARS,

YOU ACTUALLY MIGHT FIND THAT YOUR OB MIGHT ACTUALLY RECOMMEND

THAT YOU USE A SUPPLEMENT WITH FOLATE JUST TO MAKE SURE,

ALTHOUGH YOU CAN GET ALL THE FOLATE YOU NEED FROM FOOD.

SO WHERE ARE THOSE FOODS SOURCES?

WELL, WE TEND TO THINK OF FOLATE, FOLIAGE,

FOLIAGE, SO SPINACH AND DARK LEAFY GREENS.

BUT AGAIN WE'RE GOING TO SEE LENTILS,

AND ASPARAGUS, AVOCADO,

AND AGAIN YOU CAN SEE THE BEEF LIVER CONTINUES TO POP UP,

NOT THAT MANY PEOPLE ARE EATING BEEF LIVER THESE DAYS.

AND AGAIN, LIKE OUR LEGUMES,

THE LENTILS AND BEANS, PINTO BEANS.

WE'RE GOING TO FINISH UP WITH VITAMIN B12.

AND VITAMIN B12 ALSO HAS KIND OF A DISTINCTIVE FUNCTION AND

THAT'S MAINTAINING NERVE SHEATHS, PROTECTING NERVES,

IT'S VERY IMPORTANT IN HEMOGLOBIN SYNTHESIS,

AND HEMOGLOBIN REMEMBER THAT'S WHAT CARRIES OXYGEN

IN THE BLOOD STREAM THAT'S PART OF OUR RED BLOOD CELLS.

SO WHEN THERE'S A DEFICIENCY OF B12,

WE'RE GOING TO SEE AN ANEMIA.

NOW MOST PEOPLE THINK OF ANEMIA AS AN IRON DEFICIENCY ANEMIA.

BUT THIS IS SEPARATE, IT'S NOT ASSOCIATED WITH IRON.

THIS IS A B12 DEFICIENCY BECAUSE B12

IS NECESSARY FOR THE FORMATION OF HEMOGLOBIN.

SO YOU HAVE DEVELOPED THAT PERNICIOUS ANEMIA,

SO IT'S A DIFFERENT TYPE OF ANEMIA.

THE B12 DEFICIENCY WILL ALSO RESULT IN PROBLEMS

WITH THE NERVES AND THAT'S GOING TO BE A NUMBNESS,

TINGLING, PARESTHESIA, WEIRD SENSATIONS.

IT'S GOING TO BE IN THE HANDS AND THE FEET,

AND ACTUALLY I SEE THIS AS A PODIATRIST,