Dr. Paul Anderson explains the difference between fat-soluble vitamins (A, D, E, K), which accumulate in your body, and water-soluble ones (C, B vitamins), which your body excretes. He covers dietary sources, what each does, deficiency signs, and when to supplement. Most people should get vitamins from food first, then consider a multivitamin or targeted B-complex if needed.
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Good day. Welcome to Medicine Health. Dr. Paul Anderson, that's me. I'm Dr. Paul, and today we're gonna do, uh, 4 sections here. So the first one is about vitamins. So we want to go through natural therapies, and these are largely, um, aimed at being patient educational videos and, and audio. So as you know, we are both on We put these up on YouTube, but we're on CTR Radio, live streamed. We're also streamed to Facebook, and then we have the audio on all of your favorite pod burners. So wherever you like to get your material, you can find us there. I want to talk about first vitamins as a topic, and we're going to actually divide them up a little bit. But the first thing about vitamins, which I think is important, is the difference between a fat-soluble and a water-soluble vitamin. So a fat-soluble vitamin is one that we'll do our own little section on, but that would be like vitamin A, vitamin D, vitamin E, vitamin K. And the thing with fat-soluble substances is they can build up over time, whereas the water-soluble nutrients tend by your body to be eliminated as they go in. So they go into your body usually through your diet, you eat them or you take a vitamin or some mixture thereof and the nutrients get to your cells, they're used for whatever purpose they're used for, and then they are eliminated. Fat soluble can actually depot or build up in your body. So we're going to table the fat solubles for just a minute. We're going to talk about water soluble vitamins. Now, as always, this is information only. This is not medical advice. You should run any of this by a healthcare provider. And the other thing that comes up with these sort of discussions is, well, can I, can I get too much of these things? And the answer is, well, it's possible. Depends on which vitamin it is and how much you take, etc. And then the other side of the coin is, well, When would it be advisable beyond my diet to take supplemental nutrients? So those are questions we'll talk about along the way as we go. So if we break down into the water-soluble vitamins, the first one we can talk about is vitamin C. Vitamin C is very famous for being an antioxidant in most cases and being used by your body in a number of processes that keep you healthy and keep your inflammatory response sort of modulated, etc. And so vitamin C is water soluble, it comes from a number of foods, and we think of, you know, like maybe oranges or, you know, lemons and limes, going back to the days of scurvy, which is the vitamin C deficiency syndrome, and that's what they would eat. But they would also eat things like sauerkraut, which has a fair amount of vitamin C. And they would also eat any number of other things. Now, as we've gone along in food science, we have discovered that a lot of other plants have plenty of vitamin C. And one of the nice things about the internet is you can pull up food sources of vitamin C or any other vitamin we talk about, and you'll get actual how many milligrams in each, you know, each plant that you're looking at or each fruit or vegetable, etc. And that can be very helpful. Now vitamin C is one of those, because it's water soluble, what you take in today will mostly be gone tomorrow. Your body stores little tiny amounts of vitamin C and it's used by the adrenal glands and other places, kind of in a little minor storage, but not, not a lot is stored. And usually if you check the blood levels of vitamin C, they're quite low. And if you're sick or getting sick, they're even lower because you're using it faster. So vitamin C, very commonly found in fruit and many vegetables, not so much in animal products, although there is a little bit in animal products, and it is very useful all over your body as one of your primary antioxidants. Then we can go into the B and the B-like vitamins. These are all water-soluble as well. So the next 2 kind of go together, which are vitamin B12 and folic acid or folate. Now we could do very long discussions on B12 and folic acid, and we don't really have time for that. So the take-home point on those is they work together in a cycle that is called your methyl cycle. And so They are activated largely through this methyl cycle, and then they come out the other end and they do many very important things. So one of the things that methyl donors like B12 and folate do is help you in the production of a lot of your neurotransmitters, the chemicals that run your brain. They are very important in feeding the system that helps to set up the building blocks of your DNA, etc. So real, you know, core functional items. When people get low in these, they can get all sorts of issues from them. You can get certain types of anemia due to low B12 or folate or both. You can get fatigued. You can have any number of problems that come along. Now sometimes your doctor may check your B12 levels or your folic acid levels or folate levels. And that can be a good idea, especially if they're very low. There's a lot of reasons why B12 and folate can be elevated on your blood test. And those are things you would need to go over with your doctor. But these are going to commonly be in a multivitamin and/or a B complex vitamin, at least many of them. And they're very useful in that respect. Again, B12 and folic acid. Folic acid comes literally from its name, it's foliage. So they found it originally in spinach, and they, they kept reducing the spinach down until they isolated this molecule they found, which was folate. And inside of foliage, so dark green leafy vegetables, things like that, You have a combination of folate structures. So you may have heard of active folic acid. There's folinic acid and methylfolate. Methylfolate is the fully active form. Well, it turns out there's actually reasonable amounts of the methylated folate and premethylated folate in a lot of the high folic acid foods. The place you do not find those active forms is in folic acid supplemented foods. So like a lot of cereals and other things have folic acid added, and that is actually a far distant precursor to methylfolate or folinic acid, which are a little further down the trail to being active or fully active in the case of methylfolate. Kind of the same with vitamin B12. You've got different subfamilies of B12, so you have like adenosylcobalamin. They all end in cobalamin. Cobalamin, you have methylcobalamin and so on. And again, usually in an active supplemental form or in some of the food sources. Now B12 tends to come from meat and fermented foods, so it'd be like, you know, tempeh and things of that nature that you can get B12 from. Again, in some people they will react to the methylated forms of folate, so methylfolate and methyl B12, and they'll do better with the premethylated versions because, as I said, these things do help you make neurotransmitters and they do a bunch of other things that are very critical. But there are some people who are just very sensitive to those things, and so they'll do better with a, as I say, a non-methylated version. And again, if you're having trouble with that, you should really work with, you know, a nutrition provider, naturopathic doctor, anybody who, you know, is trained in area of nutritional medicine. Then we get to the other B and B-like vitamins. So there is a numbering system you've heard of, like vitamin B1 and B2 and B3, you know, thiamine, riboflavin, and niacin. And we have B5, which is pantothenic acid, and B6, which is pyridoxine. And those are all used largely as cofactors for other enzymes to work. The important thing about that is that as these B vitamins go along, they help the enzymes that create other things or detoxify things or move things around in your body chemically. They help those processes to work in the speed that they're supposed to go. So cofactor or coenzyme— a cofactor is usually a water-soluble vitamin almost always a B vitamin, although other things can do it, and it's paired with a mineral. Now we'll do another thing on minerals, but they usually go together. So thiamine, riboflavin, niacin, pantothenic acid, and pyridoxine are the most common of that group of B vitamins. Then you get to things like biotin and PABA, or para-aminobenzoic acid, and these I call the, you know, the B-like vitamins. There's are structurally similar. They have similar jobs, although their chemistry might be a little bit different than a, say, B1 or B2 or something. And they are often involved again in either restorative or regulatory or building block type processes, which are very important, obviously. So for example, in biotin, You often might be given this or prescribed extra biotin if you have certain neurological issues, which could include neurological pain or a chronic neurological problem, etc. And kind of the same with para-aminobenzoic acid or PABA. And often we will see these in, you know, a B complex or in a multivitamin. Now, one of the things that is a good concept to keep in mind is sometimes there might be a pharmacologic dosing reason to give you like a lot of one vitamin or 2 vitamins or something. But whenever you're taking B vitamins especially, and you're taking a very high amount of those B vitamins, you want to keep in mind that if you're taking one or 2 of them at high doses, you want to have the other B vitamins available because what will happen is because these things run enzymatic processes, or at least they partially help to run the speed of the enzymatic process and optimize it, there's always collateral processes. So if I run process number 1 and I speed it up, process number 2 and 3 next to it may speed up also. But what if process 2 and 3 use vitamins you're not, you don't have around, you'll get functionally deficient in those. And so that's why generally speaking you're better off with something balanced like a balanced B complex. What, you know, we do with a lot of people is a multivitamin and then if they need extra B vitamins we give them a B complex on top of that. Now as I said, sometimes there are times where we might give people extra Common nutrients that may be given in higher doses would be any of those B vitamins, but often B12, sometimes folates, B6 and B5 are commonly used. B1 is used a lot in diabetes management, etc., and on and on. There's many, many iterations of these things that you can use. Now, B vitamins and the vitamin C, etc., these are water soluble. So if I took too much today, I might feel oddly or unpleasant, but it's not going to build up in my body and create any long-lasting problem that I may have, which is important to not create long-lasting problems with nutrients that you might take. So generally speaking, you should get as many nutrients as you can from your diet. Then there are also studies that show that a large portion of the human population just don't get enough that way. And so then the next step would be, say, a multivitamin. And then if you need more B vitamins, it'd be a B complex. And then you kind of work your way out from there. Now, if you're working with a, you know, a physician or a nutritional professional or somebody else trained to do this sort of thing, they might do, as I said, more of a prescription approach where they might have you take a little more of a nutrient for a while for a specific outcome. But the water-soluble vitamins here, as we wrap up this section, are very important. You pretty much don't store these. There's a little bit of storage, but you don't store them for the most part, not like a fat-soluble. And what we need for today, we have to eat in our food and/or get, you know, from some supplemental source, which is very important to keep in mind. The other thing that's important as we wrap up here with this section is, you know, people will say, well, you know, I, I probably get enough from what I'm eating, etc. And you may or, or you may not. The testing for these vitamins is different for each of the vitamins. Some of the tests are more sensitive and some are less sensitive, which is a good thing to keep in mind. You can't always rely on, you know, some of the testing. And the other thing is that your, you know, your healthcare provider may ask you to take more of something, and they're generally going to be doing that either based on lab tests or symptomatic treatment or some other physiologic type treatment that you may be needing. All right, so Just to summarize quick before we stop this little section here, we've got fat versus water-soluble vitamins. We'll talk about the fat-soluble ones separately. The water-soluble ones are going to be all of the B vitamins and their relatives like PABA and biotin, etc. Vitamin C is going to be water-soluble, and then there's some other things we'll talk about separately like minerals, etc., that are also water-soluble. So, as we go along, we will move on to other parts, but we're going to take a little quick break here and move forward, and I'll see you on the other side.
