Terry is happy to provide his opinion on diet and nutrition, supplements and lifestyle choices. This information is for educational purposes only. It is not meant to replace the advice of your physician and is not to be considered medical advice, diagnosis or treatment. Should you have any concerns please contact your physician directly.
Q. Hello Terry, “I have heard you refer to “active” forms of vitamins, specifically the B vitamins. What do you mean by this? Thanks!” — Mary M., Tallahassee, FL
A. Dear Mary, One of the biggest challenges to supplementing with B-vitamins is conversion. Many people (some estimate up to 30% of the population) cannot fully utilize B-vitamins from food and supplements because these forms of B-vitamins must be converted into the active form before they will function.
Some individuals are genetically pre-disposed to have difficulty absorbing the crucial B-vitamins they need; so much of the value of ordinary supplemental B-vitamins is lost before they can provide any benefits. Add to this the fact that as we age, our overall ability to absorb nutrients tends to decline. For example, malabsorption of vitamin B12 becomes more prevalent as we age due to changes in protein and enzyme levels in the digestive tract.
People using prescription drugs need to be especially vigilant about making sure they are getting enough B-vitamins, too. That’s because prescription drugs, including birth control pills, certain diabetes, epilepsy, blood pressure and ulcer medications, steroids, and antibiotics actually deplete B-vitamins from the body. In fact, about 10 to 30% of people taking metformin (a drug for type 2 diabetes) have reduced vitamin B12 absorption. Even over-the-counter pain relievers like ibuprofen are at fault.
So getting the right forms of B-vitamins – especially those which need no conversion by the liver – is important. B-vitamins present in their active form are immediately available for use. When looking for a quality B-vitamin or a multivitamin and mineral formula, look for one that contains B-vitamins in the following “active” forms:
B6 as P-5-P (Pyridoxal-5-Phosphate): Vitamin B6 is available in more than one form, but only one of them is the biologically preferred form of the vitamin B6 in the human body – Pyridoxal-5-Phosphate, or “P-5-P”. By providing this necessary nutrient in the P-5-P form, it doesn’t require conversion by the liver, so it can bypass that step.
B12 as Methylcobalamin: The form of vitamin B12 you’ll find in most supplements isn’t all that usable by the body. It’s usually in the cyanocobalamin form, which requires conversion by the liver, so its value can be limited. However, by supplementing with the methylcobalamin form, the nutrient is already in the ultimate form that the body needs.
Folate as Methylfolate: Like P-5-P and methylcobalamin, the folate form of methylfolate is an active form, versus the more common folic acid.
Terry . . . Naturally