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Vitamin B-Complex

Uses

The vitamin B-complex refers to all of the known essential water-soluble vitamins except for vitamin C. These include thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pantothenic acid (vitamin B5), pyridoxine (vitamin B6), biotin, folic acid and the cobalamins (vitamin B12).

"Vitamin B" was once thought to be a single nutrient . Researchers later discovered these extracts contained several vitamins, which were given distinguishing numbers, leading many people to the erroneous conclusion that these vitamins have a special relationship to each other. Further adding to confusion has been the "unofficial" designation of other, non-essential vitamins, as members of the B-complex, such as choline, inositol, and para-aminobenzoic acid (PABA).

Each member of the B-complex has a unique structure and performs unique functions in the human body. Vitamins B1, B2, B3, and biotin participate in different aspects of energy production, vitamin B6 is essential for amino acid metabolism, and vitamin B12 and folic acid facilitate steps required for cell division.

Each of these vitamins has many additional functions, though none that require all B-complex vitamins simultaneously. Human requirements for each B vitamin vary considerably—from 3 mcg per day for vitamin B12 to 18 mg per day for vitamin B3 in adult males, for example. So, taking equal amounts of each one—as provided in many B-complex supplements—makes little sense. Megadoses of B-complex vitamins sometimes taken to combat everyday stress, boost energy, or control food cravings, do not appear to offer benefit unless a person is deficient in one or more of them.

Most multivitamin-mineral products contain the B-complex along with the rest of the essential vitamins and minerals. Since they are more complete than B-complex vitamins alone, multiple vitamin-mineral supplements are recommended to improve overall micronutrient intake and prevent deficiencies.

What Are Star Ratings?

This supplement has been used in connection with the following health conditions:

Used forWhy
3 Stars
Wound Healing
Follow label directions
Thiamine (vitamin B1), pantothenic acid (vitamin B5), and other B vitamins have all been shown to play a role in wound healing. For this reason, some healthcare practitioners recommend a high-potency B vitamin supplement to promote wound healing.

Thiamine (vitamin B1),pantothenic acid (vitamin B5), and other B vitamins have all been shown to play a role in wound healing in animal studies. For this reason, although human research is lacking, some alternative healthcare practitioners recommend a high-potency B vitamin supplement to promote wound healing.

2 Stars
Canker Sores
300 mg B1 daily, 20 mg B2 daily, 150 mg B6 daily
People with recurrent canker sores may have a B vitamin deficiency. Supplementing with vitamins B1, B2, and B6 has been reported to provide relief.

Several preliminary studies, though not all, have found a surprisingly high incidence of iron and deficiency among people with recurrent canker sores. Treating these deficiencies has been reported in preliminary and controlled studies to reduce or eliminate recurrences in most cases. Supplementing daily with B vitamins—300 mg vitamin B1, 20 mg vitamin B2, and 150 mg vitamin B6—has been reported to provide some people with relief. Thiamine (B1) deficiency specifically has been linked to an increased risk of canker sores. The right supplemental level of iron requires diagnosis of an iron deficiency by a healthcare professional using lab tests.

1 Star
Acne Rosacea
Refer to label instructions
The relationship between B vitamins and rosacea is unclear, one study found it caused rocacea-like symptoms, other preliminary reports have found benefits.

Preliminary reports in the 1940s claimed that rosacea improved with oral supplements or injections of On the other hand, one report exists of rosacea-like symptoms in a patient taking 100 mg per day of vitamin B6 and 100 mcg per day of vitamin B12; these symptoms subsided when the supplements were discontinued. More research is needed to evaluate the potential benefits or hazards of B vitamins for rosacea.

1 Star
Alcohol Withdrawal
Refer to label instructions
Research suggests it is possible that successful treatment of B-complex vitamin deficiencies may actually reduce alcohol cravings, because animals crave alcohol when fed a B-complex-deficient diet.

Deficiencies of vitamins are common with chronic alcohol use. The situation is exacerbated by the fact that alcoholics have an increased need for B vitamins. It is possible that successful treatment of B-complex vitamin deficiencies may actually reduce alcohol cravings, because animals crave alcohol when fed a B-complex-deficient diet. Many doctors recommend 100 mg of B-complex vitamins per day.

1 Star
Anxiety
Refer to label instructions
Double-blind research suggests that supplementing with vitamin B-complex multivitamin may reduce feelings of anxiety, perceived stress, and tiredness.
In one double-blind study, 80 healthy male volunteers (aged 18 to 42 years) were randomly assigned to receive a daily multivitamin-mineral formula or placebo for 28 days. The multi contained the following: thiamine (15 mg), riboflavin (15 mg), niacin (50 mg), pantothenic acid (23 mg), vitamin B6 (10 mg), biotin (150 mcg), folic acid (400 mcg), vitamin B12 (10 mcg), vitamin C (500 mg), calcium (100 mg), magnesium (100 mg), and zinc (10 mg). Compared with the placebo group, the multivitamin group experienced consistent and statistically significant reductions in anxiety and perceived stress, as determined by questionnaires measuring psychological state. This group also tended to rate themselves as less tired and better able to concentrate.
1 Star
Athletic Performance
Refer to label instructions
B-complex vitamins are needed to produce energy from carbohydrates. Exercisers may have slightly increased requirements for some of the B vitamins, including vitamins B2, B6, and B5, athletic performance can suffer if these slightly increased needs are not met.

The are important for athletes, because they are needed to produce energy from carbohydrates. Exercisers may have slightly increased requirements for some of the B vitamins, including vitamin B2, vitamin B6, and vitamin B5 (pantothenic acid); athletic performance can suffer if these slightly increased needs are not met. However, most athletes obtain enough B vitamins from their diet without supplementation, and supplementation studies have found no positive effect on performance measures for vitamin B2, vitamin B3 (niacin), or vitamin B6. On the contrary, large amounts of niacin have been shown to impair endurance performance.

1 Star
Attention Deficit–Hyperactivity Disorder
Refer to label instructions
B vitamins have been used for ADHD. High amounts of B vitamins have shown mixed results in relieving ADHD symptoms.

, particularly vitamin B6, have also been used for ADHD. Deficient levels of vitamin B6 have been detected in some ADHD patients. In a study of six children with low blood levels of the neurotransmitter (chemical messenger) serotonin, vitamin B6 supplementation (15–30 mg per 2.2 pounds of body weight per day) was found to be more effective than methylphenidate (Ritalin®). However, lower amounts of vitamin B6 were not beneficial. The effective amount of vitamin B6 in this study was extremely large and could potentially cause nerve damage, although none occurred in this study. A practitioner knowledgeable in nutrition must be consulted when using high amounts of vitamin B6. High amounts of other B vitamins have shown mixed results in relieving ADHD symptoms.

1 Star
Hives
Refer to label instructions
In one study, treatment with a hydrochloric acid supplement and a vitamin B-complex supplement helped to treat people with hives.

According to preliminary studies from many years ago, lack of hydrochloric acid (HCl) secretion by the stomach was associated with chronic hives, presumably as a result of increasing the likelihood of developing food allergies. In one such study, 31% were diagnosed as having achlorhydria (no gastric acid output), and 53% were shown to be hypochlorhydric (having low gastric acid output). In a related study, treatment with an HCl supplement and a supplement helped to treat people with hives.Betaine HCl is the most common hydrochloric acid-containing supplement; it comes in tablets or capsules measured in grains or milligrams. One or more tablets or capsules, each containing 5–10 grains (325–650 mg) are typically taken with a meal that contains protein. Diagnosis of a deficiency of HCl and supplementation with HCl should be supervised by a doctor.

1 Star
Indigestion, Heartburn, and Low Stomach Acidity
Refer to label instructions
People with achlorhydria (no stomach acid) or hypochlorhydria may not metabolize B vitamins properly, putting them at risk of developing various nutritional deficiencies, which could presumably contribute to the development of a wide range of health problems.
Many minerals and vitamins appear to require adequate concentrations of stomach acid to be absorbed optimally—examples are iron, zinc, and B-complex vitamins, including folic acid. People with achlorhydria (no stomach acid) or hypochlorhydria may therefore be at risk of developing various nutritional deficiencies, which could presumably contribute to the development of a wide range of health problems.
1 Star
Indigestion, Heartburn, and Low Stomach Acidity, and Vitamin B12 Deficiency
Refer to label instructions
For people who have inadequate absorption of vitamin B12 due to low stomach acid, supplementing with vitamin B complex can help correct a deficiency.
Vitamin B12 supplementation may be beneficial for a subset of people suffering from indigestion: those with delayed emptying of the stomach contents in association with Helicobacter pylori infection and low blood levels of vitamin B12. In a double-blind study of people who satisfied those criteria, treatment with vitamin B12 significantly reduced symptoms of dyspepsia and improved stomach-emptying times.
1 Star
Osteoporosis
Refer to label instructions
In one trial postmenopausal women who combined hormone replacement therapy with B vitamins and other nutrients and dietary changes increased their bone density by a remarkable 11%.

One trial studying postmenopausal women combined hormone replacement therapy with magnesium (600 mg per day), calcium (500 mg per day), vitamin C, , vitamin D, zinc, copper, manganese, boron, and other nutrients for an eight- to nine-month period. In addition, participants were told to avoid processed foods, limit protein intake, emphasize vegetable over animal protein, and limit consumption of salt, sugar, alcohol, coffee, tea, chocolate, and tobacco. Bone density increased a remarkable 11%, compared to only 0.7% in women receiving hormone replacement alone.

1 Star
Premenstrual Syndrome
Refer to label instructions
Research has linked B vitamin deficiencies to PMS, so some women may benefit from supplementing with B-complex vitamins for symptom relief.

Many years ago, research linked B vitamin deficiencies to PMS in preliminary research. Based on that early work, some doctors recommend B-complex vitamins for women with PMS.

1 Star
Tardive Dyskinesia
Refer to label instructions
In some studies, taking vitamin B-complex along with other nutrients appeared to prevent the development of tardive dyskinesia.

During a ten-year period, doctors at the North Nassau Mental Health Center in New York treated approximately 11,000 people with schizophrenia with a megavitamin regimen that included vitamin C (up to 4 grams per day), vitamin B3—either as niacin or niacinamide—(up to 4 grams per day), vitamin B6 (up to 800 mg per day), and vitamin E (up to 1,200 IU per day). During that time, not a single new case of TD was seen, even though many of the people were taking neuroleptic drugs. Another psychiatrist who routinely used niacinamide, vitamin C, and over a 28-year period rarely saw TD develop in her patients. Further research is needed to determine which nutrients or combinations of nutrients were most important for preventing TD. The amounts of niacinamide and vitamin B6 used in this research may cause significant side effects and may require monitoring by a doctor.

1 Star
Vitiligo
Refer to label instructions
PABA, a compound commonly found in B-complex vitamins, has been shown to repigment skin affected by vitiligo.

An early report described the use of PABA (para-aminobenzoic acid)—a compound commonly found in —for vitiligo. Consistent use of 100 mg of PABA three or four times per day, along with an injectable form of PABA and a variety of hormones tailored to individual needs, resulted, in many cases, in repigmentation of areas affected by vitiligo.

Interactions

Interactions with Supplements, Foods, & Other Compounds

Vitamin B-complex includes several different nutrients, each of which has the potential to interact with drugs. Look up the unique interactions for each and discuss the potential benefits and risks of your current medications with your doctor or pharmacist before adding vitamin B-complex:

Interactions with Medicines

Certain medicines interact with this supplement.

What Are Drug Interactions
Types of interactions:BeneficialAdverseCheck

Replenish Depleted Nutrients

Reduce Side Effects

  • AZT

    Persons with AIDS have developed lactic acidosis and fatty liver while taking AZT and other drugs in its class. AZT can inhibit crucial DNA-related riboflavin activity, which may be normalized by riboflavin supplementation. A 46-year-old woman with AIDS and lactic acidosis received a single dose of 50 mg of riboflavin, after which her laboratory tests returned to normal and her lactic acidosis was completely resolved. More research is needed to confirm the value of riboflavin for preventing and treating this side effect.

  • Desogestrel-Ethinyl Estradiol
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Didanosine

    Persons with AIDS have developed lactic acidosis and fatty liver while taking AZT and other drugs in its class. AZT can inhibit crucial DNA-related riboflavin activity, which may be normalized by riboflavin supplementation. A 46-year-old woman with AIDS and lactic acidosis received a single dose of 50 mg of riboflavin, after which her laboratory tests returned to normal and her lactic acidosis was completely resolved. More research is needed to confirm the value of riboflavin for preventing and treating this side effect.

  • Docetaxel

    Docetaxel may cause a reddening, swelling, and pain in hands and feet. Two cases have been reported of people suffering these drug-induced symptoms and responding to 50 mg of vitamin B6 given three times per day. Symptoms began to resolve in 12 to 24 hours and continued to improve for several weeks.

  • Doxorubicin

    Animal research suggests doxorubicin may deplete riboflavin and that riboflavin deficiency promotes doxorubicin toxicity.

  • Drospirenone (Contraceptive)
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Emtricitabine

    Persons with AIDS have developed lactic acidosis and fatty liver while taking AZT and other drugs in its class. AZT can inhibit crucial DNA-related riboflavin activity, which may be normalized by riboflavin supplementation. A 46-year-old woman with AIDS and lactic acidosis received a single dose of 50 mg of riboflavin, after which her laboratory tests returned to normal and her lactic acidosis was completely resolved. More research is needed to confirm the value of riboflavin for preventing and treating this side effect.

  • Ethinyl Estradiol and Levonorgestrel
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Ethinyl Estradiol and Norethindrone
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Ethinyl Estradiol and Norgestimate
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Ethinyl Estradiol and Norgestrel
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Fenofibrate

    Increased blood levels of homocysteine are associated with increased risk of atherosclerosis and heart disease. One study revealed that fenofibrate dramatically increases blood homocysteine levels, though blood levels of vitamins were not reduced. In one study, supplementation with 10 mg per day of folic acid prevented the increase in homocysteine levels resulting from fenofibrate therapy. Further research is needed to determine whether supplemental vitamin B6 and vitamin B12, which are also capable of lowering homocysteine levels, might lower fenofibrate-induced elevations in homocysteine levels.

  • Fluorouracil

    Fluorouracil occasionally causes problems on the skin of the palms and soles. Preliminary reports have appeared showing that 100 mg per day of vitamin B6 can sometimes eliminate the pain associated with this drug-induced condition.

  • Gentamicin

    In a study of guinea pigs, a single intramuscular injection of methylcobalamin (a form of vitamin B12), in the amount of 125 mg per 2.2 pounds of body weight, given immediately after administration of gentamicin, prevented damage to the inner ear, which is a common side effect of gentamicin therapy. No studies have been done to determine whether the same protective effect would occur in humans.

  • Lamivudine

    Persons with AIDS have developed lactic acidosis and fatty liver while taking AZT and other drugs in its class. AZT can inhibit crucial DNA-related riboflavin activity, which may be normalized by riboflavin supplementation. A 46-year-old woman with AIDS and lactic acidosis received a single dose of 50 mg of riboflavin, after which her laboratory tests returned to normal and her lactic acidosis was completely resolved. More research is needed to confirm the value of riboflavin for preventing and treating this side effect.

  • Levonorgestrel-Ethinyl Estrad

    Oral contraceptives have been associated with vitamin B6 depletion and clinical depression. In a small, double-blind study of women with depression taking oral contraceptivess, vitamin B6 (20 mg twice per day) improved depression. Half of the women in the study showed laboratory evidence of vitamin B6 deficiency.

  • Norethindrone (Contraceptive)
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Norgestimate-Ethinyl Estradiol
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Norgestrel
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Phenobarbital

    Anemia is an uncommon side effect experienced by people taking anticonvulsant drugs. Though the cause may be folic acid deficiency in many cases, a deficiency of vitamin B12 may also be a factor in some instances. Deficiencies of folic acid and vitamin B12 can lead to nerve and mental problems. One study revealed that individuals on long-term anticonvulsant therapy, despite having no laboratory signs of anemia, had dramatically lower levels of vitamin B12 in their cerebrospinal fluid (the fluid that bathes the brain) when compared with people who were not taking seizure medications. Improvement in mental status and nerve function was observed in a majority of symptomatic individuals after taking 30 mcg of vitamin B12 daily for a few days. Another study found that long-term anticonvulsant therapy had no effect on blood levels of vitamin B12. Despite these contradictory findings, people taking anticonvulsant drugs for several months or years might prevent nerve and mental problems by supplementing with vitamin B12.

  • Phenytoin

    Anemia is an uncommon side effect experienced by people taking anticonvulsant drugs. Though many researches believe that low blood levels of folic acid are involved, the effects might be caused by a vitamin B12 deficiency. Deficiencies of folic acid and vitamin B12 can lead to nerve and mental problems. One study revealed that individuals on long-term anticonvulsant therapy, despite having no laboratory signs of anemia, had dramatically lower levels of vitamin B12 in their cerebrospinal fluid (the fluid that bathes the brain) when compared with people who were not taking seizure medications. Improvement in mental status and nerve function was observed in a majority of symptomatic individuals after taking 30 mcg of vitamin B12 daily for a few days. Another study found that long-term anticonvulsant therapy had no effect on blood levels of vitamin B12. The results of these two studies indicate that people taking anticonvulsant drugs might experience side effects of vitamin B12 deficiency, and that the deficiency is not easily detected by the usual blood tests. Therefore, individuals taking anticonvulsant drugs for several months or years might prevent nerve and mental problems by supplementing with vitamin B12.

  • Risperidone

    Vitamin E along with vitamin B6 was used to treat a side effect of risperidone called neuroleptic malignant syndrome in a 74-year-old woman, and results were encouraging. However, whether vitamin E and vitamin B6 supplementation might help prevent this condition in people taking risperidone is unknown.

  • Stavudine

    Persons with AIDS have developed lactic acidosis and fatty liver while taking AZT and other drugs in its class. AZT can inhibit crucial DNA-related riboflavin activity, which may be normalized by riboflavin supplementation. A 46-year-old woman with AIDS and lactic acidosis received a single dose of 50 mg of riboflavin, after which her laboratory tests returned to normal and her lactic acidosis was completely resolved. More research is needed to confirm the value of riboflavin for preventing and treating this side effect.

  • Valproate

    Anemia is an uncommon side effect experienced by people taking anticonvulsant drugs. Though the cause may be folic acid deficiency in many cases, a deficiency of vitamin B12 may also be a factor in some cases. Deficiencies of folic acid and vitamin B12 can lead to nerve and mental problems. One study revealed that individuals on long-term anticonvulsant therapy had dramatically lower levels of vitamin B12 in their cerebrospinal fluid (the fluid that bathes the brain) when compared with people who were not taking seizure medications. Improvement in mental status and nerve function was observed in a majority of symptomatic individuals after taking 30 mcg of vitamin B12 daily for a few days. Another study found that long-term anticonvulsant therapy had no effect on blood levels of vitamin B12. Despite these contradictory findings, people taking anticonvulsant drugs for several months or years might prevent nerve and mental problems by supplementing with vitamin B12.

  • Zidovudine

    Persons with AIDS have developed lactic acidosis and fatty liver while taking AZT and other drugs in its class. AZT can inhibit crucial DNA-related riboflavin activity, which may be normalized by riboflavin supplementation. A 46-year-old woman with AIDS and lactic acidosis received a single dose of 50 mg of riboflavin, after which her laboratory tests returned to normal and her lactic acidosis was completely resolved. More research is needed to confirm the value of riboflavin for preventing and treating this side effect.

Support Medicine

  • Alclometasone

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

  • Amcinonide

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

  • Amitriptyline

    Combination of 6 grams per day L-tryptophan and 1,500 mg per day niacinamide (a form of vitamin B3) with imipramine has shown to be more effective than imipramine alone for people with bipolar disorder. These levels did not improve the effects of imipramine in people with depression. Lower amounts (4 grams per day of L-tryptophan and 1,000 mg per day of niacinamide) did show some tendency to enhance the effect of imipramine.

    The importance of the amount of L-tryptophan was confirmed in other studies, suggesting that if too much L-tryptophan (6 grams per day) is used, it is not beneficial, while levels around 4 grams per day may make tricyclic antidepressants work better.

  • Amoxapine

    Combination of 6 grams per day L-tryptophan and 1,500 mg per day niacinamide (a form of vitamin B3) with imipramine has shown to be more effective than imipramine alone for people with bipolar disorder. These levels did not improve the effects of imipramine in people with depression. Lower amounts (4 grams per day of L-tryptophan and 1,000 mg per day of niacinamide) did show some tendency to enhance the effect of imipramine.

    The importance of the amount of L-tryptophan was confirmed in other studies, suggesting that if too much L-tryptophan (6 grams per day) is used, it is not beneficial, while levels around 4 grams per day may make tricyclic antidepressants work better.

  • Benztropine

    Akathisia is an adverse reaction to anti-psychotic drugs, where a person has an uncontrollable desire to be in constant motion. One preliminary report suggested that 4,000 mg of L-tryptophan and 25 mg niacin per day taken with benztropine enhances the treatment of akathisia. Controlled studies are necessary to determine whether L-tryptophan and niacin supplements might benefit most people taking benztropine who experience adverse reactions to anti-psychotic drugs.

  • Betamethasone

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

  • Clobetasol

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

  • Clocortolone

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

  • Clomipramine

    Giving 10 mg per day each of vitamins B1, B2, and B6 to elderly, depressed persons already on tricyclic antidepressants improved their depression and ability to think more than placebo did. The subjects in this study were institutionalized, so it is unclear if these results apply to persons living at home.

  • Desipramine

    Giving 10 mg per day each of vitamins B1, B2, and B6 to elderly, depressed persons already on tricyclic antidepressants improved their depression and ability to think more than placebo did. The subjects in this study were institutionalized, so it is unclear if these results apply to persons living at home.

    Combination of 6 grams per day L-tryptophan and 1,500 mg per day niacinamide (a form of vitamin B3) with imipramine has shown to be more effective than imipramine alone for people with bipolar disorder. These levels did not improve the effects of imipramine in people with depression. Lower amounts (4 grams per day of L-tryptophan and 1,000 mg per day of niacinamide) did show some tendency to enhance the effect of imipramine.

    The importance of the amount of L-tryptophan was confirmed in other studies, suggesting that if too much L-tryptophan (6 grams per day) is used, it is not beneficial, while levels around 4 grams per day may make tricyclic antidepressants work better.

  • Desoximetasone

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

  • Diflorasone

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

  • Doxepin

    Giving 10 mg per day each of vitamins B1, B2, and B6 to elderly, depressed persons already on tricyclic antidepressants improved their depression and ability to think more than placebo did. The subjects in this study were institutionalized, so it is unclear if these results apply to persons living at home.

  • Fluocinonide

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

  • Flurandrenolide

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

  • Fluticasone

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

  • Folic Acid

    Folic acid and vitamin B6 have been used to reduce elevated blood levels of homocysteine, which has been associated with atherosclerosis. One controlled study showed that taking 0.3 mg of folic acid together with 120 mg of vitamin B6 reduced homocysteine levels more than taking either vitamin alone. The study also revealed that long-term supplementation with vitamin B6 alone might reduce blood folic acid levels. Therefore, people with elevated blood homocysteine levels should supplement with both folic acid and vitamin B6.

  • Gemfibrozil

    Niacin (not niacinamide) and gemfibrozil have successfully raised HDL (good) cholesterol levels, both alone and in combination.

  • Halcinonide

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

  • Halobetasol

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

  • Hydrocortisone

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

  • Hydroxychloroquine

    An individual who took hydroxychloroquine and vitamin B6 together for nine years experienced a complete disappearance of skin nodules caused by rheumatoid arthritis. Controlled study is needed to determine whether taking vitamin B6 with or without hydroxychloroquine might help eliminate nodules in people with rheumatoid arthritis.

  • Imipramine

    Giving 10 mg per day each of vitamins B1, B2, and B6 to elderly, depressed persons already on tricyclic antidepressants improved their depression and ability to think more than placebo did. The subjects in this study were institutionalized, so it is unclear if these results apply to persons living at home.

  • Minocycline

    Niacinamide taken in combination with minocycline has produced beneficial effects in an individual with cicatricial pemphigoid, an autoimmune blistering disease, as well as in a 46-year-old woman with pemphigus vegetans, another blistering disease. Several other studies have confirmed the efficacy of this combination for bullous (blistering) pemphigoid.

  • Mometasone

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

  • Nortriptyline

    Combination of 6 grams per day L-tryptophan and 1,500 mg per day niacinamide (a form of vitamin B3) with imipramine has shown to be more effective than imipramine alone for people with bipolar disorder. These levels did not improve the effects of imipramine in people with depression. Lower amounts (4 grams per day of L-tryptophan and 1,000 mg per day of niacinamide) did show some tendency to enhance the effect of imipramine.

    The importance of the amount of L-tryptophan was confirmed in other studies, suggesting that if too much L-tryptophan (6 grams per day) is used, it is not beneficial, while levels around 4 grams per day may make tricyclic antidepressants work better.

  • Prednicarbate

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs. Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

  • Protriptyline

    Giving 10 mg per day each of vitamins B1, B2, and B6 to elderly, depressed persons already on tricyclic antidepressants improved their depression and ability to think more than placebo did. The subjects in this study were institutionalized, so it is unclear if these results apply to persons living at home.

  • Thioridazine

    In a controlled study, individuals taking thioridazine for psychosis cooperated better and withdrew less from other people when niacin (nicotinic acid), 300–1,500 mg each day, was added. Whether people who are taking thioridazine for other mental health problems might benefit from niacin supplementation is unknown.

  • Trimipramine

    Giving 10 mg per day each of vitamins B1, B2, and B6 to elderly, depressed persons already on tricyclic antidepressants improved their depression and ability to think more than placebo did. The subjects in this study were institutionalized, so it is unclear if these results apply to persons living at home.

Reduces Effectiveness

  • Phenobarbital

    One controlled study revealed that supplementing with 200 mg of vitamin B6 daily for four weeks resulted in a 45% reduction in phenobarbital blood levels. Therefore, people taking phenobarbital should probably avoid supplementing with large amounts of vitamin B6.

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

Potential Negative Interaction

  • Glimepiride

    Vitamin B3 can raise blood sugar levels, which makes diabetes difficult to control. Use of niacin along with glimepiride may increase requirements for the drug. On the other hand, individuals who stop taking niacin while on glimepiride should monitor their blood for lower-than-usual glucose levels.

  • Repaglinide

    Supplementation with large amounts of niacin (also called nicotinic acid) can increase blood glucose levels in diabetics, which might interfere with the blood-sugar-lowering effects of repaglinide. The form of vitamin B3 known as niacinamide does not have this effect. People who start or stop supplementing niacin while on repaglinide should carefully monitor their blood sugar levels and consult their prescribing doctor about making adjustments in the daily amount of drug taken.

Explanation Required

  • Atorvastatin

    Niacin is the form of vitamin B3 used to lower cholesterol. Ingestion of large amounts of niacin along with lovastatin (a drug closely related to atorvastatin) or with atorvastatin itself may cause muscle disorders (myopathy) that can become serious (rhabdomyolysis). Such problems appear to be uncommon when HMG-CoA reductase inhibitors are combined with niacin. Moreover, concurrent use of niacin with HMG-CoA reductase inhibitors has been reported to enhance the cholesterol-lowering effect of the drugs. Individuals taking atorvastatin should consult their physician before taking niacin.

  • Carbamazepine

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

  • Carbidopa-Levodopa

    Vitamin B6 supplementation above 5–10 mg per day reduces the effectiveness of levodopa. However, combining levodopa with carbidopa prevents this adverse effect, so vitamin B6 supplements may safely be taken with Sinemet® (carbidopa/levodopa).

  • Cerivastatin

    Some sources have reported that taking niacin (vitamin B3) together with HMG-CoA reductase inhibitors may result in serious muscle damage. However, niacin has also been used in combination with statin drugs without ill effects, and has been found to enhance the cholesterol-lowering effect of these drugs. Persons taking cerivastatin or any other HMG-CoA reductase inhibitor should consult with their doctor before taking niacin.

  • Felbamate

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

  • Fluvastatin

    Niacin is the form of vitamin B3 used to lower cholesterol. Fluvastatin and niacin used together have been shown to be more effective than either substance alone. Ingestion of large amounts of niacin along with HMG-CoA reductase inhibitors such as fluvastatin may cause muscle disorders (myopathy) that can become serious (rhabdomyolysis). Such problems appear to be uncommon. Nonetheless, individuals taking fluvastatin should consult with their doctor before taking niacin.

  • Gabapentin

    Anemia is an uncommon side effect experienced by people taking anticonvulsant drugs. Though many researches believe that low blood levels of folic acid are involved, the effects might be caused by a vitamin B12 deficiency. Deficiencies of folic acid and vitamin B12 can lead to nerve and mental problems. One study revealed that individuals on long-term anticonvulsant therapy, despite having no laboratory signs of anemia, had dramatically lower levels of vitamin B12 in their cerebrospinal fluid (the fluid that bathes the brain) when compared with people who were not taking seizure medications. Improvement in mental status and nerve function was observed in a majority of symptomatic individuals after taking 30 mcg of vitamin B12 daily for a few days. Another study found that long-term anticonvulsant therapy had no effect on blood levels of vitamin B12. The results of these two studies indicate that people taking anticonvulsant drugs might experience side effects of vitamin B12 deficiency, and that the deficiency is not easily detected by the usual blood tests. Therefore, individuals taking anticonvulsant drugs for several months or years might prevent nerve and mental problems by supplementing with vitamin B12.

  • Gentamicin

    Gentamicin administration has been associated with vitamin B6 depletion in rabbits. The authors of this study mention early evidence that vitamin B6 administration may protect against gentamicin-induced kidney damage.

  • Glyburide
  • Insulin
    Biotin supplements have been shown to improve blood sugar control in people with diabetes. Consequently, supplementing with biotin could reduce blood sugar levels in people with taking insulin, potentially resulting in abnormally low blood sugar levels (hypoglycemia). While biotin supplementation may be beneficial for people with diabetes, its use in combination with insulin or with any other blood sugar–lowering medication should be supervised by a doctor.
  • Levetiracetam

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

  • Lovastatin

    Niacin is a vitamin used to lower cholesterol. Large amounts of niacin taken with lovastatin have been reported to cause potentially serious muscle disorders (myopathy or rhabdomyolysis). However, niacin also enhances the cholesterol-lowering effect of lovastatin. Taking as little as 500 mg three times per day of niacin with lovastatin has been shown to have these complementary, supportive actions with almost none of the side effects seen when higher amounts of niacin are taken. Nevertheless, individuals taking lovastatin should consult with their doctor before taking niacin.

  • Phenytoin

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

  • Pravastatin

    Niacin is a vitamin used to lower cholesterol. Sixteen people with diabetes and high cholesterol were given pravastatin plus niacin to lower cholesterol. Niacin was added over a two week period, to a maximum amount of 500 mg three times per day. The combination of pravastatin plus niacin was continued for four weeks. Compared with pravastatin, niacin plus pravastatin resulted in significantly reduced cholesterol levels. Others have also shown that the combination of pravastatin and niacin is more effective in lowering cholesterol levels than is pravastatin alone. However, large amounts of niacin taken with pravastatin might cause serious muscle disorders (myopathy or rhabdomyolysis). Individuals taking pravastatin should consult a doctor before taking niacin.

  • Primidone

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

  • Rosuvastatin

    A recent blinded study showed that individuals taking both rosuvastatin and niacin had a greater increase in HDL (“good”) cholesterol and apolipoprotein A-I than did those taking rosuvastatin alone. People taking rosuvastatin might benefit from taking niacin, though they should consult with their healthcare provider before starting the supplement. When taken with niacin, some statin drugs may become more toxic so there is a possibility of an adverse interaction.

  • Simvastatin

    Niacin is the form of vitamin B3 used to lower cholesterol. Taking large amounts of niacin along with HMG-CoA reductase inhibitors may cause muscle disorders (myopathy) that can become serious (rhabdomyolysis). Such problems appear to be uncommon. Moreover, concurrent use of niacin has been reported to enhance the cholesterol-lowering effect of HMG-CoA reductase inhibitors. Individuals taking simvastatin should consult a doctor before taking niacin.

  • Topiramate

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

  • Zonisamide

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.

Side Effects

Side Effects

Vitamin B-complex includes several different nutrients, each of which has the potential for side effects. Look up the unique side effects for each and discuss the potential benefits and risks with your doctor or pharmacist:

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