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This section contains information about vitamins, which are essential for good health.

It is even more important than normal to maintain as good a health as possible when suffering from a long-term illness to give the best chance of recovery.

The best way to ensure that the body receives the correct nutritional requirements is to eat a healthy balanced diet.

However, if the list of deficiency symptoms seems to point accurately to a problem or if you have a reason for a deficiency then supplementation may well be relevant.

Sufferers of long-term illnesses such as chronic fatigue syndrome are often tempted to take vitamin and mineral supplements to excess.

Toxicity problems may occur with some supplements if taken to excess.

Further information is given under the headings:

Sources - given from best to reasonable concentrations

Deficiency - possible symptoms

Toxicity - possible symptoms

Vitamins are either water soluble or fat-soluble.

Water-soluble vitamins are held in water throughout the body. These vitamins need regular replacement because they are lost in body fluids such as sweat and urine.

Fat-soluble vitamins are stored in fats and carried within blood. It is less critical when the intake of these vitamins is interrupted, as they are less easily lost than their water-soluble counterparts. Because of this, excess intake of this type of vitamin is more likely to cause toxicity problems in the body.


VITAMIN A (Retinol or Carotene) Fat-soluble
Vitamin A is needed for immune functions, synthesis of glycogen and helps your digestive and urinary tracts.

It has antioxidant properties, which can protect against pollution and cancer formation and other diseases.

Additional Information
It is important for growth and repair of body tissue, bone and teeth development, night vision, reproduction, development and maintenance of the epithelial cells in the mucus membranes, storage of fat, brain development and the synthesis of protein.

Carrots, liver, spinach, kale, bell peppers, lettuce, swiss chard, sweet potatoes, apricots, broccoli, squashes, tomatoes, asparagus and egg yolk.

Deficiency symptoms include poor night vision, dryness of the conjunctiva and cornea of the eye, higher risk of infections, dry skin, poor growth and a precancerous condition called metaplasia.

Hypothyroidism causes a weakened ability to change beta-carotene into vitamin A.

Elderly people suffering from type-two-diabetes often have a decline in vitamin A blood levels due to their age, despite sufficient dietary intake.

An excess of vitamin A can cause nausea, dizziness, menstrual problems, skin changes, dryness, itchiness, irritability, vomiting, headaches, fatigue, joint pain, blurred vision, drowsiness, diarrhoea and enlargement of the spleen and liver.

In the long term an excess can cause hair loss, bone and muscle pain, liver damage and an increase in blood lipid concentrations.

Pregnant women should be especially careful as too high an intake of this vitamin can lead to birth defects.

Pro-vitamin A (beta-carotene), which the body uses to make vitamin A, does not cause toxicity.


VITAMIN B1 (Thiamine) Water-soluble
Vitamin B1 is needed for the nervous system and is used by the body to help form <a href="http://www.awaythroughcfs.co.uk/content/adenosine-tri-phosphate-and-its-role-cfs">adenosine triphosphate (ATP)</a>, which is used for energy transfer in cells.

Vitamin B1 is used in the manufacture of the hydrochloric acid that is used for digestion in the stomach.

Additional Information
It is important for protein, fat and carbohydrate metabolism, appetite regulation and the production of the neurotransmitter acetylcholine and also gamma-aminobutyric acid (GABA).

It may help with depression, memory and learning and may help combat arthritis, cataracts and infertility.

It is required for growth in children

It may be useful to help combat motion sickness.

Lettuce, asparagus, spinach, sunflower seeds, tuna, celery, peas, tomatoes, mushrooms, brussel sprouts, cabbage, watermelon, bell peppers, carrots, squashes, broccoli, beans, pineapple, whole-grains, oranges, cauliflower, swiss chard and lentils.

Some flours can be fortified with vitamin B1.

Deficiency can result in beriberi and can cause extreme fatigue, nervousness, irritability, constipation, oedema, an enlarged liver, forgetfulness, gastrointestinal disturbances, heart changes, laboured breathing, loss of appetite, numbness of the hands and feet, pain and sensitivity, poor coordination, tingling sensations, weak and sore muscles and severe weight loss.

Excess thiamine is readily excreted, so toxicity reactions are very rare.


VITAMIN B2 (Riboflavin) Water-soluble
Vitamin B2 is needed for antibody production, is essential for cell respiration and can also work as an antioxidant.

Additional Information
It is important for carbohydrate, fat and protein metabolism, hair, nails, skin, mucous membranes, red blood cell formation and growth.

It is used to activate vitamin B6 and folic acid and to help create niacin.

Vitamin B2 helps with the absorption of iron and assists the adrenal gland.

It can be used to ease watery eye fatigue and may be helpful in the prevention and treatment of cataracts.

It is also needed when protein intake is high.

Liver, mushrooms, green leafy vegetables (spinach, lettuce, asparagus, swiss chard, broccoli, celery, kale and cabbage), venison, eggs, yoghurt, milk, green beans and tomatoes.

Some flours can be fortified with vitamin B2.

Vitamin B2 is destroyed by exposure to light.

Deficiency may cause cracks and sores at the corners of the mouth, eye disorders, inflammation of the mouth and tongue, skin lesions, dermatitis, dizziness, hair loss, insomnia, light sensitivity, poor digestion, retarded growth, sensation of burning feet and slow mental responses.

The only symptom of too high an intake is a normal yellow discoloration of the urine, which is harmless.


VITAMIN B3 (Niacin) Water-soluble
Vitamin B3 is needed for blood circulation, cell respiration, nerve function and mental alertness.

There are two forms of Vitamin B3 – niacin or nicotinic acid and niacinamide or nicotinamide.

The form of vitamin B3 known as niacin/nicotinic acid (not niacinamide/nicotinamide) has been used to clear the body of organic poisons, such as certain insecticides.

Additional Information
Vitamin B3 is important for carbohydrate, fat and protein metabolism, cholesterol maintenance, healthy skin, normal secretion of bile and stomach fluids and appetite regulation.

Fish (tuna, halibut and salmon), liver, meat (chicken, venison, lamb, turkey and beef) and vegetables (asparagus, lettuce, tomatoes and peas) are good sources of vitamin B3.

White flour is often fortified with vitamin B3.

Deficiency can cause skin eruptions and inflammation, depression, dizziness, headaches, insomnia, halitosis, diarrhoea, indigestion, loss of appetite, low blood sugar, muscular weakness, limb pains and fatigue.

Severe deficiency can cause a condition known as 'pellagra', which is characterized by bilateral dermatitis, diarrhoea, and dementia.

Use of oral contraceptives can decrease the availability of vitamin B3 in the body.

Niacin or nicotinic acid, (but not niacinamide/nicotinamide) in doses larger than 200 mg causes flushing by dilating the blood vessels. This can cause the blood pressure to drop, although normally this is harmless.

Larger doses can also cause itching, high blood sugar, liver damage and peptic ulcers.

Inositol hexaniacinate is a variation of niacin that can be found in some supplements. This form of niacin is sometimes recommended by doctors for those needing large amounts of niacin because it is not currently thought to cause niacin toxicity.


VITAMIN B5 (Pantothenic Acid) Water-soluble
Pantothenic acid is needed for nutrient conversion into energy, vitamin utilisation and nerve function.

It is used to make the neurotransmitter acetylcholine, which is used in energy production and it also plays a role in fighting allergies.

Additional Information
It is important for the creation of lipids, steroid hormones and haemoglobin.

It plays a crucial role in synthesizing cholesterol and in the secretion of hormones, such as cortisone, in the adrenal glands. These hormones assist with metabolism, fighting allergies and benefitting the maintenance of skin, muscles and nerves.

Cauliflower, broccoli, liver, sunflower seeds, mushrooms, tomatoes, strawberries, grapefruit, yoghurt, eggs and swiss chard.

Freezing foods can destroy a large percentage of pantothenic acid (vitamin B5).

Deficiency can cause fatigue, headaches, nausea, numbness, tingling in the hands, paresthesia (abnormal sensations like burning feet), depression, personality changes, cardiac instability, abdominal pains, sleep disturbances, muscle weakness and cramps.

Taking more than 1,500 mg a day for an extended period may cause some sensitivity in teeth, but it does not appear to be toxic unless very high doses are taken.

Even then the worst symptoms that may occur in doses higher than 10g per day are diarrhoea, digestive disturbances and water retention.


VITAMIN B6 (Pyridoxine) Water-soluble
Vitamin B6 is important for nerve function and the formation of antibodies.

It may assist with controlling your mood.

Additional Information
It is important for carbohydrate and protein metabolism, red blood cells and for the balancing of hormonal changes in women.

It assists in the balancing of sodium and potassium and is involved in the nucleic acids, RNA and DNA.

It also combats the formation of the toxic chemical homocysteine, which is detrimental to the brain and the heart muscle.

Spinach, bell peppers, garlic, tuna, cauliflower, chilli peppers, bananas, celery, cabbage, asparagus, broccoli, kale, brussel sprouts, watermelon, cod, swiss chard, leeks, tomatoes, carrots, chicken, halibut, turkey and beef are very good sources.

Deficiency can cause irritability, nervousness, insomnia, general weakness, dermatitis, acne, asthma, ridged nails and an inflamed tongue.
Long term deficiency may cause osteoporosis, arthritis and kidney stones.

Vitamin B6 deficiency symptoms are similar to those of B2 and B3, especially as vitamin B6 is needed by the body to manufacture its own vitamin B3.

When deficient, women may suffer with pre-menstrual fluid retention, severe period pains, premenstrual acne and nausea in early pregnancy.
Those on birth control pills or hormone replacement therapy may be more at risk from deficiency and may suffer mood swings, depression and loss of sexual drive.

Extreme doses taken over a long period can cause hyperaesthesia (sensory sensitivity), paraesthesia (abnormal sensations in any part of the body, like pins and needles), muscle weakness, numbness and loss of proprioception (ability to feel your muscles).

Doses in excess of 2,000 mg per day can cause neurological damage.


VITAMIN B9 (Folic Acid or Folacin) Water-soluble
Vitamin B9 is needed for the digestive tract and is essential for creating haeme, the iron containing substance in haemoglobin, which is crucial for oxygen transport.

It may help improve mental and emotional health, depression and anxiety.

Additional Information
It is important for red blood cell formation, fat and protein metabolism, cell division and growth, skin, hair, nervous system, amino acid formation, muscles and other tissues in the body.

Vitamin B9 assists in producing RNA and DNA and is essential in periods of rapid growth such as pregnancy, adolescence and infancy.

Lettuce, spinach, asparagus, liver, kelp, broccoli, celery, lentils, brussel sprouts, beans, cucumber, papaya, cabbage, squashes, bell peppers, leeks, peas, tomatoes, oranges, mushrooms and strawberries.

Deficiency can cause cracking at the corners of the mouth (as also with deficiency of vitamin B2, B6 or iron), fatigue, acne, a sore tongue, diarrhoea, heartburn and constipation.

Long-term deficiency can cause anaemia, osteoporosis and even cancer of the bowel and cervix.

Vitamin B9 or folic acid is the most important of all B vitamins in lowering homocysteine levels in the blood, high levels of which can lead to heart disease and other serious problems.
Deficiency of folic acid has also been commonly found in elderly people suffering from hearing loss.

Folic acid absorption can be hampered by certain prescription drugs such as antacids, triamterene, anticonvulsants, cimetidine, anticancer drugs and sulfasalazine.

Pregnancy can cause a high risk of folic acid deficiency, which may increase the risk of the baby being born with spina bifida and other serious defects of the nervous system.

A regular high intake of folic acid may cause digestive upset, energy loss and insomnia.


VITAMIN B12 (Cyalocobalamin) Water-soluble
Vitamin B12 is needed for the nervous system and may help improve neuropsychiatric disorder symptoms in those suffering with chronic fatigue.

Additional Information
It is important for carbohydrate, fat and protein metabolism and for blood cell formation and maintenance.

Vitamin B12 works with folate to create building blocks for RNA and DNA synthesis.

Homocysteine levels are controlled by vitamin B12 when working in conjunction with vitamin B6 and folic acid, excess levels of which have been linked to increased risk of stroke, osteoporosis, heart disease, and Alzheimer’s disease.

Meat (liver, venison, beef and lamb), shellfish (shrimp and scallops), fish (red snapper, cod and halibut), poultry, eggs and dairy products (although processing of milk may destroy the vitamin B12 within it.)
Vegans may have to turn to kelp, blue-green algae and brewer's yeast.

Those who have had gastric surgery, are vegetarian, chronically ill or are elderly are at an increased risk of vitamin B12 deficiency.

Deficiency can cause a sore tongue, weakness, fatigue, weight loss, back pain and apathy.
In the long term it could result in loss of balance, decreased reflexes, tingling of the fingers, ringing in the ears, eroding of the myelin sheath and cause the raising of homocysteine level in the blood, which in high doses can be toxic to the brain and could be a causal factor in Alzheimer disease.

Severe deficiency could also cause (Addisonian) pernicious anaemia.

Skin problems may be experienced by people taking vitamin B12 injections if in large excess, but will clear up if the injections are stopped.


VITAMIN C (Ascorbic Acid) Water-soluble
Vitamin C is important for infection resistance, neurotransmitters and healthy muscles.

It is a great antioxidant and helps protect the body against pollutants.

It is a natural antihistamine and can help detoxify the body of substances like alcohol.

Additional Information
It is important for healthy cell development, wound healing, collagen maintenance, steroid hormones, carnitine, conversion of cholesterol to bile acids, enhancing iron bioavailability, proper calcium absorption and healthy gums and blood vessels.

The retaining and accumulation of lead may be also be stopped by vitamin C.

Furunculosis, or recurrent boils, may be caused by white blood cells with defects that can be corrected by vitamin C.

Vitamin C has been shown to reverse the dysfunction of cells lining the blood vessels. By helping to normalize these cells, heart disease may be prevented.

Fruits such as blackcurrants, guava, kiwifruit, lychees, papaya, strawberries, grapefruit, oranges, mandarins/tangerines, passion-fruit, mango and raspberries are very good sources, though it can also be found in other fruit, new potatoes, tomatoes, green and red peppers and some leafy green vegetables like broccoli.
Rosehip syrup is another excellent source.

Deficiency can cause scurvy with haemorrhages under the skin and a tendency to bruise easily, poor wound healing, bleeding gums and loose teeth.

It can also cause oedema (water retention), weakness, a lack of energy, poor digestion and painful joints

As people age, levels of vitamin C present in the eye begin to decrease. Supplementation may help lower the risk of developing cataracts by preventing this decrease.

Being water-soluble excesses of vitamin C is lost mostly through the urine.

Extremely large amounts can cause diarrhoea, nausea and abdominal cramps, but will normalize quickly when the excess intake is reduced or stopped.

Some people can tolerate as much as 25,000mg per day, while others start having a problems with just 600mg.

Large doses may interfere with anticoagulant drugs.

Large doses can affect urine sugar test for diabetes.


VITAMIN D (Cholecalciferol) Fat-soluble
Vitamin D is needed for the nervous system, may assist with the immune system and may be useful for patients with erratic blood pressure.

Research is currently taking place to see whether vitamin D, because of its association with vascular function and arterial stiffness, may be useful to help a weak cardiovascular system, which may be a problem for people with CFS.

Additional Information
It is important for calcium and phosphorus metabolism, bone and teeth formation and blood cell formation.

Vitamin D helps the body maintain necessary insulin blood levels and may assist with psoriasis, thyroid function and blood clotting.

Fatty fish (salmon, sardines, mackerel and kipper), shrimps, milk, cod and eggs.

It is also made in skin when exposed to sunlight.

Deficiency can cause softening of the bone, muscle twitching, convulsions, burning sensation in the mouth and throat, diarrhoea, insomnia, visual problems, loss of minerals from the bones (osteomalacia), weak muscles and even deafness.
In children deficiency can cause rickets, leading to bent legs.

In older people, osteoporosis can occur when protein is also lost from the bone.

An excess of vitamin D supplementation can cause a lower appetite, increased thirst, nausea, vomiting, drowsiness and abdominal pain.

An excess can also cause too high a calcium level, which in the long term can lead to the depositing of calcium in soft tissues of the body such as blood vessel walls and kidneys where it can cause serious damage.


VITAMIN E (Tocopherol) Fat-soluble
Vitamin E is a powerful antioxidant able to protect body cells from oxidation thus helping to prevent degenerative diseases like heart disease, strokes, arthritis, senility, diabetes and cancer and has a possible role in immune function
It also protects the body and especially the lungs, from pollution

Additional Information
It is essential for red blood cells, is useful in preventing blood clots from forming, promotes fertility and reduces or prevents hot flushes in menopause.

Used topically Vitamin E can help eczema, skin ulcers, cold sores and shingles.

Swiss chard, sunflower seeds, almonds, spinach, kale, papaya, olives, bell peppers, brussel sprouts, kiwifruit, tomatoes, blueberries and broccoli.
Although wheat germ, whole grains, vegetable and wheat oils can also contain vitamin E, much of it can be lost in processing and exposure to air.

Deficiency is very uncommon, but can cause fatigue, inflamed varicose veins, acne, anaemia, muscle disease, dementia, gallstones, shortened red blood cell life span, miscarriages and uterine degeneration.

Very high intakes can cause diarrhoea, nausea or abdominal wind.


VITAMIN H (Biotin) Water-soluble
Biotin or vitamin H plays a role in the Kreb cycle, which is the process in which energy is released from food.

Biotin helps with nerve tissue, assists with muscle pain and is helpful in maintaining a steady blood sugar level.

Additional Information
It is also important for carbohydrate, fat and protein metabolism, fatty acid production, cell growth and B vitamin utilization.

It is useful for healthy hair and skin, healthy sweat glands, nerve tissue, bone marrow and helps with the transfer of carbon dioxide.

Swiss chard is the best source of biotin, but it can also be found in spinach, bell peppers, tuna, cauliflower, bananas, celery, cabbage, asparagus, broccoli, kale, brussel sprouts, watermelon, cod, leeks, tomatoes, carrots, chicken, halibut, turkey, beef and egg yolk.

Biotin is also made by micro-organisms inside the intestinal tract.

Deficiency is very rare and can cause thinning of the hair, dry scaly skin, fatigue, loss of appetite, nausea and vomiting, mental depression, inflammation of the tongue, pins and needles and high cholesterol.

Raw eggs contain a substance called avidin, which binds with the biotin, thus making it impossible to be absorbed by the body.

Any excess of biotin is easily lost in the urine and faeces so no known toxicity occurs.


VITAMIN K Fat-soluble
Vitamin K helps with the conversion of glucose to glycogen, which can be stored in the liver.

Additional Information
It is also important for blood clotting functions and bone metabolism.

Kale, spinach, swiss chard, lettuce, brussel sprouts, broccoli, cabbage, asparagus, celery, kelp, green beans, cauliflower, tomatoes, peas, carrots and bell peppers.

Deficiency can cause increased bruising, gastrointestinal bleeding, epistaxis (nosebleeds), internal haemorrhaging, hematuria (blood in the urine) and menorrhagia (excessive blood flow during menstruation).

Toxicity can only occur when using high doses of the synthetic form of this vitamin known as vitamin K3 (menadione) and could cause flushing and sweating or even jaundice and anaemia.






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