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Over the course of your health journey, you may have heard about how crucial B vitamins are for cardiovascular health and health in general. You may have even been encouraged to take a B complex supplement or prescribed a B12 shot. What’s the big deal about these three B vitamins, and why should you take them? How do you know if you’re deficient? That’s the topic of today’s article –Keep reading.

What Do Vitamins B6, B9, and B12 Do for The Heart?

Vitamins B6, B9, and B12 are part of the eight essential B vitamins (B1, B2, B3, B5, B6, Biotin, B9, and B12). These vitamins are “essential” because they are essential to take in through diet. Our bodies cannot make these vitamins from other nutrients in the food we eat. We need to consume foods that are naturally high in B’s. Vitamins B6 (pyridoxine), B9 (folate), and B12 (cobalamin) help reduce the risk of cardiovascular disease by improving methylation and lowering homocysteine.

Vitamins B6, B9, and B12 and Homocysteine

High levels of an amino acid called homocysteine are a known risk factor for heart disease. A process called methylation converts homocysteine to another amino acid, methionine. Without the MTHFR enzyme working optimally, this doesn’t happen properly. Instead, homocysteine builds up in the blood, which can be toxic to the blood vessels, causing damage. Additionally, if homocysteine isn’t converted to methionine in appropriate amounts, it can result in a methionine deficiency, which also increases your risk for cardiovascular disease.

You are more at risk of having “hyperhomocysteinemia” (high homocysteine) if you have an MTHFR genetic mutation or SNP. MTHFR stands for 5,10-MethyleneTetraHydroFolate Reductase. This gene provides instructions for making the MTHFR enzyme, which is needed to keep your levels of homocysteine in check. In addition to converting homocysteine to methionine, this enzyme converts folate (vitamin B9) into a form the body can use — its “active” form.

Vitamins B6, folate, and B12 work together to keep homocysteine concentrations low. Vitamin B6, in its active form pyridoxal-5’-phosphate (P5P) helps with transsulfuration, turning homocysteine into the super antioxidant glutathione. Folate and B12 help with remethylation. If you have a deficiency in any of these vitamins, it can lead to cardiovascular problems, including the following:

Blood Clots – Excess homocysteine due to poor methylation can lead to venous thrombosis, a blockage caused by a blood clot.

Vascular disease, including stroke –High homocysteine levels can damage the vascular endothelial tissue. One study found that two copies of the MTHFR C677T mutation (causing high homocysteine) tripled the risk of premature cardiovascular disease.

How Do These Vitamins Individually Benefit the Heart?

The effects of B vitamin supplements on the heart are a regular subject of research. Here’s how each of these vitamins supports the cardiovascular system besides lowering blood homocysteine:

B6 (Pyridoxine)

Pyridoxine helps with over 100 enzyme-dependent reactions in the body. It affects mental health due to its impact on neurotransmitters. High-dose pyridoxine is even suggested as an “anti-stress strategy” because it has a powerful effect on serotonin and GABA. A deficiency may contribute to cancer, heart disease, or cognitive decline.

In animal studies, a deficiency shifts the nervous system toward the sympathetic and increases blood pressure. Supplementing with the active form (pyridoxal phosphate or “P5P”) may help decrease high blood pressure, protecting the heart and cardiovascular system.

Those with type 2 diabetes tend to have lower B6 levels. In a study of men with type 2 diabetes, 150 mg of vitamin B6 per day for 6 weeks lowered their hemoglobin A1C levels. Hemoglobin A1C is an average of blood sugar levels over 2-3 months. Type 2 diabetes is a risk factor for heart disease.

B9 (Folate)

As mentioned earlier, folate is critical for the metabolic process of methylation, which lowers homocysteine. Since homocysteine can damage blood vessels, it’s critical to keep it at normal levels by consuming adequate amounts of folate through diet or supplementation.

Methylation is also vital for normal detoxification processes that happen daily. Toxins are one of the “3 T’s” (along with trauma and thoughts) that contribute to inflammation and dis-ease in the body. If they build up, due to poor methylation, these toxins can damage the heart or blood vessels, leading to cardiovascular disease.

B12 (cobalamin)

Cobalamin is the other key player in methylation. It not only lowers homocysteine but helps in the detoxification process. B12 deficiency is a risk factor for heart disease in vegetarians.

However, it’s important to note that researchers have not noticed a benefit to B vitamin supplementation alone for reducing your risk of myocardial infarction (a heart attack) or your risk of stroke. Why? There are more contributing factors to cardiovascular events than elevated homocysteine. It goes back to the Swiss Watch Principle.

The Swiss Watch Principle

At The Wellness Way, we talk about your body’s systems as working together like the gears of a Swiss Watch. Each “gear” affects all the others. Consequently, your B vitamin (and other) nutrient status affects every aspect of your health. While B vitamins massively impact cardiovascular health, that does not mean you should pop a bunch of pills every day. Doing so will not necessarily reduce your risk for heart disease. B vitamins and total homocysteine are not the only things to look at.

Other cardiovascular risk factors to consider are metabolic syndrome (including diabetes), chronic inflammation, and the particle size of your LDL cholesterol. One of the most important risk factors is chronic systemic inflammation. What causes inflammation? There are three sources: trauma, toxins, and thoughts. Each person is different, so you have to find out what’s causing inflammation for you.

The best overall homocysteine-lowering and inflammation-lowering strategy is to avoid sugar, avoid your food allergies, and eat nutrient-dense foods.

What Are The Best Food Sources of B’s: 6, 9, and 12?

Overall, the best food sources of B vitamins are grass-fed organ meats, greens, and whole grains. However, grains can be inflammatory for some people. Before adding higher amounts of certain foods, get your food allergies tested. Once you have your list of non-reactive foods, focus on getting plenty of green leafy vegetables and other B-rich foods:

  • Leafy greens: spinach, kale, collard greens, mustard greens, Bok choy, arugula
  • Broccoli, cauliflower, Brussels sprouts, asparagus
  • Beets and beet greens
  • Avocado
  • Legumes, including kidney beans, black beans, chickpeas, lentils, pinto beans, and white beans
  • Pumpkin seeds, sunflower seeds, sesame seeds
  • Brazil nuts and pistachios
  • Fish, such as tuna, salmon, mackerel, and sardines
  • Grass-fed beef, organic meats, liver, and other organ meats
  • Seaweed
  • Chicken eggs or duck eggs

Seek out food sources first. Whole foods have beneficial effects that go beyond the cardiovascular system. They support whole-body health and vitality with vitamins, minerals, fiber, antioxidants, and more. Only use supplementation when absolutely necessary. When you do opt for supplements, carefully consider which ones you buy. Not all are created equal.

Forms Matter!

Forms of B vitamins matter! Synthetic forms like cyanocobalamin (synthetic B12) or folic acid (synthetic B9/folate) may do more harm than good. Over the 20th century, the quality of American food went down significantly. As a result, methylation in women of childbearing age went down. That ultimately led to babies being born with neural tube and other birth defects like spina bifida.

The government came to the rescue with food fortification. They started adding folic acid and other synthetic vitamins and minerals to “all-purpose” white flour and other processed foods. The medical field followed suit. It was all for the good of “public health.” In the 1990s, doctors began recommending folic acid supplementation to expectant mothers. These scientific recommendations seemed like a good idea at the time.

However, the body does not metabolize synthetic vitamins the same way it does natural vitamins. While taking folic acid may help correct a severe folate deficiency, it slows down other metabolic pathways supported by the original nutrient (folate). Ultimately, that means taking folic acid DECREASES your methylation! – that leads to other health problems. Researchers have linked “un-metabolized folic acid syndrome” (UMFA) to colorectal and prostate cancers.

The effect of folic acid in the food supply has been to keep people eating processed fortified foods and neglecting to eat green leafy vegetables and other healthy foods. Cardiologists recommend patients limit vitamin K-rich leafy greens if they are on blood thinners (since K stands for clotting factor in German). The idea is that these foods would counteract the positive effect of the medication. However, avoiding healthy foods is rarely a good idea –unless you’re allergic to them.

Support Through Supplements

Real, unprocessed food is still the best source of B vitamins you can get. However, if you need therapeutic doses, supplements can help. These are the active B vitamins and combinations we use and recommend at The Wellness Way:

  • B-Complex: Wellness B Complex
  • Active B12-Folate is a supplement featuring high doses of methyl folate and methyl-B12.
  • Methyl-B12: Methylcobalamin
  • Liver Glandular: Folate is naturally present in beef liver, so the Liver Glandular may also be a helpful addition. Liver also contains B6, B12, and even CoQ10.
  • Nitric Oxide: NEO40 is a nitric oxide supplement that also has vitamin C, methylated folate, and methyl-B12.

Learn more about NEO40 here. Supplements are there to do exactly that; supplement your diet. It is generally best to start with foods, and if you’re not able to get enough nutrients, then turn to supplements.

You Are Not What You Eat

Whether you choose to support methylation with food or supplements, it’s crucial to remember that you aren’t what you eat (or supplement); you are what you absorb! You could be at risk for high homocysteine and cardiovascular disease (and many other conditions) if you’re not able to absorb the nutrients you eat.

Difficulty absorbing nutrients in general tends to go back to a compromised digestive system. This can happen through dysbiosis, infections, inflammation, or specific disease processes, like inflammatory bowel disease (Crohn’s and Colitis). Certain medications may also reduce nutrient absorption.

Low levels of vitamin B6 are associated with autoimmune conditions, chronic alcohol dependence, Celiac disease, or inflammatory bowel disease. A lack of adequate stomach acid or intrinsic factor can lead to poor absorption of vitamin B12. Compromised folate levels can go back to an MTHFR genetic polymorphism.

We Don’t Guess – We Test!

The only way you will know your B-vitamin status is to test! At The Wellness Way, we do comprehensive testing to find out your nutrient status and your methylation ability. We have a cardiometabolic panel that goes beyond traditional lipid panels and looks at inflammation, blood sugar regulation, homocysteine, cholesterol particle size, methylation, and other important markers for cardiovascular disease risk. Take action toward achieving healthy nutrient levels and cardiovascular fitness! Make an appointment at one of our Wellness Way clinics today!


  1. B Vitamins: MedlinePlus
  2. DNA methylation, cancer susceptibility, and nutrient interactions – PubMed (
  3. MTHFR gene: MedlinePlus Genetics
  4. DNA methylation and cancer – PubMed (
  5. Role of homocysteine in the development of cardiovascular disease – PubMed (
  6. Homocysteine metabolism – PubMed (
  7. Homocysteine and Hyperhomocysteinaemia – PubMed (
  8. Molecular genetic analysis in mild hyperhomocysteinemia: a common mutation in the methylenetetrahydrofolate reductase gene is a genetic risk factor for cardiovascular disease. – PMC (
  9. B6-responsive disorders: a model of vitamin dependency – PubMed (
  10. High-dose pyridoxine as an ‘anti-stress’ strategy – PubMed (
  11. Antihypertensive and neuroprotective actions of pyridoxine and its derivatives – PubMed (
  12. Erythrocyte O2 transport and metabolism and effects of vitamin B6 therapy in type II diabetes mellitus – PubMed (
  13. Is vitamin B12 deficiency a risk factor for cardiovascular disease in vegetarians? – PubMed (
  14. Association between B Vitamins Supplementation and Risk of Cardiovascular Outcomes: A Cumulative Meta-Analysis of Randomized Controlled Trials – PMC (
  15. Folic Acid Food Fortification—Its History, Effect, Concerns, and Future Directions – PMC (
  16. MTHFR isoform carriers. 5-MTHF (5-methyl tetrahydrofolate) vs folic acid: a key to pregnancy outcome: a case series – PMC (
  17. Vitamin B6 Deficiency – StatPearls – NCBI Bookshelf (
  18. Vitamin B12 – Consumer (