By a community pharmacist
In Malaysia, life can be hectic. We rush to work, sit in traffic, skip breakfast, grab nasi lemak or roti canai on the way, and rely on kopi or teh tarik to get through the day.
So, when someone walks into the pharmacy and says, “Pharmacist, lately I feel tired all the time. Is it because I lack vitamins?”, it is a question worth taking seriously.
Sometimes, tiredness is related to poor sleep, stress or an unbalanced diet. In other cases, it may be a sign of anaemia, a thyroid problem or a vitamin deficiency.
One group of nutrients that deserves our attention is the B vitamins.
These eight vitamins help the body use energy from food, maintain healthy nerves and produce red blood cells. Each has a different role, and the NHS guide to B vitamins and folic acid explains their functions and food sources.
Are you getting enough B vitamins from your daily meals?
Think about a typical Malaysian day. Breakfast might be nasi lemak, roti canai or kaya toast. Lunch could be rice with chicken, fish, tofu or vegetables. Dinner may be noodles, chapati, soup or another rice-based meal.
These foods can contribute to our nutritional needs, but the overall variety matters. A diet dominated by refined carbohydrates, with little protein, vegetables or other nutrient-rich foods, may leave nutritional gaps. Malaysia’s Ministry of Health provides recommended nutrient intake information through its nutrition guidance.
Good sources of B vitamins include eggs, fish, chicken, meat, milk, tempeh, beans, nuts, green vegetables and fortified cereals. Different foods supply different B vitamins, so variety is more useful than relying on one “healthy” food. The NHS vitamin B guide gives further examples.
The B vitamins, in everyday terms
Vitamin B1 — Thiamine
Thiamine helps the body release energy from food and supports nerve function. It is found in wholegrains, beans, nuts and some fortified foods.
People with very poor diets, prolonged heavy alcohol use or certain medical conditions may be at risk of deficiency. Severe deficiency can affect the nerves and heart. NHS guidance on thiamine and other B vitamins explains the risks and food sources.
Vitamin B2 — Riboflavin
Riboflavin supports energy metabolism and helps maintain healthy skin, eyes and nerves. Eggs, milk, yoghurt, mushrooms and fortified cereals are useful sources.
A deficiency may cause cracks at the corners of the mouth, sore lips or a swollen tongue. These symptoms can have other causes too, so they should not be used to diagnose a deficiency on their own. NHS vitamin B guidance provides further information.
Vitamin B3 — Niacin
Niacin helps the body use nutrients and maintain normal skin and nervous system function. Fish, chicken, meat, peanuts and other protein-containing foods can contribute to intake.
Severe deficiency can cause a condition called pellagra, although it is uncommon in people eating a reasonably varied diet. High-dose niacin supplements should not be taken casually because they can cause side effects, including flushing and, at high doses, liver problems. The US National Institutes of Health Office of Dietary Supplements provides detailed information about niacin, deficiency and supplement safety.
Vitamin B5 — Pantothenic acid
This vitamin helps the body process fats and produce substances needed for normal metabolism. It is widely available in foods, so deficiency is rare and a separate supplement is usually unnecessary. NHS guidance on B vitamins explains why most people can obtain these nutrients from their diet.
Vitamin B6 — Pyridoxine
B6 helps process protein, form haemoglobin and maintain healthy nerves. Sources include fish, chicken, potatoes, bananas, chickpeas and nuts.
Here is an important warning from the pharmacy counter: too much vitamin B6 can damage the nerves. High supplemental doses taken over time may cause tingling, burning or numbness in the hands and feet.
The NHS advises adults not to take more than 10 mg of vitamin B6 daily in supplements unless advised by a doctor. Check the labels of multivitamins and other supplements, including products marketed for nerve health, because the same ingredient may appear in more than one product. Read the NHS advice on vitamin B6 safety.
Vitamin B7 — Biotin
Biotin helps the body process carbohydrates, fats and proteins. It is found in eggs, nuts, seeds, fish and other foods.
It is often promoted for hair growth and stronger nails, but extra biotin is not proven to improve hair or nails in people who are not deficient. High-dose biotin can also interfere with certain blood tests, potentially producing misleading results. Tell your doctor or laboratory team if you take it, especially before investigations involving thyroid function or the heart. The US National Institutes of Health biotin fact sheet explains these limitations.
Vitamin B9 — Folate and folic acid
Folate is needed to make DNA and healthy red blood cells. Green leafy vegetables, beans, chickpeas and fortified foods are useful sources.
Folic acid is particularly important before and during early pregnancy because it helps reduce the risk of neural tube defects, including spina bifida. Malaysia’s government health guidance recommends discussing folic acid as part of pre-pregnancy care; see Malaysia’s pre-pregnancy health guidance.
Women planning a pregnancy should seek advice about the recommended dose and timing. Some women need a higher prescribed dose because of specific risk factors.
Do not assume folic acid alone will treat every type of anaemia. High-dose folic acid may improve the anaemia associated with vitamin B12 deficiency while allowing nerve damage from untreated B12 deficiency to continue. The NHS guidance on B12 and folate deficiency explains why B12 levels should be considered before treating folate deficiency.
Vitamin B12 — Especially important for some diets
Vitamin B12 helps produce red blood cells and maintain healthy nerves. It occurs naturally mainly in animal-derived foods such as fish, chicken, meat, eggs, milk and cheese. Some fortified foods also provide B12. See the NHS guide to vitamin B12.
People following a vegan diet need a reliable source from fortified foods or supplements. Older adults and people with conditions affecting absorption may also be at risk.
B12 deficiency can cause tiredness, anaemia, a sore tongue, pins and needles, numbness and problems with balance or memory. Nerve symptoms can occur even without obvious anaemia, so persistent symptoms deserve medical assessment. The NHS guide to B12 or folate deficiency anaemia describes the symptoms and treatment options.
Certain medicines, including long-term metformin, can be associated with lower B12 levels in some people. The UK’s National Institute for Health and Care Excellence guidance on B12 deficiency lists metformin and proton pump inhibitors among medicines that may be relevant when assessing deficiency risk.
Do not stop a prescribed medicine yourself; discuss your symptoms and risk factors with your doctor or pharmacist.
Should you buy a B-complex supplement?
Not necessarily. If you eat a varied diet, you may already get enough B vitamins.
If you often skip meals, follow a restrictive diet, are pregnant or planning pregnancy, or have a medical condition that affects nutrient absorption, ask a healthcare professional whether you need a supplement.
Remember that high-strength products are not automatically better. In particular, check the amount of vitamin B6 and avoid combining several products without checking their ingredients.
A pharmacist’s practical advice
When a customer asks me for something to “boost energy”, I would first ask a few questions: How long have you felt tired? Are you eating regularly? Do you have heavy menstrual periods? Are you taking any medicines? Have you noticed numbness, breathlessness or unusual paleness?
These details matter far more than choosing the most expensive bottle of vitamins.
A balanced Malaysian diet can include familiar foods such as fish, eggs, tofu, tempeh, beans, vegetables, nuts and wholegrains. You do not need to buy expensive health foods to improve variety.
If tiredness persists, or you have unexplained anaemia, a sore tongue, tingling or numbness, please seek medical advice rather than treating yourself indefinitely with supplements. A clinician may recommend blood tests to investigate the cause.
The aim is not simply to take more vitamins. It is to understand what your body needs and address the real cause of the problem.
In the next Health Matters article, we will look at essential minerals — including iron, calcium, magnesium and zinc — and how they affect our blood, bones, muscles and general health.
Until next time, take care of your health.
Health Matters — practical health advice from a community pharmacist.
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