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ConsumerLab.com Answers
Question: Being over 50 years old, I'm looking to take a vitamin B-12 supplement. I see that many contain a form of vitamin B-12 called cyanocobalamin, yet I read on the Internet that this form is toxic. Should I be concerned?
Answer: The most common form of vitamin B-12 (cobalamin) in supplements is cyanocobalamin and although this form includes a cyanide molecule, it is very safe. Why? Even at a very high dose, it would provide about a thousand times less cyanide than is toxic, and the cyanide is excreted in the urine.
Some non-authoritative websites claim that methylcobalamin is better absorbed or more bioavailable than cyanocobalamin, but there is no clinical evidence supporting this claim. Other sites suggest that methylcobalamin supplements cannot yield one of the important, active metabolites of B-12, but this is not correct. More information about this, and another form of B-12, hydroxocobalamin, is found in the "Cobalamin (B-12)" section of the B Vitamin Supplements Review >>
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Question: What is Lipo-flavonoid and does it work for tinnitus or other ear problems?
Answer: Lipo-flavonoid® Plus is a supplement promoted for ringing in the ears (tinnitus) and other ear-related conditions including vertigo, ear aches, ear infection, and Meniere's disease.
The product is actually a formula consisting of several ingredients. The main ingredient is a lemon flavonoid extract containing eriodictyol glycoside and other flavonoids. The product also contains several B vitamins, vitamin C, choline, and inositol.
In the 1960s, a paper was published describing 122 cases of Meniere's disease that were treated with a lemon flavonoid complex containing eriodictyol glycoside. Many people reported reduced vertigo and improved hearing (Williams, Ann Otol Rhinol Laryngol 1963). A paper published in 1947 described 87 cases of vertigo, often as a result of Meniere's disease, treated with pyridoxine (B6), usually 100 mg daily. Many people reported improvement (Lewy, Arch Otolaryngol 1947).
Based on these reports, some have assumed that these ingredients would be beneficial for a variety of ear disorders including tinnitus and others. However, these reports are very preliminary. Neither Lipo-flavonoid Plus, nor its main ingredient, have been evaluated in reliable clinical studies for tinnitus or other ear-related conditions.
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Question: Which supplements are important after bariatric surgery (i.e., weight loss or stomach-reducing surgery)? Are there any I should avoid?
Answer: Weight loss surgeries such as gastric bypass, gastric sleeve, and gastric band procedures, reduce the amount of food and liquid a person comfortably digest in one sitting, leading to smaller meals and potentially, inadequate nutrient intake. Gastric bypass (re-routing around the stomach) and gastric sleeve surgery (removing a portion of the stomach) also reduce stomach acid and normal digestive action, leading to reduced absorption of various vitamins and minerals. The use of supplemental vitamins and minerals is recommended for gastric bypass and gastric sleeve patients, and sometimes for gastric band patients. However, for bypass and sleeve patients, the changes in digestion and nutrient absorption also mean that some supplements may not be tolerated or absorbed as well as others. For details about supplements to take or avoid, see the full answer >>
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Question: Are enterically coated supplements better than non-enterically coated ones?
Answer: Enteric coatings help protect supplement ingredients from being released in the stomach and keep them away from stomach acid and enzymes. This allows the supplement to stay intact until it reaches the less acidic small intestine (where most nutrient absorption takes place). An enteric coating may also be desirable for ingredients which, for some people, otherwise cause an unpleasant aftertaste. Consequently, with ingredients that need protection it is sometimes worthwhile to purchase an enterically coated supplement. However, enteric coatings are not always necessary or beneficial, and, in some case, may just be an expensive gimmick. There are also some concerns about enteric coatings of which you should be aware. See the full answer (with information about enteric coatings for fish oil, marine oils, probiotics, garlic, and SAMe)>>
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Question: I take fluoxetine (Prozac), a SSRI drug to treat depression. Are there supplements I should avoid, or be taking, due to this drug?
Answer: Fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil) and other selective serotonin-reuptake inhibitor (SSRI) drugs can be affected by taking supplements and can affect your ability to absorb certain vitamins and minerals. Certain herbal supplements, such as St. John's wort and Garcinia cambogia (HCA), may increase the risk of serotonin syndrome associated with SSRIs. Other supplements, like 5-HTP, and SAMe, may also increase this risk.
On the other hand, folic acid, a B vitamin, may be beneficial for some people taking an SSRI.
These interactions are explained in the SSRIs article, which is part of the extensive Drug Interactions section of our website (where you can look up interaction for other drugs you may be taking).
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Question: Do any supplements really help with brain function, like memory and cognition?
In girls deficient in iron, iron supplementation may improve learning and memory.
Although green tea has been touted for improving brain function, this effect is not well established. Other supplements touted for brain function, such as Gingko biloba and vitamin E have, by and large, not been found to be helpful.
You can read more about the potential memory and cognition benefits of these supplements by using the links above. Also see ConsumerLab.com's Encyclopedia article about Enhancing Memory and Mental Function.
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Question: What is benfotiamine and can it really improve or prevent complications from diabetes?
Answer: Benfotiamine is a derivative of thiamin (vitamin B-1) which may be more effective at raising thiamine levels in the body. There is preliminary evidence that benfotiamine may be helpful to people with diabetes. For more details, see the information about benfotiamine in the B Vitamins Supplements Review >>
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Question: The maker of my multivitamin says it doesn't include folic acid because too much from supplements can be harmful. Is that true?
Answer: Although folic acid is an essential B vitamin with important functions, there are legitimate concerns about getting too much folic acid from supplements and fortified foods. For example, a high daily dose of folic acid from a supplement has been associated with a more than doubling of the risk of prostate cancer. High doses of folic acid from supplements can also complicate the diagnosis of vitamin B-12 deficiency and cause kidney damage. For details about how much is too much, and how this compares to the amounts of folic acid in the many popular multivitamins and B vitamins we've tested, see the Multivitamin Supplements Review and B Vitamin Supplements Review >>
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Question: Do any supplements help with migraines?
Answer: There is evidence that magnesium, CoQ10 and riboflavin (B2) may help to reduce the frequency or severity of migraine headaches. The amino acid 5-HTP may also reduce frequency, although the evidence is mixed.
Some herbal supplements, such as butterbur and feverfew may also be helpful. However, be aware that taking St. John’s wort with migraine medications or the painkiller tramadol can cause adverse effects.
One clinical study found that a DAO (diamine oxidase) supplement reduced the duration of migraine attacks by 30%, but did not reduce pain or frequency.
For more information, see the article about Migraine in our Encyclopedia, and also use links above.
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Question: Can taking too much vitamin B-6 be dangerous? The label on my multivitamin states it contains 2000% the Daily Value!
Answer: High doses of vitamin B-6 can cause nerve damage and skin lesions, as well as other adverse effects. If your multi contains 2,000% of the Daily Value (DV), which is 2 mg for adults, then your multi has 40 mg of B-6. While that amount alone does not exceed the Upper Tolerable Intake Limit for adults, it is important to consider the total daily amount you are getting from foods and other supplements, combined. Furthermore, there does not seem to be solid evidence to support getting such a large amount of B-6 if you are not deficient in it. The mega doses of vitamins found in some daily multis may be driven more by marketing considerations than science.
One clinical study found that 25 mg of B-6 taken daily as part of a B-complex vitamin was shown to increase the risk of heart attack, stroke and death in diabetes patients with advance kidney disease.
Also, be aware that people taking certain medications may need to limit their intake of B-6 from supplements. Get more information, including Recommended Daily Allowance and Upper Limit for B-6 (by age and gender), potential side-effects and drug interactions, plus test results for popular products, in the B Vitamin Supplements Review >>
You can check the recommended intakes of other vitamins and minerals here.
ConsumerLab.com Answers
Question: Can taking too much vitamin B-12 be dangerous? The label on my B-complex states it contains 50,000% the Daily Value!
Answer: If your B-complex contains 50,000% of the Daily Value (DV), which is 6 mcg for adults, then it has 3,000 mcg of B-12. For people without a severe B-12 deficiency, this is certainly more than necessary.
Taking some B-12 is advisable for people over the age of 50 (when you're less able to extract B-12 from food), as well as for those taking medications that interfere with B-12 absorption, strict vegetarians, alcohol and drug abusers, people recovering from surgery or burns, and those with bowel or pancreatic cancer.
Although vitamin B-12 is generally considered to be safe, and no "Upper Tolerable Intake Level" has been established, there are some reports of doses of 20 mcg per day or higher causing outbreaks of acne and rosacea. There is also a study which showed that a high-dose B complex supplement (with 1,000 mcg of B-12) hurt, rather than helped, people with type 1 or type 2 diabetes and advanced kidney disease, resulting in a worsening of kidney function and an increase in the risk of heart attack, stroke and death.
In women who are pregnant, excessive blood levels of vitamin B-12 have been associated with an increased risk of autism in their child.
In general, it's best to avoid excessive doses of any vitamin if it is not needed.
Get more information, including the Recommended Daily Allowance for B-12 (by age and gender), differences in the forms of B-12, potential side-effects and drug interactions, plus ConsumerLab.com's tests of popular products, in the B Vitamin Supplements Review >>
You can check the recommended intakes of other vitamins and minerals here.
Question: Which supplements help reduce the risk of colorectal cancer?
Answer: There is good evidence that getting adequate folate and fiber from foods and supplements can reduce the risk of developing colorectal cancer. (Listen to ConsumerLab.com's Fiber Supplements Webinar for more on fiber and colon health).
In people with low blood levels of selenium, selenium supplements have been found to reduce the risk of colon cancer, and in people who smoke, taking curcumin can reduce early changes in the colon that can lead to cancer.
Maintaining higher levels of vitamin D in the body -- which can be achieved through exposure to sunlight or obtained from foods and supplements -- is associated with a reduced risk of developing colorectal cancer.
Calcium supplements may possibly reduce the risk of colon polyps or colon cancer.
Although a high dietary intake of CLA (conjugated linoleic acid) from high-fat dairy foods has been associated with a reduction of colorectal cancer by up to 39% in women, it is not known if taking CLA supplements has this potential benefit.
For more information about each of these supplements, use the links above. Also see the Cancer Prevention article in our Natural Products Encyclopedia.
ConsumerLab.com Answers
Question: Do any supplements help relieve stress?
Answer: Fish oil may blunt some of the effects of mental stress, such as increased heart rate and nervous activity. Several clinical studies show ashwagandha may help to relieve symptoms in people with anxiety. And, interestingly, a particular probiotic has been shown to lower levels of the "stress" hormone cortisol, and measures of psychological distress such as depression and anger.
L-theanine, an amino acid found in black and green tea, has been shown to reduce stress responses without causing drowsiness, and there is some evidence that the herbs passionflower and lemon balm may be helpful for anxiety.
One clinical trial found 500 mg of holy basil leaf extract taken twice daily significantly reduced measures of anxiety in men and women (Bhattacharyya, Nepal Med Coll J 2008). See the Encyclopedia article about Ayurvedic medicine for other uses for this herb - which is listed by its scientific name, Ocimum sanctum.
Ginseng is sometimes promoted for reducing stress, although one clinical study found it did not have an effect on cortisol levels. There is weak evidence that valerian supplements may produce a calming effect in stressful situations.
Be aware that low blood levels of iron and vitamin B6 have been associated with stress responses such as hyperventilation and panic attacks in women (Mikawa, Acta Med Okayama 2013), so be sure you're getting sufficient intake of these nutrients. There is some evidence that daily supplementation with a multivitamin-multimineral supplement may help people to cope with stressful situations.
For more information, use the links above, and see the Encyclopedia article about Stress.
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Question: Do any supplements help with nerve pain, like sciatica or diabetic neuropathy?
Answer: Several supplements have been shown to be helpful for nerve pain caused by conditions such as sciatica or diabetic neuropathy. These include fish oil, curcumin, alpha-lipoic acid (ALA) and GLA, and benfotiamine. Read the full answer for details and dosage >>
ConsumerLab.com Answers
Question: I have been having neurological symptoms, and a blood test showed I have toxic levels of vitamin B-6. My multivitamin contains 75 mg of B-6, but this is below the upper limit of 100 mg per day. Could my vitamin contain more than it lists?
Answer: As noted in our B Vitamin Supplements Review, unless you are deficient, you only need to get slightly less than 2 mg of vitamin B6 per day from your diet (including supplements), while the daily upper tolerable intake level (UL) is 100 mg. When you exceed the UL, you start increasing your chances of side effects.
Since supplements are required to provide at least 100% of their listed amounts of ingredients at the time you purchase them and, if properly maintained, until a listed expiration date, it is customary and acceptable for companies to put in a bit more (an "overage") than the listed amount of an ingredient to compensate for normal degradation. In fact, according the USP, up to 50% more is permitted for B vitamins.
So, yes, it is possible that your multivitamin provided more than the daily upper limit of vitamin B6 -- putting you at some risk of toxicity. This is because your supplement provided an amount of B6 close to the upper limit (and much more than normally needed) and there is an allowable manufacturing overage, as noted above. However, side effects have generally been reported with daily intakes above 200 mg and, more typically, above 1,000 mg, so it would be unusual for the B6 in your supplement alone (if properly made) to cause the side effects you reported. Foods also contribute B6, but it would also be unusual for any non-fortified food to have put you over the UL since foods naturally rich in B6 (like liver, other meats, potatoes, and bananas) only provide about 0.25 to 1 mg of B6 per serving ? although enough to meet the daily requirement.
Question: I thought the B vitamins were all water soluble and did not build up in the body, so you would not build up toxic levels. Am I wrong?
Answer: Although B vitamins are water soluble and don't stay long in your body, large doses of certain B vitamins can cause serious toxicity, as summarized below. The same is true of vitamin C -- the other water soluble vitamin.
Unfortunately, there is no requirement for supplement labels to warn of these toxicities. As we have shown in our B Vitamin Supplements Review, many vitamins and energy drinks exceed the established Upper Tolerable Intake Levels (which vary by age) for B vitamins. If you have an established deficiency, high doses may be necessary; otherwise, remember that "more" does not necessarily mean "better."
Question: Does nicotinamide riboside (Niagen) really have anti-aging or other health benefits?
Answer: Nicotinamide riboside (sold as Niagen and Niacel) is a form of vitamin B3 (niacin) that has been promoted as having anti-aging effects, such as increasing energy, improving cognitive function, and improving cholesterol levels -- without causing flushing. However, the evidence for these uses appears to be very preliminary, as discussed in the Niacin section of the B Vitamin Supplements Review >>
Question: Do any supplements help prevent or improve cataracts?
Answer: A number of supplements have been promoted to preventing or improving cataracts. These include multivitamins, vitamin A, C, and E: the B vitamins niacin, thiamin, and riboflavin; lutein, zeaxanthin, astaxanthin, carnosine, NACA, and St. John's wort. The evidence, however, is better for some than for others. Get the details in the full answer >>
See the Encyclopedia article on Cataracts for more information.
Question: Is sublingual vitamin B-12 really better than the pill form?
Answer: Although sublingual B-12 is often promoted for better absorption, there does not appear to be much evidence for this. In fact, one clinical study comparing the same amount of B-12 given orally or sublingually found they were equally effective at correcting B-12 deficiency over a two-month period.
It should also be noted that unlike the vitamin B-12 in foods, the purified form of B-12 found in supplements, including tablets, does not require stomach acid for absorption -- a potential concern for people with low stomach acid (including many people over the age of 50) or those who take acid blockers such as Pepcid or Zantac, or proton pump inhibitors such as Prevacid, or Prilosec, who are at an increased for B-12 deficiency. For those who have difficulty with large pills, keep in mind that only a very small amount of B-12 is required to meet the recommended daily intake and can be obtained in small tablets (including some tested by ConsumerLab.com in its B Vitamins Supplement Review). For more information about buying and using B-12 supplements, plus our tests of popular products, see the B Vitamins Supplements Review >>
Question: I take estrogen replacement (Vagifem), to help relieve the symptoms of menopause. Are there supplements I should avoid, or be taking, due to this drug?
Answer: Oral estrogen replacements, as well as estrogen creams and tablets (Vagifem, Estrace) can be affected by certain supplements and foods. See the full answer >>
ConsumerLab.com Answers
Question: Is P-5-P really better than "regular" vitamin B6?
Answer: Pyridoxal-5-phosphate, sometimes called P-5-P or PLP, is the active form of vitamin B6 (pyridoxine). Most supplements provide the pyridoxine form of B6, although some provide pyridoxal-5-phosphate, or a combination of both. Taken at recommended doses, both forms appear to be relatively safe and have similar bioavailability for most people. Although pyridoxal-5-phosphate is sometimes promoted as more beneficial for people with diabetes, there do not appear to be any studies in people to support this. For more details, see the "What to Consider When Buying" section of the B Vitamin Supplements Review >>
ConsumerLab.com Answers
Question: Which supplements can help to lower blood pressure?
Answer: There are many supplements, including CoQ10, fish oil, curcumin, certain probiotics, cinnamon and others, which may lower blood pressure. However, if you already take medication to lower blood pressure, always consult your physician before using these supplements, as they may lower your blood pressure too much, or interfere in some other way with your current medication. Be aware that a number of supplements can increase blood pressure. Sign in to see the full answer >>
See the Encyclopedia article about Hypertension for more information.
Question: Do any supplements improve balance or reduce the risk of falls?
Answer: Moderate doses of vitamin D may improve balance and reduce the risk of falls in older adults deficient in vitamin D, however, be aware that too much vitamin D may actually increase the risk of falls.
When combined with resistance exercise, supplementation with protein or creatine may help to build muscle in older adults (muscle loss has been associated with an increased risk of falls).
Also, be aware that being deficient in vitamin B12 can cause problems with balance and gait, which could increase the risk of falls.
Question: Are lozenges and sublingual pills considered dietary supplements?
Answer: Lozenges and sublingual pills are, according the FDA, not dietary supplements if they deliver their contents only to the mouth or throat to exert their effect. (An example of this is noted in an FDA Warning Letter sent to a company marketing a "Zinc & Echinacea" throat lozenge).
Keep in mind that just because a product is sold as a sublingual does not mean that it's been proven to work sublingually. Also keep in mind that the ingredients in lozenges do, of course, make their way into the gastrointestinal tract and can have additional effects once there. For example, while the zinc in zinc lozenges may have a local effect on the throat to reduce cold symptoms when taken at the correct dosage and frequency, ingestion of too much zinc from lozenges can cause one to exceed tolerable intake levels and, over time, have detrimental effects (see the Zinc Supplements and Lozenges Review for more information).
ConsumerLab.com tests lozenges and sublingual pills (such as some vitamin B-12 products) and holds them to the same standards as dietary supplements — making sure they contain what they claim, lack common contaminants, and that tablets will properly disintegrate.
Question: I was told I have a MTHFR gene mutation. What do I need to know about taking B vitamins?
Answer: The MTHFR gene mutation may make your body less efficient at converting folic acid and folate into L-methylfolate, the active form of folate in the body. People with this mutation may also be more likely to be deficient in vitamin B-12. Although certain forms of B vitamins are sometimes promoted for people with this mutation, they may not be necessary. For more about this, see the "What to Consider When Using" section of the B Vitamin Supplements Review >>
ConsumerLab.com Answers
Question: Which supplements can help with indigestion and/or heartburn?
Question: What are the most common, potentially dangerous interactions between supplements and drugs?
Answer: Fifteen percent of men and women ages 62 to 85 in the U.S. are potentially at risk for a dangerous interaction between a prescription drug, over the counter drug (OTC), and/or supplement they are taking, according to a study published in 2016 (Qato, JAMA Intern Med 2016).
The most common drug and supplement combinations with the potential for harmful effects, according to that study, are warfarin (Coumadin) interacting with fish oil or garlic; the ACE inhibitor drug lisinopril (Zestril) interacting with potassium; and statin drugs like atorvastatin (Lipitor) and rosuvastatin (Crestor) interacting with niacin.
For more about these drug interactions, use the links above. You may also check for others in the extensive Drug Interactions section in the Encyclopedia.
Question: My HDL (good) cholesterol level is low. Should I take niacin to raise my HDLs?
Answer: Niacin, at very high doses, can raise HDL levels, as well as lower elevated triglycerides -- both of which would seem to be good objectives, since higher HDL levels are generally associated with reduced risk coronary artery disease, as are lower triglyceride levels. However, it's not necessarily a good idea to take niacin to raise HDLs and there are safer ways to boost HDL levels. See the full answer >>
ConsumerLab.com Answers
Question: I've been taking a Daily Advantage multi but am now concerned by the very high % DV for vitamin C (833% DV), niacin (325% DV), and B vitamins (over 1,000% DV for several). The company tells me this formula is based on clinical experience and the scientific literature. What do you think?
Answer: Unless you are deficient in each of these vitamins you don't need to take such high doses of each. Some may being doing more harm than good. It's good that you are now studying the ingredients listed on the label. You may still benefit from a multivitamin, but one which is likely to fill your nutritional gaps without exceeding upper tolerable intake levels.
The following resources on ConsumerLab.com can help you:
Question: What is Brain Bright and can it really improve memory or cognition?
Answer: Brain Bright (BioTrust Nutrition) is promoted on the company's website as a "science-backed" "triple-action brain enhancement formula" which promises to provide: 1) greatly improved memory and recall, 2) immediate concentration and razor-sharp focus and 3) second-to-none long-term brain health (by shielding the brain from toxins).
Evidence:
While the ingredients (and the amounts of these ingredients) in Brain Bright are each supported by some research suggesting a potential benefit, there do not appear to be any published clinical studies on the effects of these ingredients when combined. The closest thing is an undated blog post by the makers of Brain Bright in which they claim that a double-blind, placebo controlled study found the supplement improved overall cognitive function and mental capacity by 240% "just minutes" after consuming. However, no further details about the study are given, and it does not appear to have been published. The claims made on the website appear to be based on this unpublished study, along with other studies by others on the different ingredients listed in the product. Here is the evidence for each of the key ingredients in Brain Bright based on studies of the individual ingredients. You can use the links to get more information about each ingredient on ConsumerLab.com. Also shown is the amount of each ingredient listed in the suggested daily serving size of 2 capsules:
B Vitamins (riboflavin (8 mg), B-6 (20 mg), folate (as folic acid) (800 mcg), B-12 (methylcobalamin) (500 mcg) - The same doses of B-6, folic acid, and B-12, taken together, were found in one clinical study to slow cognitive decline in people age 70 years or older with mild cognitive impairment (riboflavin, however, was not used in the study).
Gingko biloba (240 mg of extract standardized to 24% glycosides, 6% lactones, and < 1 ppm ginkgolic acid) - Although this amount and type of extract is in-line with those used in some clinical studies for cognitive function, some experts have concluded there is little evidence that gingko improves cognitive function. The Brain Bright claim of "second-to-none long term brain health (by shielding the brain from toxins)" appears to be based on laboratory and animals studies demonstrating the antioxidant activity of ginkgo glycosides. However, we are not aware of any studies demonstrating long-term brain health benefits based on gingko's antioxidant properties.
Rhodiola rosea (200 mg root extract standardized to 5% rosavins and 2% salidrosides) — Doses in this range have shown some efficacy for improving certain measures memory and mental fatigue in a few small studies. However, overall, due to contradictory findings and design flaws in the studies, some researchers concluded there is insufficient evidence for this use.
N-acetyl-L-tyrosine (500 mg) - N-acetyl-L-tyrosine is converted into the amino acid tyrosine in the body. Although a few, small studies suggest tyrosine may improve memory or mental function in people who are sleep deprived or exposed to other forms of stress, it should be noted that these studies used higher doses of L-tyrosine (2,000 mg to 15,000 mg). In addition, it's not clear how much N-acetyl-L-tyrosine is actually converted into tyrosine in the body (Magnusson, Metabolism 1989; Van Goudoever, J Parenter Enteral Nutr 1994).
Acetyl-L-carnitine (500 mg) - There is some evidence that acetyl-L-carnitine may provide some help for age-related memory impairment, however, typically at a higher dosage (1,500 to 2,000 mg).
L-theanine (100 mg) - There is evidence that taking 50 mg of this amino acid (which is also found in black and green tea) may increase alpha brain wave activity, which plays an important role in attention, within less than an hour of taking. This research may be part of the basis for the claim that Brain Bright promise of "immediate concentration."
Brain Bright also contains 5 mg of black pepper extract (BioPerine), an ingredient which is sometimes added to supplements to enhance the bioavailability of certain ingredients.
Safety:
It's important to note that the directions for use state: "Take 1 tablet 2 times daily, preferably without food, or, for enhanced concentration take 2 tablets as needed. Do not exceed 6 tablets per day." Taking the maximum recommended dosage of 6 tablets would provide three times the dosages of each ingredient as listed above. There are risks associated with taking such high doses of some of these ingredients, including vitamin B-6, B-12 and folic acid. Furthermore, there are no published studies on the safety of taking all of these ingredients together. For example, both Ginkgo biloba and Rhodiola may lower blood sugar, and both Rhodiola and L-theanine may lower blood pressure.
There are also potential interactions with medications for some of these ingredients. More information about potential side-effects and drug interactions for each ingredient can be found in the "Concerns and Cautions" sections of ConsumerLab.com's product reviews, which you can find by clicking on the above links to each review.
ConsumerLab.com has not tested Brain Bright to determine whether this product contains what it claims, and without contaminants.
Cost: Brain Bright costs $49 for a bottle containing 60 tablets - a 30 day supply if you take the recommended 2 per day. The website claims there is a one-year money back guarantee and you will not be enrolled in an auto-delivery program.
The bottom line:
Brain Bright contains several ingredients in doses which some small studies suggest may help to improve memory and cognition. However, there are no published clinical studies showing that these ingredients are safe or effective when taken together as in the Brain Bright formula. Furthermore, the overall evidence for two of its main ingredients, ginkgo and rhodiola, is currently considered insufficient for memory and cognition, and the evidence for the other ingredients is quite preliminary.
Question: Are the "% DV" numbers on vitamin supplement labels really based on what I need?
Answer: Unfortunately, the % DV (percent of Daily Value) numbers are not nearly as useful as they could be. One reason is that they are woefully out of date. The DVs are based on calculations done in 1968 (with some additions in 1989) and do not reflect the latest intake recommendations from the Institute of Medicine which show that some DVs are too high and others are too low. In addition, the DVs do not distinguish nutritional needs by age and gender since the DVs are intended to cover healthy adults and children over 4 years of age (except pregnant and lactating women), while the needs of people vary significantly within this expansive group — even between men and women of the same age.
In some situations, the DVs actually exceed the upper tolerable intake levels for adults and/or children. In these cases, when you get 100% or more of the DV from a supplement, you are actually putting yourself at risk of toxicity.
In other situations, 100% of the DV or more is simply much higher than the current recommendations. What appears be 100% of the DV could actually be as much as 1,000% of what you need.
For several popular vitamins and minerals, if you get 100% of the DV, you are actually getting much less than the current recommendations.
The DVs do not include the special needs of women or are pregnant or lactating, whose needs are often much greater than 100% of the DV.
The nutrients for which the DVs can be particularly misleading are vitamin A, vitamin B12, vitamin C, vitamin D, vitamin K, biotin, calcium, chromium, copper, folate, iron, iodine, magnesium, molybdenum, niacin, pantothenic acid, potassium, and zinc.
Question: Are there any supplements I should avoid when taking an antibiotic? Are there any that may be helpful?
Answer: Antibiotics can be affected by the supplements you take, and they can affect your ability to absorb certain vitamins and minerals.
The interactions will depend on the type of antibiotic you are taking. You can search for the specific antibiotic you are taking by name in the Drug Interactions section of our ConsumerLab.com.
Some of the most common antibiotics are listed below, followed by the supplements with which they can interact. Use the links for more details:
Amoxicillin (Amoxil, Trimox, Wymox): Bromelain, vitamin K
Tetracyclines (doxycycline (Bio-Tab, Doryx, Doxy-Caps), tetracycline hydrochloride (Achromycin V, Panmycin etc.):Calcium, magnesium, iron and zinc, Dong Quai, St. John's Wort, citrate (i.e. potassium citrate)
Trimethoprim/sulfamethoxazole (Bactrim, Cotrim, Septra, Sulfatrim): Folate, PABA (para-aminobenzoic acid), potassium, white willow, St. John's wort
Interestingly, some of the supplements noted above (folate and vitamin K) may, at times, be helpful when taking certain antibiotics, as can probiotics.
Question: Which supplements help with Raynaud's phenomenon?
Answer: As discussed in the Raynaud's phenomenon article in the Encyclopedia, fish oil, Ginkgo biloba, inositol hexanicotinate (a form of the B vitamin niacin), and ginseng have shown some benefit in Raynaud's phenomenon (abnormal sensitivity of hands and feet to cold). Several other types of supplements have been tried without success. For more information, including dosage and clinical evidence, use the links above, and see the Encyclopedia article about Raynaud's phenomenon.
You can also find information for many other medical conditions in the Conditions section of the Encyclopedia, and by searching our index of Health Conditions.
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Product Review:B Vitamin Supplements and Energy Drinks (Including B Complexes, Niacin, B-6, B-12, Biotin, Thiamin, and Folic Acid)
Posted: 9/6/14 Last Update: 9/16/16
Tests Show Many B-Complex Supplements and "Energy" Drinks Contain Wrong Amounts of Vitamins
Find Out Now If Yours Passed!
B vitamin supplements and energy drinks in this review (including B-complexes, thiamin, niacin, vitamin B-6, vitamin B-12, biotin, folate, and pantothenic acid supplements):
Dr. Mercola Vitamin B-12 Energy Booster - Natural Cherry Flavor
Nature's Life Biotin Hair, Skin & Nails
Solgar Vitamin B 12
Finest Nutrition Folic Acid
Nature's Plus Vitamin B-6
Spring Valley B 12 - Natural Cherry Flavor
Garden of Life Vitamin Code RAW B-Complex
Nature's Way Pantothenic Acid
The Vitamin Shoppe Vitamin B12
GNC B-Complex + Energy
NOS High Performance Energy Drink
Thorne Research 5-MTFH
GNC B-Complex
NOW B-12
Thorne Research Stress B-Complex
Jamieson Natural B12
NOW Niacinamide
Twinlab B-12 Dots
Jarrow Formulas Methyl Folate
Nutrilite Natural B Complex
Vitacost Quickdot Chewables
Klaire Labs Vitamin B6
Nutrition Now B Complex
Vitamin World B-12
Life Extension Complete B-Complex
PhysioLogics Flush Free Niacin
Whole Foods Folic Acid
MegaFood Vegan B12
Puritan's Pride B-12
Make sure the B-complex, B vitamin, or "energy" supplement you take passed our test and is right for you!
Isn't your health worth it?
Which are the best B-complexes and single vitamins? Our tests and quality ratings of B vitamin supplements, including B-complexes and energy drinks/shots, revealed problems with the quality of 6 out of 30 products selected for review. Among B vitamin supplements, the most problematic were B complexes. This new report shows which products passed or failed independent testing, how they compare on dosage and ingredients, and which provide the best value.
Testing also revealed the actual amounts of caffeine in popular energy drinks/shots/squirts. Just a single small bottle of one of these contained more than twice the caffeine you would expect from a regular cup of coffee. Following the serving suggestions for some may cause you to ingest greater amounts of B vitamins than you would normally want.
In this comprehensive report, you'll get quality ratings and reviews of 41 B vitamin supplements and fortified energy drinks: 30 products selected by ConsumerLab.com and 11 others that passed voluntary certification testing. You'll also get information about two supplements similar to one that passed testing. Tested products include B-complexes, energy shots/drinks/squirts, and single-B vitamin supplements with thiamin, niacin, vitamin B-6, vitamin B-12, biotin, folate (folic acid), or pantothenic acid.
In this comprehensive report, you'll discover:
Which B vitamin supplements and energy drinks failed testing and which passed
Cost comparisons and quality ratings of B vitamin supplements and energy drinks
Information on what B vitamin supplements and energy drinks can and cannot do for you -- some may reduce memory decline!
Important differences between forms of B vitamins, such as those of niacin: nicotinic acid, niacinamide, inositol hexanicotinate, and delayed-release formulations.
Usage and dosage information for thiamin, niacin, vitamin B-6, B-12, biotin, folate (folic acid), and pantothenic acid.
How to avoid getting too much folate due to misleading labels.
Side effects and potential drug interactions with B vitamins
Safety concerns about energy drinks and how to use them more safely, including concern over ingredients such as L-carnitine
ConsumerLab.com Answers -- for B Vitamin Supplements and Energy Drinks (Including B Complexes, Niacin, B-6, B-12, Biotin, Thiamin, and Folic Acid)
Question: Being over 50 years old, I'm looking to take a vitamin B-12 supplement. I see that many contain a form of vitamin B-12 called cyanocobalamin, yet I read on the Internet that this form is toxic. Should I be concerned? Get the answer >>
Question: What is Lipo-flavonoid and does it work for tinnitus or other ear problems? Get the answer >>
Question: Which supplements are important after bariatric surgery (i.e., weight loss or stomach-reducing surgery)? Are there any I should avoid? Get the answer >>
Question: Are enterically coated supplements better than non-enterically coated ones? Get the answer >>
Question: I take fluoxetine (Prozac), a SSRI drug to treat depression. Are there supplements I should avoid, or be taking, due to this drug? Get the answer >>
Question: Do any supplements really help with brain function, like memory and cognition? Get the answer >>
Question: What is benfotiamine and can it really improve or prevent complications from diabetes? Get the answer >>
Question: The maker of my multivitamin says it doesn't include folic acid because too much from supplements can be harmful. Is that true? Get the answer >>
Question: Do any supplements help with nerve pain, like sciatica or diabetic neuropathy? Get the answer >>
Question: I have been having neurological symptoms, and a blood test showed I have toxic levels of vitamin B-6. My multivitamin contains 75 mg of B-6, but this is below the upper limit of 100 mg per day. Could my vitamin contain more than it lists? Get the answer >>
Question: I thought the B vitamins were all water soluble and did not build up in the body, so you would not build up toxic levels. Am I wrong? Get the answer >>
Question: Do any supplements help for tinnitus? Is it true that some supplements can cause tinnitus? Get the answer >>
Question: Does nicotinamide riboside (Niagen) really have anti-aging or other health benefits? Get the answer >>
Question: Do any supplements help prevent or improve cataracts? Get the answer >>
Question: Is sublingual vitamin B-12 really better than the pill form? Get the answer >>
Question: I take estrogen replacement (Vagifem), to help relieve the symptoms of menopause. Are there supplements I should avoid, or be taking, due to this drug? Get the answer >>
Question: Is P-5-P really better than "regular" vitamin B6? Get the answer >>
Question: Which supplements can help to lower blood pressure? Get the answer >>
Question: Do any supplements improve balance or reduce the risk of falls? Get the answer >>
Question: Are lozenges and sublingual pills considered dietary supplements? Get the answer >>
Question: I was told I have a MTHFR gene mutation. What do I need to know about taking B vitamins? Get the answer >>
Question: Which supplements can help with indigestion and/or heartburn? Get the answer >>
Question: What are the most common, potentially dangerous interactions between supplements and drugs? Get the answer >>
Question: My HDL (good) cholesterol level is low. Should I take niacin to raise my HDLs? Get the answer >>
Question: I've been taking a Daily Advantage multi but am now concerned by the very high % DV for vitamin C (833% DV), niacin (325% DV), and B vitamins (over 1,000% DV for several). The company tells me this formula is based on clinical experience and the scientific literature. What do you think? Get the answer >>
Question: What is Brain Bright and can it really improve memory or cognition? Get the answer >>
Question: Are the "% DV" numbers on vitamin supplement labels really based on what I need? Get the answer >>
Question: Are there any supplements I should avoid when taking an antibiotic? Are there any that may be helpful? Get the answer >>
Question: Which supplements help with Raynaud's phenomenon? Get the answer >>
