By George J. Goodheart, DC

Many doctors and many patients may suffer from a need for the riboflavin or niacin factors of the B complex. The excessively worried patient, the moody, apprehensive, suspicious, or depressed patient is a candidate for nutritional support from the riboflavin-niacin family.

A bright red tip on the tongue is a good indicator for riboflavin-niacin help. This condition of an irritated mucous membrane may exist not only in the parts of the digestive tract available to visual inspection, but to the other parts more difficult to observe. Lack of digestive juices may inflame the entire digestive tract with pronounced irritations of the rectum, which can also irritate the vagina. Frequent crying for no cause is a symptom of thyroid trouble as you know, but it also is involved in the riboflavin-niacin pattern, which we will refer to as the RN syndrome.

The strawberry tongue may also have sort of a purple color as well if the riboflavin of the “R” deficiency is prominent. The cracking of the lips, especially at the corners, is a well- known indicator of the RN pattern; however, a little-known but common pattern is the loss of substance of the upper lip; it becoming smaller and smaller until it almost disappears.

The first tissue to suffer from an RN deficiency is the endothelium of the capillary system with the loss of tone and function. The lips are highest in capillary numbers (witness their red color) so it is reasonable that they should show signs first such as wrinkling or cracking. These signs are at their height in highly specialized mucocutaneous structures such as the mouth, rectum, and vagina.

The strawberry or purple color to the tongue is the result of capillary dilation and sluggish blood flow, the characteristic lesion of the RN pattern.

The loss of capillary tone produces the one prominent symptom that is usually related to the RN syndrome: the “blood shot” eye. The “blood shot” eye is the characteristic that allows an understanding of the physiological relationship of thiamin and its partners, riboflavin and niacin.

Thiamin is water soluble, as are riboflavin and niacin, but thiamin is readily soluble in alcohol where riboflavin and niacin to all practical purposes are not. This chemical difference is the key to their different functions in relation to the enzyme systems of the body.

The RN complexes are fundamentally catalysts or trigger chemicals for oxidative processes. They transfer hydrogen and oxygen to suitable acceptors of these elements in the body. They also act as go-betweens in sugar metabolism, and as such intermediaries they are of immense importance to the eyes where levels of oxygen are most critical for proper function. This lack of oxygen transport that can occur in the RN pattern produces the photophobia, burning and itching and blepharospasm of the eyes.

As you know, the cornea can directly absorb oxygen from the atmosphere, but the lack of riboflavin and niacin interfere with its utilization just as transportation of warehouse supplies interfere with their ultimate use by the consumer.

A peculiar pattern that sometimes occurs in the severe RN pattern is why some patients describe how objects come into vision and then disappear. Sometimes, they say, they see only part of printed words. There is often pallor of the temporal or outer half of the optic disc when examined by an ophthalmoscope and this is often seen in the author’s experience if it is looked for. This is a valuable sign in this condition. All these signs relate to oxygenation which is an essential part of the enzymatications of the substances.

A good general way to think of these factors of the B complex as opposed to the B one factors is to remember that they are concerned with oxygen transfer and fat metabolism while the B one complex is associated with the nervous system.

They were first identified to be different when they were precipitated by alcohol from the beri-beri preventing materials of certain foods. This chemical reaction identified them as protein in character and enzymatic in action.

The engorgement of the capillaries seen in the tongue as previously mentioned can take place at the other areas as well, and this sets up the stagnation at the capillary level, which follows the engorgement. This can sometimes be seen easily in the “blood shot” eye and may be noticed in a finer or less discernable way by examining the cornea for circumcorneal vascularization following minor irritations. Normally these blood vessels are not seen and

if they appear following chemical or mechanical trauma, they quickly disappear. When they persist it is a sign the diet should be changed to include high levels of these materials so important to the health of our patients.

Now, as you recall, glucose is not directly oxidized in the body but is subjected to a series of changes until pyruvic acid is formed. Since the nervous system utilizes only carbohydrate for its energy, the proper metabolism of glucose requires the normal amount of B complex that usually accompanies the carbohydrate food in this normal state.

The myelin sheath of the nervous system produces acetylcholine with the help of the B complex. This chemical helps in the propagation of the nerve impulse and we as chiropractic physicians should be vitally interested in this phase of nutrition since it influences the results we obtain from our basic therapy.

The acetylcholine produced by the body at the myoneural junction is necessary at one stage for the nerve stimulus. Once it has been produced, it’s just as rapidly destroyed by an enzyme which the body, with its innate intelligence, provides for just this purpose. The promotion of the right amount of cholinesterase that neutralizes the potentially dangerous acetylcholine is a function of the RN complex.

The spastic reactions that occur when there is a failure of sufficient cholinesterase to neutralize the constant production of the necessary but dangerous acetylcholine are well known. High in the incidence of troubles caused are gastritis and ulcer cases. These are the cases that are treated by antichoinergic drugs, when in reality there is an interference with the nervous system at some point, and usually a deficiency in the production of cholinesterase due to an RN deficiency or lack of uptake.

Depending on which organ system is involved, you can see the problems that such spasticity can cause and the resulting difficulty in the function of the nervous system. The same gears that make a watch run on time can make it run slow or fast as the case may be. You adjust the watch properly and it performs its function as it was built to do. But you have to wind the watch. The piling-up of acetylcholine is the accumulation of biological dynamite setting off vasospastic explosions in various parts of the body with very little provocation, for this particular form of dynamite comes pre-capped and ready to blow if it is not defused regularly.

Without this cholinesterase, there is little chance of the accumulation of the vitally necessary nutrient, choline, in the tissues. Taking in certain natural fats aids in the production of choline, since it can come from a partitioning of lecithin, found in many fats. This splitting up of lecithin is accomplished by lecithinase, which as you can surmise is found in large quantities in RN-rich foods. So you see, God does not make mistakes, but we do, in the poor choice or the lack of opportunity of choice of RN-rich foods.

The accumulating quantities of acetylcholine can produce an arteriosclerosis which defies correction until these factors are taken into consideration. The coronary artery is probably the most active artery in the body and the atherosclerosis so often seen even in young individuals should be seen as perhaps just more evidence of this acetylcholine biological dynamite which can be taken out of harm’s way by an intelligent knowledge and use of proper dietary regimes.

The unavailability of the choline interferes with the proper fat metabolism by the liver, which in turn produces digestive disturbances, failure of detoxification of sex hormones, and a bewildering and perplexing number of other conditions all brought about by nutritional failure. Emphasis of one fraction of the B complex over another can produce problems of its own so use of foods high in all is best, or the use of natural sources high in all components in the form of nutritional supplementation is also indicated.

The “three Ds” of diarrhea, dermatitis, and dementia are the classic symptoms of pellagra, but there are many subclinical states. The nerve normalizing action of the B one complexes should be supplemented by vasodilating antispasmodic, and lipotropic actions of the RN group.

Too much B one can aggravate the RN state, so use intelligent appraisal of the patient’s history and nervous system workup. Make the proper nutrition be the springboard for the proper response to your adjustments. Treat the whole body, the whole person with your whole effort and watch the response of your patient.