Should you take B vitamins and low-dose aspirin together?

Breakthrough research reveals a potent effect on brain and heart health 

Did you know that B vitamins are SO potent for brain health that in Europe, they’re referred to as “neuro vitamins”?  

But sadly, the mainstream U.S. medical establishment hasn’t really embraced that moniker…despite reams of research showing their ability to boost mood, improve cognition, and lower stress.  

Not to mention, a new analysis of two multinational studies found significant benefits of B vitamins for older people with mild cognitive impairment (MCI).1 Of course, these studies have a kicker we don’t often see in B vitamin research—which is why the analysis caught my eye. 

In both studies, the researchers looked at the effects of B vitamins and aspirin on MCI.  

As you know, I recommend taking a daily low-dose aspirin for heart health. I also recommend taking B vitamins every day not only for brain health, but also for heart health, nerve health, cancer prevention, and overall energy—beginning at the cellular level.  

So the findings in these new studies concerned me—as the data appeared to indicate that B vitamins don’t work as well for the brain when taken with aspirin. That is, until I took a closer look…  

It turns out that, like so many other studies on dietary supplementation, their conclusions are dependent on the nutrient doses the researchers used. And—stop me if you’ve heard this before—there are issues with the doses.  

So, with that in mind, let’s look closely at what this new analysis found, didn’t find, and may have found. 

Two studies on two continents with similar results 

To better understand the study analysis, it’s helpful to begin with a definition of MCI. While some brain functioning naturally declines as we get older, people with MCI have changes in memory, decision-making, language skills, and some other brain functions that aren’t due to normal aging.  

Some people with MCI can go about their daily activities with minimal problems. In others, MCI increases risk of dementia. And because we don’t know exactly what causes MCI, it’s an appropriate—and important—research topic.  

Now, let’s take a closer look at the two important studies included in the new analysis… 

The first study, called VITACOG, was conducted in the U.K. and published in 2015. Researchers divided older men and women (with an average age of 77 years) with MCI into two groups. One group took what the researchers called “high dose” daily vitamin B supplements (B6, B12, and folic acid). The other group took a placebo. 

After two years, results showed that the B vitamin group had an impressive 40 percent less brain atrophy compared with the placebo group. The B group also had a modest improvement in memory and other brain functions that can be impaired by MCI. 

But there were caveats: These beneficial results were only found in people who also had adequate omega-3 blood levels. And aspirin appeared to have a slightly negative effect on the B vitamin brain benefits.  

The second study, conducted in Hong Kong and published in 2020, also evaluated vitamin B supplementation on men and women in their mid-70s with MCI. Like the U.K. study, the Hong Kong trial also lasted two years. 

But unlike the U.K. study, the Hong Kong study used even lower doses of B vitamins, and participants weren’t given any B6. Results showed reduction in brain atrophy, but no improvement in cognitive function in the vitamin B group versus the placebo group.  

Plus, the researchers found that taking aspirin plus vitamin B had a significant impact on cognitive function.  

So—what do these findings mean? 

The B vitamin/aspirin link 

Ultimately, the new analysis combined data from both the U.K. and Hong Kong studies, which allowed researchers to look at the vitamin B and MCI relationship more closely—in more people. (There were 545 older people with MCI from both studies.) 

The combined analysis showed that B vitamins significantly reduced harmful brain changes (atrophy), for both aspirin users and non-users.  

BUT, only the people who took both B vitamins without aspirin had significant improvement in dementia rating scores.  

The researchers think it’s possible that taking aspirin may have an effect on the ability of B vitamins to prevent cognitive impairment and dementia. Specifically, they think this is due to an interaction between aspirin and folic acid (a B vitamin).  

There also appears to be a connection between B vitamins and the amino acid homocysteine. Some scientists think higher levels of homocysteine are connected to a greater degree of brain atrophy—and thus, cognitive impairment. 

Of course, as I’ve reported for years, high homocysteine is also considered a key risk factor for heart disease. And the famous Framingham Heart Study also found that people with high homocysteine (above 14 micromoles per liter of blood serum) had TWICE the risk of dementia. Other studies have shown an association between high homocysteine levels and suspected or confirmed cases of dementia as well. 

That’s why supporting both brain and heart health usually goes together—through supplementation with high-quality B vitamins and by lowering homocysteine.  

Meanwhile, many people also take low-dose aspirin for heart health because it lowers the risk of blood clots, which can help protect against heart attacks and strokes (potentially causing vascular dementia). Of course, now, the new study analysis appears to cast doubts on aspirin use and the benefits of B vitamins for brain health (just as other reports have attempted to cast doubt on using low-dose aspirin for heart health).  

We also know there’s an anti-aspirin campaign going on out there, which should be taken into consideration when looking at the conclusions from the analysis. Plus, circling back to my original point, we must consider the dosages (of both B vitamins and aspirin) used in both studies included in the analysis… 

Another example of dosages potentially skewing study results 

The fact is, many big scientific trials simply don’t use optimal doses of vitamins and nutrients. 

For instance, the U.K. trial used 500 mcg of vitamin B12, 800 mcg of folic acid, and 20 mg of B6 daily. The Hong Kong trial didn’t use any B6 and only 400 mcg of folic acid. (The B12 dosage was the same as the U.K. trial.)  

But the latest scientific research on vitamin B doses recommends much more B6 (55 mg) than either trial—and much less folic acid (250 mcg).  

Now, remember how the researchers who conducted the analysis of these trials linked folic acid and aspirin with the failure of B vitamins in preventing cognitive impairment and dementia? Well…these dosages bear out their theory. But they also suggest taking less folic acid (but still an adequate amount for health) may counteract the effects aspirin had in the studies. 

Plus, we need to consider aspirin dosages as well. Neither the U.K. nor Hong Kong studies tracked how much aspirin participants took. The daily recommendation of low-dose of aspirin for heart health is 81 mg. But standard aspirin pills (for pain and headache, for example) can carry doses of 325 mg…and you take two at a time, multiple times per day (just not every day).  

But since we don’t know how much aspirin the study participants took, it’s difficult to know whether low-dose aspirin has the same effect on B vitamins and brain health as high-dose aspirin.    

That’s why if you’re taking low-dose aspirin for heart health and have any questions about it, I urge you to consult with a doctor who’s knowledgeable about nutrition and dietary supplementation. 

The analysis also pointed out how critical it is that omega-3 levels are high for B vitamins to work best—and other studies show that standard recommendations for omega-3s are too low. Meaning that with dietary supplementation, it’s a “team effort,” just as it is with following a balanced diet with diverse food groups. 

That’s why I interpret ALL of the science when recommending vitamin B doses—not just one or two analyses. And I have found that the dosages I suggest (see the sidebar) deliver optimum potency, helping to ensure the vitamins work at the best of their ability for brain health (and overall health), under almost all conditions. 

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My science-backed recommendations for B vitamin doses  

Vitamin B is not just a single vitamin, but rather a group of eight vitamins that work synergistically. The best way to get an optimum amount of each of these vitamins is to take a high-quality vitamin B complex every day.  

According to the latest science, I recommend a daily B complex that contains: 

  • Thiamin (vitamin B1): 55 mg 
  • Riboflavin (B2): 55 mg
  • Niacin (B3): 55 mg
  • Pantothenic acid (B5): 55 mg
  • Pyridoxine (B6): 55 mg
  • Biotin (B7): 100 mcg
  • Folate (B9): 250 mcg
  • Cobalamin (B12): 12 mcg

In addition, your B complex should also contain the following compounds that are related to B vitamins:  

  • Choline: 55 mg
  • Inositol: 55 mg
  • ABA: 55 mg


  1. “Effectiveness of B Vitamins and Their Interactions with Aspirin in Improving Cognitive Functioning in Older People with Mild Cognitive Impairment: Pooled Post-Hoc Analyses of Two Randomized Trials.” J Nutr Health Aging25, 1154–1160 (2021).