Vitamin B6 (Pyridoxine)


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What is vitamin B6 ?

Vitamin B6, also known as pyridoxine, is one of the more well-known B-vitamins. As with other vitamins in the B-complex family, vitamin B6 is absolutely an integral part of regulating many of our body’s processes.


What does the body use vitamin B6 for?


Vitamin B6 is essential in the regulation of sleep, mood, and appetite. It also aids skin and hair health.


Additionally, vitamin B6 helps in the process of producing insulin, regulating immunity, and protein metabolism.




Dietary Reference Intakes (DRIs)

The amount of vitamin B6 recommended for daily intake is based upon Recommended Dietary Allowance or the RDA developed by the Institutes of Medicine (IOM). This amount is the amount that meets the needs of most people.


Helpful terms to know

  • Recommended Dietary Allowance (RDA): covers the needs of 97-98% of individuals in a group; the average amount of a nutrient a healthy person should consume daily. Vary by gender, age, and whether a woman is pregnant or breastfeeding. Developed by the Food and Nutrition Board at the Institutes of Medicine (IOM) of the National Academies.

  • mg = milligram


Deficiency


A lack of vitamin B6 is relatively rare in the United States, but certain groups such as infants, alcoholics, older adults, or others prone to poor intestinal absorption may be more susceptible. Deficiency can also impair some of the body’s processes which help to control or convert certain chemicals.


Who is at risk for a vitamin B6 deficiency?

Individuals that may be prone to a deficiency of B6. The following conditions may increase the need for vitamin B6:

  • Older adults

  • Those who have a poor intake of vitamin B6

  • Individuals with alcoholism

  • Systemic inflammation or autoimmune disease

  • People on a variety of drug therapies and/or immune system medications

  • Individuals with Wilson’s disease

  • Individuals with Crohn’s disease

  • Those on medications that may alter vitamin concentrations


Niacin is also known as vitamin B3.


Toxicity

Excessive use of vitamin B6 (>~200 mg/day) has been known to cause the following symptoms:

  • Sensory and peripheral neuropathy

  • Unsteady gait

  • Paresthesias in the extremities (burning or prickling sensation)

  • Impaired tendon reflexes

High intakes of over 2 g/day can cause the following symptoms:

  • Impaired motor control

  • Ataxia (degenerative nerve disease)

  • Paresthesias of the hands and feet

  • Degeneration of neurons in the spinal cord


Needless to say, overdosing on vitamin B6 can be dangerous for a number of reasons. The upper levels (UL) of vitamin B6 are listed in the following chart.


Helpful Terms to Know

Tolerable Upper Intake Level (UL): the highest level of nutrient intake that is likely to pose no adverse health effects


How to determine levels of Vitamin B6

These tests should be run under direct medical supervision. Ask your doctor and dietitian for more information. Your vitamin status can be assessed through measurement of the following:

  • Best Indicator: Plasma PLP Concentrations

  • <20 nmol PLP/L suggestive of deficiency

  • 20-30 nmol PLP/L suggestive of marginal status

  • >30 nmol PLP/L indicates adequate tissue stores

  • Plasma concentrations: not normally used to assess status

  • Other common measures

  • Urinary vitamin B6- Measured over a specified period of days or weeks

  • Urinary 4-pyridoxic acid- Considered to be a short-term indicator

  • Functional tests

  • Xanthurenic acid excretion following tryptophan loading

  • Transaminase activity before and after administering vitamin B6 (an indicator of longer-term status)

Due to some of the limitations of some of these methods, multiple tests assessed in tandem may be best to establish vitamin B6 status.


Sources of Vitamin B6

There are many sources of vitamin B6, with animal sources, nuts, seeds, vegetables, and legumes providing good amounts of the nutrient.


How stable is vitamin B6?

Vitamin B6 is fairly stable in cooking conditions, however it can be altered if exposed to high heat for a prolonged period. Losses of the vitamin tend to be minimized in plant foods when compared to animal sources, and the processing and refining of grains can also alter the vitamin content or availability. Some loss may also occur with food storage.




Supplementation & Treatment with Vitamin B6

Uses

Supplemental vitamin B6 can be prescribed for many reasons, under appropriate medical direction and supervision, for the following:

  • Hyperhomocysteinemia

  • Carpal tunnel syndrome

  • Morning sickness

  • Premenstrual syndrome (PMS)

  • Depression

  • Muscular fatigue

If you have these conditions, be sure to ask the advice of your doctors and healthcare team before supplementing.

Treatment

Treatment with vitamin B6 should be carefully considered as toxicity and misdosing can cause serious side effects. Those with Parkinson’s disease should be aware that even low levels of vitamin B6 supplementation can interfere with the effectiveness of L-dopa drug therapy.


The Bottom Line

B6 is an incredibly important vitamin with the ability to assist the body in powerful ways. However, treatment and supplementation should always be under medical supervision and with the recommendation of a knowledgeable and nutrient literate healthcare team. Depending on your health and other existing conditions, your vitamin B6 supplementation may need to be closely tailored to avoid adverse effects.

FREE Patient Resources


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Related Professional Resources


Vitamin B6 (Pyridoxine)-Professional Resource


Don't you wish you had a quick reference to brush up on vitamin B6 before seeing your clients or patients? This quick reference will help you organize your thoughts and prove to be a great resource in between appointments.





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References

  1. Hart J. Eat Pretty. Chronicle Books. 2014. ISBN 978-1452123660.

  2. Gropper SS, Smith JL, Carr TP. Advanced Nutrition and Human Metabolism, Seventh Edition. Cengage Learning. 2017. ISBN: 978-1305627857.

  3. Klemm S. What are B-vitamins. Academy of Nutrition and Dietetics. 2020. Accessed at https://www.eatright.org/food/vitamins-and-supplements/types-of-vitamins-and-nutrients/what-are-b-vitamins-and-folate

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