To B6 or Not to B6… That is the Question

Vitamins are “vital amines” and are vital to just about every metabolic process in the body. In this post, we discuss vitamin B6 and the rare occasions when serum levels are high in patients supplementing with B6. 

Importance of Vitamins B12, B6, and Folate

Vitamins B12, B6, and folate, in particular, are crucial for brain development and function throughout one's life, and deficiencies in these vitamins are linked to various neurological and psychiatric conditions.

The exact mechanisms by which deficiencies lead to such conditions are poorly understood but are thought to involve genetic polymorphisms that affect vitamin-associated metabolic pathways. These polymorphisms can influence how the body responds to vitamin deficiencies, potentially worsening or masking symptoms.

Vitamin B6, in particular, is involved in numerous metabolic processes, including neurotransmitter production, which is vital for brain communication and mood regulation. It also works with vitamins B12 and B9 to reduce homocysteine levels, which are associated with an increased risk of cardiovascular and neurodegenerative diseases.

Vitamin B6 deficiency is rare due to its availability in the diet, but certain conditions can impair its absorption or conversion to its active form, leading to neurological symptoms like peripheral neuropathy.

Excessive intake of B6 can also cause toxicity, presenting similar neuropathic symptoms. Furthermore, the MTHFR gene, which plays a role in processing B vitamins, can complicate B6 levels in the body, leading to apparent high levels of this vitamin in the blood despite a true cellular deficiency.

Those at risk of vitamin deficiencies, especially where genetic factors like MTHFR polymorphisms are involved, should undergo genetic testing to guide appropriate supplementation strategies, including the use of active forms of these vitamins to ensure proper cellular utilization and avoid complications associated with synthetic forms.

While synthetic B6 may not be well tolerated in those with MTHFR SNPs, the pyridoxal 5’ phosphate (PHP) form may be safely consumed and help reduce the elevated B6 levels that can be seen with synthetic B6 use.

Be aware of the symptoms of a B6 imbalance:

Insufficiency

• Abnormal tryptophan metabolism
• Allergies
• Atherosclerosis
• Compromised immunity
• Confusion
• Convulsions
• Diabetes, diabetic complications
• Dental decay
• Depression
• EEG abnormalities
• Elevated homocysteine
• Hypertension
• Irritability
• Oral cheilosis, glossitis, and stomatitis
• Peripheral neuropathy
• Preeclampsia, eclampsia
• Pruritic rash
• Seborrheic dermatitis
• Stroke
• Thrombosis

Source: Stach, Kamilla et al. “Vitamin B6 in Health and Disease.” Nutrients vol. 13,9 3229. 17 Sep. 2021, doi:10.3390/nu13093229 This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

Source: Mascolo, Elisa, and Fiammetta Vernì. “Vitamin B6 and Diabetes: Relationship and Molecular Mechanisms.” International journal of molecular sciences vol. 21,10 3669. 23 May. 2020, doi:10.3390/ijms21103669 This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

Toxicity 

• Ataxia
• Decreased coordination
• Decreased sensations of touch, vibration, and temperature.
• Decreased sperm motility
• Excess supplementation above 250 mg/day
• Extremity pain
• Heartburn
• Loss of balance
• Nausea
• Photosensitivity
• Sensory neuropathy
• Skin eruptions
• Testicular atrophy

Want to Learn More?

CLICK HERE to learn more about Vitamin B6 health consequences, the ODX ranges, etc.

References

Abosamak, NourEldin R. and Vikas Gupta. “Vitamin B6 (Pyridoxine).” StatPearls, StatPearls Publishing, 23 May 2022.

Brown, Mary J., et al. “Vitamin B6 Deficiency.” StatPearls, StatPearls Publishing, 18 July 2022.

Houston, Mark C. “Nutrition and nutraceutical supplements in the treatment of hypertension.” Expert review of cardiovascular therapy vol. 8,6 (2010): 821-33. doi:10.1586/erc.10.63

Mascolo, Elisa, and Fiammetta Vernì. “Vitamin B6 and Diabetes: Relationship and Molecular Mechanisms.” International journal of molecular sciences vol. 21,10 3669. 23 May. 2020, doi:10.3390/ijms21103669

Stach, Kamilla et al. “Vitamin B6 in Health and Disease.” Nutrients vol. 13,9 3229. 17 Sep. 2021, doi:10.3390/nu13093229

Vitamin B6 and MTHFR. MTHFR Support. November 12, 2018. https://mthfrsupport.com.au/2018/11/vitamin-b6-mthfr/