VITAMIN B6 (PYRIDOXINE)

Vitamin B-6 (pyridoxine) is important for normal brain development and for keeping the nervous system and immune system healthy. Because it is involved in so many enzymatic reactions, adequate levels are key for promoting and maintaining a healthy body.

“Vitamin B6” is a term that actually refers to six compounds in the body that all work in a similar way.

  • pyridoxine (PN), an alcohol
  • pyridoxal (PL), an aldehyde
  • pyridoxamine (PM), which contains an amino group
  • Pyridoxal 5′ phosphate (PLP or P5P)
  • Pyridoxine 5′-phosphate (PNP)
  • Pyridoxamine 5′ phosphate (PMP)

Some foods high in vitamin B6 include sunflower seeds, pistachios, Black cumin seed (Nigella sativa) is also a good source of B6.

  • Very important for inflammatory conditions.
  • Improves IBS, Crohn’s, and Colitis.
  • Necessary for optimal cognitive function.
  • Improves sleep.
  • Decreases risk of cancers.

DEFICIENCY

Those at Risk for Deficiency: 

  • People with poor kidney function (R).
  • Those with autoimmune disease, particularly rheumatoid arthritis (R) and disorders associated with poor absorption, including patients with celiac disease, Crohn’s disease, ulcerative colitis, and inflammatory bowel disease (R).
  • People with alcohol dependence (R).
  • People who routinely take non-steroidal anti-inflammatory drugs (NSAIDs) over 6 months’ time may have low B6 (R).

SUPPLEMENTS

Pyridoxal 5′ phosphate (PLP), otherwise known as P5P, can be found in supplement form as an alternative to taking B6 (pyridoxine). In a healthy body, the liver converts B6 to the active form, P5P. However, certain individuals may have difficulty making that conversion, and therefore may need to take vitamin B6 in its already active form: P5P.

BENEFITS

INFLAMMATORY CONDITIONS

Systemic inflammation is associated with decreased B6 status: Specifically, blood levels of P5P were 24% lower in individuals with the highest inflammation (R).

Low levels of B6 are associated with inflammatory conditions such as inflammatory bowel disease (IBD). Supplemental B6 can be used to manage the condition (R).

Low levels of the activated form of B6, P5P, in the bloodstream are associated with higher levels of the inflammatory marker, C-reactive protein (R).

Low B6 increases inflammation associated with cardiovascular disease (R).

Patients with Rheumatoid Arthritis tend to have low B6.

In 2010, a Taiwanese study of Rheumatoid Arthritis patients found that vitamin B6 supplementation at 100 mg/day suppressed IL-6 and TNF-alpha over a 3-month period. Blood levels of IL-6 remained significantly inversely related to blood levels of P5P (R).

B6 inhibits NF-κB activation (in mouse cells) (R).

B6 is also required for normal immune function (specifically, for CD8 T cells) (R).

DIGESTIVE HEALTH

A low intake of vitamin B6 is correlated with worse symptoms of IBS (R).

Patients with Inflammatory Bowel Disease (IBD) tend to have low B6. Supplements can be used to manage the condition (R).

HISTAMINE

B6 is required for the synthesis of Histamine (R+).

Even though B6 helps form histamine, B6 also is important for normal functioning of diamine oxidase (DAO), the enzyme which breaks down histamine.

Intake of B6 could help lower histamine levels and benefit histamine intolerant patients (R).

BRAIN & NERVOUS SYSTEM HEALTH

Low B6 is associated with Higher homocysteine levels, which can lead to brain damage (R, R).

Even if a patient has high levels of homocysteine, research suggests that B6 supplements can still improve cognitive function (R).

However, there are no consistent results between B6 and a reduction in dementia (R, R)

And there are no short-term benefits of B6 in terms of cognitive function, fatigue, and depression (R).

Deficiency in the Pyridoxal phosphate (P5P) form of B6 in the brain can cause neurological dysfunction, particularly epilepsy (R).

B6 can help alleviate symptoms of polyneuropathy, degeneration of peripheral nerves associated with diabetes and some types of Guillain–Barré syndrome (R).

HORMONAL BALANCE, PMS & PROGESTERONE

The most important nutrient for maintaining normal progesterone levels seems to be Vitamin B6. Vitamin B6 is absolutely essential for the development of the corpus luteum (a gland produced in the ovary after the egg is released) out of which progesterone is produced. Therefore, vitamin B6 is necessary for preventing progesterone deficiency and through progesterone for balancing other hormones including oestrogen.

That is the reason why B6, together with B5, Magnesium, D3 and Agnus castus (Vitex), are so effective in helping women with hormonal imbalance, menstrual problems, PMS > and other symptoms associated with low progesterone.

A group of British researchers suggest that taking daily dose of  100 to 200 milligrams of vitamin B6 may be very helpful in relieving PMS symptoms. According to the study women with PMS taking vitamin B6 supplements experienced significantly reduced PMS symptoms (such as depression) compared to the placebo group. In order to be more effective B6 supplements should be taken about seven days before menstruation. For the first two weeks of the cycle, it is recommanded to take about 100 mg of B6 daily with other B vitamins. Also keep in mind that the more vitamin B6 you is used, the more magnesium is needed. magnesium is also necessary to be used with vitamin D supplements.

Vitamin B6 alleviates depression associated with premenstrual syndrome >

Taking a combination of B6 and magnesium supplements reduces PMS-associated anxiety (>, >).

SLEEP

A deficiency in B6 can cause sleep disturbances (R).

B6 seems to stimulate parts of the brain during rapid eye movement (REM) sleep, leading to seemingly more vivid dreams (R).

B6 can improve one’s awakening cortisol levels, which means that it’s easier for the brain to wake up to prepare for any anticipated stress (R).

In order to increase levels of the bodie’s natural and strongest antidepressant hormone serotonin you need to provide the body with 5HTP (most bioavailable form of tryptophan), vitamin B6, B1, B3 (Niacin), folic acid, magnesium, and zinc as all of them are required to produce this precious happy hormone.

A deficiency in the active form of B6, P5P, may cause tryptophan to be used in the production of an organic acid called kynurenine, leading to low serotonin and melatonin, thus contributing to depression and sleep difficulties (>).

5HTP in our liver is converted to 5HT but it can do it only with the help of Vitamin B6. However, if you are even mildly deficient in Vitamin B6, this tryptophan will be converted to toxic metabolites, by the liver! It is therefore very important 5-HTP should be taken with either vitamin B6 or multivitamin which is high in B6, B complex, or such as Healthy Mega.

ANXIETY

Taking a combination of B6 and magnesium supplements reduces PMS-associated anxiety (>, >).

This combination is also effective when treating different forms of epilepsy that are characterized by depression or anxiety (R).

B6 deficiency is seen in those who have panic attacks or hyperventilation attacks (R).

Children with Autism (who often have anxiety) tend to have deficiencies in B6 and can be treated with the supplement (R).

DEPRESSION

Low levels of B6 are significantly associated with symptoms of depression (R).

On the other hand, B6 was not an effective treatment for depression in a two-year study with older men (R).

Dopamine has been found to alter the requirements and storage mechanisms of B6, suggesting that excess dopamine can lead to B6 deficiency and in turn depression (R).

Women who take in more foods that contain B6 have lower chances of getting depression (R).

However, women who have post-pregnancy depression don’t show signs of B6 deficiency (R).

B6 is required in the body to convert amino acid l-glutamine to the relaxing hormone known as GABA. L-glutamine is the precursor of GABA and therefore should increase its production. However, the conversion from glutamine to GABA requires vitamin B6 or P5P (the active form of this vitamin).

WEIGHT MANAGEMENT

A calorie-restricted diet enriched with cereal grains (rich in B6) can improve B6 levels. B6 levels also help maintain muscle mass during times of weight loss (R).

Supplemental B6 along with B12 for a long period of time results in overall less weight gain in obese men and women (R).

PAIN

B6 is effective at reducing breast pain (cyclic mastalgia) (R).

B6 is also effective at relieving symptoms of carpal tunnel syndrome (R).

Migraines have been linked to B6 deficiency (R).

Vitamin B6 modulates Nitric Oxide in the cell, which is a mechanism by which deficiency causes vasodilation. Deficiencies in vitamins B6, B12 and folate result in less methylation, which can trigger a migraine (R).

CANCER

B6 may reduce the risk of cancer since it lessens inflammation, a major factor in the creation of cancer cells (R).

Those with cervical cancer have B6 deficiency (R).

Increased B6 intake decreased the risk of colorectal cancer (RR).

CARDIOVASCULAR HEALTH

A high intake of B6 and folate decreases the chance of dying from stroke, coronary heart disease, or heart failure in a Japanese population (R).

Dietary intake of B6 was associated with a reduced risk of coronary heart disease among middle-aged non-multivitamin supplement users (R).

In a study of 267 patients with coronary artery disease (CAD) and 475 healthy controls, higher levels of B6 (P5P) were correlated with lower levels of two indicators of systemic inflammation, C-reactive protein (CRP) and fibrinogen (R).

However, low B6 raises the risk of heart disease independent of inflammation status (R).

Studies have yet to show that supplemental vitamin B6 lessens inflammation in patients with cardiovascular disease (R).

Higher homocysteine levels are related to lower B6 levels (R), yet B6 is not effective at lowering the inflammation-causing homocysteine (R).

ANAEMIA

Vitamin B6 deficiency may lead to certain types of anaemia (R).

BLOOD SUGAR & DIABETES

Vitamin B6 plays important role in normal glycogen metabolism, preventing glycation, and regulating the release of stored glucose. In addition, vitamin B6, together with B12 and Alpha Lipoic Acid, helps in managing diabetic neuropathy.

Vitamin B6 helps in managing diabetic neuropathy and prevents glycation in which sugars react with proteins and fats in an abnormal way, producing harmful molecules. It can lead to cataract, kidney failure, and even Alzheimer’s.

Deficiencies of B6 are common in those with type 2 diabetes (R).

A 6-week treatment with 150 mg/day of B6 lowered haemoglobin A1c levels (a measure of long-term blood sugar) in a study of 15 white men with type II diabetes (R).

B6 helps some cases of gestational diabetes as it increases glucose tolerance (R).

BONE HEALTH

B6 deficiency leads to reduced neutrophils and lymphocytes resulting in bone marrow deficiency (in rats) (R).

Supplementation with B6 may reduce the incidence of hip fractures (RR).

Decreased B6 status leads to lower bone mass density in patients with osteoporosis (R).

SKIN HEALTH

B6 is key for skin development and maintenance (R).

Deficiency in B6 can lead to lesions as well as collagen deficiency, which maintains the skin’s elasticity (R, R).

MORNING SICKNESS (NAUSEA DURING PREGNANCY)

Apart from magnesium you also need 10-50 mg of vitamin B6 and 15-50 mg of zinc citrate (must be citrate as other types of zinc may trigger nausea) after breakfast as both B6 and zinc deficiency (very common today) are believed to contribute to nausea during pregnancy.

DOSAGE

In EU and UK the recommended daily intake of B6 for adults is 1.4 mg and in US 1.7mg.

Institute of Medicine’s Food and Nutrition Board (FNB) Recommended Dietary Allowance (RDA) for Vitamin B6

Life Stage       Age     Males (mg/day)            Females (mg/day)

Infants            0-6 months     0.1 ( AI )         0.1 (AI)

Infants            7-12 months   0.3 (AI)          0.3 (AI)

Children         1-3 years         0.5       0.5

Children         4-8 years         0.6       0.6

Children         9-13 years       1.0       1.0

Adolescents    14-18 years     1.3       1.2

Adults 19-50 years     1.3       1.3

Adults 51 years and older     1.7       1.5

Pregnancy      all ages           –          1.9

Breastfeeding all ages           –          2.0

SAFE UPPER INTAKE

Safe upper intake from supplements for vitamin B6 (Pyridoxine) 10mg (up to 200mg long term) in EU and UK and 100mg in US. Dosages between 10 mg and 200 mg may be used short-term, but intakes above 200 mg are not generally recommended except under medical supervision. According to some sources the upper level suggested by the EU is also 25 mg per day from supplements.

SAFETY

High intakes of vitamin B6 from food sources have not been reported to cause adverse effects (R).

However, taking 1 – 6 grams of B6 per day for more than a year can lead to severe neuropathy with loss of movement control (R).

The tolerable upper intake level set for adults is 100 mg per day (R).

Fortunately, symptoms usually go away after supplementation has been stopped. Other symptoms of excessive vitamin B6 supplementation include painful skin lesions, light sensitivity, and symptoms of digestive upset, such as nausea and heartburn (R).

INTERACTIONS WITH OTHER NUTRIENTS

– B6 helps absorption of niacin, riboflavin, folate & zinc.

– B6 enhances the uptake of magnesium and vice versa.    

– Vitamin B6 can inhibit the biosynthesis of thiamine (B1).

– High levels of B6 may increase the need for zinc.

– Vitamin B6 deficiency increases intestinal uptake of zinc but serum zinc levels decrease, demonstrating an impairment in zinc utilization.

– The amino acid taurine increases the communication and productivity of P5P (active form of Vitamin B6) and promotes the production of GABA.  Studies have shown that a deficiency of taurine can contribute to anxiety (>).

INTERACTIONS WITH MEDICATIONS

Here are some medications that interfere with the metabolism of vitamin B6 or that are affected by B6 supplementation:

Broad-spectrum antibiotic Cycloserine (Seromycin®), used to treat tuberculosis, increases urinary loss of B6. This may worsen the seizures and neurotoxicity associated with cycloserine. (B6 supplements can help prevent these adverse effects) (R).

Antiepileptic Medications, including valproic acid (Depakene®, Stavzor®), carbamazepine (Carbatrol®, Epitol®, Tegretol®, and others), and phenytoin (Dilantin®) increase the breakdown rate of vitamin B6, resulting in low blood levels of P5P and high homocysteine. High homocysteine levels in antiepileptic drug users may increase the rate of seizures and stroke (R).

Anti-seizure medications phenytoin and phenobarbital may be reduced in the blood by B6 supplementation of 200 mg/day for 12 – 120 days (R).

COPD medications like Theophylline (Aquaphyllin®, Elixophyllin®, Theolair®, Truxophyllin®, et cetera) can cause low blood levels of P5P, which could cause seizures (R).

Non-steroidal Anti-inflammatory Drugs (NSAIDS) can lower blood levels of B6 (P5P), especially when taken chronically, over 6 months’ time (R).

 

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