Vitamin B6 Requirement
  Vitamin B6 Deficiency
 Signs and symptoms
 Conditions that suggest it
 Contributing risk factors
 Conditions suggested by it
 Treatment
 



Vitamin B6 Requirement: Overview

Many people are consuming less than the suggested RDA amounts of vitamin B6 (pyridoxine). This is due largely to the practice of milling that removes up to 90% of it from grain sources. As yet, there are no laws requiring the enrichment of milled grains with vitamin B6.
Causes and Development

Probably the biggest cause of deficiency (or an increased requirement) is the addition of antagonists in the environment over the last 50 years. Antagonists include:
  • Hydrazine Compounds: Hydrazine compounds used in medicine INH (isonicotinic acid hydrazine), and hydralazine, high levels of which are found in store-bought mushrooms. Hydralazine is a medication that is used to treat hypertension and has been linked to a few cases of peripheral neuritis which is associated with pyridoxine deficiency
  • Phenelzine is a drug used to treat depression and some people taking it have been found to experience pronounced edema especially in the legs
  • Succinic acid 2,2-Dimethylhydrazide is another chemical used in the U.S. and Canada to speed the ripening of fruits. It is sprayed on such fruits as peaches, nectarines, tomatoes, brussels sprouts, cherries, grapes and apples. Residues remain on these fruits after harvesting. This can be avoided by eating only organic produce
  • Maleic hydrazide is another derivative of hydrazine used in agriculture as a plant growth inhibitor and herbicide (potato chips have particularly high levels maleic hydrazide with as high as 25mg per 6oz bag of chips). Once again, choose the organic alternatives
  • Antioxidants in the petroleum industry and plating materials and anti-tarnish agents used in metal manufacturing
  • Tartrazine (yellow dye #5): From 1949-1970 nearly 1 million pounds per year were used in foods and medications
  • Peroxides and free radicals found in abundance in our food supply as oxidized fats. Foods such as barbequed foods, fried foods, potato and corn chips, and all foods processed with fats or oils which includes most restaurant-prepared foods
  • Birth Control Pills are well known B6 antagonists. 15-20% of women on oral contraceptives show deficient levels of pyridoxine on tryptophan load tests and many suffer deficiency symptoms. It should be noted that 10-30mg per day of vitamin B6 corrected both the load test and relieved the symptoms in most of these women
  • PCBs (polychlorinated biphenols): Although they have been banned, there are still incredible amounts in the environment. They have been found in 99% of all Americans tested and 100% of all Canadians. Fish taken from contaminated waters are the primary source of PCBs. In 1975, 69% of all breast milk tested positive and in Michigan and of more than 1000 women tested, 100% were positive
  • Environmental toxins: Jet or rocket fuel produces hydrazines that can persist for weeks after their production. Tobacco smoke contains significant amounts as well as the tobacco itself thus chewing tobacco will increase the need for more B6. One study on the birth weight of newborns showed that the normal growth inhibition that occurs with exposure in utero to tobacco smoke could be inhibited with the addition of 15mg of B6 per day
  • L-canavanine: compound found in alfalfa sprouts
  • Other non-hydrazine medications that act as pyridoxine antagonists include penicillamine and cycloserine
  • Alcohol has been shown to deplete B6 stores
  • Caramel coloring acts as an antagonist to B6 and has been found to prevent B6 from entering into the brain. Caramel coloring is produced by the heating up of certain sugars
  • Other foods that contain lysine (an essential amino acid found in many foods) that have been processed with heat have been found to antagonize B6
Other causes include:
  • Pregnancy: Up to 50% of pregnant women may suffer vitamin B6 deficiencies on normal diets according to tryptophan load test studies. It is known that B6 is actively transported to the fetus and concentrated up to 4 times the normal level
  • Malabsorption: Celiac disease, Crohn's disease, etc.
  • Age-related: several studies of Danes and Americans showed low B6 status corresponding to age.
Signs and Symptoms

Deficiency symptoms include pain and stiffness in arms and hands, painful 'knots' on the last joints of the fingers, headaches, bad breath, dizziness, extreme nervousness, foul-smelling flatulence, burning pain and cramps in abdomen, lethargy, dizziness, swollen ankles, an itching red rash around genitals, nausea, sore lips, mouth and tongue, and "showers of dandruff".

Severe B6 depletion may result in depression, nausea, vomiting, mucous membrane lesions, seborrheic dermatitis, peripheral neuritis, ataxia, hyperacusis, hyperirritability, altered mobility and alertness, abnormal head movements and convulsions.


Signs, symptoms & indicators of Vitamin B6 Requirement:
Lab Values - CellsMicrocytic red cells may be a sign or symptom of Vitamin B6 Requirement  Microcytic red cells
Pyridoxine-responsive anemia is indicated by small red blood cells.

Lab Values - Nutrients

Low B6 levels is a sign or symptom of Vitamin B6 Requirement  History of B6 deficiency or low B6 levels (confirmed)

Counter-indicators:
Normal/high B6 levels (confirmed) strongly contraindicates Vitamin B6 Requirement  Normal/high B6 levels (confirmed)

Symptoms - Head - Eyes/Ocular

(High) sensitivity to bright light is often a sign or symptom of Vitamin B6 Requirement  (High) sensitivity to bright light

Symptoms - Head - Mouth/Oral

A sore tongue is often a sign or symptom of Vitamin B6 Requirement  A sore tongue

Symptoms - Nervous

Numb/tingling/burning extremities may be a sign or symptom of Vitamin B6 Requirement  Numb/tingling/burning extremities

Symptoms - Reproductive - Female Cycle

Water retention before menstruation may be a sign or symptom of Vitamin B6 Requirement  Water retention before menstruation

Symptoms - Skeletal

Joint pain/swelling/stiffness may be a sign or symptom of Vitamin B6 Requirement  Joint pain/swelling/stiffness
Heberdens nodes may be a sign or symptom of Vitamin B6 Requirement  Heberden's nodes
In treating Heberden's nodes and trigger finger, B6 at 100-150mg per day may not work unless you eat one handful of raw pecans a day (i.e. you need both) says Dr. Goodheart. The nodes may not go away but pain and mobility should be much better over several weeks.

Symptoms - Skin - Conditions

History of adult acne may be a sign or symptom of Vitamin B6 Requirement  History of adult acne

Symptoms - Sleep

Forgetting dreams is often a sign or symptom of Vitamin B6 Requirement  Forgetting dreams

Conditions that suggest Vitamin B6 Requirement:
DigestionHydrochloric Acid Deficiency may suggest Vitamin B6 Requirement  Hydrochloric Acid Deficiency
Vitamin B6 is necessary for the production of hydrochloric acid.

Mental

Depression may suggest Vitamin B6 Requirement  Depression
B6 is a cofactor for the conversion of tryptophan to serotonin and for the synthesis of dopamine and norepinephrine. It has been found to be quite low in patients admitted to hospital for depression. [Lancet April 18,1970, pp.832-33] Some doctors claim that when women have depression and insomnia, B6 and tryptophan work consistently.

Metabolic

Gestational Diabetes Tendency often suggests Vitamin B6 Requirement  Gestational Diabetes Tendency
By impairing pancreatic insulin production, vitamin B6 deficiency may increase the tendency towards hyperglycemia in cases of gestational diabetes. [J Am Coll Nutr 15(1): pp.14-20, 1996] Supplementation with vitamin B6 may be beneficial during this condition. [Editorial, Lancet: pp.788-9, 1976, J Optimal Nutr 2(4): pp.239-43, 1993]

In one study of 14 women with gestational diabetes, taking 100mg of vitamin B6 for 2 weeks resulted in eliminating this diagnosis in 12 of the 14 women.

Musculo-Skeletal

Carpal Tunnel Syndrome often suggests Vitamin B6 Requirement  Carpal Tunnel Syndrome

Respiratory

Asthma often suggests Vitamin B6 Requirement  Asthma
Children with asthma have been shown to have a metabolic defect in tryptophan metabolism. Tryptophan is converted to serotonin, a known bronchoconstricting agent in asthmatics. Studies have shown that patients benefit from either a tryptophan-restricted diet or B6 supplementation to correct the blocked tryptophan metabolism. Pyridoxine may also be of direct benefit to asthmatic patients, since it is a key cofactor in the synthesis of all the major neurotransmitters.

Skin-Hair-Nails

Dandruff often suggests Vitamin B6 Requirement  Dandruff
A vitamin B6 deficiency can cause dandruff.

Female Hair Loss may suggest Vitamin B6 Requirement  Female Hair Loss
Especially if associated with birth control pill use.

Adult Acne may suggest Vitamin B6 Requirement  Adult Acne

Risk factors for Vitamin B6 Requirement:
Childhood(Severe) Perthes disease may increase risk of Vitamin B6 Requirement  (Severe) Perthes disease
Zinc, Manganese and vitamin B6 have been helpful in treating osteochondrosis (Leg-hip Perthes disease). This might suggest an ongoing requirement.

Metabolic

Pyroluria often increases risk of Vitamin B6 Requirement  Pyroluria
A functional pyridoxine deficiency is common in pyroluria (often seen in alcoholics), due not so much to inadequate intake as impaired conversion to its active form, pyridoxal-5-phosphate, and enhanced degradation.

Supplements and Medications

Current birth control pill use often increases risk of Vitamin B6 Requirement  Current birth control pill use
History of birth control pill use often increases risk of Vitamin B6 Requirement  History of birth control pill use
(Discontinued) non-human estrogen use may increase risk of Vitamin B6 Requirement  (Discontinued) non-human estrogen use

Counter-indicators:
Multiple vitamin use often decreases risk of Vitamin B6 Requirement  Multiple vitamin use
Some/regular vitamin B6 supplementation decreases risk of Vitamin B6 Requirement  Some/regular vitamin B6 supplementation

Symptoms - Food - Intake

(High) refined white flour consumption may increase risk of Vitamin B6 Requirement  (High) refined white flour consumption

Symptoms - Skeletal

History of carpal tunnel syndrome may increase risk of Vitamin B6 Requirement  History of carpal tunnel syndrome

Vitamin B6 Requirement suggests the following may be present:
MetabolicVitamin B6 Requirement may suggest Pyroluria  Pyroluria
A functional pyridoxine deficiency is common in pyroluria (often seen in alcoholics), due not so much to inadequate intake as impaired conversion to its active form, pyridoxal-5-phosphate, and enhanced degradation.

Respiratory

Vitamin B6 Requirement may suggest Asthma  Asthma
Children with asthma have been shown to have a metabolic defect in tryptophan metabolism. Tryptophan is converted to serotonin, a known bronchoconstricting agent in asthmatics. Studies have shown that patients benefit from either a tryptophan-restricted diet or B6 supplementation to correct the blocked tryptophan metabolism. Pyridoxine may also be of direct benefit to asthmatic patients, since it is a key cofactor in the synthesis of all the major neurotransmitters.

Recommendations and treatments for Vitamin B6 Requirement:
VitaminsVitamin B6 (Pyridoxine) is highly recommended for Vitamin B6 Requirement  Vitamin B6 (Pyridoxine)


KEY
Weak or unproven link: may be a sign or symptom of; may suggest; may increase risk ofWeak or unproven link: may be a sign or symptom of; may suggest; may increase risk of
Strong or generally accepted link: is often a sign or symptom of; often suggests; often increases risk ofStrong or generally accepted link: is often a sign or symptom of; often suggests; often increases risk of
Definite or direct link: is a sign or symptom ofDefinite or direct link: is a sign or symptom of
Strong counter-indication: often decreases risk ofStrong counter-indication: often decreases risk of
Definitely or absolutely counter-indicates: strongly contraindicates; decreases risk ofDefinitely or absolutely counter-indicates: strongly contraindicates; decreases risk of
Very useful: is highly recommended forVery useful: is highly recommended for




Last updated: Apr 08, 2012