Vitamin B6 (Pyridoxine)

Vitamin B6 (Pyridoxine): Overview

Alternative names: Pyridoxine, or Pyridoxine HCL.

Vitamin B6 is an antioxidant nutrient that helps the body inhibit the formation of damaging free radicals.  Excess homocysteine causes atherosclerosis (thickening and hardening of the artery walls) and an adequate supply of Vitamin B6 will prevent the accumulation of this toxic metabolite.  B6 deficiency can weaken the heart muscle and raise serum cholesterol levels.

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Source

Pyridoxine HCl is the molecule most often correlated with vitamin B6.  It is found in a variety of vegetables and grains, and is especially high in rice bran, green leafy vegetables, meat, legumes and whole grains.

Other good food sources are pork, organ meats, wheat bran, poultry, fish, corn, seeds, grains, wheat, potatoes, bananas, green beans, brewer's yeast, avocados, wheat germ, soybeans, walnuts, blackstrap molasses, cantaloupe, cabbage, milk, egg yolks, green peppers, carrots, peanuts and pecans.  Cooking and food processing destroys vitamin B6.  Even the best sources generally have less than 1mg per serving.

Supplementing with the more active form (pyridoxal-5'-phosphate, or P5P) may improve the response some individuals experience.  Some supplements come with both forms of the vitamin included.  P5P is used in supplemental products to increase the effective B6 concentration.  It is often used in combination with pyridoxine HCl, because P5P is much more expensive than pyridoxine HCl.  P5P B-6 should be obtainable from your Nutritional Doctor or local Health Food Store.

Function; Why it is Recommended

Vitamin B6 is involved in more bodily functions than almost any other single nutrient.  It affects both physical and mental health, and is necessary for the production of hydrochloric acid and the absorption of fats and protein.  Pyridoxine also aids in maintaining sodium and potassium balance and promotes red blood cell formation.  It is required by the nervous system for normal brain function, for the synthesis of RNA and DNA, which contain the genetic instructions for the reproduction of all cells and for normal cellular growth.  It activates many enzymes and aids in the absorption of vitamin B12, in immune system function, and in antibody production.

Pyridoxal 5'-phosphate (P5P) is the active form of vitamin B6.  Three forms of vitamin B6 exist: pyridoxine, pyridoxal, and pyridoxamine.  Upon absorption and uptake into the liver, these are all converted to P5P, which is a co-factor in approximately 100 different enzymatic reactions.  P5P is crucial in a number of different metabolic activities including glucose production, niacin formation, lipid metabolism, neurotransmitter synthesis, hormone modulation and more.  The recent understanding of the use of B6 (as well as folic acid) in the reduction of high homocysteine levels (an independent risk factor for cardiovascular disease) can also be added to the benefits of P5P.

Vitamin B6 is easily destroyed by the heavy use of alcohol, drugs or refined sugars.  Vitamin B-6 is very important for the metabolism of amino acids – most people should be taking some of this nutrient as a supplement anyway.

Instructions

The RDA for adult females is 1.4 to 1.6mg daily, and for adult males is 1.7 to 2mg daily.  This dose is considered by many to be less than that required for optimal health; B6 is most effective when taken along with a B-complex supplement.

Caution: Be sure to read up on B6, since individual needs vary greatly – some people need a lot more, and you can take too much B6.

Side-Effects

Caution: For most people, B6 can cause a nasty stomach ache on a completely empty stomach, so the recommendation is to take it with food, such as juice, fruit, chip, cracker, even a crust of bread.

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Vitamin B6 (Pyridoxine):

Vitamin B6 (Pyridoxine) can help with the following:

Aging

Parkinson's Disease

In a Russian trial, 60 patients with Parkinsonism of various causes with pronounced tremor were effectively treated with intramuscular doses of vitamin B6.  Single doses were as high as 400mg; the total doses were from 3000 to 6000mg.  Changes in laboratory findings (EMG, tremorographic and myotonometric) correlated with the clinical picture.  Vitamin B6 is recommended irrespective of the cause of the disease and of the patient's age, and can be given either alone or in combination with anti-Parkinsonian drugs aside from DOPA. [Sov Med (7): pp14-9, 1979 (in Russian)]

Allergy

Allergic Rhinitis / Hay Fever

One older study reported that L-tyrosine (200mg), vitamin B6 (2.5mg) and niacinamide (10mg) when given in combination for the treatment of hay fever, hives, allergic headaches and poison oak dermatitis produced significant symptomatic relief when 1-3 tablets were taken four times/day in milder cases and up to 6 tablets 4-6 times/day in more severe cases.  In some cases characterized by more chronic disorders, such as chronic sinusitis, a worsening of symptoms often occurred during the first few days of treatment.  This study found that treatment with each the nutrients individually, or with any two in combination, was ineffective. [Widmann RR, Keye JD Epinephrine precursors an control of allergy. Northwest Med 1952:51: pp.588-90]

Autoimmune

Vitiligo

See the link between Vitiligo and Copper.  Typical recommended dosage is 1000mg twice daily.

Lupus, SLE (Systemic Lupus Erythematosus)

Vitamin B6 at a dosage of 500mg tid causes some patients to feel better.  Side effects such as pain, numbness and weakness in the limbs are a possibility at this dose.  If found to be beneficial, supplementation may need to be long term or permanent.

Circulation

Coronary Disease / Heart Attack

It is estimated that individuals with low vitamin B6 levels have a five times greater risk of suffering a heart attack than individuals with higher B6 levels.

Sideroblastic Anemia

Treatment with oral pyridoxine usually benefits patients whose sideroblastic anemia was present at birth.  This treatment improves the condition of some patients but does not cure the anemia.

Not recommended for
Angina

High doses of B6 are not recommended for patients with angina. [Sov Med (7): pp.14-9, 1979 (in Russian)]

Congestive Heart Failure

High doses of B6 are not recommended for patients with coronary insufficiency. [Sov Med (7): pp.14-9, 1979 (in Russian)]

Dental / Oral

Susceptibility To Cavities

See the link between Cavities and Magnesium.

Environment / Toxicity

Copper Toxicity

Carl Pfeiffer, M.D. also suggests using vitamin B6 at 50mg daily without supplemental copper to increase copper excretion.

Female-Specific

Premenstrual Syndrome

Vitamin B6 is effective for PMS symptoms because it reduces estrogen while raising progesterone levels.  Numerous clinical studies have demonstrated the efficacy of vitamin B6 supplementation in treating PMS.  In one double blind crossover trial, 84% of the subjects had a lower symptomatology score during the B6 treatment period.  Although PMS is of multifactorial origin, B6 supplementation alone appears to benefit most patients.  In another study, premenstrual acne flare-up was reduced in 72% of 106 affected young women taking 50mg of pyridoxine daily for one week prior and during the menstrual period.  Pyridoxine acts as a mild diuretic, reducing the symptoms of premenstrual syndrome.

Morning Sickness

Increase vitamin B6 in your diet by eating whole grains, nuts, seeds, and legumes.  Talk to your doctor about possibly taking vitamin B6 supplements.  Taking vitamin B6 (50mg daily) has been shown to help with pregnancy-induced nausea.

Premenstrual Syndrome PMS A (Anxiety)

In one study, women received 50mg per day of vitamin B6 or a placebo for 3 months.  Symptoms amongst these women included depression, irritability, tiredness, headache, breast tenderness and swollen abdomen/hands.  At this dose depression, irritability and tiredness were the only symptoms to respond and they were reduced by 50%. [Gynecol Obstet Invest 1997;43(2): 120-124]

Premenstrual Syndrome PMS D (Depression)

In one study, women received 50mg per day of vitamin B6 or a placebo for 3 months.  Symptoms amongst these women included depression, irritability, tiredness, headache, breast tenderness and swollen abdomen/hands.  At this dose depression, irritability and tiredness were the only symptoms to respond and they were reduced by 50%. [Gynecol Obstet Invest 1997;43(2): 120-124]

Pregnancy-Related Issues

Vitamin B6 is necessary for optimal brain development and is an essential coenzyme for neurotransmitter synthesis. [Gerster II. Z. Ernahrungswiss 1996;35(4): pp.309-17]  One animal study found that vitamin B6 helped prevent the formation of cleft palates. [Jacobsson C, Granstrom G. Cleft Palate Craniofacial J 1997;34(2):95-100]  Like magnesium, vitamin B6, together with vitamin B1, may also ease pregnancy-related leg cramps. [Avsar AF, et al. Am J of Obst & Gyn 1996;175(1):233-4]

The U.S. RDA is 2.2mg.

Fibrocystic Breast Disease

Some, but not all, studies find that B6 reduces symptoms.  Women with premenstrual syndrome in addition to breast tenderness should discuss the use of vitamin B6 with their nutritionally oriented doctor.

Glandular

Hormones

Low Melatonin Level

Vitamins B3 and B6, as well as calcium and magnesium support the production of melatonin.

Infections

Sinusitis

One older study reported that L-tyrosine (200mg), vitamin B6 (2.5mg) and niacinamide (10mg) when given in combination for the treatment of hay fever, hives, allergic headaches and poison oak dermatitis produced significant symptomatic relief when 1-3 tablets were taken four times/day in milder cases and up to 6 tablets 4-6 times/day in more severe cases.  In some cases characterized by more chronic disorders, such as chronic sinusitis, a worsening of symptoms often occurred during the first few days of treatment.  This study found that treatment with each the nutrients individually, or with any two in combination, was ineffective. [Widmann RR, Keye JD Epinephrine precursors an control of allergy. Northwest Med 1952:51: pp.588-90]

Lab Values

Mental

Obsessive-Compulsive Disorder (OCD)

A study found plasma pyridoxal-5-phosphate (active vitamin B6) levels were about 48% lower in depressed patients than in controls, a statistically significant finding.  57% of depressed patients, but none of the controls, were B6-deficient.  When B6 nutriture was evaluated by enzyme stimulation testing (a more sensitive method), all the depressed patients and none of the controls were deficient. [Russ CS et al. Vitamin B6 status of depressed and obsessive-compulsive patients. Nutr Rep Int 27( 4): pp.867-73, 1983]

Anxiety

A deficiency of vitamin B6 (pyridoxine) causes extreme anxiety, nervousness, confusion, and melancholy.  Vitamin B6 is easily destroyed by heavy use of alcohol, drugs and refined sugars.

Migraine/Tension Headaches

One older study reported that L-tyrosine (200mg), vitamin B6 (2.5mg) and niacinamide (10mg) when given in combination for the treatment of hay fever, hives, allergic headaches and poison oak dermatitis produced significant symptomatic relief when 1-3 tablets were taken four times/day in milder cases and up to 6 tablets 4-6 times/day in more severe cases.  In some cases characterized by more chronic disorders, such as chronic sinusitis, a worsening of symptoms often occurred during the first few days of treatment.  This study found that treatment with each the nutrients individually, or with any two in combination, was ineffective. [Widmann RR, Keye JD Epinephrine precursors an control of allergy. Northwest Med 1952:51: pp.588-590.]

Metabolic

Pyroluria

Pyrolurics commonly respond within a few months to B6, zinc and manganese.  The nutrient dosage usually must be increased when the pyroluric patient is under increased stress.

Meniere's Disease

B6 supplementation may be effective in vertigo, including Meniere's syndrome.  One study found that 15 of 47 patients with Meniere's disease who had failed to respond to previous treatments improved with B6 (pyridoxine).  Three patients failed to improve and others gradually improved but it was uncertain whether pyridoxine supplementation was responsible.  Furthermore, 23 patients with vertigo due to unknown causes received pyridoxine and many of them responded.  Intravenous administration relieved symptoms more rapidly than oral administration [Lewy A., Fox N. Clinical notes; New instruments and techniques: pyridoxine (B6) used in the treatment of vertigo. Arch Otolaryngol November, 1947, pp.681- 3]

Musculo-Skeletal

Rheumatoid Arthritis

When nodules (Heberden's nodes) are present, vitamin B6 at 100-150mg per day may help.  One doctor reports seeing even better results if one handful of raw pecans is eaten every day.  The nodes may not go away but pain and mobility are better over several weeks.

Heberden's Nodes

Where Heberden's nodes is affecting the index finger, doses of 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 one Dr. Goodheart.  Nodes may not go away but pain and mobility may be much better over several weeks.

Nervous System

Tardive Dyskinesia

See the link between Tardive Dyskinesia and Melatonin.

Nutrients

Organ Health

Kidney Stones (Urolithiasis)

Vitamin B6 deficiency leads to an increase in kidney stones as a result of elevated urinary oxalate levels.  Vitamin B6 supplementation inhibits the production of oxalate in the body and can reduce elevated urinary oxalate in some stone formers who are not necessarily B6 deficient.

Respiratory

Asthma

Vitamin B6 deficiency is common in asthmatics. [Ann Allergy 1975;35: pp.153-8]  This deficiency may relate to the asthma itself or to certain asthma drugs (such as theophylline and aminophylline) that deplete vitamin B6. [Ann Allergy 1990;65: pp.59-62]  In a double-blind trial, 200mg per day of vitamin B6 for two months reduced the severity of asthma in children and reduced the amount of asthma medication they needed. [Ann Allergy 1975;35: pp.93-7]  In another trial, asthmatic adults experienced a dramatic decrease in the frequency and severity of asthma attacks while taking 50mg of vitamin B6 twice per day. [Am J Clin Nutr 1985;41: pp.684-8]  Nonetheless, the research remains somewhat inconsistent, and one double-blind trial found that high amounts of B6 supplements did not help asthmatics who required the use of steroid drugs. [Ann Allergy 1993;70: pp.141-52]

Skin-Hair-Nails

Body Odor

See the link between Body Odor and Vitamin B-Complex.

Hives (Urticaria)

Should be taken in combination with Tyrosine.  See Hives/Tyrosine note.

Adult Acne

Women with premenstrual aggravation of acne are often responsive to vitamin B6 supplementation, reflecting its role in the normal metabolism of steroid hormones.  Vitamin B6 can be used during the flair or continuously at 50 to 200mg per day.

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Vitamin B6 (Pyridoxine) can help prevent the following:

Circulation

Stroke

Vitamin B6 at 150-200mg daily reduces platelet aggregation, and thus may help prevent ischemic (clotting type) strokes.

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