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Vitamin B-6 is an essential nutrient for overall good health, protein metabolism, red blood cell function, the nervous and immune systems, and the synthesis of the amino acid tryptophan and the vitamin niacin. 

According to the National Institutes of Health and the Linus Pauling Institute, vitamin B-6 has been shown to be beneficial to the following conditions:




•  Carpal Tunnel
•  Pre-Menstrual Syndrome
• Healthy Heart
•  Kidney Stones
•  Depression
•  Morning Sickness
•  Stress

NOTE: DO NOT TAKE MORE THAN 100mg OF B-6 PER DAY.

 

(Click for Ingredient Information.)

Seniors are particularly at risk for vitamin B-6 deficiency.   Many Americans, however, do not receive the Recommended Daily Allowance (RDA) of vitamin B-6 in their diet, and age, alcohol abuse, and bad nutrition can all contribute to B-6 deficiency (Linus Pauling Institute). 

Supplementation with vitamin B-6 may compensate for these conditions.

Vitamin B-6 and Red Blood Cells:  B-6 is necessary to form quality hemoglobin, the compound in red blood cells which carries oxygen to tissues throughout the body.  Patients with B-6 deficiency often show symptoms of anemia. 

B-6 and the Immune System:  Vitamin B-6 benefits the immune system by maintaining a healthy lymphatic system.  The lymphatic systems produce the white blood cells involved in the immune response. 

Blood Sugar Levels:  Vitamin B-6 is needed to convert carbohydrates to glucose when the body is low in calories.  Healthy levels of vitamin B-6 are necessary for maintaining stable blood sugar levels.

Symptoms of vitamin B-6 deficiency include skin inflammation (dermatitis), sore tongue (glossitis), depression, confusion, convulsions, and anemia.  Alcoholics, older individuals, and those with poor diets are more likely to have a deficiency.

 

(Click to Read about B-6's Effect on the Nervous System.)

 

 

 

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Other Functions of Vitamin B-6: 
Vitamin B-6 is necessary for producing serotonin and dopamine, among other neurotransmitters, in the brain.  Some researchers believe there may be a connection between vitamin B-6 levels and conditions such as seizures, chronic pain, depression, headache, and Parkinson’s disease (National Institutes of Health).

For almost thirty years, vitamin B-6 has been prescribed as a treatment for carpal tunnel syndrome.  Carpal tunnel syndrome is the result of stress placed on nerves in the hands and wrists, leading to pain, stiffness, and discomfort.

Some women find that vitamin B-6 supplementation helps alleviate the symptoms associated with pre-menstrual syndrome (PMS), such as fatigue, irritability, moodiness, depression, fluid retention, and breast tenderness (Linus Pauling Institute).

Another important factor in vitamin B-6 function has to do with homoscysteine, a non-essential amino acid.  Recent research has found that elevated levels of homocysteine can cause platelets in the blood to clot more easily, and it may also damage the artery walls.  These two conditions greatly increase the risk of heart disease. 

Deficiency in vitamin B-6 can be a cause of elevated homocysteine levels.  Therefore, adequate levels of vitamin B-6 are vital to minimizing the risk of heart disease.  One study found that women who ingested a good amount of vitamin B-6 had 67% the risk of heart disease as women who ingested a significantly lower dose (Linus Pauling Institute).

Dietary Supplement Fact Sheet: Vitamin B6
From the Office of Dietary Supplements, NIH Clinical Center, National Institutes of Health

 

Vitamin B6: What is it?

Vitamin B6 is a water-soluble vitamin that exists in three major chemical forms: pyridoxine, pyridoxal, and pyridoxamine. It performs a wide variety of functions in your body and is essential for your good health. For example, vitamin B6 is needed for more than 100 enzymes involved in protein metabolism. It is also essential for red blood cell metabolism. The nervous and immune systems need vitamin B6 to function efficiently, and it is also needed for the conversion of tryptophan (an amino acid) to niacin (a vitamin).

Hemoglobin within red blood cells carries oxygen to tissues. Your body needs vitamin B6 to make hemoglobin. Vitamin B6 also helps increase the amount of oxygen carried by hemoglobin. A vitamin B6 deficiency can result in a form of anemia that is similar to iron deficiency anemia.

An immune response is a broad term that describes a variety of biochemical changes that occur in an effort to fight off infections. Calories, protein, vitamins, and minerals are important to your immune defenses because they promote the growth of white blood cells that directly fight infections. Vitamin B6, through its involvement in protein metabolism and cellular growth, is important to the immune system. It helps maintain the health of lymphoid organs (thymus, spleen, and lymph nodes) that make your white blood cells. Animal studies show that a vitamin B6 deficiency can decrease your antibody production and suppress your immune response.

Vitamin B6 also helps maintain your blood glucose (sugar) within a normal range. When caloric intake is low your body needs vitamin B6 to help convert stored carbohydrate or other nutrients to glucose to maintain normal blood sugar levels. While a shortage of vitamin B6 will limit these functions, supplements of this vitamin do not enhance them in well-nourished individuals.

What foods provide vitamin B6?
Vitamin B6 is found in a wide variety of foods including fortified cereals, beans, meat, poultry, fish, and some fruits and vegetables. The table of selected food sources of vitamin B6 suggests many dietary sources of B6.

When can a vitamin B6 deficiency occur?
Clinical signs of vitamin B6 deficiency are rarely seen in the United States. Many older Americans, however, have low blood levels of vitamin B6, which may suggest a marginal or sub-optimal vitamin B6 nutritional status. Vitamin B6 deficiency can occur in individuals with poor quality diets that are deficient in many nutrients. Symptoms occur during later stages of deficiency, when intake has been very low for an extended time. Signs of vitamin B6 deficiency include dermatitis (skin inflammation), glossitis (a sore tongue), depression, confusion, and convulsions. Vitamin B6 deficiency also can cause anemia. Some of these symptoms can also result from a variety of medical conditions other than vitamin B6 deficiency. It is important to have a physician evaluate these symptoms so that appropriate medical care can be given.
Who may need extra vitamin B6 to prevent a deficiency?

Individuals with a poor quality diet or an inadequate B6 intake for an extended period may benefit from taking a vitamin B6 supplement if they are unable to increase their dietary intake of vitamin B6. Alcoholics and older adults are more likely to have inadequate vitamin B6 intakes than other segments of the population because they may have limited variety in their diet. Alcohol also promotes the destruction and loss of vitamin B6 from the body.

Asthmatic children treated with the medicine theophylline may need to take a vitamin B6 supplement. Theophylline decreases body stores of vitamin B6, and theophylline-induced seizures have been linked to low body stores of the vitamin. A physician should be consulted about the need for a vitamin B6 supplement when theophylline is prescribed.
What are some current issues and controversies about vitamin B6?

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Vitamin B6 and interactions with medications
There are many drugs that interfere with the metabolism of vitamin B6. Isoniazid, which is used to treat tuberculosis, and L-DOPA, which is used to treat a variety of neurologic problems such as Parkinson's disease, alter the activity of vitamin B6. There is disagreement about the need for routine vitamin B6 supplementation when taking isoniazid. Acute isoniazid toxicity can result in coma and seizures that are reversed by vitamin B6, but in a group of children receiving isoniazid, no cases of neurological or neuropsychiatric problems were observed regardless of whether or not they took a vitamin B6 supplement. Some doctors recommend taking a supplement that provides 100% of the RDA for B6 when isoniazid is prescribed, which is usually enough to prevent symptoms of vitamin B6 deficiency. It is important to consult with a physician about the need for a vitamin B6 supplement when taking isoniazid.

What is the relationship between vitamin B6, homocysteine, and heart disease?

A deficiency of vitamin B6, folic acid, or vitamin B12 may increase your level of homocysteine, an amino acid normally found in your blood. There is evidence that an elevated homocysteine level is an independent risk factor for heart disease and stroke. The evidence suggests that high levels of homocysteine may damage coronary arteries or make it easier for blood clotting cells called platelets to clump together and form a clot. However, there is currently no evidence available to suggest that lowering homocysteine level with vitamins will reduce your risk of heart disease. Clinical intervention trials are needed to determine whether supplementation with vitamin B6, folic acid, or vitamin B12 can help protect you against developing coronary heart disease.

What is the health risk of too much vitamin B6?

Too much vitamin B6 can result in nerve damage to the arms and legs. This neuropathy is usually related to high intake of vitamin B6 from supplements, and is reversible when supplementation is stopped. According to the Institute of Medicine, "Several reports show sensory neuropathy at doses lower than 500 mg per day". As previously mentioned, the Food and Nutrition Board of the Institute of Medicine has established an upper tolerable intake level (UL) for vitamin B6 of 100 mg per day for all adults. "As intake increases above the UL, the risk of adverse effects increases."


References

Leklem JE. Vitamin B6. In: Shils ME, Olson JA, Shike M, Ross AC, ed. Modern Nutrition in Health and Disease. 9th ed. Baltimore: Williams and Wilkins, 1999: 413-421.

Bender DA. Vitamin B6 requirements and recommendations. Eur J Clin Nutr 1989 ;43:289-309. [PubMed abstract]

Gerster H. The importance of vitamin B6 for development of the infant. Human medical and animal experiment studies. Z Ernahrungswiss 1996; 35:309-17. [PubMed abstract]

Bender DA. Novel functions of vitamin B6. Proc Nutr Soc 1994; 53:625-30. [PubMed abstract]

Chandra R and Sudhakaran L. Regulation of immune responses by Vitamin B6. NY Acad Sci 1990; 585:404-423. [PubMed abstract]

Trakatellis A, Dimitriadou A, Trakatelli M. Pyridoxine deficiency: New approaches in immunosuppression and chemotherapy. Postgrad Med J 1997; 73:617-22. [PubMed abstract]

Shibata K, Mushiage M, Kondo T, Hayakawa T, Tsuge H. Effects of vitamin B6 deficiency on the conversion ratio of tryptophan to niacin. Biosci Biotechnol Biochem 1995; 59:2060-3. [PubMed abstract]

Leyland DM and Beynon RJ. The expression of glycogen phosphorylase in normal and dystrophic muscle. Biochem J 1991; 278:113-7. [PubMed abstract]

Oka T, Komori N, Kuwahata M, Suzuki I, Okada M, Natori Y. Effect of vitamin B6 deficiency on the expression of glycogen phosphorylase mRNA in rat liver and skeletal muscle. Experientia 1994; 50:127-9. [PubMed abstract]

Okada M, Ishikawa K, Watanabe K. Effect of vitamin B6 deficiency on glycogen metabolism in the skeletal muscle, heart, and liver of rats. J Nutr Sci Vitaminol (Tokyo) 1991; 37:349-57. [PubMed abstract]

U.S. Department of Agriculture, Agricultural Research Service,1999. USDA Nutrient Database for Standard Reference, Release 13. Nutrient Data Lab Home Page, http://www.nal.usda.gov/fnic/foodcomp

Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. National Academy Press. Washington, DC, 1998.

Alaimo K, McDowell M, Briefel R, Bischof A, Caughman C, Loria C, and Johnson C. Dietary intake of vitamins, minerals, and fiber of persons ages 2 months and over in the United States: Third National Health and Nutrition Examination survey, Phase 1, 1988-91. Hyattsville, MD: U.S. Department of Health and Human Services; Center for Disease Control and Prevention; National Center for Health Statistics, 1994:1-28.

Combs G. The Vitamins: Fundamental aspects in nutrition and health. San Diego, California: Academic Press, Inc., 1992; 311-328.

Lumeng L, Li TK. Vitamin B6 metabolism in chronic alcohol abuse. Pyridoxal phosphate levels in plasma and the effects of acetaldehyde on pyridoxal phosphate synthesis and degradation in human erythrocytes. J Clin Invest 1974; 53:693-704. [PubMed abstract]

Weir MR, Keniston RC, Enriquez JI, McNamee GA. Depression of vitamin B6 levels due to theophylline. Ann Allergy 1990; 65:59-62. [PubMed abstract]

Shimizu T, Maeda S, Mochizuki H, Tokuyama K, Morikawa A. Theophylline attenuates circulating vitamin B6 levels in children with asthma. Pharmacology 1994; 49:392-7. [PubMed abstract]

Bernstein AL. Vitamin B6 in clinical neurology. Ann N Y Acad Sci 1990;585:250-60. [PubMed abstract]

Villegas-Salas E, Ponce de Leon R, Juarez-Perez MA, Grubb GS. Effect of vitamin B6 on the side effects of a low-dose combined oral contraceptive. Contraception 1997; 55:245-8. [PubMed abstract]

Vinik AI. Diabetic neuropathy: pathogenesis and therapy. Am J Med 1999; 107:17S-26S. [PubMed abstract]

Copeland DA and Stoukides CA. Pyridoxine in carpal tunnel syndrome. Ann Pharmacother 1994; 28:1042-4. [PubMed abstract]

Foca FJ. Motor and sensory neuropathy secondary to excessive pyridoxine ingestion. Arch Phys Med Rehabil 1985; 66:634-6. [PubMed abstract]

Johnson SR. Premenstrual syndrome therapy. Clin Obstet Gynecol 1998; 41:405-21. [PubMed abstract]

Diegoli MS, da Fonseca AM, Diegoli CA, Pinotti JA. A double-blind trial of four medications to treat severe premenstrual syndrome. Int J Gynaecol Obstet 1998; 62:63-7. [PubMed abstract]

Dalton K. Pyridoxine overdose in premenstrual syndrome. Lancet 1985; 1, May 18:1168. [PubMed abstract]

Brown A, Mallet M, Fiser D, Arnold WC. Acute isoniazid intoxication: Reversal of CNS symptoms with large doses of pyridoxine. Pediatr Pharmacol 1984; 4:199-202. [PubMed abstract]

Brent J, Vo N, Kulig K, Rumack BH. Reversal of prolonged isoniazid-induced coma by pyridoxine. Arch Intern Med 1990; 150:1751-1753 [PubMed abstract]

Selhub J, Jacques PF, Bostom AG, D'Agostino RB, Wilson PW, Belanger AJ, O'Leary DH, Wolf PA, Scaefer EJ, Rosenberg IH. Association between plasma homocysteine concentrations and extracranial carotid-artery stenosis. N Engl J Med 1995; 332:286-291. [PubMed abstract]

Rimm EB, Willett WC, Hu FB, Sampson L, Colditz GA, Manson JE, Hennekens C, Stampfer MJ. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. J Am Med Assoc 1998; 279:359-64. [PubMed abstract]

Refsum H, Ueland PM, Nygard O, Vollset SE. Homocysteine and cardiovascular disease. Annu Rev Med 1998; 49:31-62. [PubMed abstract]

Boers GH. Hyperhomocysteinaemia: A newly recognized risk factor for vascular disease. Neth J Med 1994; 45:34-41. [PubMed abstract]

Selhub J, Jacques PF, Wilson PF, Rush D, Rosenberg IH. Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. J Am Med Assoc 1993; 270:2693-2698. [PubMed abstract]

Malinow MR. Plasma homocyst(e)ine and arterial occlusive diseases: A mini-review. Clin Chem 1995; 41:173-6. [PubMed abstract]

Flynn MA, Herbert V, Nolph GB, Krause G. Atherogenesis and the homocysteine-folate-cobalamin triad: Do we need standardized analyses? J Am Coll Nutr 1997; 16:258-67. [PubMed abstract]

Fortin LJ, Genest J, Jr. Measurement of homocyst(e)ine in the prediction of arteriosclerosis. Clin Biochem 1995; 28:155-62. [PubMed abstract]

Siri PW, Verhoef P, Kok FJ. Vitamins B6, B12, and folate: Association with plasma total homocysteine and risk of coronary atherosclerosis. J Am Coll Nutr 1998; 17:435-41. [PubMed abstract]

Ubbink JB, van der Merwe A, Delport R, Allen RH, Stabler SP, Riezler R, Vermaak WJ. The effect of a subnormal vitamin B-6 status on homocysteine metabolism. J Clin Invest 1996; 98:177-84. [PubMed abstract]

 

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From the Linus Pauling Institute,  
Oregon State University

Vitamin B6 is a water-soluble vitamin that was first isolated in the 1930's. There are six forms of vitamin B6: pyridoxal (PL), pyridoxine (PN), pyridoxamine (PM), and their phosphate derivatives: pyridoxal 5'-phosphate (PLP), pyridoxine 5'-phosphate (PNP), and pridoxamine 5'-phospate (PMP). PLP is the active coenzyme form, and has the most importance in human metabolism.

Function
Vitamin B6 must be obtained from the diet because humans cannot synthesize it, and the coenzyme, PLP plays a vital role in the function of approximately 100 enzymes that catalyze essential chemical reactions in the human body. For example, PLP functions as a coenzyme for glycogen phosphorylase, an enzyme that catalyzes the release of glucose stored in the muscle as glycogen. Much of the PLP in the human body is found in muscle bound to glycogen phosphorylase. PLP is also a coenzyme for reactions used to generate glucose from amino acids, a process known as gluconeogenesis.

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Toxicity
Because adverse effects have only been documented from vitamin B6 supplements and never from food sources, only the supplemental form of vitamin B6 (pyridoxine) is discussed with respect to safety. Although vitamin B6 is a water-soluble vitamin and is excreted in the urine, very high doses of pyridoxine over long periods of time may result in painful neurological symptoms known as sensory neuropathy. Symptoms include pain and numbness of the extremities, and in severe cases difficulty walking. Sensory neuropathy typically develops at doses of pyridoxine in excess of 1,000 mg per day.

However, there have been a few case reports of individuals who developed sensory neuropathies at doses of less than 500 mg daily over a period of months. None of the studies, in which an objective neurological examination was performed, found evidence of sensory nerve damage at intakes of pyridoxine below 200 mg/day. In order to prevent sensory neuropathy in virtually all individuals, the Food and Nutrition Board of the Institute of Medicine set the tolerable upper intake level (UL) for pyridoxine at 100 mg/day for adults (see table below). Because placebo-controlled studies have generally failed to show therapeutic benefits of high doses of pyridoxine, there is little reason to exceed the UL of 100 mg/day.

Tolerable Upper Intake Level (UL) for Vitamin B6

Age Group    UL (mg/day)
Infants 0-12 months  Not possible to establish*
Children 1-3 years    30
Children 4-8 years    40
Children 9-13 years              60
Adolescents 14-18 years     80
Adults 19 years and older   100
*Source of intake should be from food and formula only.

Drug interactions
Certain medications, interfere with the metabolism of vitamin B6, and may result in deficiency if individuals taking such medications are not given supplemental vitamin B6. The anti-tuberculosis medications, isoniazid and cycloserine, the metal chelator, penicillamine, and antiparkinsonian drugs, including L-dopa, form complexes with vitamin B6, creating a functional deficiency. The efficacy of other medications may be altered by high doses of vitamin B6. High doses of vitamin B6 have been found to decrease the efficacy of the anticonvulsants, phenobarbitol and phenytoin, and L-dopa.

Linus Pauling Institute Recommendation
Metabolic studies suggest that young women require 0.02 mg of vitamin B6 per gram of protein consumed daily. Using the upper boundary for acceptable levels of protein intake for women (100 grams/day), the daily requirement for young women would be calculated at 2.0 mg daily. Older adults may also require at least 2.0 mg/day. For these reasons, the Linus Pauling Institute recommends that all adults consume at least 2.0 mg of vitamin B6 daily. Following the Linus Pauling Institute recommendation to take a daily multi-vitamin/mineral supplement containing 100 % of the Daily Value for vitamin B6 will ensure an intake of at least 2.0 mg/day of vitamin B6. Although a vitamin B6 intake of 2.0 mg daily is slightly higher than the most recent RDA, it is 50 times less than the tolerable upper intake level (UL) set by the Food and Nutrition Board.

Older adults (65 years and older)
Metabolic studies have indicated that the requirement for vitamin B6 in older adults is approximately 2.0 mg daily, and could be higher if the effect of marginally deficient intakes of vitamin B6 on immune function and homocysteine levels are clarified. Despite evidence that the requirement for vitamin B6 may be slightly higher in older adults, several surveys have found that over half of individuals over age 60 consume less than the current RDA (1.7 mg/day for men and 1.5 mg/day for women). For these reasons, the Linus Pauling Institute recommends that older adults take a multivitamin/multimineral supplement, which generally provides at least 2.0 mg of vitamin B6 daily.

 

 

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vitamin b-6 support for carpal tunnel syndrome, Typists, Computer Operators, & Computer Game Players. vitamin b-6 for Nervous System & Immune Support available from Good Health Group of America