Vitamin B6 is a water-soluble vitamin
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.
Calories, protein, vitamins, and minerals are all important to your immune system
because they promote the growth of white blood cells that directly fight infections.
Because of its involvement in protein metabolism and cellular growth Vitamin B6
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.
How much vitamin B6 do we need?
The Recommended Dietary Allowance (RDA) is the average daily dietary intake level
that is sufficient to meet the nutrient requirements of nearly all (97 to 98%) healthy
individuals in each life-stage and gender group. The 1998 RDAs for vitamin B6 (in
milligrams), are: 1.3 mg for men and women under age 50; 1.7 mg for men and 1.5
mg for women over the age of 50, 1.9 mg for pregnant women, and 2 mg for women who
are breastfeeding.
When can a vitamin B6 deficiency occur?
Clinical signs of vitamin B6 deficiency are rarely seen in the US. Many older Americans,
however, have low blood levels of vitamin B6, which may suggest a marginal or suboptimal
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.
Current Issues and Controversies about Vitamin B6
Vitamin B6 and the nervous system
Vitamin B6 is needed for the synthesis of neurotransmitters such as serotonin and
dopamine. These neurotransmitters are required for normal nerve cell communication.
Researchers have been investigating the relationship between vitamin B6 status and
a wide variety of neurologic conditions such as seizures, chronic pain, depression,
headache, and Parkinson's disease.
Lower levels of serotonin have been found in individuals suffering from depression
and migraine headaches. So far, however, vitamin B6 supplements have not proved
effective for relieving these symptoms. One study found that a sugar pill was just
as likely as vitamin B6 to relieve headaches and depression associated with low
dose oral contraceptives.
Alcohol abuse can result in neuropathy, abnormal nerve sensations in the arms
and legs. A poor dietary intake contributes to this neuropathy and dietary supplements
that include vitamin B6 may prevent or decrease its incidence.
Vitamin B6 and carpal tunnel syndrome
Vitamin B6 was first recommended for carpal tunnel syndrome almost 30 years ago.
Several popular books still recommend taking 100 to 200 milligrams (mg) of vitamin
B6 daily to treat carpal tunnel syndrome, even though scientific studies do not
indicate it is effective. Anyone taking large doses of vitamin B6 supplements for
carpal tunnel syndrome needs to be aware that the Institute of Medicine recently
established an upper tolerable limit of 100 mg per day for adults. There are documented
cases in the literature of neuropathy caused by excessive vitamin B6 taken for treatment
of carpal tunnel syndrome.
Vitamin B6 and premenstrual syndrome
Vitamin B6 has become a popular remedy for treating the discomforts associated with
premenstrual syndrome (PMS). Unfortunately, clinical trials have failed to support
any significant benefit. One recent study indicated that a sugar pill was as likely
to relieve symptoms of PMS as vitamin B6. In addition, vitamin B6 toxicity has been
seen in increasing numbers of women taking vitamin B6 supplements for PMS. One review
indicated that neuropathy was present in 23 of 58 women taking daily vitamin B6
supplements for PMS whose blood levels of B6 were above normal. There is no convincing
scientific evidence to support recommending vitamin B6 supplements for PMS.
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. 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.
Food Sources of Vitamin B6
Foods such as fortified breakfast cereals, fish including salmon and tuna fish,
meats such as pork and chicken, bananas, beans and peanut butter, and many vegetables
will contribute to your vitamin B6 intake.
- Ready-to-eat cereal, 100% fortified, 3/4 c: 2 mg of B6 ~ 100% of the recommended
daily value (DV)
- Baked potato, flesh and skin, 1 medium: 0.7 mg ~ 35% DV
- Banana, raw, 1 medium: 0.68 mg ~ 34% DV
- Garbanzo beans, canned, 1/2 c: 0.57 mg ~ 30% DV
- Chicken breast, meat only, cooked, 1/2 breast: 0.52 mg ~ 25% DV
- Oatmeal, instant, fortified, 1 packet: 0.42 mg ~ 20% DV
- Pork loin, lean only, cooked, 3 oz: 0.42 mg ~20% DV
- Roast beef, eye of round, lean only, cooked, 3 oz: 0.32 mg ~ 15% DV
- Trout, rainbow, cooked, 3 oz: 0.29 mg ~ 15% DV
- Sunflower seeds, kernels, dry roasted, 1 oz: 0.23 mg ~ 10% DV
- Avocado, raw, sliced, 1/2 cup: 0.2 mg ~ 10% DV
- Salmon, Sockeye, cooked, 3 oz: 0.19 mg ~ 10% DV
- Tuna, canned in water, drained solids, 3 oz: 0.18 mg ~ 10% DV
- Peanut butter, smooth, 2 Tbs: 0.15 mg ~ 8% DV
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