Vitamin B 6 plays a major role in making proteins, hormones, and neurotransmitters (chemicals that carry signals between nerve cells). Because mild deficiency of vitamin B 6 is common, this is one vitamin that is probably worth taking as insurance.
However, there is little evidence that taking vitamin B 6 above nutritional needs offers benefits in the treatment of any particular illnesses, except, possibly, nausea of pregnancy (morning sickness).
Vitamin B 6 requirements increase with age. The official US and Canadian recommendations for daily intake are as follows:
The National Institutes of Health's Office of Dietary Supplements offers this list of foods that are high in vitamin B 6:77
Vitamin B 6 Deficiency TOP
Severe deficiencies of vitamin B 6 are rare, but mild deficiencies are extremely common. In a survey of 11,658 adults, 71% of men and 90% of women were found to have diets deficient in B 6.1 Vitamin B 6 is the most commonly deficient water-soluble vitamin in the elderly,2 and children, too, often don't get enough.3 In addition, evidence has been presented that current recommended daily intakes should be increased.4
B 6 deficiency might be worsened by use of hydralazine (for high blood pressure),5penicillamine (used for rheumatoid arthritis and certain rare diseases),6theophylline (an older drug for asthma),7-11MAO inhibitors,12 and the antituberculosis drug isoniazid (INH),13-16 all of which are thought to interfere with B 6 to some degree. Good sources of B 6 include nutritional (torula) yeast, brewer's yeast, sunflower seeds, wheat germ, soybeans, walnuts, lentils, lima beans, buckwheat flour, bananas, and avocados.
Therapeutic Dosages TOP
One study found that 30 mg of vitamin B 6 daily was effective for symptoms of morning sickness.17 While far above nutritional needs, this dosage should be safe. However, for the treatment of other conditions, B 6 has been recommended at doses as high as 300 mg daily. There are potential risks at this level of vitamin B 6 intake. (See the Safety Issues section below for more information).
Therapeutic Uses TOP
Vitamin B 6 has been proposed for numerous other uses as well, but without much (if any) scientific substantiation. For example, the two most famous uses of vitamin B 6, carpal tunnel syndrome and premenstrual syndrome PMS, have no reliable supporting evidence at all, and the best-designed studies found it ineffective for either of these purposes.18,55
Higher intake of vitamin B 6 reduces the level of homocysteine in the blood, a substance that might accelerate cardiovascular disease (heart disease, strokes, and related conditions.) However, there is as yet no meaningful evidence that reducing homocysteine is beneficial, and considerable evidence that it is not. See the full Homocysteine article for more information.
A series of studies suggests that vitamin B 6 may be helpful for the treatment of TD. In the first study, a 4-week, double-blind crossover trial of 15 people, treatment with vitamin B 6 significantly improved TD symptoms as compared to placebo.51 Benefits were seen beginning at 1 week of treatment. The subsequent follow-up study tested the benefits of vitamin B 6 used over a period of 26 weeks in 50 people with tardive dyskinesia, and once again the supplement proved more effective than placebo.71
For the following other conditions, current evidence for benefit with vitamin B 6 remains incomplete and/or contradictory: allergy to monosodium glutamate (MSG), asthma,24,25depression,23diabetes of pregnancy,26HIV infection,27,28photosensitivity,32 preventing kidney stones,19-22schizophrenia,56,57,65seborrheic dermatitis,35tardive dyskinesia and other side effects of anti-psychotic drugs,29-31,51,66,67 and vertigo.33
Despite some claims in the media, vitamin B 6 has not shown benefit for enhancing mental function.68 Research investigating the benefits of B 6 (in combination with folate and vitamin B 12) as a potential treatment for cognitive decline due to Alzheimer’s disease (AD) has also shown disappointing results.74
One study failed to find B 6 at a dose of 50 mg daily helpful for rheumatoid arthritis (despite a general B 6 deficiency seen in people with this condition).70
What Is the Scientific Evidence for Vitamin B 6 ? TOP
Nausea and Vomiting
Vitamin B 6 supplements have been used for years by conventional physicians as a treatment for morning sickness. In 1995, a large double-blind study validated this use.38 A total of 342 pregnant women were given placebo or 30 mg of vitamin B 6 daily. Subjects then graded their symptoms by noting the severity of their nausea and recording the number of vomiting episodes. The women in the B 6 group experienced significantly less nausea than those in the placebo group, suggesting that regular use of B 6 can be helpful for morning sickness. However, vomiting episodes were not significantly reduced.
At least 3 studies have compared vitamin B 6 to ginger for the treatment of morning sickness. Two studies found them to be equally beneficial,69,72 while the other found ginger to be somewhat better.73 However, as ginger is not an established treatment for this condition, these studies alone do not provide any additional evidence in favor of B 6.
Chemotherapy-induced Nausea and Vomiting
Researchers also investigated whether vitamin B 6 can reduce the nausea and vomiting that often accompanies chemotherapy.75 One hundred and forty-two women with ovarian cancer who were undergoing chemotherapy were randomized into 3 groups: acupuncture plus B 6 injection into the P6 acupuncture point (located on the inside of the forearm, about 2 inches above the wrist crease), acupuncture alone, or B 6 alone. Those that received both acupuncture and B 6 experienced less nausea and vomiting compared to the other two groups.
Premenstrual Syndrome (PMS)
A recent, properly designed double-blind study of 120 women found no benefit of vitamin B 6 for PMS.39 In this study, three prescription drugs were compared against vitamin B 6 (pyridoxine, at 300 mg daily) and placebo. All study participants received 3 months of treatment and 3 months of placebo. Vitamin B 6 proved to be no better than placebo.
Approximately a dozen other double-blind studies have investigated the effectiveness of vitamin B 6 for PMS, but none were well designed; overall the evidence for any benefit is weak at best.40,41 Some books on natural medicine report that the negative results in some of these studies were due to insufficient B 6 dosage, but in reality there was no clear link between dosage and effectiveness.
However, preliminary evidence suggests that the combination of B 6 and magnesium might be more effective than either treatment alone.42
One double-blind, placebo-controlled crossover study found indications that very high doses of vitamin B 6 may produce beneficial effects in the treatment of autism.34 However, this study was small and poorly designed; furthermore, it used a dose of vitamin B 6 so high that it could cause toxicity.
It has been suggested that combining magnesium with vitamin B 6 could offer additional benefits, such as reducing side effects or allowing a reduced dose of the vitamin. However, the two reasonably well-designed studies using combined vitamin B 6 and magnesium have failed to find benefits.58-60 Therefore, it isn’t possible at present to recommend vitamin B 6 with or without magnesium as a treatment for autism.
A double-blind study of 76 children with asthma found significant benefit from vitamin B 6 after the second month of usage.43 Children in the vitamin B 6 group were able to reduce their doses of asthma medication (bronchodilators and steroids). However, a recent double-blind study of 31 adults who used either inhaled or oral steroids did not show any benefit.44 The dosages of B 6 used in these studies were quite high, in the range of 200 to 300 mg daily. Because of the risk of nerve injury, it is not advisable to take this much B 6 without medical supervision (see Safety Issues).
Safety Issues TOP
The safe upper levels for daily intake of vitamin B 652 are as follows:
At higher dosages (especially above 2 g daily) there is a very real risk of nerve damage. Nerve-related symptoms have even been reported at doses as low as 200 mg.45 (This is a bit ironic, given that B 6 deficiency also causes nerve problems.) In some cases, very high doses of vitamin B 6 can cause or worsen acne symptoms.46,47
In addition, doses of vitamin B 6 over 5 mg may interfere with the effects of the drug levodopa when it is taken alone.48-50 However, vitamin B 6 does not impair the effectiveness of drugs containing levodopa and carbidopa.
Maximum safe dosages for individuals with severe liver or kidney disease have not been established.
Interactions You Should Know About TOP
If you are taking:
References[ + ]
1. Kant AK, Block G. Dietary vitamin B-6 intake and food sources in the US population: NHANES II, 1976-1980. Am J Clin Nutr. 1990;52:707-716.
2. van der Wielen RP, de Groot LC, van Staveren WA. Dietary intake of water soluble vitamins in elderly people living in a Western society (1980-1993). Nutr Res. 1994;14:605-638.
3. Albertson AM, Toblemann RC, Engstrom A, et al. Nutrient intakes of 2- to 10-year-old American children: 10-year trends. J Am Diet Assoc. 1992;92:1492-1496.
4. Hansen CM, Shultz TD, Kwak HK, et al. Assessment of vitamin B-6 status in young women consuming a controlled diet containing four levels of vitamin B-6 provides an estimated average requirement and recommended dietary allowance. J Nutr. 2001;131:1777-1786.
5. Vidrio H. Interaction with pyridoxal as a possible mechanism of hydralazine hypotension. J Cardiovasc Pharmacol. 1990;15:150-156.
6. Rumsby PC, Shepherd DM. The effect of penicillamine on vitamin B6 function in man. Biochem Pharmacol. 1981;30:3051-3053.
7. Delport R, Ubbink JB, Serfontein WJ, et al. Vitamin B6 nutritional status in asthma: the effect of theophylline therapy on plasma pyridoxal-5'-phosphate and pyridoxal levels. Int J Vitam Nutr Res. 1988;58:67-72.
8. Ubbink JB, Vermaak WJ, Delport R, et al. The relationship between vitamin B6 metabolism, asthma, and theophylline therapy. Ann N Y Acad Sci. 1990;585:285-294.
9. Delport R, Ubbink JB, Vermaak WJ, et al. Theophylline increases pyridoxal kinase activity independently from vitamin B 6 nutritional status. Res Commun Chem Pathol Pharmacol. 1993;79:325-333.
10. Ubbink JB, Delport R, Bissbort S, et al. Relationship between vitamin B-6 status and elevated pyridoxal kinase levels induced by theophylline therapy in humans. J Nutr. 1990;120:1352-1359.
11. Shimizu T, Maeda S, Mochizuki H, et al. Theophylline attenuates circulating vitamin B 6 levels in children with asthma . Pharmacology. 1994;49:392-397.
12. Heller CA, Friedman PA. Pyridoxine deficiency and peripheral neuropathy associated with long-term phenelzine therapy. Am J Med. 1983;75:887-888.
13. Goldman AL, Braman SS. Isoniazid: A review with emphasis on adverse effects. Chest. 1972;62:71-77.
14. Heller CA, Friedman PA. Pyridoxine deficiency and peripheral neuropathy associated with long-term phenelzine therapy. Am J Med. 1983;75:887-888.
15. Biehl JP, Vilter RW. Effect of isoniazid on vitamin B 6 metabolism; its possible significance in producing isoniazid neuritis. Proc Soc Exp Biol Med. 1954;85:389-392.
16. Snider DE Jr. Pyridoxine supplementation during isoniazid therapy. Tubercle. 1980;61:191-196.
17. Vutyavanich T, Wongtra-ngan S, Ruangsri R. Pyridoxine for nausea and vomiting of pregnancy: a randomized, double-blind, placebo-controlled trial. Am J Obstet Gynecol. 1995;173:881-884.
18. Diegoli MS, da Fonseca AM, Diegoli CA, et al. A double-blind trial of four medications to treat severe premenstrual syndrome. Int J Gynaecol Obstet. 1998;62:63-67.
19. Parivar F, Low RK, Stoller ML. The influence of diet on urinary stone disease. J Urol. 1996;155:432-440.
20. Murthy MS, Farooqui S, Talwar HS, et al. Effect of pyridoxine supplementation on recurrent stone formers. Int J Clin Pharmacol Ther Toxicol. 1982;20:434-437.
21. Curhan GC, Willett WC, Speizer FE, et al. Intake of vitamins B6 and C and the risk of kidney stones in women. J Am Soc Nephrol. 1999;10:840-845.
22. Curhan GC, Willett WC, Rimm EB, et al. A prospective study of the intake of vitamins C and B6, and the risk of kidney stones in men. J Urol. 1996;155:1847-1851.
23. Bell IR, Edman JS, Morrow FD, et al. Brief communication. Vitamin B 1, B 2, and B 6 augmentation of tricyclic antidepressant treatment in geriatric depression with cognitive dysfunction. J Am Coll Nutr. 1992;11:159-163.
24. Collipp PJ, Goldzier S III, Weiss N, et al. Pyridoxine treatment of childhood bronchial asthma. Ann Allergy. 1975;35:93-97.
25. Sur S, Camara M, Buchmeier A, et al. Double-blind trial of pyridoxine (vitamin B6) in the treatment of steroid-dependent asthma. Ann Allergy. 1993;70:147-152.
26. Bennink HJ, Schreurs WH. Improvement of oral glucose tolerance in gestational diabetes by pyridoxine. Br Med J. 1975;3:13-15.
27. Tang AM, Graham NM, Saah AJ. Effects of micronutrient intake on survival in human immunodeficiency virus type 1 infection. Am J Epidemiol. 1996;143:1244-1256.
28. Baum MK, Mantero-Atienza E, Shor-Posner G, et al. Association of vitamin B6 status with parameters of immune function in early HIV-1 infection. J Acquir Immune Defic Syndr. 1991;4:1122-1132.
29. DeVeaugh-Geiss J, Manion L. High-dose pyridoxine in tardive dyskinesia. J Clin Psychiatry. 1978;39:573-575.
30. Sandyk R, Pardeshi R. Pyridoxine improves drug-induced parkinsonism and psychosis in a schizophrenic patient. Int J Neurosci. 1990;52:225-232.
31. Lerner V, Kaptsan A, Miodownik C, et al. Vitamin B6 in treatment of tardive dyskinesia: a preliminary case series study. Clin Neurpharmacol. 1999;22:241-243.
32. Ross JB, Moss MA. Relief of the photosensitivity of erythropoietic protoporphyria by pyridoxine. J Am Acad Dermatol. 1990;22:340-342.
33. Lewy A, Fox N. Clinical notes; new instruments and techniques: pyroxidine (B6) used in the treatment of vertigo. Arch Otolaryngol. 1947; 681-683.
34. Rimland B, Callaway E, Dreyfus P. The effect of high doses of vitamin B6 on autistic children: a double-blind crossover study. Am J Psychiatry. 1978;135:472-475.
35. Effersoe H. The effect of topical application of pyridoxine ointment on the rate of sebaceous secretion in patients with seborrheic dermatitis. Acta Derm Venereol. 1954;3:272-278.
36. Rimm EB, Willett WC, Hu FB, et al. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. JAMA. 1998;279:359-364.
37. Folsom AR, Nieto FJ, McGovern PG, et al. Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins: the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 1998;98:204-210.
38. Vutyavanich T, Wongtra-ngan S, Ruangsri R. Pyridoxine for nausea and vomiting of pregnancy: a randomized, double-blind, placebo-controlled trial. Am J Obstet Gynecol. 1995;173:881-884.
39. Diegoli MS, da Fonseca AM, Diegoli CA, et al. A double-blind trial of four medications to treat severe premenstrual syndrome. Int J Gynaecol Obstet. 1998;62:63-67.
40. Kleijnen J, Ter Riet G, Knipschild P. Vitamin B6 in the treatment of premenstrual syndrome—a review. Br J Obstet Gynaecol. 1990;97:847-852.
41. Wyatt KM, Dimmock PW, Jones PW, et al. Efficacy of vitamin B6 in the treatment of premenstrual syndrome: systematic review. BMJ. 1999;318:1375-1381.
42. De Souza MC, Walker AF, Robinson PA, et al. A synergistic effect of a daily supplement for 1 month of 200 mg magnesium plus 50 mg vitamin B6 for the relief of anxiety-related premenstrual symptoms: a randomized, double-blind, crossover study. J Womens Health Gend Based Med. 2000;9:131-139.
43. Collipp PJ, Goldzier S III, Weiss N, et al. Pyridoxine treatment of childhood bronchial asthma. Ann Allergy. 1975;35:93-97.
44. Sur S, Camara M, Buchmeier A, et al. Double-blind trial of pyridoxine (vitamin B6) in the treatment of steroid-dependent asthma. Ann Allergy. 1993;70:147-152.
45. Parry GJ, Bredesen DE. Sensory neuropathy with low-dose pyridoxine. Neurology. 1985;35:1466-1468.
46. Sherertz EF. Acneiform eruption due to "megadose" vitamins B6 and B12. Cutis. 1991;48:119-120.
47. Braun-Falco O, Lincke H. The problem of vitamin B6/B12 acne. A contribution on acne medicamentosa [in German]. MMWMunch Med Wochenschr. 1976;118:155-160.
48. Lim D, McKay M. Food-drug interactions. Drug Information Bulletin. 1995;15:UCLA Dept. of Pharmaceutical Services.
49. Yahr MD, Duvoisin RC. Pyridoxine and levodopa in the treatment of Parkinsonism. JAMA. 1972;220:861.
50. Leon AS, Spiegel HE, Thomas G, et al. Pyridoxine antagonism of levodopa in parkinsonism. JAMA. 1971;218:1924-1927.
51. Lerner V, Miodownik C, Kaptsan A, et al. Vitamin B6 in the treatment of tardive dyskinesia: a double-blind, placebo-controlled, crossover study. Am J Psychiatry. 2001;158:1511-1514.
52. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998). Available at www.nap.edu. Accessed October 4, 2001 .
53. Villegas-Salas E, Ponce de Leon R, Juarez-Perez MA, et al. Effect of vitamin B6 on the side effects of a low-dose combined oral contraceptive. Contraception. 1997;55:245-248.
54. Mabin DC, Hollis S, Lockwood J, et al. Pyridoxine in atopic dermatitis. Br J Dermatol. 1995;133:764-767.
55. Gerritsen AA, de Krom MC, Struijs MA, Scholten RJ, de Vet HC, Bouter LM. Conservative treatment options for carpal tunnel syndrome: a systematic review of randomised controlled trials. J Neurol. 2002;249:272-280.
56. Ananth JV, Ban TA, Lehmann HE. Potentiation of therapeutic effects of nicotinic acid by pyridoxine in chronic schizophrenics. Can Psychiatr Assoc J 1973;18:377-383.
57. Hoffer A. Megavitamin B-3 therapy for schizophrenia. Can Psychiatr Assoc J. 1971;16:499-504.
58. Nye C, Brice A. Combined vitamin B6-magnesium treatment in autism spectrum disorder (Cochrane Review). Cochrane Database Syst Rev. 2002;CD003497.
59. Findling RL, Maxwell K, Scotese-Wojtila L, et al. High-dose pyridoxine and magnesium administration in children with autistic disorder: an absence of salutary effects in a double-blind, placebo-controlled study. J Autism Dev Disord. 1997;27:467-478.
60. Tolbert L, Haigler T, Waits MM, et al. Brief report: lack of response in an autistic population to a low dose clinical trial of pyridoxine plus magnesium. J Autism Dev Disord. 1993;23:193-199.
61. Cohen KL, Gorecki GA, Silverstein SB, et al. Effect of pyridoxine (vitamin B6) on diabetic patients with peripheral neuropathy. J Am Podiatry Assoc. 1984;74:394-397.
62. McCann VJ, Davis RE. Pyridoxine and diabetic neuropathy: a double-blind controlled study. Diabetes Care. 1983;6:102-103.
63. Levin ER, Hanscom TA, Fisher M, et al. The influence of pyridoxine in diabetic peripheral neuropathy. Diabetes Care. 1981;4:606-609.
64. Schwammenthal Y, Tanne D. Homocysteine, B-vitamin supplementation, and stroke prevention: from observational to interventional trials. Lancet Neurol. 2004;3:493-5.
65. Miodownik C, Cohen H, Kotler M, Lerner V. Vitamin B 6 add-on therapy in treatment of schizophrenic patients with psychotic symptoms and movement disorders. Harefuah. 2003;142:592-6,647.
66. Lerner V, Bergman J, Statsenko N, et al. Vitamin b(6) treatment in acute neuroleptic-induced akathisia: a randomized, double-blind, placebo-controlled study. J Clin Psychiatry. 2004;65:1550-1554.
67. Miodownik C, Cohen H, Kotler M, Lerner V. Vitamin B 6 add-on therapy in treatment of schizophrenic patients with psychotic symptoms and movement disorders. Harefuah. 2003;142:592-6,647.
68. Malouf R, Grimley EJ.. The effect of vitamin B 6 on cognition. Cochrane DatabaseSyst Rev. 2003;(4):CD004393.
69. Sripramote M, Lekhyananda N. A randomized comparison of ginger and vitamin B 6 in the treatment of nausea and vomiting of pregnancy. J Med Assoc Thai. 2003;86:846-53.
70. Chiang EP, Selhub J, Bagley PJ et al. Pyridoxine supplementation corrects vitamin B6 deficiency but does not improve inflammation in patients with rheumatoid arthritis. Arthritis Res Ther. 2005;7:R1404-11.
71. Lerner V, Miodownik C, Kaptsan A, et al. Vitamin B 6 treatment for tardive dyskinesia: a randomized, double-blind, placebo-controlled, crossover study. J Clin Psychiatry. 2007;68:1648-1654.
72. Smith C, Crowther C, Willson K, et al. A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynecol. 2004;103:639-645.
73. Ensiyeh J, Sakineh MA. Comparing ginger and vitamin B 6 for the treatment of nausea and vomiting in pregnancy: a randomised controlled trial. Midwifery. 2008 Feb 11.
74. Aisen PS, Schneider LS, Sano M, et al. High-dose B vitamin supplementation and cognitive decline in Alzheimer disease: a randomized controlled trial. JAMA. 2008;300(15):1774-1783.
75. You Q, Yu H, Wu D, Zhang Y, Zheng J, Peng C. Vitamin B6 points PC6 injection during acupuncture can relieve nausea and vomiting in patients with ovarian cancer. Int J Gynecol Cancer. 2009;19(4):567-771.
76. Huang SC, Wei JC, Wu DJ, Huang YC. Vitamin B(6) supplementation improves pro-inflammatory responses in patients with rheumatoid arthritis. Eur J Clin Nutr. 2010;64(9):1007-1013.
77. Dietary supplement fact sheet: B6. Office of Dietary Supplements website. Available at: http://ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional/. Accessed September 10, 2012.
Last reviewed December 2015 by EBSCO CAM Review Board
Last Updated: 12/15/2015
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