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.
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.
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/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, 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/day of B-6 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
- 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, symptoms & indicators of Vitamin B6 Requirement
Microcytic red cells
Pyridoxine-responsive anemia is indicated by small red blood cells.
History of B6 deficiency or low B6 levels
Counter Indicators
Normal/high B6 levels
(High) sensitivity to bright light
A sore tongue
Numb/tingling/burning extremities
Water retention before menstruation
Joint pain/swelling/stiffness
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.
Forgetting dreams
Conditions that suggest Vitamin B6 Requirement
Anemia (Uncommon Nutritional)
Another way to develop an anemia that looks like an iron deficiency anemia, is to have a problem with a vitamin B6. It is necessary to form the molecule that holds the iron in place in hemoglobin. People who drink excessive amounts of alcohol may run into trouble with lack of this vitamin.
Hydrochloric Acid Deficiency
Vitamin B6 is necessary for the production of hydrochloric acid.
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.
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.
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.
Dandruff
A vitamin B6 deficiency can cause dandruff.
Female Hair Loss
Especially if associated with birth control pill use.
Risk factors for Vitamin B6 Requirement
Gluten Sensitivity / Celiac Disease
In one trial, 11 people with celiac disease suffered from persistent depression despite being on a gluten-free diet for more than two years. However, after supplementation with vitamin B6 (80mg per day) for six months, the depression disappeared. [Scand J Gastroenterol 1983;18: pp.299-304]
(Severe) Perthes disease
Zinc, Manganese and vitamin B6 have been helpful in treating osteochondrosis (Leg-hip Perthes disease). This might suggest an ongoing requirement.
Birth Control Pill / Contraceptive Issues
Several B vitamins are affected negatively by birth control pill use, especially vitamin B6 if depression is present.
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.
Current birth control pill use
History of birth control pill use
(Past) non-human estrogen use
Counter Indicators
Multiple vitamin supplement use
Regular/occasional vitamin B6 use
(High) refined white flour consumption
History of carpal tunnel syndrome
History of adult acne
Vitamin B6 Requirement suggests the following may be present
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.
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 for Vitamin B6 Requirement
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Proven definite or direct link |
| Strongly counter-indicative |
| Very strongly or absolutely counter-indicative |
| Likely to help |
Glossary
RDA
Recommended Daily Allowance of vitamins or other nutrients as determined by the FDA. U.S. RDAs are more widely used than RDAs, and focus on 3 age groups: Infants of 0-12 months; Children of 1-4 years; Adults and children of more than 4 years.
Vitamin B6
Influences many body functions including regulating blood glucose levels, manufacturing hemoglobin and aiding the utilization of protein, carbohydrates and fats. It also aids in the function of the nervous system.
Pyridoxine
(Vitamin B-6): A B-complex vitamin that plays a role as a coenzyme in the breakdown and utilization of carbohydrates, fats and proteins. It facilitates the release of glycogen for energy from the liver and muscles. It also participates in the utilization of energy in the brain and nervous tissue and is essential for the regulation of the central nervous system.
Nausea
Symptoms resulting from an inclination to vomit.
Mucous Membranes
The membranes, such as the mouse, nose, anus, and vagina, that line the cavities and canals of the body which communicate with the air.
Seborrhea
Skin disease characterized by dry or moist, greasy, yellow crusts or scales.
Dermatitis
A general term used to refer to eruptions or rashes on the skin.
Neuritis
Nerve inflammation, commonly accompanying other conditions such as tendonitis, bursitis or arthritis. Neuritis is usually accompanied by neuralgia (nerve pain).
Ataxia
Failed muscular coordination, irregular muscular action.
Hyperacusis
Increased sensitivity to sound.
Hypertension
High blood pressure. Hypertension increases the risk of heart attack, stroke, and kidney failure because it adds to the workload of the heart, causing it to enlarge and, over time, to weaken; in addition, it may damage the walls of the arteries.
Edema
Abnormal accumulation of fluids within tissues resulting in swelling.
Milligram
(mg): 1/1,000 of a gram by weight.
oz
Ounce. Approximately 28 grams.
Antioxidant
A chemical compound that slows or prevents oxygen from reacting with other compounds. Some antioxidants have been shown to have cancer-protecting potential because they neutralize free radicals. Examples include vitamins C and E, alpha lipoic acid, beta carotene, the minerals selenium, zinc, and germanium, superoxide dismutase (SOD), coenzyme Q10, catalase, and some amino acids, like cystiene. Other nutrient sources include grape seed extract, curcumin, gingko, green tea, olive leaf, policosanol and pycnogenol.
Peroxides
Free radicals that are by-products formed in our bodies when molecules of fat react with oxygen.
Free Radical
A free radical is an atom or group of atoms that has at least one unpaired electron. Because another element can easily pick up this free electron and cause a chemical reaction, these free radicals can effect dramatic and destructive changes in the body. Free radicals are activated in heated and rancid oils and by radiation in the atmosphere, among other things.
Tryptophan
Essential amino acid. Natural relaxant and sleep aid due to its precursor role in serotonin (a neurotransmitter) synthesis. Along with tyrosine, it is used in the treatment of addictions.
Lysine
Essential amino acid. Important for growth, tissue repair, and the production of hormones, enzymes and antibodies. Research indicates that lysine may be useful in the treatment of migraine and herpes simplex. Precursor to carnitine in the body.
Amino Acid
An organic acid containing nitrogen chemical building blocks that aid in the production of protein in the body. Eight of the twenty-two known amino acids are considered "essential," and must be obtained from dietary sources because the body can not synthesize them.
Celiac Disease
(Gluten sensitivity) A digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten. Common symptoms include diarrhea, increased appetite, bloating, weight loss, irritability and fatigue. Gluten is found in wheat (including spelt, triticale, and kamut), rye, barley and sometimes oats.
Crohn's Disease
Chronic inflammatory disease of the gastrointestinal tract. The most common symptoms are abdominal pain, often in the lower right area, and diarrhea. Rectal bleeding, weight loss, and fever may also occur. Bleeding may be serious and persistent, leading to anemia.
Anemia
A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.
Red Blood Cell
Any of the hemoglobin-containing cells that carry oxygen to the tissues and are responsible for the red color of blood.
Heberden's Nodes
Bony swellings around the margins of joints, associated with degenerative changes of arthritis.
Iron
An essential mineral. Prevents anemia: as a constituent of hemoglobin, transports oxygen throughout the body. Virtually all of the oxygen used by cells in the life process are brought to the cells by the hemoglobin of red blood cells. Iron is a small but most vital, component of the hemoglobin in 20,000 billion red blood cells, of which 115 million are formed every minute. Heme iron (from meat) is absorbed 10 times more readily than the ferrous or ferric form.
Hemoglobin
The oxygen-carrying protein of the blood found in red blood cells.
Hydrochloric Acid
(HCl): An inorganic acidic compound, excreted by the stomach, that aids in digestion.
Cofactor
A substance that acts with another substance to bring about certain effects, often a coenzyme.
Serotonin
A phenolic amine neurotransmitter (C10H12N2O) that is a powerful vasoconstrictor and is found especially in the brain, blood serum and gastric membranes of mammals. Considered essential for relaxation, sleep, and concentration.
Dopamine
A neurohormone; precursor to norepinephrine which acts as a stimulant to the nervous system.
Noradrenaline
(Norepinephrine): A catecholamine hormone secreted from the adrenal medulla and post-ganglionic adrenergic fibers in response to hypotension or emotional stress.
Insulin
A hormone secreted by the pancreas in response to elevated blood glucose levels. Insulin stimulates the liver, muscles, and fat cells to remove glucose from the blood for use or storage.
Gestational Diabetes
Gestational diabetes is defined as any degree of glucose intolerance with the onset or first recognition occurring during pregnancy. Many pregnant women do not notice any symptoms of diabetes, but urine and blood tests may show that they have it. Symptoms of diabetes may include thirst, weight loss, eating too much, urinating in large quantities and unexplained fatigue.
Diabetes Mellitus
A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Asthma
A lung disorder marked by attacks of breathing difficulty, wheezing, coughing, and thick mucus coming from the lungs. The episodes may be triggered by breathing foreign substances (allergens) or pollutants, infection, vigorous exercise, or emotional stress.
Metabolism
The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.
Neurotransmitters
Chemicals in the brain that aid in the transmission of nerve impulses. Various Neurotransmitters are responsible for different functions including controlling mood and muscle movement and inhibiting or causing the sensation of pain.
Zinc
An essential trace mineral. The functions of zinc are enzymatic. There are over 70 metalloenzymes known to require zinc for their functions. The main biochemicals in which zinc has been found to be necessary include: enzymes and enzymatic function, protein synthesis and carbohydrate metabolism. Zinc is a constituent of insulin and male reproductive fluid. Zinc is necessary for the proper metabolism of alcohol, to get rid of the lactic acid that builds up in working muscles and to transfer it to the lungs. Zinc is involved in the health of the immune system, assists vitamin A utilization and is involved in the formation of bone and teeth.
Manganese
An essential mineral found in trace amounts in tissues of the body. Adults normally contain an average of 10 to 20mg of manganese in their bodies, most of which is contained in bone, the liver and the kidneys. Manganese is essential to several critical enzymes necessary for energy production, bone and blood formation, nerve function and protein metabolism. It is involved in the metabolism of fats and glucose, the production of cholesterol and it allows the body to use thiamine and Vitamin E. It is also involved in the building and degrading of proteins and nucleic acid, biogenic amine metabolism, which involves the transmitting of nerve impulses.
Osteochondrosis
The osteochondroses, also called Epiphyseal Ischemic Necrosis, are a relatively common group of orthopedic disorders of children, which are poorly understood. In an osteochondrosis, the epiphysis (growing end) of a bone dies and then is gradually replaced over a period of years, resulting in abnormal bone growth and deformity. The immediate cause of bone death is loss of blood supply, but why this occurs remains unclear.
Perthes Disease
Also known as Legg-Calvé-Perthes Disease (capital femoral epiphysis). The most common osteochondrosis, which occurs in the head of the thighbone, which dies and is then gradually replaced over a period of years. It occurs in youngsters aged 3-13 and is much more frequent in boys than in girls. Persistent pain is the most prominent symptom. Uncorrected severe cases lead to arrest of growth, deformity, and arthritic changes in the hip joint.
Pyroluria
This condition is caused by an overproduction during hemoglobin synthesis of kryptopyrrole, which chemically combines with vitamin B6 and zinc, resulting in their excretion and a severe deficiency of both of these essential nutrients. Most pyroluric individuals never develop schizophrenia symptoms.