Natural Standard® Patient Monograph, Copyright © 2014 (www.naturalstandard.com). All Rights Reserved. Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Background
Vitamin B6 is also called pyridoxine. It is involved in the process of making serotonin and norepinephrine, which are chemicals that transmit signals in the brain. Vitamin B6 is also involved in the formation of myelin, a protein layer that forms around nerve cells.
Vitamin B6 deficiency in adults may cause health problems affecting the nerves, skin, mucous membranes, and circulatory system. In children, the central nervous system is also affected. Deficiency can occur in people with kidney failure complications, alcoholism, liver scarring, overactive thyroid, problems with absorbing nutrients, and heart failure, as well as those taking certain medications. Mild deficiency of vitamin B6 is common.

Major sources of vitamin B6 include cereal grains, legumes, vegetables (carrots, spinach, peas, and potatoes), milk, cheese, eggs, fish, liver, meat, and flour. Vitamin B6 is often used with other B vitamins in vitamin B complex formulas.

High blood levels of the amino acid homocysteine may be a risk factor for heart disease. Taking vitamin B6 supplements with other B vitamins (folic acid and vitamin B12) has been shown to be effective for lowering homocysteine levels.

Vitamin B6 has been studied for the treatment of many conditions, including anemia (low amounts of healthy red blood cells), vitamin B6 deficiency, certain seizures in newborns, and side effects of the drug cycloserine. Evidence in support of other uses is lacking.
Related terms

2-Methyl-3-hydroxy-4,5-dihydroxymethylpyridine, 5-hydroxy-6-methyl-3,4-pyridinedimethanol [65-23-6], adermine hydrochloride, B complex vitamin, B6, B(6), Bio Zinc, Beesix, Benadon, Bexivit, Bonadon N, Hexobion 100, Naturetime B6, pyridoxal, pyridoxal phosphate, pyridoxal-5-phosphate, pyridoxamine, pyridoxine HCl, pyridoxine hydrochloride, Pyroxin, Rodex, Vicotrat, Vita-Valu, Vitabee 6, vitamin B-6.

Dosing
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)
The recommended daily intake of vitamin B6 is as follows: 1.3 milligrams in men and women ages 19-50; 1.7 milligrams in men aged 51 and older; and 1.3 milligrams in women aged 51 and older. The maximum daily intake of vitamin B6 in adults and pregnant or breastfeeding women over age 18 is 100 milligrams.

For anemia, 25 milligrams of vitamin B6 has been taken by mouth with multivitamins.
For anxiety, 50 milligrams of vitamin B6 has been taken by mouth daily with magnesium.
For birth outcomes, the following doses of vitamin B6 have been taken by mouth: three lozenges daily, each containing 6.67 milligrams of pyridoxine; 6.67-20 milligrams of pyridoxine daily; 1-25 milligrams of pyridoxine HCl daily; and a single dose of 100 milligrams. A dose of 100 milligrams of pyridoxinum hydrochloricum has been injected into the muscle.

For heart disease (high homocysteine levels), 40 milligrams of vitamin B6 has been taken by mouth daily.
For carpal tunnel syndrome, 200 milligrams of vitamin B6 has been taken by mouth daily for 10-12 weeks.
For cognitive function, 20 milligrams of vitamin B6 has been taken by mouth daily for 12 weeks.

For menstrual cramps, 200 milligrams of vitamin B6 has been taken by mouth daily.
For diabetes, 100 milligrams of vitamin B6 has been taken by mouth daily for 14 days.
For high blood pressure, 5 milligrams of vitamin B6 per kilogram of body weight has been taken by mouth daily for four weeks.

For reducing breast milk, 200 milligrams of pyridoxine has been taken by mouth 2-3 times daily for 6-7 days.
For McArdle’s disease, 50 milligrams of vitamin B6 has been taken by mouth daily for 10 weeks, without evidence of benefit.
For nerve pain, 6 milligrams of vitamin B6 has been taken by mouth daily.

For nausea and vomiting of pregnancy, the following doses of vitamin B6 have been taken by mouth: 25 milligrams every eight hours for 72 hours; 10 milligrams of pyridoxine HCl every eight hours for five days; and 100 milligrams daily for seven days. Doses of 30-100 milligrams of pyridoxine have been taken by mouth in 1-3 divided doses daily for three days to three weeks.

For premenstrual syndrome (PMS), up to 600 milligrams of vitamin B6 has been taken by mouth, with 100 milligrams daily suggested as the optimal level.
Children (under 18 years old)

The recommended daily intake of vitamin B6 is as follows: 0.1 milligrams for babies aged 0-6 months; 0.3 milligrams for babies aged 7-12 months; 0.5 milligrams for children aged 1-3 years; 0.6 milligrams for children aged 4-8 years; 1 milligram for children aged 9-13 years; 1 milligram for males aged 14-18 years; and 1.2 milligrams for females aged 14-18 years. The maximum daily intake of vitamin B6 is 30 milligrams for children aged 1-3 years, 40 milligrams for children aged 4-8 years, 60 milligrams for children aged 9-13 years, and 80 milligrams for adult males and females and pregnant or breastfeeding females aged 14-18 years.

For atopic eczema (skin disorder causing itchy, scaly rashes) in children over 12 months of age, 50 milligrams of pyridoxine hydrochloride has been taken by mouth for four weeks.

For anemia, 2-25 milligrams of vitamin B6 has been taken by mouth alone or with iron or a multivitamin for up to eight weeks.
For seizures caused by fever, 20 milligrams of pyridoxine has been taken by mouth twice daily for 12 months.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies
Avoid in people with known allergy or sensitivity to any ingredient in vitamin B6 products.

Side Effects and Warnings
Vitamin B6 is likely safe when taken by mouth in recommended daily intake amounts. The recommended daily intake of vitamin B6 is as follows for adults: 1.3 milligrams in men and women ages 19-50; 1.7 milligrams in men aged 51 and older; and 1.3 milligrams in women aged 51 older. The recommended daily intake of vitamin B6 is as follows for children: 0.1 milligrams for babies aged 0-6 months; 0.3 milligrams for babies aged 7-12 months; 0.5 milligrams for children aged 1-3 years; 0.6 milligrams for children aged 4-8 years; 1 milligram for children aged 9-13 years; 1 milligram for males aged 14-18 years; and 1.2 milligrams for females aged 14-18 years.

Vitamin B6 may cause abnormal heart rhythms, acne, allergic reactions, breast enlargement or soreness, changes in folic acid levels, decreased muscle tone, drowsiness or sedation, feeling of a lump in the throat, feeling of tingling on the skin, headache, heartburn, loss of appetite, nausea, rash, recurrence of ulcerative colitis (an inflammatory bowel disorder), stomach discomfort or pain, sun sensitivity, vomiting, and worsened asthma.

Side effects to some ingredients of high-dose pyridoxine hydrochloride (which is injected into the vein) are possible.

Vitamin B6 may cause low blood pressure. Caution is advised in people with blood pressure disorders or in those taking drugs or herbs and supplements that lower blood pressure.

Vitamin B6 may affect blood sugar levels. Caution is advised in people with diabetes or low blood sugar, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood sugar levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
Vitamin B6 may increase the risk of bleeding. Caution is advised in people with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

Use cautiously in people who have heart conditions or stomach and intestine conditions.
Use cautiously in people taking agents for Parkinson’s disease, as they may interact with vitamin B6.

Avoid in people with known allergy or sensitivity to any ingredient in vitamin B6 products.
Avoid in doses higher than 200 milligrams daily, due to the risk of nerve pain and seizures.
Avoid high doses during pregnancy or breastfeeding. A special product has been approved by the U.S. Food and Drug Administration (FDA) for use during pregnancy, but it should not be used long-term or in high doses without the guidance of a medical provider, due to the risk of seizures in infants.

Pregnancy and Breastfeeding
Vitamin B6 is likely safe for pregnant and breastfeeding women when taken by mouth in doses not exceeding the recommended daily intake.

Avoid high doses during pregnancy or breastfeeding. A special product has been approved by the U.S. Food and Drug Administration (FDA) for use during pregnancy, but it should not be used long-term or in high doses without the guidance of a medical provider, due to the risk of seizures in infants.

Interactions

Interactions with Drugs
Vitamin B6 may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (“blood thinners”) such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Vitamin B6 may affect blood sugar levels. Caution is advised when using medications that may affect blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Vitamin B6 may cause low blood pressure. Caution is advised in people taking drugs that lower blood pressure.

Vitamin B6 may interfere with the way the body processes certain drugs using the liver’s “cytochrome P450” enzyme system. As a result, the levels of these drugs may be altered in the blood, and may cause altered effects or potentially serious adverse reactions. People using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

Vitamin B6 may also interact with agents that affect the immune or nervous system, agents that increase sun sensitivity, agents that lower homocysteine levels, agents that prevent vomiting, agents that promote breast milk, agents that stimulate red blood cell production, Alzheimer’s agents, amiodarone, anti-anxiety agents, anti-asthma agents, antibiotics, anticancer agents, antidepressants, cycloserine, furosemide, hormonal agents, hydrazines, ion exchange phosphate binding resins, kidney agents, magnesium, osteoporosis agents, Parkinson’s agents, penicillamine (Cuprimine®, Depen®), phenobarbital, phenytoin, and skin agents.

Interactions with Herbs and Dietary Supplements
Vitamin B6 may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Vitamin B6 may affect blood sugar levels. Caution is advised when using herbs or supplements that may affect blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Vitamin B6 may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.

Vitamin B6 may interfere with the way the body processes certain herbs or supplements using the liver’s “cytochrome P450” enzyme system. As a result, the levels of other herbs or supplements may be altered in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

Vitamin B6 may also interact with Alzheimer’s herbs and supplements, anti-asthma herbs and supplements, antibacterials, anticancer herbs and supplements, antidepressants, herbs and supplements that affect the immune or nervous system, herbs and supplements that increase sun sensitivity, herbs and supplements that lower homocysteine levels, herbs and supplements that prevent vomiting, herbs and supplements that promote breast milk, herbs and supplements that stimulate red blood cell production, hormonal herbs and supplements, ion exchange phosphate binding resins, kidney herbs and supplements, magnesium, omega-3 fatty acids, osteoporosis herbs and supplements, Parkinson’s herbs and supplements, sedatives, and skin herbs and supplements.

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