Vitamin B2 Deficiency Can Cause B6 Toxicity! PWP Are Commonly Deficient In B2.

[park_bear]

Vitamin B6 recycling. Image credit frontiersin.org/files/Artic...

From: frontiersin.org/journals/ne...

Vitamin B6 is a coenzyme required for over 100 different biochemical transformations, including conversion of levodopa to dopamine. When it enters into such reactions, it is converted from the active form, typically P5P (pyridoxal 5 phosphate), to an inactive form, typically pyridoxine. B6 supplementation can be had in either form. The body recycles B6 from pyridoxine to P5P, as shown in the image above. Excessive supplementation of B6 in the form of pyridoxine results in toxicity because it occupies binding sites where the active form of B6 is needed. For details regarding this see here: healthunlocked.com/cure-par...

Due to this recycling ability, healthy people may not require supplementation of vitamin B6 because minute amounts in the diet may be adequate. However, for people with Parkinson's, levodopa medication takes B6 out of circulation and supplementation becomes necessary. B6 deficiency can result in peripheral neuropathy, and if it remains untreated, intractable epileptic seizures and Parkinson's progression. For details regarding this see here: healthunlocked.com/cure-par...

Even people not taking B6 supplements, or small amounts of P5P, can experience symptoms of toxicity. Testing B6 levels in the blood plasma evaluates levels of P5P only, and not pyridoxine. So we are lacking essential information to know whether toxicity is due to excessive levels of pyridoxine, but now we have an important clue: scielo.br/j/bjmbr/a/BM4WLJB...

"Abnormal [low] riboflavin status in the absence of a dietary deficiency was detected in 31 consecutive outpatients with Parkinson’s disease (PD)... In contrast, only 3 of 10 consecutive outpatients with dementia without previous stroke had abnormal riboflavin status"

What happens if someone is deficient in B2 / riboflavin? The recycling of B6 lags, resulting in high levels of pyridoxine, and potential pyridoxine B6 toxicity:

annualreviews.org/content/j...

"Consistent with riboflavin’s role in vitamin B6 metabolism, a compromised vitamin B6 status is a common consequence of riboflavin deficiency. Correspondingly, our small intervention trial in older adults with insufficiency of either vitamin at baseline showed that riboflavin supplementation resulted in not only improved riboflavin status but also increased plasma PLP, the biologically active vitamin B6 derivative"

Anyone experiencing this problem should get their B2/ riboflavin levels checked promptly, or start riboflavin supplementation promptly.

Riboflavin Supplementation Safety en.wikipedia.org/wiki/Ribof...

"In humans, there is no evidence for riboflavin toxicity produced by excessive intakes and absorption becomes less efficient as dosage increases. Any excess riboflavin is excreted via the kidneys into urine, resulting in a bright yellow color known as flavinuria.... During a clinical trial on the effectiveness of riboflavin for treating the frequency and severity of migraines, subjects were given up to 400 mg of riboflavin orally per day for periods of 3–12 months. Abdominal pains and diarrhea were among the side effects reported. "

Small study shows riboflavin benefit for Parkinson's scielo.br/j/bjmbr/a/BM4WLJB...

High doses of riboflavin and the elimination of dietary red meat promote the recovery of some motor functions in Parkinson's disease patients

In this small non-controlled study, 90 mg of riboflavin daily plus abstention from red meat benefited Parkinson's motor impairment. Improvement took about 3 months for most patients, with additional improvement for a few over the next few months. I have been taking riboflavin supplementation at 100 mg per day for many months without any adverse effects.

Vitamin B2 deficiency is rampant:

annualreviews.org/content/j... “Although there are no universally accepted EGRac cutoff values to define an optimal or low status, a coefficient of 1.40 is widely accepted as the cutoff value indicative of riboflavin deficiency Sufficient riboflavin status is generally recognized as an EGRacvalue of <1.2, while insufficiency is very broadly recognized as an EGRac value of somewhere between 1.2 and 1.4 …

The United Kingdom and Ireland are among the very few (if only) countries worldwide to include riboflavin biomarkers in their national nutrition surveys. Results from the UK NDNS rolling program (2014/15–2015/16) reported mean riboflavin intakes of 1.8 mg/day for men and 1.4 mg/day for women aged 19–64 years, with corresponding mean EGRac values of 1.33 and 1.38, while 47% of men and 61% of women had an EGRac value >1.3 …

Although no population-based riboflavin biomarker data are available for Canada, EGRac values >1.40 were reported in 40% of a convenience sample of women of child-bearing age who were participating in a study aimed at investigating the association of riboflavin biomarkers with hemoglobin concentration and anemia"

Riboflavin study in healthy athletes: A Placebo-Controlled Trial of Riboflavin for Enhancement of Ultramarathon Recovery

ncbi.nlm.nih.gov/pmc/articl...

In this double-blind, placebo-controlled trial, participants of the 2016 161-km Western States Endurance Run were assigned to receive a riboflavin or placebo capsule shortly before the race start and when reaching 90 km. Capsules contained either 100 mg of riboflavin or 95 mg of maltodextrin and 5 mg of 10% ß-carotene. Subjects provided muscle pain and soreness ratings before, during, and immediately after the race and for the 10 subsequent days. Subjects also completed 400-m runs at maximum speed on days 3, 5, and 10 after the race.

Results

For the 32 (18 in the riboflavin group, 14 in the placebo group) race finishers completing the study, muscle pain and soreness ratings during and immediately after the race were found to be significantly lower (p = .043) for the riboflavin group. Analysis of the 400-m run times also showed significantly faster (p < .05) times for the riboflavin group than the placebo group at post-race days 3 and 5.

[reedboat2]

thanks for this post

[BoomMate112055]

As always…valuable info delivered by the Bear.

[Parkie1]

Very useful info,thanks

[Esperanto]

Valuable info park_bear! A first conclusion could be that it is important for people with Parkinson's disease to ensure an adequate intake of all B-vitamins, including vitamin B2. A B-complex supplement with a limited amount of vitamin B6 in the form of P5P (pyridoxal 5'-phosphate) could be a wise choice. Alternatively, one could consider a B-complex without B6 and, if necessary (after testing), supplement with an adequate amount of P5P separately. However, I will also consider getting a B2 test done next time!

[Gioc in reply to Esperanto]

”A B-complex supplement with a limited amount of vitamin B6 in the form of P5P (pyridoxal 5'-phosphate) could be a wise choice.”

Which brand do you use? Thanks in advance for the information.

the same question for   park_bear 🙏

I have a really hard time finding a b complex brand without pyridoxine.

[Juliegrace in reply to Gioc]

This is the one I take every three days and I have been tested several times for B6 levels, which were low when I only took it once a week.

amazon.com/Thorne-Research-...

[Gioc in reply to Juliegrace]

Thank Juliegrace, good advice as always. I know this brand that makes really good products.

[park_bear in reply to Gioc]

Hi Gioc,

Sorry for delay.This is what I use as a B complex: seekinghealth.com/products/...

Note that it does not have folate and B12. I avoid folate because it is carcinogenic and I supplement B12 separately.

I did a search and found this fully configured B complex that does have P5P: amazon.com/Kirkman-B-Comple...

[Gioc in reply to park_bear]

Thanks Park_ bear excellent choice excellent brand ( Seekinghealt) but I think it is low in content for me. Now I understand why Dr C had the bcommplex tailor made by the Pharmacy in Tuscany for which I lost the information.

I think I'll use Thorne bcomplex basic.

[Esperanto in reply to Gioc]

Indeed difficult to find a B- complex with P5P and certainly with ''normal'' low dosages that I am in favour of. They are on the market, but very pricey. In France Dynveo with 1.4 mg P5P. Https://dynveo.fr/complexe-vitamine...

I myself use a B complex from Etos a cheap Dutch drugstore chain. In addition to the low budget series with pyridoxine, these also have a more expensive, but still very affordable product with well-receptible bioactive forms of the various B vitamins including B6 3.6 mg P5P (ETOS Premium B Complex 60 capsules). Probably only to order online in the Netherlands and Belgium…

Thorne, what Juliegrace proposed, may be a reliable and easily available option for you. Contains 10 mg of P5P and you can take it 2 times a week instead of daily.

[Gioc in reply to Esperanto]

Thanks Esperanto, very informative, as always. Excellent B complex.

I think I'll use Thorne bcomplex basic, because it's a brand I'm familiar with and already know from other products.

[Gioc in reply to Gioc]

Greetings from Italy to all of you.

  Juliegrace ,   park_bear ,   Esperanto

The sun on HU never sets .

Thank You very Much

A window for two , full moon

[chartist]

I believe forum member 38yearoldmale is a regular user of B2/Riboflavin as discussed here :

healthunlocked.com/cure-par...

Art

[park_bear in reply to chartist]

Good catch and worthy of note from the post: "My b2 was very low"

See his comment below!

[artinson]

Thank you, Park_bear

[Bolt_Upright]

Good stuff, except for the no red meat part. I see that was from 2003. Here is an article from 2017: Riboflavin Has Neuroprotective Potential: Focus on Parkinson’s Disease and Migraine 2017 ncbi.nlm.nih.gov/pmc/articl....

"Riboflavin protects against neurotoxicity through ameliorating oxidative stress, mitochondrial dysfunction, neurogenic inflammation, glutamate excitotoxicity, and homocysteine neurotoxicity. Oxidative stress, mitochondrial dysfunction, neurogenic inflammation, glutamate excitotoxicity, and homocysteine neurotoxicity are involved in neurodegeneration and neurotoxicity. Also, those neurotoxic factors have the ability to cause each other leading to the formation of a neurotoxic cycle."

I like that this article does not even mention red meat!

"Conclusion: Riboflavin is a potential neuroprotective agent. In fact, riboflavin has demonstrated its ability to tackle significant pathogenesis-related mechanisms in neurological disorders, exemplified by the ones attributed to the pathogenesis of PD and migraine. Indeed, riboflavin ameliorates oxidative stress, mitochondrial dysfunction, neuroinflammation, and glutamate excitotoxicity; all of which are involved in the pathogenesis of a wide range of neurological disorders. In addition, riboflavin is required for pyridoxine activation. Riboflavin and PLP, the active form of pyridoxine, play essential roles in homocysteine metabolism, and tryptophan-kynurenine pathway. Indeed, any accumulation of homocysteine or kynurenines due to vitamin insufficiency can lead to significant neurological consequences. Taking into consideration the limited riboflavin absorption and utilization in 10–15% of global population, long term riboflavin insufficiency could participate in the development of multiple neurological disorders, emphasizing the importance of long-term riboflavin-sufficient diet especially in vulnerable populations. Indeed, randomized double-blind placebo-controlled trials, with extended time frame and large number of patients, are encouraged to clinically evaluate the role of riboflavin in PD and migraine headache patients."

Neurotoxic Cycle

[park_bear in reply to Bolt_Upright]

Red meat abstention was one of the interventions undertaken as part of the riboflavin supplementation study I cited, so it was necessary to mention it in order to maintain full transparency. Whether or not to consume red meat is a separate issue I will choose to leave for another day.

[Bolt_Upright in reply to park_bear]

Oh sure! Your study was Riboflavin + No red meat. This looks promising. I might add Riboflavin to my stack.

[LAJ12345]

hubby takes a vitamin b2 capsule dissolved in bottle of water and drinks it all day.

And also in the Hardys den.

[gomelgo]

This sounds very promising. could someone please tell me the TLDR version for dummies? It seems there is much room for error here.

[AGH_1966 in reply to gomelgo]

Rigth with ya gomelog

[38yroldmale]

That exactly happened to me. Last year I became severely toxic on very little b6. My b2 at the time was very low. It make’s perfect sense. It’s key to my form of PD, and possibly many of us. Simple, cheap, wonderful b2. I think I need to supplement with b6 but I’m am very scared became I became toxic so quickly. Thank you!!!!

[park_bear in reply to 38yroldmale]

Thank you for your comment!!!

[JCRO]

The small Brazilian study. I’d already eliminated red meat in 2020 when dx PD. I added B2 having read this paper 6 months ago. No harm , no foul. Cheap to add to stack.

[Jmellano]

park_bear I just read your post and the following article:

parkinsonsnewstoday.com/new...

I also plan to do a low dose thiamin that was just discussed on healthunlocked. Hi dose did not work for me.

Since the B vitamins appear to be crucial to PwP. I was thinking of taking pure encapsulations-complex plus which has:

Thiamin (as thiamin HCI) B1 -100mg

Riboflavin (as it b2 and 60% riboflavin 5’phosphate (activated B2)) - 12.7 mg

Niacin (as niacinamide and 8% no flush niacin - 108 mg

B6 (as pyridoxine HCI and 40% pyridoxal 5’phosphate (activated B6)) - 16.7 mg

Folate (as Metafolin,L-5-MTHF)- 667mcg

B12 (as methylcobalamin -400 mcg

Biotin- 400 mcg

Pantothenicacid (as calcium pantothenate B5 - 100mg

So I am thinking this pure encapsulations b complex should suffice for my low dose b1, satisfy b2/riboflavin deficiencies identified in your post , b3 to ease motor symptomsfrom link above

your thoughts? Forgive me if I am rambling as I start losing ability to focus this time of day…

[park_bear in reply to Jmellano]

Not rambling at all

I cannot recommend the B-complex you have cited because it contains pyridoxine as well as P5P. Unfortunately this is all too common and there's no good reason for it. Is it cheaper for them, or do they think they're somehow covering all the bases? I do not know but whatever the reason it is not okay.

This is what I use as a B complex: seekinghealth.com/products/... Note that it does not have folate and B12. I avoid folate because it is carcinogenic and I supplement B12 separately.

JulieGrace uses this fully configured B complex: amazon.com/Thorne-Research-...

Both have P5P only

----

The study behind the news article that you link to is located here: nature.com/articles/s41467-...

My thoughts: The dosage they used was 3 grams per day. This could end up being a bit pricey, although worth it if it actually works. It looks like it may work - they found an 11 point improvement in the UPDRS score in the test arm but not in the placebo arm, which is big. This was confounded by the fact that patients in the test arm ended up taking levodopa more frequently at the end of the study than at the beginning. So the good results cannot be definitively attributed to the NR supplementation. But worth a try if you are so inclined.

[Jmellano in reply to park_bear]

Thnx for responding. I keep searching for the holy grail (red lite helmet,b1,ps128, mucuna, mannitol) maybe one day I will find it

[JayPwP]

Just so that I understand correctly

B6 toxicity is pyridoxine excess and not P-5-P excess. As long as enough B2 is available, the inactive form of B6 is converted back to P-5-P which is not toxic.

Correct?

[park_bear in reply to JayPwP]

Correct!

[JayPwP in reply to park_bear]

Thank you PB 🙏

[hawk289]

hello im new is it possible to get toxic if ur taking b1 fat soluble along with b2 but the b1 depletes b2 and u become deficient can u get b6 toxicity like that too or no

[park_bear in reply to hawk289]

I was not aware that B1 depletes B2. Do you have any reference for that?

[hawk289 in reply to park_bear]

my b2 was a little low but would that raise b6 thats the question or do u have to be taking it in conjunction

[park_bear in reply to hawk289]

Are you taking levodopa medication and if so how much?

[hawk289 in reply to park_bear]

no i dont have parkinsons but im severely b6 toxic though im searching for answers as to why symtoms never got better

[hawk289]

according to multiple people ive asked i was taking the b1 fat soluble for and i guess it made me deficient and it must have raised my b6 idk if it works that way though idk if they mean it just raises the levels a little or to toxic no idea but my palpatations/chest pain dizziness came back bad this time

[park_bear in reply to hawk289]

Your B2 deficiency was not necessarily a result of taking B1. People with Parkinson's are typically deficient in B2 in any case.

[hawk289 in reply to park_bear]

but would a b2 deficiency raise b6 in general

[park_bear in reply to hawk289]

As I explained in the post, vitamin B2 is required to recycle the potentially toxic and inactive form of B6, pyridoxine, to the active non-toxic form, P5P. So vitamin B2 deficiency could cause vitamin B6 toxicity.

[hawk289 in reply to park_bear]

is that with supplementing or without though wat if u have low normal b6 levels

[park_bear in reply to hawk289]

Palpitations/chest pain dizziness are not a symptom of B6 toxicity. Please see a doctor without delay and get this problem properly diagnosed.

[hawk289 in reply to park_bear]

no it is b6 toxicity messes with ur whole autonomic system/small fiber nerves

[park_bear in reply to hawk289]

Possibly but there are a lot of other conditions that can cause these symptoms. Why do you think you have B6 toxicity ?

[hawk289 in reply to park_bear]

well tested high in 2017 was taking a b complex then in december started taking b1 and b2 and felt a little chest pain then i stopped taking b1 and b2 then symptoms amost similar to b6 toxicity started some never got better from 2017 i have alot of autonomic issues affecting every part of my body/organs

[park_bear in reply to hawk289]

That was 7 years ago. When was the last time you saw a doctor concerning these issues?

[hawk289 in reply to park_bear]

every yr

[hawk289 in reply to park_bear]

so basically if ur deficient in b2 u can be b6 toxic just from not supplementing. My b6 levels are always low normal basically deficient wouldnt i need more b6 in me to get toxic

[park_bear in reply to hawk289]

If you are deficient in vitamin B2 you can become vitamin B6 toxic without supplementing B6

[hawk289 in reply to park_bear]

also even if ur low normal always wouldnt u need ur b6 levels to be higher thx

[hawk289 in reply to park_bear]

i just think my b1 depleted my b2 and i got toxic by the blood work it looks like i was cause my b6 is never that high

[park_bear in reply to hawk289]

The blood test for vitamin B6 only measures the active non-toxic form of B6. It does not measure the inactive potentially toxic form. So the B6 blood test does not tell you what you need to know. For further detail see here: healthunlocked.com/cure-par...

[hawk289 in reply to park_bear]

all i kno is i took b1 and b2 multiple people told me to take b1 it wont hurt and now they said b1 the fat soluble depletes b2 and thats how i got toxic again but my levels were tested 2 months later everything is in normal range but i kno it happened same symptoms as 2017

[park_bear in reply to hawk289]

If everything including B2 is in normal range, most likely your problem lies elsewhere. This is the kind of problem a doctor should be extremely concerned about and should make effort to get diagnosed and treated. Yes I hear you that this is the same as when you thought you were B6 toxic, but that might not have been the problem in the first place. In any case you need to find a doctor who is concerned about this and wants to help you. I've done all I can here.

[hawk289 in reply to park_bear]

my b2 2 months after stoping b1 and b2 is basicallly .2 higher from the normal range

[hawk289 in reply to park_bear]

wat if ur b6 levels are low or do they have to be optimal for this to occur

[hawk289 in reply to park_bear]

one last thing would it matter if its plasma or cellular

[park_bear in reply to hawk289]

YOU HAVE A SERIOUS UNDIAGNOSED MEDICAL CONDITION. PLEASE SEEK APPROPRIATE MEDICAL HELP WITHOUT DELAY.

This forum is for Parkinson's patients who have been properly diagnosed. Although we try to be helpful to all, you need to have a proper diagnosis and be under treatment first. Nothing said here shall be deemed medical advice nor a reason to delay medical attention.

[LAJ12345]

Hubby has 25 mg b2 dissolved in a litre bottle of water and drinks from it all day. An easy way to ensure it’s always there when required by his body.