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 do not require supplementation of vitamin B6 because minute amounts in the diet are 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...
We have a mystery here at Health Unlocked as to why people who are taking P5P, even small amounts, are experiencing 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 of10 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. Anyone experiencing this problem should get their B2/ riboflavin levels checked promptly, or start riboflavin supplementation promptly.
"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. "
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.
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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!
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.
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.
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."
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.
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!!!!
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.
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…
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.
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.
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.
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
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
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.
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
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
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...
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
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.
YOU HAVE A SERIOUS UNDIAGNOSED MEDICAL CONDITION. PLEASE SEEK APPROPRIATE MEDICAL HELP WITHOUT DELAY.
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