I posted about my experiences with B6 and could not find the post, I got many helpful replies and wanted to give an update.
B6 for me was a breakthrough. 4 hours and my pain was much less and is all but gone now. Could be the B12 and B6 working together. The improvement was definitive. There is a test but it is so unreliable that the diagnosis is many clinically. It is very rare and physicians who do diagnose it most often write that it may be rare as it is under diagnosed. I am comfortable stating anything that is diagnosed clinically will be under diagnosed because physicians ignore patient symptoms and rely on testing.
I thought perhaps with the healing I have done my body has changed enough so the B6 was not needed. If you are B6 deficient it is thought to be for life. Thing is physicians are doing the thinking.
After the helpful reply's to my post I read more on B6 and decided to do a trial of not taking it. The first day symptoms over all got worse. My swimmers ear came back, my back hurt a bit and there was minor shooting pain. My toes were more numb. I slept more than I have been. I did not have chills but I did not feel warm I was not in distress, I went with perhaps that was just my body adjusting. 8 days later I took 50 mg liquid sublingual B6. Slept for 3 hours in the day and feel much better.
I am comfortable that 50 mg a day is not going to be an issue. I suspect that the reports of it some times causing peripheral nephropathy after a year of taking B6 500 mg a day and the peripheral nephropathy going away when the B6 supplementation is stopped is related to people who take B6 for weight loss.
I will try another trial on not taking it at the end of next summer.
Note: When looking for my post on B6 I noticed my first post was only 14 days ago. It amazes me how much valuable information I have got in that time.
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WIZARD6787
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I've been taking Brewer's Yeast (which contains many of the B complex vitamins including B6) since the early 1960s as recommended then by my girlfriend's mother Pamela as she knew that I'd had gastric surgery performed in 1959.
That surgery led to an eventual diagnosis of P.A. 13 years later in 1972 and I'm sure that unknowingly Pam helped keep my nervous system in "good order" until then.
Nowadays I also get B6 from my daily dose of "All Bran" (which keeps me going 🤣) and "Grape Nuts" for breakfast.
Some time ago, I mentioned that the form in which we take vitamin B6 is important. I think I linked to this paper:
Toxicol In Vitro . 2017 Oct;44:206-212.
doi: 10.1016/j.tiv.2017.07.009. Epub 2017 Jul 14.
The vitamin B6 paradox: Supplementation with high concentrations of pyridoxine leads to decreased vitamin B6 function
Misha F Vrolijk 1 , Antoon Opperhuizen 2 , Eugène H J M Jansen 3 , Geja J Hageman 4 , Aalt Bast 4 , Guido R M M Haenen 4
• PMID: 28716455
• DOI: 10.1016/j.tiv.2017.07.009
Abstract
Vitamin B6 is a water-soluble vitamin that functions as a coenzyme in many reactions involved in amino acid, carbohydrates and lipid metabolism. Since 2014, >50 cases of sensory neuronal pain due to vitamin B6 supplementation were reported. Up to now, the mechanism of this toxicity is enigmatic and the contribution of the various B6 vitamers to this toxicity is largely unknown. In the present study, the neurotoxicity of the different forms of vitamin B6 is tested on SHSY5Y and CaCo-2 cells. Cells were exposed to pyridoxine, pyridoxamine, pyridoxal, pyridoxal-5-phosphate or pyridoxamine-5-phosphate for 24h, after which cell viability was measured using the MTT assay. The expression of Bax and caspase-8 was tested after the 24h exposure. The effect of the vitamers on two pyridoxal-5-phosphate dependent enzymes was also tested. Pyridoxine induced cell death in a concentration-dependent way in SHSY5Y cells. The other vitamers did not affect cell viability. Pyridoxine significantly increased the expression of Bax and caspase-8. Moreover, both pyridoxal-5-phosphate dependent enzymes were inhibited by pyridoxine. In conclusion, the present study indicates that the neuropathy observed after taking a relatively high dose of vitamin B6 supplements is due to pyridoxine. The inactive form pyridoxine competitively inhibits the active pyridoxal-5'-phosphate. Consequently, symptoms of vitamin B6 supplementation are similar to those of vitamin B6 deficiency.
Absolutely brilliant. Thank you so very much. Being lazy, do you happen to know if Pyridoxine HCI or Pyridoxine Hydrochloride are the best form to take. They could be the same for all I know.
My “take-home” from Helbella’s abstract was that taking P-5-P would be best. Not sure I understood it. Also I am unsure of a safe starting dose? I test at the bottom end of the range for B6 on bloodwork.
"In conclusion, the present study strongly indicates that the neuropathy observed after taking a relatively high dose of vitamin B6 supplements is due to the vitamer that is used in the supplements, namely pyridoxine. The inactive form pyridoxine competitively inhibits the active pyridoxal-phosphate. As a consequence, the paradox arises that the symptoms of vitamin B6 supplementation are similar to those of vitamin B6 deficiency. Vitamin B6 supplements are used by a large number of people. The safety of vitamin B6 is debated and recently EFSA has lowered the upper limit for vitamin B6. The question is whether lowering the safe dose for vitamin B6 is the solution. Remarkably, even at relatively low dose, vitamin B6 supplementation has given rise to complaints. Our study indicates that the toxicity of vitamin B6 is not only determined by the dose, but by the vitamer in which it is taken. Perhaps it might be better to replace pyridoxine by pyridoxal or pyridoxal-phosphate as vitamin B6 supplements, which are much less toxic. In this way, the vitamin B6 paradox may potentially be prevented."
I see the RDA for B6 is not that high for a 68 year old woman (1.5 mg) but I have malabsorption syndrome so I guess my low blood level would indicate that I am not absorbing it from food (which is why I give myself B12 injections and get Vitamin D from the sun...I have seen B6 injection sold, but not in the P-5-P form. I already have neuropathy; I am afraid of making it worse. Also if one takes 5mg. of an oral supplement how much of that is really being absorbed?
My take away was B12 in the form of pyridoxine is responsible for the neuropathy experienced by some that have taken relatively high doses is caused by the pyrodoxine as it inhibits the active pyridoxal-5'-phosphate. So not only is it best the pyridoxine is harmful. I have no handle on what dose is best and am guessing it is going to be confusing as there are two supplements being referenced, both B6.
Thanks for the interesting update. I found for me that moderate levels of methyl(tetrahydro)folate made a big positive shift and am taking B6 as P5P but perhaps too little still. My neurologist was concerned at me taking it at all, even though I knew that this was the form less likely to cause neuropathy, and he tested me thinking it likely to be causal. Although I was in range, I was very low in range, so ended up increasing my dose. Not sure about improvement, maybe a little, but not as dramatic as the folate for sure. Maybe will ease it a bit higher and see. Best wishes
I've been recommended to take that! Starting tomorrow after my unnecessary B12 blood test along with getting my intrinsic factor tested, which I found out wasn't actually done a year ago when it should have been. Luckily the negligent gaslighting GP has now moved on.
Thank you for the reply. I am having a hard time evaluating what is positive and what is not or if things are making any difference at all. I am aware what I want is the instant relief that I got when I started injecting B6 However I know I had to be doing very poorly to experience that much of a change. .
I injected B6 30 mg intramuscular from January 01 2022 for six months and then went to sublingual lozenges twice a day 50 mg each time. The last month I have used liquid sublingual With the helpful information from those on this site I will be switching to 5 mg of Pyridoxal 5-Phosphate. Trying to find a liquid or lozenge so I can do sublingual. I use sublingual as it includes saliva in the process and I experience PA and try and avoid any absorption issues.
I became toxic from B6 on a magnesium supplement that contained only 16mg. When I stopped the supplement the symptoms got worse for a while, which is, apparently what happens. The problem is that the toxicity symptoms are similar to a deficiency so you can end up taking more thinking that you are deficient. I think it very much depends on your body, but I would advise caution as there are so many incidences of B6 toxicity out there.
Thanks. As you'll have seen from the rest of the thread, pyridoxine competes with pyridoxal. You were on the more problematic sort of B6. Sadly there is insufficient knowledge (even with neurologists, as I found out) and reports of B6 toxicity often do not make a distinction between the types/vitamers. Best wishes
I agree the different types of B6 are not separated in literature which leads to misinformation. I just came across a liquid B6 that lists Pyridoxal (not Pridoxal Hydrochloride) as a precursor to Pyridoxal 5' Phosphhate. No idea what that is about.
I wouldnt agree with "no problems under 100mg". Neurological symptoms seem to be seen at 100mg and some negative effects even at 50mg. Some reports even at lower doses. I think as the thread and paper linked to by Hellvella said, taking the correct (safest) form seems to be very important. That form being the active pyridoxal-phosphate (p-5-p).
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