Just a Thought: Can dosing with high Vit B1... - Thyroid UK

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Just a Thought

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Can dosing with high Vit B12 without taking a B complex supplement cause low Vit B6 - or other imbalance?

In summer of 2017 I raised my B12 from 330 to 1147 (over range - top of range is 900), It was a short time later that I started to get muscle pain and neuropathic burning.

Vit B6 deficiency is known for these symptoms although conversely high doses of B6 can cause toxic neuropathy.

Wondering if the sudden appearance of my symptoms was down to causing a Vit B imbalance.

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radd

Grincho,

Yes, many supplement a B complex when taking high doses of Vit B12 to keep all B's in balance.

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Hidden
Hidden
in reply to radd

Thank you. Just beginning a Vit b complex with s higher b6 to sort things.

What an idiot I am. Taken a year to realise this.

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radd
radd
in reply to Hidden

Grincho,

There is an awful lot to think about and remember ! 😳

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chinchi
chinchi
in reply to radd

According to the NHS it’s the other way round, excess B6 is linked to peripheral neuropathy nhs.uk/conditions/vitamins-...

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Hidden
Hidden
in reply to chinchi

This is a paradoxical vitamin. Too much can cause PN and deficiency likewise. I think NHS site errs on side of caution as toxic doses are more common than deficiencies.

In the 1970s. large doses were routinely prescribed for PMS. It was at about this time that the issue of toxity emerged. Ironically, it is still prescribed for PMS (ref: BNF) but there is greater awareness now and patients are warned to stop taking if symptoms of tingling and numbness begin.

Below is extract from Pub Med. Full link at end.

Vitamin B6

Pathogenesis

Vitamin B6, or pyridoxine, is unique in that either a deficiency or an excess can cause a neuropathy. Pyridoxine is readily available in the diet and dietary deficiency of B6 is rare. Humans are not able to synthesize B6, so dietary intake is essential. After absorption, pyridoxine is converted into pyridoxal phosphate which is an important co-factor in numerous metabolic reactions. The RDA for pyridoxine is 1.3 mg daily with the upper limit of 100mg daily[2]. Doses of 50mg to 100mg of vitamin B6 should mainly be used in certain conditions such as pyridoxine deficient seizures and patients taking certain medications to avoid toxicity.

Vitamin B6 deficiency is most commonly seen in patients treated with the certain medications that are B6 antagonists, namely isoniazid, phenelzine [29], hydralazine [30], and penicillamine. B6 deficiency can also be seen in patients receiving chronic hemodialysis [31]. Vitamin B6 deficiency may also result from the malnutrition due to chronic alcoholism and in patients with high metabolic needs such as the pregnant or lactating woman. Risk factors for vitamin B6 toxicity are excessive intake of supplements [32,33].

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

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chinchi
chinchi
in reply to Hidden

Thanks, but now I’m confused. Where does it say that taking B6 can counteract excess B12?

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Hidden
Hidden
in reply to chinchi

It doesn't say that explicitly in that article. The issue is that taking a mega dose of one (usually B12) puts the others 'out of balance'. It can be any of the B vitamins that's affected. Another link below - explains it well.

In my opinion, there's not enough warning given when B vitamins are sold as 'singles' about the potential for this.

seleneriverpress.com/histor...

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chinchi

Hi Grincho,

Do you also take vitamin D?

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Hidden
Hidden
in reply to chinchi

Hi Chinchi

Because Vit D deficiency can also contribute to PN, I've just had test done. At 82 nmol/mg my levels are adequate, but not according to the new guidelines recently issued by Vit D Council.

I've just bought a 2000 mcg with co factor Vit K2 - I already take the other co-factor which is magnesium.

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chinchi
chinchi
in reply to Hidden

Thanks. I’m asking because I have burning peripheral neuropathy (hands, arms and feet) and my vitamin D levels skyrocketed after taking supplements for one year. The Nephrologist said that it could be the culprit. I’m not taking any supplements for about 3 months (neuropathy symptoms began in February) and I feel much better now.

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Hidden
Hidden
in reply to chinchi

Do you mean that nephrologist thinks that high Vit D levels can cause Neuropathy?

Oh my. More research coming up. I'm not taking it if that's the case.

I have read that toxic levels of Vit D can cause kidney damage. Vit D is fat soluble and excess isn't excreted. I'm aiming to stay within 'safe' limits. My main reason for taking it is to improve bone health. Apparently, 1000 mcg Vit D increases levels by 10 nmol/mg over a 3 month period and it's important to get tested every 3-6 months. It's also vital to take the co factors of Magnesium and Vit K2 with it to direct calcium into the bones where it's intended to be.

Were you taking very large doses?

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chinchi
chinchi
in reply to Hidden

Not large doses, but I live in Brazil so the supplement wasn’t really necessary, although it has been prescribed by a GP for menopause symptoms.

I think it’s a very complex area (metabolism) and my final conclusion is: have a healthy diet and only treat symptoms after a thorough examination and tests. Supplements are risky, not just because we can cause severe imbalance but because there are too many manufacturers and we simply can’t trust them regarding contaminants and precise dosing.

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Hidden
Hidden
in reply to chinchi

You are absolutely right. The integrity of many supplements is suspect and you have to know what you're doing via medical advice and / or tests.

I eat a healthy diet but these days many of the vitamins in that diet are depleted by prescribed meds. In fact, I would go so far as to say that prescribed meds should be treated with as much caution as supplements. eg anti-convulsant meds have 'robbed' me of Vitamin B - as have Breast Cancer meds.

I've just had a quick look about Vitamin D and PN. It seems that at toxic levels it has the ability to cause kidney damage which, in turn, can cause PN.

'When the kidneys are impaired, fluids and waste products accumulate in the body. In some cases, kidney failure may cause peripheral neuropathy. ... Also, many complications may occur, including uremic neuropathy—a type of peripheral neuropathy that progresses slowly and may afflict 20% to 50% of people with kidney disease.'

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chinchi
chinchi
in reply to Hidden

That’s right. I have a big kidney stone caused by high calcium caused by high vitamin D...

I agree that most problems are caused by both supplements and prescribed medication. We can only hope that doctors do their research as well.

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Hidden
Hidden
in reply to chinchi

I was going to mention that it causes high calcium and kidney stones - but thought I shouldn't. This happens if you take Vit D without its co-factors. It took me ages and lots of patience from other posters to understand this :)

You have to take manesium amd Vit K2 with Vit D to stop this happening. These co-factors direct the Vitamin D into the bones where it should be. Otherwise it ujst raises blood calcium levels and you get the problem you've got - and others.

They now sell Vit D with the co factors incorporated. That's what I'm going for now.

It infuriates me that GPs will prescribe Vit D without knowing this. One poster on this forum said that neither his GP nor pharmacist had ever heard of Vitamin K2.

Similarly, not many GPs seem to know that long-term use of drugs like Omeprazole or Lanzoprazole (for acid reflux) cause all sorts of serious vitamin and mineral deficiencies. I could go - but I won't. Hubby is waiting for lunch :)

I make sure that whenever I'm prescribed a drug I do my research. I have no thyroid and take thyroid meds. My GP tried to give me Propranalol - a beta blocker for high BP. It lowers thyroid levels quite dramatically because it interferes with thyroid meds. When I said I didn't want it for that reason, he looked it up and said:

Oh yes. I didn't know that.

It's just appalling.

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chinchi
chinchi
in reply to Hidden

Hi again, hope lunch was tasty 😋 I hope you don’t mind me asking, are you peri or post menopause? Have you ever thought that hormonal migraines could be another cause for the PN?

I have migraines since I was a baby and during hormonal fluctuations after first period and perimenopause the migraines have changed patterns a lot. I’m 2 years post menopause but still feel symptoms of hormonal fluctuations and migraines have morphed into chronic daily headaches. I wonder if the burning peripheral neuropathy could be a morphed migraine aura.

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Hidden
Hidden
in reply to chinchi

I am post menopausal (67). I suffered bad migraines until my surgical menopause (hysterectomy) at age 47. They began again after I had breast cancer meds (which completely annilahate oestrogen and put you through 'another' menopause). I tried to explain to all the doctors I saw that they morphed into a chronic daily headache. In fact, that was the vocabulary I used. The leg and arm pain before the neuropathy began always felt 'migrainous'. I used to complain that I had migraine pain in my legs. I think they had me marked down as a nutter but one very erudite neurologist did say the leg pain was part of a migraine aura. There was no burning or tingling attached to this pain. I got rid of the migraine and the leg pain by using the high dose B12 I described earlier. I haven't had a migraine - or aura - for twelve months or more.

But now of course the burning neuropathic pain caused by high levels of B12 which have unbalanced other B vits. *sigh*

Lunch was great thanks. Hubby mad a bacon sandwich :)

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chinchi
chinchi
in reply to Hidden

Thanks! It’s a bloody nightmare... have you ever been on hormone replacement therapy? Was it just hysterectomy or have you had oophorectomy as well?

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Hidden
Hidden
in reply to chinchi

i had a total hysterctomy - including oophorectomy - and was immediately put on HRT patches and told to stay on them for ten years as they would protect me from osteoporosis and heart disease which can be result of falling (disappearing in my case) oestrogen levels.

I stayed on it until I was 57 and felt great - fit, healthy, alert, full of energy. A year after stopping it, after a routine mammogram, I was diagnosed with oestrogen receptive breast cancer. Among the battery of tests that was then done was a DEXA scan which measures bone density. To my horror, I had osteoporosis. Oh, the irony.

They treated me for the BC with meds which stripped me of any oestrogen. Although I had no ovaries, small amounts are made elsewhere in body. And so the 'no oestrogen' nightmare with headaches etc began again.

Six months after my treatment began, they 'incidentally' discovered a huge mass on my thyroid which turned out to be thyroid cancer. There is a body of opinion which asserts that this cancer is also caused by high oestrogen (as in HRT). The size of the cancer indicated it would have begun at about the same time as I started HRT.

I know that my body is screaming out for HRT even now. On bad days, I even consider using low dose hormone to alleviate pain and fatigue.

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chinchi
chinchi
in reply to Hidden

So sorry to hear that. What docs and researchers say about transdermal HRT is that it doesn’t increase the chance of cancers... so that’s not entirely correct. Have you had chemo? If yes, could the PN be a side effect?

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Hidden
Hidden
in reply to chinchi

Didn't have chemo - just radiotherapy - but I did have radioactive iodine treatment for thyroid cancer. Some think there's a risk of PN even years after treatment.

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chinchi
chinchi
in reply to Hidden

You have been through a lot, bless you 💕

I know very little of thyroid issues, my TSH, T4 and T3 are normal range but calcitonin is high. My GP is clueless 🙄 So far Rheumatologist thinks I have fibromyalgia and Neurologist said I have Chronic Pain Syndrome. Each one has prescribed different meds and I haven’t had the guts to take any of them yet.

PN has become tolerable but I need ice packs for hands and feet in order to get some sleep.

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Hidden
Hidden
in reply to chinchi

I use a cold gel. It's called Deep Freeze. They do it in spray form as well.

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thyr01d

Yes Grincho and it's more complicated than this, because, most B complexes include more than 100% RDA of the cheap B vitamins and less than 100% RDA of the expensive ones - so even further moving the Bs out of balance.

I too was over-range with B12, like you by accident, (and huge gratitude to the endo who alerted me) so am currently trying a B complex which seems to contains 100% of each. Having said, that, I've just looked at it while writing to you and noticed that it says %NRV, I don't know what that is but probably looked it up at the time. (Here's the answer: Nutrient Reference Value is the amount set by the European Food Safety Authority (EFSA), primarily to support food labelling, which the majority of the population requires to maintain health.)

Doubt if I can tell you the make without breaking a rule but think it's allowed as a private message so please ask if you'd like to know.

The other thing I find confusing is that B vitamins are water soluble and it is said that we excrete any excess of the water soluble ones, so I wonder how we can then end up out of balance?!?

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helvella
helvellaAdministrator
in reply to thyr01d

The only one that seems to be a significant problem is B6.

Water solubility is not the only factor. Salt is water soluble but we could easily consume too much salt water - as in drinking seawater.

For example, with B12, our ability to absorb it is a critical issue - I suspect often more important than the dose in the product.

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thyr01d
thyr01d
in reply to helvella

Ah yes, what a good analogy the salt is.

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Hidden
Hidden
in reply to thyr01d

Helvella is very good at analogies :) Salt of the earth :)

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Hidden
Hidden
in reply to thyr01d

I think the 'out of balance' issue is because mega doses of one vitamin - usually B12 - 'outperform' the others leaving them in deficiency status.

I'm only going to do the higher dose complex with 50 mg B6 for a month - then halve it and then go on to the small dose ones. NICE guidelines state 50 - 100 mg B6 for neuropathy and give a very long period of safety. However, I'm going to err on the side of caution given the potential toxicity.

I've researched B6 deficiency and there are some vile symptoms - most of which I had. I couldn't understand how I could be 'deficient' until all this clicked into place. Two weeks ago, before I realised what was going on, I took 2000 mcg B12 (although I stopped it a while ago because I was over range). After an initial surge of energy I felt even worse.

Seaside Susie is so good on vitamins and usually says you muct take a B complex if supplementing B12. I should have been more awake (not likely at the moment).

I'd be really grateful if you could PM me the name of the one you use when you have a moment.

Many thanks

Maureen

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