Vitamin B2 Deficiency Can Cause B6 Toxici... - Cure Parkinson's

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

park_bear profile image
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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.

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58 Replies
reedboat2 profile image
reedboat2

thanks for this post

BoomMate112055 profile image
BoomMate112055

As always…valuable info delivered by the Bear.

Parkie1 profile image
Parkie1

Very useful info,thanks

Esperanto profile image
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 profile image
Gioc in reply toEsperanto

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 profile image
Juliegrace in reply toGioc

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 profile image
Gioc in reply toJuliegrace

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

park_bear profile image
park_bear in reply toGioc

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 profile image
Gioc in reply topark_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 profile image
Esperanto in reply toGioc

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 profile image
Gioc in reply toEsperanto

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 profile image
Gioc in reply toGioc

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 profile image
chartist

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

healthunlocked.com/cure-par...

Art

park_bear profile image
park_bear in reply tochartist

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

See his comment below!

artinson profile image
artinson

Thank you, Park_bear

Bolt_Upright profile image
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 profile image
park_bear in reply toBolt_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 profile image
Bolt_Upright in reply topark_bear

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

LAJ12345 profile image
LAJ12345

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

And also in the Hardys den.

gomelgo profile image
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 profile image
AGH_1966 in reply togomelgo

Rigth with ya gomelog :-)

38yroldmale profile image
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 profile image
park_bear in reply to38yroldmale

Thank you for your comment!!!

JCRO profile image
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 profile image
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 profile image
park_bear in reply toJmellano

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 profile image
Jmellano in reply topark_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 profile image
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 profile image
park_bear in reply toJayPwP

Correct!

JayPwP profile image
JayPwP in reply topark_bear

Thank you PB 🙏

hawk289 profile image
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 profile image
park_bear in reply tohawk289

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

hawk289 profile image
hawk289 in reply topark_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 profile image
park_bear in reply tohawk289

Are you taking levodopa medication and if so how much?

hawk289 profile image
hawk289 in reply topark_bear

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

hawk289 profile image
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 profile image
park_bear in reply tohawk289

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

hawk289 profile image
hawk289 in reply topark_bear

but would a b2 deficiency raise b6 in general

park_bear profile image
park_bear in reply tohawk289

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 profile image
hawk289 in reply topark_bear

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

park_bear profile image
park_bear in reply tohawk289

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

hawk289 profile image
hawk289 in reply topark_bear

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

park_bear profile image
park_bear in reply tohawk289

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

hawk289 profile image
hawk289 in reply topark_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 profile image
park_bear in reply tohawk289

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

hawk289 profile image
hawk289 in reply topark_bear

every yr

hawk289 profile image
hawk289 in reply topark_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 profile image
park_bear in reply tohawk289

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

hawk289 profile image
hawk289 in reply topark_bear

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

hawk289 profile image
hawk289 in reply topark_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 profile image
park_bear in reply tohawk289

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 profile image
hawk289 in reply topark_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 profile image
park_bear in reply tohawk289

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 profile image
hawk289 in reply topark_bear

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

hawk289 profile image
hawk289 in reply topark_bear

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

hawk289 profile image
hawk289 in reply topark_bear

one last thing would it matter if its plasma or cellular

park_bear profile image
park_bear in reply tohawk289

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 profile image
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.

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