In latest weeks, stories have been circulating about extreme reactions in individuals who’ve taken over-the-counter vitamin B6 dietary supplements.
Vitamin B6 poisoning can injure nerves and result in signs together with numbness, tingling and even bother strolling and transferring.
In some circumstances, these affected did not know the product contained any vitamin B6.
So what’s vitamin B6, the place is it discovered and the way a lot is an excessive amount of? This is what it is advisable to find out about this important nutrient.
What’s vitamin B6?
Vitamin B6 (also referred to as pyridoxine) is a bunch of six compounds that share an identical chemical construction.
It’s a vital nutrient, which means we’d like it for regular physique capabilities, however we won’t produce it ourselves.
Adults aged 19–50 want 1.3mg of vitamin B6 per day. The beneficial dose is decrease for teenagers and youngsters, and better for these aged 51 and over (1.7mg for males and 1.5mg for girls) and people who find themselves breastfeeding or pregnant (1.9mg).
Most of us get this in our weight loss plan – largely from animal merchandise, together with meat, dairy and eggs.
The vitamin can also be accessible in a spread of various plant meals, together with spinach, kale, bananas and potatoes, so deficiency is uncommon, even for vegetarians and vegans.
The vitamin B6 we devour within the weight loss plan is inactive, which means the physique cannot use it. To activate B6, the liver transforms it right into a compound known as pyridoxal-5′-phosphate (PLP).
On this type, vitamin B6 helps the physique with greater than 140 mobile capabilities, together with constructing and breaking down proteins, producing purple blood cells, regulating blood sugar and supporting mind operate.
Vitamin B6 is necessary for total well being and has additionally been related to lowered most cancers danger and irritation.
Regardless of being available within the weight loss plan, vitamin B6 can also be broadly included in varied dietary supplements, multivitamins and different merchandise, comparable to Berocca and power drinks.
Ought to we be apprehensive about toxicity?
Vitamin B6 toxicity is extraordinarily uncommon. It virtually by no means happens from dietary consumption alone, until there’s a genetic issues or illness that stops nutrient absorption (comparable to coeliac illness).
It’s because all eight nutritional vitamins within the B group are water-soluble. Should you devour extra of the vitamin than your physique wants, it may be excreted readily and harmlessly in your urine.
Nonetheless, in some uncommon circumstances, extreme vitamin B6 accumulates within the blood, leading to a situation known as peripheral neuropathy. We’re nonetheless unsure why this happens in some folks however not others.
Peripheral neuropathy happens when the sensory nerves – these outdoors our mind and spinal twine that ship data to the central nervous system – are broken and unable to operate. This may be brought on by a variety of ailments (and is most well-known in sort 2 diabetes).
The most typical signs are numbness and tingling, although in some circumstances sufferers could expertise issue with steadiness or strolling.
We do not know precisely how extra vitamin B6 causes peripheral neuropathy, however it’s thought to intervene with how the neurotransmitter GABA sends indicators to the sensory nerves.
Vitamin B6 may cause everlasting injury to nerves. Research have proven signs improved when the particular person stopped taking the complement, though they did not fully resolve.
What is taken into account extreme? And has this modified?
Toxicity often happens solely when folks take dietary supplements with excessive doses of B6.
Till 2022, solely merchandise with greater than 50mg of vitamin B6 have been required to show a warning about peripheral neuropathy. However the Therapeutic Items Administration lowered this and now requires any product containing greater than 10mg of vitamin B6 to hold a warning.
The Therapeutic Items Administration has additionally halved the day by day higher restrict of vitamin B6 a product can present – from 200mg to 100mg.
These modifications adopted a evaluate by the administration, after receiving 32 stories of peripheral neuropathy in folks taking dietary supplements. Two thirds of those folks have been taking lower than 50mg of vitamin B6.
The Therapeutic Items Administration acknowledges the danger varies between people and lots is unknown. Its evaluate couldn’t establish a minimal dose, period of use or affected person danger components.
⚠️Peripheral neuropathy with supplementary vitamin B6 (pyridoxine)⚠️
The TGA has strengthened labelling necessities so merchandise containing day by day doses over 10mg of vitamin B6 should carry a warning about peripheral neuropathy.
Learn extra: https://t.co/WOmKtEYLtx pic.twitter.com/ByNIFwK2SG
— TGA Australia (@TGAgovau) October 5, 2022
However I believed B nutritional vitamins have been good for me?
An excessive amount of of something may cause issues.
The up to date tips are more likely to considerably decrease the danger of toxicity. Additionally they make shoppers extra conscious of which merchandise comprise B6, and the dangers.
The Therapeutic Items Administration will proceed to watch proof and revise tips if vital.
Whereas vitamin B6 toxicity stays very uncommon, there are nonetheless many questions on why some folks get peripheral neuropathy with decrease dose dietary supplements.
It might be that some particular vitamin B compounds have a stronger impact, or some folks could have genetic vulnerabilities or ailments which put them at greater danger.
So what ought to I do?
Most individuals needn’t actively search vitamin B6 in dietary supplements.
Nonetheless, many stories to the Therapeutic Items Administration have been of vitamin B6 being added to dietary supplements labelled as magnesium or zinc – and a few weren’t conscious they have been consuming it.
It is very important at all times examine the label in case you are taking a brand new medication or complement, particularly if it hasn’t been explicitly prescribed by a health-care skilled.
Be significantly cautious in case you are taking a number of dietary supplements. Whereas one multivitamin is unlikely to trigger a difficulty, including a magnesium complement for cramping, or a zinc complement for chilly and flu signs, could trigger an extreme vitamin B6 dose over time, and enhance your danger.
Importantly, take note of signs that will point out peripheral neuropathy, comparable to pins and needles, numbness, or ache within the toes or arms, when you do change or add a complement.
Most significantly, when you want recommendation, it’s best to discuss to your physician, dietitian or pharmacist.
Vasso Apostolopoulos, Distinguished Professor, Professor of Immunology, RMIT College and Jack Feehan, Vice Chancellors Senior Analysis Fellow in Immunology, RMIT College
This text is republished from The Dialog underneath a Inventive Commons license. Learn the unique article.
