Vitamin B6 (Pyridoxine)

Effects and Benefits

Core Identification

Common Names:
- Vitamin B6
- Pyridoxine
- Pyridoxal
- Pyridoxamine
- P5P (Pyridoxal-5-Phosphate) - active form

Latin Name: N/A (synthetic vitamin)

Category: Vitamin

Uses

Traditional Uses

• Treatment of nutritional deficiency states - historically recognized in populations with limited dietary variety
• Support for nervous system function - traditional use in nerve-related complaints
• Pregnancy support - long-standing use for nausea relief

Modern Uses

• Morning Sickness (Pregnancy Nausea) - Reduces nausea and vomiting in early pregnancy | Research quality: Strong
• Key findings: Multiple studies confirm efficacy at 10-25 mg every 8 hours; recognized by American College of Obstetricians and Gynecologists as first-line treatment

• Source citations: Moyad - The Supplement Handbook; Home Remedies (Hale); Mars - The Country Almanac of Home Remedies

• Premenstrual Syndrome (PMS) - Reduces mood symptoms, bloating, and breast tenderness | Research quality: Strong

• Key findings: Meta-analysis of 9 trials with over 900 women confirmed doses up to 100 mg daily reduce PMS symptoms including depression

• Source citations: Brewer - TDT Encyclopedia of Vitamins; Brighten - Beyond the Pill

• Homocysteine Reduction - Lowers elevated homocysteine levels associated with cardiovascular risk | Research quality: Strong

• Key findings: B6 combined with folate and B12 effectively lowers homocysteine; women with highest B6 and folate intake had lowest coronary heart disease risk over 14 years

• Source citations: Brewer - TDT Encyclopedia of Vitamins; Gaby - A-Z Guide to Drug-Herb-Vitamin Interactions

• Kidney Stone Prevention - Reduces oxalate production | Research quality: Moderate

• Key findings: Higher B6 intake (40+ mg daily from food) associated with lower kidney stone risk; therapeutic doses of 50-100 mg may reduce high oxalate levels

• Source citations: Moyad - The Supplement Handbook; Brewer - TDT Encyclopedia of Vitamins

• Chronic Fatigue Support - May improve symptoms in those with B vitamin deficiency | Research quality: Preliminary

• Key findings: Preliminary research shows people with chronic fatigue syndrome often have low B6 status; supplementation may help with long-term tiredness
• Source citations: Brewer - TDT Encyclopedia of Vitamins

Active Compounds

Primary Active Ingredients:
- Pyridoxine - most common supplemental form; converted to active form in the body
- Pyridoxal-5-Phosphate (P5P) - the biologically active coenzyme form; directly utilized by enzymes
- Pyridoxal - intermediate form found in animal foods
- Pyridoxamine - form found in animal tissues; participates in amino acid metabolism

Dosage Information

Standard Dosage:
- Form: Tablets, capsules
- Amount: 1.3-2 mg per day (adults)
- Frequency: Once daily

Therapeutic Dosage:
- Form: Tablets, capsules
- Amount: 10-100 mg per day depending on condition
- Purpose: For morning sickness: 10-25 mg every 8 hours; For PMS: up to 100 mg daily; For kidney stones: 50-100 mg daily
- Duration: Morning sickness - as needed through first trimester; PMS - cyclically or continuously for several months

Maximum Safe Dosage:
- Daily maximum: Generally considered safe up to 100 mg daily long-term
- Warning threshold: Do not exceed 200 mg daily without medical supervision; doses above 300 mg daily associated with peripheral neuropathy

Bioavailability Notes:
- Standard pyridoxine requires liver conversion to active P5P form
- P5P (pyridoxal-5-phosphate) may be more effective for some individuals who have difficulty with conversion
- Plant-based sources contain pyridoxine glucoside which is less bioavailable than forms from animal sources
- Water-soluble; readily lost in urine requiring regular intake

How to Take It

Timing:
- Can be taken any time of day
- May be taken with or without food
- For morning sickness: Space doses throughout the day (every 8 hours)
- For sleep support: Some practitioners recommend taking 45 minutes before bed as B6 supports serotonin and melatonin production

Synergies - What It Works Well With

Complementary Supplements:
1. Folate (Vitamin B9) - Works together to lower homocysteine | More effective for cardiovascular protection than either alone
2. Vitamin B12 - Partners with B6 and folate for homocysteine metabolism | Combined B vitamin supplementation shown to lower homocysteine especially in older adults
3. Magnesium - B6 and magnesium work synergistically for mood and PMS | Both support neurotransmitter production and stress response
4. Vitamin B2 (Riboflavin) - Required to convert B6 to its active form | Ensures optimal B6 utilization
5. Vitamin C - Both support serotonin synthesis | Combined support for mood and immune function

Avoidance - What NOT to Combine With

Supplement Interactions:
1. High-dose single B vitamins long-term - May create relative deficiencies of other B vitamins | Best taken as part of B-complex

Drug Interactions:
1. Levodopa (without Carbidopa) - B6 above 5-10 mg reduces drug effectiveness | Severity: Severe - can worsen Parkinson's symptoms. Note: This interaction is blocked when levodopa is combined with carbidopa (Sinemet), making B6 supplementation safe
2. Phenobarbital and other anticonvulsants - High-dose B6 (80-200 mg) may reduce blood levels of anticonvulsant drugs | Severity: Moderate - could trigger seizures; conversely, anticonvulsants deplete B6
3. Isoniazid (tuberculosis antibiotic) - Depletes B6; supplementation often recommended but consult prescriber | Severity: Moderate
4. Hydralazine (blood pressure medication) - Depletes B6 stores | Severity: Moderate
5. Penicillamine - Depletes B6 in the body | Severity: Moderate
6. Oral corticosteroids - May increase loss of vitamin B6 | Severity: Mild - doctors recommend at least 2 mg daily during long-term steroid use

Food Interactions:
- No significant food interactions
- Extensive food processing removes B6 from foods (especially refined grains)

Safety Information

Contraindications:
- Known hypersensitivity to pyridoxine
- Patients on levodopa monotherapy (without carbidopa) should avoid supplementation above 5-10 mg

Side Effects:
- Common: Generally well tolerated at recommended doses
- At high doses (200+ mg daily): Sensory neuropathy causing numbness, tingling, pain in extremities, difficulty walking, loss of position sense
- Rare: Nausea, headache, photosensitivity at very high doses

Long-Term Use:
- Safe at doses up to 100 mg daily for extended periods
- Doses above 100 mg daily should not be taken for more than a few months without medical supervision
- High-dose neuropathy is typically reversible upon discontinuation, though recovery may be slow and incomplete

Special Precautions:
- Pregnancy: Safe at recommended doses (10-25 mg for morning sickness); first-line treatment but consult healthcare provider before use
- Breastfeeding: Safe at normal supplemental doses
- Pre-surgery: No specific precautions required
- Elderly: May have increased needs; deficiency more common

Primary Uses At-a-Glance

Primary: Morning sickness/pregnancy nausea, PMS and premenstrual symptoms, elevated homocysteine/cardiovascular support, kidney stone prevention (oxalate type)

Secondary: Chronic fatigue support, mood support, immune function, nerve health, asthma symptom reduction

Sources

Local Library:
- Brewer, Sarah - TDT Encyclopedia of Vitamins
- Moyad, Mark - The Supplement Handbook
- Gaby, Alan R. - A-Z Guide to Drug-Herb-Vitamin Interactions 2nd Ed.
- Merck - The Merck Manual Home Health Handbook
- Cordain, Loren - The Paleo Answer
- Brighten, Jolene - Beyond the Pill
- Hale, Meredith - Home Remedies
- Mars, Brigitte - The Country Almanac of Home Remedies
- Gladstar, Rosemary - Herbal Recipes for Vibrant Health
- Wilen, Lydia - Healing Remedies

General Knowledge:
- American College of Obstetricians and Gynecologists recommendations for pregnancy nausea
- National Institutes of Health Office of Dietary Supplements