Jess says: Like many doctors, I was taught to mainly think about thiamine (vitamin B1) and vitamin B12 when considering low B vitamin levels in patients. Vitamin B6 has emerged as being just as critical for our overall health. It is particularly important for regulating the brain and mood. Vitamin B6 is a necessary cofactor for making serotonin (our happy hormone), dopamine (helps motivation) and GABA (calms the nervous system), all of which are important neurotransmitters in the brain. Consider supplementing with a good multivitamin, if you suspect your levels may be low.
Vitamin B6, also called pyridoxine, is a water-soluble vitamin (carried in the bloodstream and eliminated in the urine) that is often unwittingly destroyed in food, when cooked or heated. It is a critical vitamin for the brain and nervous system, helping make myelin, a protective fat around our nerves. It is also very important for making blood, improving protein metabolism and boosting our immune function.
B6 is important for the immune system and inflammation. Vitamin B6 has been shown to be low in inflammatory conditions. A deficiency increases the risk of chronic diseases like cardiovascular (heart disease and stroke) and some cancers.1 When vitamin B6 was given to critically ill patients over two weeks, there was a significant improvement in their immune system cells.2
Vitamin B6 has also been shown to be a powerful antioxidant and may reduce homocysteine levels, a powerful amino acid that affects our heart and blood vessels.3
B6 is essential for forming neurotransmitters like serotonin, dopamine and GABA in our brain, that regulate our mood. Low vitamin B6 levels have been associated with depression.4 The combination of magnesium and vitamin B6 supplementation has been shown to help treat symptoms of severe stress.5
Patients at risk of Vitamin B6 deficiency are those with a poor diet and women taking the oral contraceptive pill, who have been found to have lower levels of vitamin B6 and B12.6 Patients taking COX inhibitors (non-steroid antiinflammatories), like aspirin or ibuprofen are also more likely to have low vitamin B6 levels.7
Vitamin B6 can reduce the risk of cancer, Parkinson’s and cardiovascular disease. Studies show that your chance of getting cancer is higher if your vitamin B6 levels are low,8 particularly gastrointestinal (stomach and bowel) cancers. Heart disease risk is also directly related to low levels of Vitamin B6 and supplements containing several B vitamins, including B6, have been used to help cardiac autonomic dysfunction caused by pollution – heart problems triggered by pollution.9
Vitamin B6 has been shown to significantly reduce the risk of Parkinson’s disease,10 particularly in people who have smoked.
It may reduce diabetic complications. Children with type 1 diabetes given vitamin B6 for eight weeks had an improvement in inflammation in their blood vessels.11 Like vitamin B1, vitamin B6 seems to have an important role in blood sugar, diabetes and its complications. Vitamin B6 deficiency may contribute to the development of type 1 diabetes.12
It can help reduce nausea and vomiting in pregnancy. Vitamin B6 has been found to be anti-emetic (it stops vomiting). Studies of pregnant women show that vitamin B6 can help vomiting and nausea,13,14,15, so should be considered in hyperemesis gravidarum (severe morning sickness).
Supplements may reduce migraine headaches. Daily vitamin B6 supplements reduced the severity and duration of migraines, when given to sufferers in a study.16
Vitamin B6 supplements can also affect sleep. High doses of vitamin B6 have been shown to affect sleep, particularly our ability to remember our dreams.17 Several pilot studies are investigating whether B6 could help people be able to control lucid dreaming.
Used with magnesium, B6 could help childhood autism. A trial of magnesium and B6 supplements for four weeks was given to children with autism. They showed a significant improvement in their behaviour and brain recordings.18 The changes were only seen when B6 was taken alongside magnesium. As we are discovering, many of our essential nutrients work better together.
An earlier study showed that vitamin B6, taken on its own, improved behaviour in autistic children.19 Studies have also shown an abnormality in the pathways of B6 in children with autism, which may help to explain its benefit.20
B6 may help with hair loss and condition. A small study of women was given B6 injections for hair loss (alopecia) over 4-5 months. They saw a reduction in hair loss and an improvement in hair condition.21
other benefits of vitamin B6
- Sensitivity to MSG (monosodium glutamate). A deficiency in B6 has been linked with side effects from Chinese restaurant food, where MSG – a common food additive – causes side effects such as headaches and sweating. When vitamin B6 is given for three months, these effects resolve.22
- Lithium side effects. A tiny study of tremors induced by lithium showed vitamin B6 supplements completely resolved this.23
- Movement disorders – Tourette’s and tardive dyskinesia. Small studies have shown an improvement in both tardive dyskinesia24 and Tourette’s syndrome, with vitamin B6 supplements. This improvement is also seen in patients on schizophrenic medication, causing movement side effects.25
- Schizophrenia. B vitamins including B6, B8 and B12 have been found to improve symptoms of schizophrenia.26
- Childhood epilepsy. There is a genetic B6-dependent childhood epilepsy, which, while rare, can account for some cases of seizures in children.27
- Hypertension (high blood pressure). A small study showed that vitamin B6 supplements significantly reduced blood pressure in patients with hypertension, when taken daily for four weeks.28
what is the best way to get my vitamin B6 level checked?
Vitamin B6 levels can be checked with a blood test: plasma pyridoxal 5′-phosphate – plasma PLP. However, the accuracy of this test can be affected by inflammation, low albumin, raised ALP levels and pregnancy. If any of these conditions are present then the test may not be reliable, but as yet there are no commercially available definitive tests.29 The normal range of plasma PLP is 5-50 µg/L.
how much vitamin B6 do I need?
The recommended daily amount of Vitamin B6 is 1.4 mg daily (the amount needed to prevent deficiency), however, it is very safe at much higher levels and trials use anywhere from 25mg-200mg daily. Excess vitamin B6 is excreted in the urine and trials have shown no danger to a mother or baby taking supplements in pregnancy of over 100mg daily.30 It is also likely that amounts of B6 much higher than the recommended daily amount are required to prevent vitamin B6 deficiency in pregnancy.31
top 5 sources of vitamin B6
- Chicken (cooked). One breast = 1.1mg
- Tuna (yellowfin, cooked). One steak = 0.9mg
- Pistachios (dry roasted and salted). ½ cup = 0.7mg
- Grass-fed beef (cooked mince). 150g portion = 0.6mg
- Avocado. One avocado = 0.5mg
which supplement is best?
The best type of vitamin B6 in supplement form is pyridoxine hydrochloride (HCl). This is quickly and easily absorbed to help optimise the amount of B6 absorbed by your body. Vitamin B6 supplements are regarded as very safe up to levels of 100mg. Any excess is easily excreted in the urine.32 Vitamins and minerals work well together, so it is often a good idea to take a high-quality multivitamin with a good level of B vitamins (like our One. supplement), or a vitamin B complex.
q&a with jess and xandra
I’m vegetarian. Is it likely that I’m low in B6, as most of the best sources seem to be animal-based?
Some small studies have found that whilst vegetarians and vegans are most likely to be deficient in B12, deficiency of vitamins B2 and B6 were higher.33 Another small study found that B6 deficiency was also found in one-third of people on a non-vegetarian diet.34 A German study showed that even when vegans consumed a diet that was high in vitamin B6 they still struggled to have adequate B6 levels and were at higher risk of deficiency.35 We would encourage vegetarians and vegans to eat a diet that is rich in avocado, beans, lentils and pistachios and consider adding a B vitamin supplement, or a multivitamin like One. with high levels of all the B vitamins.
You said that cooking can deplete vitamin B6 in food. How do I avoid this when preparing meat?
Old, but detailed studies looking at a variety of meats showed that they retained an average of 54-60% of their B6 levels when cooked.36, 37 There is little data on a comparison of different cooking methods and how they affect vitamin B6, although a study comparing B6 levels in both microwaved and oven-cooked food showed that levels were significantly higher in the oven-cooked food.38
- Ueland PM, McCann A, Midttun Ø, Ulvik A. Inflammation, vitamin B6 and related pathways Mol Aspects Med. 2017 Feb;53:10-27. doi: 10.1016/j.mam.2016.08.001. Epub 2016 Sep 1. PMID: 27593095.
- Cheng CH, Chang SJ, Lee BJ, Lin KL, Huang YC. Vitamin B6 supplementation increases immune responses in critically ill patients Eur J Clin Nutr. 2006 Oct;60(10):1207-13. doi: 10.1038/sj.ejcn.1602439. Epub 2006 May 3. PMID: 16670691.
- Biselli PM, Sanches de Alvarenga MP, Abbud-Filho M, Ferreira-Baptista MA, Galbiatti AL, Goto MT, Cardoso MA, Eberlin MN, Haddad R, Goloni-Bertollo EM, Pavarino-Bertelli EC. Effect of folate, vitamin B6, and vitamin B12 intake and MTHFR C677T polymorphism on homocysteine concentrations of renal transplant recipients Transplant Proc. 2007 Dec;39(10):3163-5. doi: 10.1016/j.transproceed.2007.08.098. PMID: 18089344.
- Hvas AM, Juul S, Bech P, Nexø E. Vitamin B6 level is associated with symptoms of depression Psychother Psychosom. 2004 Nov-Dec;73(6):340-3. doi: 10.1159/000080386. PMID: 15479988.
- Pouteau E, Kabir-Ahmadi M, Noah L, Mazur A, Dye L, Hellhammer J, Pickering G, Dubray C. Superiority of magnesium and vitamin B6 over magnesium alone on severe stress in healthy adults with low magnesemia: A randomized, single-blind clinical trial PLoS One. 2018 Dec 18;13(12):e0208454. doi: 10.1371/journal.pone.0208454. PMID: 30562392; PMCID: PMC6298677.
- Lussana F, Zighetti ML, Bucciarelli P, Cugno M, Cattaneo M. Blood levels of homocysteine, folate, vitamin B6 and B12 in women using oral contraceptives compared to non-users Thromb Res. 2003;112(1-2):37-41. doi: 10.1016/j.thromres.2003.11.007. PMID: 15013271.
- Chang HY, Tang FY, Chen DY, Chih HM, Huang ST, Cheng HD, Lan JL, Chiang EP. Clinical use of cyclooxygenase inhibitors impairs vitamin B-6 metabolism Am J Clin Nutr. 2013 Dec;98(6):1440-9. doi: 10.3945/ajcn.113.064477. Epub 2013 Oct 23. PMID: 24153347.
- Mocellin S, Briarava M, Pilati P. Vitamin B6 and Cancer Risk: A Field Synopsis and Meta-Analysis J Natl Cancer Inst. 2017 Mar 1;109(3):1-9. doi: 10.1093/jnci/djw230. PMID: 28376200.
- Zhong J, Trevisi L, Urch B, Lin X, Speck M, Coull BA, Liss G, Thompson A, Wu S, Wilson A, Koutrakis P, Silverman F, Gold DR, Baccarelli AA. B-vitamin Supplementation Mitigates Effects of Fine Particles on Cardiac Autonomic Dysfunction and Inflammation: A Pilot Human Intervention Trial Sci Rep. 2017 Apr 3;7:45322. doi: 10.1038/srep45322. PMID: 28367952; PMCID: PMC5377246.
- de Lau LM, Koudstaal PJ, Witteman JC, Hofman A, Breteler MM. Dietary folate, vitamin B12, and vitamin B6 and the risk of Parkinson disease Neurology. 2006 Jul 25;67(2):315-8. doi: 10.1212/01.wnl.0000225050.57553.6d. PMID: 16864826.
- MacKenzie KE, Wiltshire EJ, Gent R, Hirte C, Piotto L, Couper JJ.Folate and vitamin B6 rapidly normalize endothelial dysfunction in children with type 1 diabetes mellitus Pediatrics. 2006 Jul;118(1):242-53. doi: 10.1542/peds.2005-2143. PMID: 16818571.
- Rubí B. Pyridoxal 5′-phosphate (PLP) deficiency might contribute to the onset of type I diabetes Med Hypotheses. 2012 Jan;78(1):179-82. doi: 10.1016/j.mehy.2011.10.021. Epub 2011 Nov 15. PMID: 22088923.
- Wibowo N, Purwosunu Y, Sekizawa A, Farina A, Tambunan V, Bardosono S.Vitamin B₆ supplementation in pregnant women with nausea and vomiting Int J Gynaecol Obstet. 2012 Mar;116(3):206-10. doi: 10.1016/j.ijgo.2011.09.030. Epub 2011 Dec 20. PMID: 22189065.
- Sahakian V, Rouse D, Sipes S, Rose N, Niebyl J. Vitamin B6 is effective therapy for nausea and vomiting of pregnancy: a randomized, double-blind placebo-controlled study Obstet Gynecol. 1991 Jul;78(1):33-6. PMID: 2047064.
- Sripramote M, Lekhyananda N. A randomized comparison of ginger and vitamin B6 in the treatment of nausea and vomiting of pregnancy J Med Assoc Thai. 2003 Sep;86(9):846-53. PMID: 14649969.
- Sadeghi O, Nasiri M, Maghsoudi Z, Pahlavani N, Rezaie M, Askari G. Effects of pyridoxine supplementation on severity, frequency and duration of migraine attacks in migraine patients with aura: A double-blind randomized clinical trial study in Iran . Iran J Neurol. 2015 Apr 4;14(2):74-80. PMID: 26056551; PMCID: PMC4449397.
- Aspy DJ, Madden NA, Delfabbro P. Effects of Vitamin B6 (Pyridoxine) and a B Complex Preparation on Dreaming and Sleep Percept Mot Skills. 2018 Jun;125(3):451-462. doi: 10.1177/0031512518770326. Epub 2018 Apr 17. PMID: 29665762.
- Martineau J, Barthelemy C, Garreau B, Lelord G. Vitamin B6, magnesium, and combined B6-Mg: therapeutic effects in childhood autism Biol Psychiatry. 1985 May;20(5):467-78. doi: 10.1016/0006-3223(85)90019-8. PMID: 3886023.
- Rimland B, Callaway E, Dreyfus P.The effect of high doses of vitamin B6 on autistic children: a double-blind crossover study Am J Psychiatry. 1978 Apr;135(4):472-5. doi: 10.1176/ajp.135.4.472. PMID: 345827.
- Adams JB, George F, Audhya T. Abnormally high plasma levels of vitamin B6 in children with autism not taking supplements compared to controls not taking supplements J Altern Complement Med. 2006 Jan-Feb;12(1):59-63. doi: 10.1089/acm.2006.12.59. PMID: 16494569.
- Brzezińska-Wcisło L. [Evaluation of vitamin B6 and calcium pantothenate effectiveness on hair growth from clinical and trichographic aspects for treatment of diffuse alopecia in women] Wiad Lek. 2001;54(1-2):11-8. Polish. PMID: 11344694.
- Folkers K, Shizukuishi S, Willis R, Scudder SL, Takemura K, Longenecker JB. The biochemistry of vitamin B6 is basic to the cause of the Chinese restaurant syndrome Hoppe Seylers Z Physiol Chem. 1984 Mar;365(3):405-14. doi: 10.1515/bchm2.1984.365.1.405. PMID: 6724532.
- Miodownik C, Witztum E, Lerner V. Lithium-induced tremor treated with vitamin B6: a preliminary case series Int J Psychiatry Med. 2002;32(1):103-8. doi: 10.2190/DB1V-85M4-E65T-R3QA. PMID: 12075913.
- Lerner V, Kaptsan A, Miodownik C, Kotler M. Vitamin B6 in treatment of tardive dyskinesia: a preliminary case series study Clin Neuropharmacol. 1999 Jul-Aug;22(4):241-3. PMID: 10442256.
- Miodownik C, Cohen H, Kotler M, Lerner V. [[Vitamin B6 add-on therapy in treatment of schizophrenic patients with psychotic symptoms and movement disorders] Harefuah. 2003 Sep;142(8-9):592-6, 647. Hebrew. PMID: 14518160.
- Firth J, Stubbs B, Sarris J, Rosenbaum S, Teasdale S, Berk M, Yung AR. The effects of vitamin and mineral supplementation on symptoms of schizophrenia: a systematic review and meta-analysis Psychol Med. 2017 Jul;47(9):1515-1527. doi: 10.1017/S0033291717000022. Epub 2017 Feb 16. Erratum in: Psychol Med. 2018 Feb;48(3):528. PMID: 28202095.
- Baumgart A, Spiczak Sv, Verhoeven-Duif NM, Møller RS, Boor R, Muhle H, Jähn JA, Klitten LL, Hjalgrim H, Lindhout D, Stephani U, van Kempen MJ, Helbig I. Atypical vitamin B6 deficiency: a rare cause of unexplained neonatal and infantile epilepsies J Child Neurol. 2014 May;29(5):704-7. doi: 10.1177/0883073813505354. Epub 2013 Oct 10. PMID: 24114605.
- Aybak M, Sermet A, Ayyildiz MO, Karakilçik AZ. Effect of oral pyridoxine hydrochloride supplementation on arterial blood pressure in patients with essential hypertension Arzneimittelforschung. 1995 Dec;45(12):1271-3. PMID: 8595083.
- Ueland PM, Ulvik A, Rios-Avila L, Midttun Ø, Gregory JF. Direct and Functional Biomarkers of Vitamin B6 Status Annu Rev Nutr. 2015;35:33-70. doi:10.1146/annurev-nutr-071714-034330
- Vitamin B6 – Health Professional Fact Sheet
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- Vitamin B6 – Health Professional Fact Sheet
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