Product Images
GNC Vitamin B-6 100 mg - GNC - GNC Zoom
Product Videos

GNC Vitamin B-6 100 mg

Shop all GNC

100 Vegetarian Tablets

Item #255215 See Product Details

Price: $5.99

Member Price: $5.39 Become a Member

Availability: In Stock Details

Available Promotions:

  • Buy One Get One 50% Off Mix and Match Wellness Products! Details
  • $3.99 Flat Rate Shipping! Details

Auto-Delivery Available

Sign Up & Save! Enroll in Auto-Delivery and lock in your price for 12 months.

Learn More

Price: $5.99

Member Price: $5.39 Become a Member
Ship every:
Add to Cart
People Who Buy This Also Bought
You May Also Be Interested In
More Sizes Available
Description
  • Essential for a healthy nervous system & metabolism
  • Supports immune system function

* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Supplement Facts

As a dietary supplement, take one tablet daily.

Serving Size 1 Tablet
Servings Per Container 100
Amount Per Serving % DV
Vitamin B-6 (as Pyridoxine Hydrochloride) 100.00 mg 5000%
** Daily Value (DV) not established

Other Ingredients: Dicalcium Phosphate, Whole Brown Rice Powder (Oryza sativa)

No sugar, no artificial colors, no artificial flavors, no preservatives, sodium free, no wheat, no gluten, no corn, no soy, no dairy, yeast free.

Storage Instructions: Store in a cool, dry place.

Warning: Keep out of reach of children.

Distributed by: General Nutrition Corporation, Pittsburgh, PA 15222

Health Notes

Vitamin B6

Vitamin B6
This nutrient has been used in connection with the following health goals
  • Reliable and relatively consistent scientific data showing a substantial health benefit.
  • Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
  • For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary "Star-Rating" system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

This supplement has been used in connection with the following health conditions:

High Homocysteine
Dose: 400 to 1,000 mcg of folic acid daily, 10 to 50 mg of vitamin B6 daily, and 50 to 300 mcg of vitamin B12 daily
Vitamin B6, folic acid, and vitamin B12 all play a role in converting homocysteine to other substances within the body and have consistently lowered homocysteine levels in trials.(more)
Anemia
Dose: 2.5 to 25 mg daily for three weeks, then 1.5 to 2.5 mg per day as maintenance therapy
Vitamin B6 deficiency can contribute to anemia, supplementing with this vitamin may restore levels and improve symptoms.(more)
Intermittent Claudication
Dose: 200 mg of EPA and 130 mg of DHA daily, plus small amounts of vitamin B6, folic acid, vitamin E, oleic acid, and alpha-linolenic acid
In one study, men with intermittent claudication who drank a milk product fortified with fish oil, vitamin B6, folic acid, vitamin E, oleic acid, and alpha-linolenic acid could walk further without pain than those who drank regular milk.(more)
Atherosclerosis
Dose: Refer to label instructions
Blood levels of the amino acid homocysteine have been linked to atherosclerosis and heart disease in most research. Taking vitamin B6 may help lower homocysteine levels.(more)
Heart Attack
Dose: Refer to label instructions
Taking vitamin B6 may reduce blood levels of homocysteine. High homocysteine levels have been linked to an increased heart attack risk.(more)
Stroke and High Homocysteine
Dose: Refer to label instructions
Elevated blood levels of homocysteine have been linked to stroke risk in most studies. Supplementing with vitamin B6 may lower homocysteine levels and reduce stroke risk.(more)
Morning Sickness
Dose: 10 to 25 mg three times daily
In two double-blind trials, supplementation with vitamin B6 significantly reduced the severity of morning sickness.(more)
Celiac Disease
Dose: 3 mg vitamin B6, 0.8 mg folic acid, and 0.5 mg vitamin B12
Daily supplementation with a combination of vitamin B6 (3 mg), folic acid (0.8 mg), and vitamin B12 (0.5 mg) have been shown to help relieve depression in people with celiac disease.(more)
Celiac Disease
Dose: Refer to label instructions
For people with celiac disease who experience depression even after following a gluten-free diet, supplementing with vitamin B6 may be beneficial.(more)
Premenstrual Syndrome
Dose: 100 to 200 mg per day on a regular basis
Many clinical trials show that taking vitamin B6 helps relieve PMS symptoms.(more)
Pregnancy and Postpartum Support and High Homocysteine
Dose: 750 mg daily taken under the supervision of a doctor
Women who habitually miscarry have been found to have high homocysteine levels. Vitamin B6 may reduce these levels and increase the chances of a successful pregnancy.(more)
Amenorrhea
Dose: Refer to label instructions
Preliminary evidence found that vitamin B6 restored menstruation and normalized hormone levels in three women with amenorrhea who had high prolactin levels. (more)
Bulimia
Dose: Refer to label instructions
Vitamin B6, when taken with L-tryptophan, has been shown to improve eating behavior, feelings about eating, and mood among women with bulimia.(more)
Premenstrual Syndrome
Dose: 100 to 200 mg per day on a regular basis
Many clinical trials show that taking vitamin B6 helps relieve PMS symptoms.(more)
Amenorrhea
Dose: Refer to label instructions
Preliminary evidence found that vitamin B6 restored menstruation and normalized hormone levels in three women with amenorrhea who had high prolactin levels. (more)
Macular Degeneration
Dose: 2.5 mg folic acid, 50 mg vitamin B6, and 1 mg vitamin B12
In a double-blind study of female health professionals who had cardiovascular disease or risk factors, daily supplementation with folic acid, vitamin B6, and vitamin B12 significantly decreased age-related macular degeneration. (more)
Age-Related Cognitive Decline
Dose: 20 mg daily
There is evidence that supplementing with vitamin B6 (pyridoxine) may improve memory performance, especially in people who are deficient.(more)
Age-Related Cognitive Decline
Dose: Refer to label instructions
In women with cardiovascular disease or related risk factors and low dietary intake of folic acid, vitamin B6, and vitamin B12, supplementing with a combination of these nutrients may protect against age-related cognitive decline. (more)
Alzheimer's Disease
Dose: Refer to label instructions
A combination of coenzyme Q10, iron (sodium ferrous citrate), and vitamin B6 may improve mental status in people with Alzheimer's disease.(more)
Low Back Pain
Dose: Take under medical supervision: 50 to 100 mg each of vitamins B1 and B6, and 250 to 500 mcg of vitamin B12, all taken three times per day
A combination of vitamin B1, vitamin B6, and vitamin B12 may prevent a common type of back pain linked to vertebral syndromes and may reduce the need for anti-inflammatory medications.(more)
Carpal Tunnel Syndrome
Dose: 100 to 300 mg daily for no more than three months; 50 to 100 mg daily after that
Vitamin B6 deficiency is common in people with carpal tunnel syndrome, supplementing with the vitamin has reportedly relieved symptoms.(more)
Type 2 Diabetes
Dose: 1,800 mg pyridoxine alpha-ketoglutarate daily or 50 mg daily pyridoxine daily
People with diabetes often have low vitamin B6 levels. Supplementing with the vitamin may restore levels and improve glucose tolerance.(more)
Type 1 Diabetes
Dose: 1,800 mg daily of of pyridoxine alpha-ketoglutarate or 50 mg daily pyridoxine
People with diabetes often have low vitamin B6 levels. Supplementing with the vitamin may restore levels and improve glucose tolerance.(more)
Type 2 Diabetes and Diabetic Neuropathy
Dose: 25 mg of vitamin B1 daily, with 50 mg of vitamin B6 daily
Taking vitamin B1 combined with vitamin B6 may improve symptoms of diabetic neuropathy.(more)
Hypoglycemia
Dose: Refer to label instructions
Vitamin B6 helps control blood sugar levels in people with diabetes, and since there are similarities in the way the body regulates high and low blood sugar levels, it might be helpful for hypoglycemia as well.(more)
Age-Related Cognitive Decline
Dose: 20 mg daily
There is evidence that supplementing with vitamin B6 (pyridoxine) may improve memory performance, especially in people who are deficient.(more)
Age-Related Cognitive Decline
Dose: Refer to label instructions
In women with cardiovascular disease or related risk factors and low dietary intake of folic acid, vitamin B6, and vitamin B12, supplementing with a combination of these nutrients may protect against age-related cognitive decline. (more)
Schizophrenia
Dose: Consult a qualified healthcare practitioner
Vitamin B6 has been used in combination with niacin in the treatment of schizophrenia with some reported benefits.(more)
Low Back Pain
Dose: Take under medical supervision: 50 to 100 mg each of vitamins B1 and B6, and 250 to 500 mcg of vitamin B12, all taken three times per day
A combination of vitamin B1, vitamin B6, and vitamin B12 may prevent a common type of back pain linked to vertebral syndromes and may reduce the need for anti-inflammatory medications.(more)
Asthma
Dose: 100 to 200 mg daily
Vitamin B6 deficiency is common in asthmatics. Supplementing with the vitamin may decrease the frequency and severity of asthma attacks.(more)
Schizophrenia and High Homocysteine
Dose: Take folic acid (2 mg), vitamin B6 (25 mg), and vitamin B12 (400 mcg) daily
People with schizophrenia who have high homocysteine levels may improve symptoms by supplementing with folic acid, vitamin B6, and vitamin B12.(more)
Tooth Decay
Dose: For adults: 20 mg per day in capsules or lozenges; for children: 9 mg daily
Vitamin B6 appears to increase growth of beneficial mouth bacteria and decrease growth of cavity-causing bacteria.(more)
Macular Degeneration
Dose: 2.5 mg folic acid, 50 mg vitamin B6, and 1 mg vitamin B12
In a double-blind study of female health professionals who had cardiovascular disease or risk factors, daily supplementation with folic acid, vitamin B6, and vitamin B12 significantly decreased age-related macular degeneration. (more)
Vertigo
Dose: Consult a qualified healthcare practitioner
Studies have shown vitamin B6 to be effective at reducing symptoms.(more)
Autism
Dose: 30 mg daily per 2.2 lbs (1 kg) of body weight; doctor's supervision recommended
Research shows that vitamin B6 can be helpful for autistic children.(more)
Attention Deficit-Hyperactivity Disorder
Dose: Refer to label instructions
In one study, high amounts of vitamin B6 was more effective than methylphenidate (Ritalin). A healthcare practitioner knowledgeable in nutrition must be consulted when using high amounts of this vitamin. (more)
Osgood-Schlatter Disease
Dose: Refer to label instructions
Some doctors have reported good results using a combination of zinc, manganese, and vitamin B6 for people with Osgood-Schlatter disease.(more)
Kidney Stones
Dose: Refer to label instructions
Taking vitamin B6 with magnesium can inhibit oxalate stone formation.(more)
Acne Vulgaris
Dose: Refer to label instructions
While not proven in research, some reports suggest that it may alleviate adolescent and premenstrual acne, however, another report has suggested that it might make acne worse.(more)
Photosensitivity
Dose: Refer to label instructions
Vitamin B6 has been used to successfully reduce reactions to sunlight.(more)
Seborrheic Dermatitis in Adults
Dose: Refer to label instructions
Topical applied vitamin B6 ointment improved adult seborrheic dermatitis in one study. However, oral vitamin B6 was ineffective.(more)
Osteoporosis and High Homocysteine
Dose: Refer to label instructions
Homocystinuria, a condition associated with high homocysteine levels, frequently causes osteoporosis. By lowering homocysteine levels, vitamin B6 may help prevent osteoporosis.(more)
Pregnancy and Postpartum Support and High Homocysteine
Dose: 750 mg daily taken under the supervision of a doctor
Women who habitually miscarry have been found to have high homocysteine levels. Vitamin B6 may reduce these levels and increase the chances of a successful pregnancy.(more)
Preeclampsia
Dose: Refer to label instructions
Supplementing with vitamin B6 and folic acid may lower homocysteine levels. Elevated homocysteine damages the lining of blood vessels and can lead to the preeclamptic symptoms.(more)
Pre- and Post-Surgery Health
Dose: Refer to label instructions
In one trial, a combination of vitamins B1, B6, and B12 before and after surgery prevented post-surgical reductions in immune activity.(more)
HIV and AIDS Support
Dose: Refer to label instructions
Vitamin B6 deficiency was found in more than one-third of HIV-positive men, deficiency was associated with decreased immune function in this group. Supplementing with the vitamin may improve survival rate.(more)
High Homocysteine
Dose: 400 to 1,000 mcg of folic acid daily, 10 to 50 mg of vitamin B6 daily, and 50 to 300 mcg of vitamin B12 daily

Vitamin B6, folic acid, and vitamin B12 all play a role in converting homocysteine to other substances within the body. By so doing, they consistently lower homocysteine levels in research trials,1, 2, 3 a finding that is now well accepted. Several studies have used (and some doctors recommend) 400-1,000 mcg of folic acid per day, 10-50 mg of vitamin B6 per day, and 50-300 mcg of vitamin B12 per day.

Of these three vitamins, folic acid supplementation lowers homocysteine levels the most for the average person.4, 5 It also effectively lowers homocysteine in people on kidney dialysis.6 In 1996, the FDA required that all enriched flour, rice, pasta, cornmeal, and other grain products contain 140 mcg of folic acid per 3 0.5 ounces.7 This level of fortification has led to a measurable decrease in homocysteine levels.8 However, even higher levels of food fortification with folic acid have been reported to be more effective in lowering homocysteine,9 suggesting that the FDA-mandated supplementation is inadequate to optimally protect people against high homocysteine levels. Therefore, people wishing to lower their homocysteine levels should continue to take folic acid supplements despite the FDA-mandated fortification program.

References

1. Glueck CJ, Shaw P, Land JE, et al. Evidence that homocysteine is an independent risk factor for atherosclerosis in hyperlipidemic patients. Am J Cardiol 1995;75:132-6.

2. Ubbink JB, Vermaak WJH, van der Merwe A, Becker PJ. Vitamin B12, vitamin B6, and folate nutritional status in men with hyperhomocysteinemia. Am J Clin Nutr 1993;57:47-53.

3. Ubbink JB, Vermaak WJH, ven der Merwe A, et al. Vitamin requirements for the treatment of hyperhomocysteinemia in humans. J Nutr 1994;124:1927-33.

4. Dierkes J, Kroesen M, Pietrzik K. Folic acid and vitamin B6 supplementation and plasma homocysteine concentrations in healthy young women. Int J Vitam Nutr Res 1998;68:98-103.

5. Stein JH, McBride PE. Hyperhomocysteinemia and atherosclerotic vascular disease: pathophysiology, screening, and treatment. Arch Intern Med 1998;158:1301-6.

6. McGregor D, Shand B, Lynn K. A controlled trial of the effect of folate supplements on homocysteine, lipids and hemorheology in end-stage renal disease. Nephron 2000;85:215-20.

7. Food standards: amendment of standards of identity for enriched grain products to require addition of folic acid. Fed Regist 1996;61:8781-97.

8. Jacques PF, Selhub J, Bostom AG, et al. The effect of folic acid fortification on plasma folate and total homocysteine concentrations. N Engl J Med 1999;340:1449-54.

9. Malinow MR, Duell PB, Hess DL, et al. Reduction of plasma homocyst(e)ine levels by breakfast cereal fortified with folic acid in patients with coronary heart disease. N Engl J Med 1998;338:1009-15.

Anemia
Dose: 2.5 to 25 mg daily for three weeks, then 1.5 to 2.5 mg per day as maintenance therapy

Deficiencies of iron, vitamin B12, and folic acid are the most common nutritional causes of anemia.1 Although rare, severe deficiencies of several other vitamins and minerals, including vitamin A,2, 3vitamin B2,4vitamin B6,5, 6vitamin C,7 and copper,8, 9 can also cause anemia by various mechanisms. Rare genetic disorders can cause anemias that may improve with large amounts of supplements such as vitamin B1.10, 11

References

1. Little DR. Ambulatory management of common forms of anemia. Am Fam Physician 1999;59:1598-604 [review].

2. Hodges RE, Sauberlich HE, Canham JE, et al. Hematopoietic studies in vitamin A deficiency. Am J Clin Nutr 1978;31:876-85 [review].

3. Bloem MW. Interdependence of vitamin A and iron: an important association for programmes of anaemia control. Proc Nutr Soc 1995;54:501-8 [review].

4. Lane M, Alfrey CP. The anemia of human riboflavin deficiency. Blood 1965;25:432-42.

5. Orehek AJ, Kollas CD. Refractory postpartum anemia due to vitamin B6 deficiency. Ann Intern Med 1997;126(10):834-5 [letter].

6. Iwama H, Iwase O, Hayashi S, et al. Macrocytic anemia with anisocytosis due to alcohol abuse and vitamin B6 deficiency. Rinsho Ketsueki 1998;39:1127-30 [in Japanese].

7. Hirschmann JV, Raugi GJ. Adult scurvy. J Am Acad Dermatol 1999;41:895-906 [review].

8. Summerfield AL, Steinberg FU, Gonzalez JG. Morphologic findings in bone marrow precursor cells in zinc-induced copper deficiency anemia. Am J Clin Pathol 1992;97:665-8.

9. Freycon F, Pouyau G. Rare nutritional deficiency anemia: deficiency of copper and vitamin E. Sem Hop 1983;59:488-93 [review] [in French].

10. Borgna-Pignatti C, Marradi P, Pinelli L, et al. Thiamine-responsive anemia in DIDMOAD syndrome. J Pediatr 1989;114:405-10.

11. Neufeld EJ, Mandel H, Raz T, et al. Localization of the gene for thiamine-responsive megaloblastic anemia syndrome, on the long arm of chromosome 1, by homozygosity mapping. Am J Hum Genet 1997;61:1335-41.

Intermittent Claudication
Dose: 200 mg of EPA and 130 mg of DHA daily, plus small amounts of vitamin B6, folic acid, vitamin E, oleic acid, and alpha-linolenic acid

Men with intermittent claudication consumed a fortified milk product or regular milk daily for one year. The fortified product provided daily 130 mg of eicosapentaenoic acid and 200 mg of docosahexaenoic acid (EPA and DHA, two fatty acids in fish oil), small amounts of supplemental vitamin E, folic acid, and vitamin B6, and additional amounts of oleic acid and alpha-linolenic acid. Compared with regular milk, the fortified milk product significantly increased the distance the participants could walk before the onset of pain.1

References

1. Carrero JJ, Lopez-Huertas E, Salmeron LM, et al. Daily supplementation with (n-3) PUFAs, oleic acid, folic acid, and vitamins B-6 and E increases pain-free walking distance and improves risk factors in men with peripheral vascular disease. J Nutr2005;135:1393-9.

Atherosclerosis
Dose: Refer to label instructions

Blood levels of an amino acid called homocysteine have been linked to atherosclerosis and heart disease in most research,1, 2 though uncertainty remains about whether elevated homocysteine actually causes heart disease.3, 4 Although some reports have found associations between homocysteine levels and dietary factors, such as coffee and protein intakes,5 evidence linking specific foods to homocysteine remains preliminary. Higher blood levels of vitamin B6, vitamin B12, and folic acid are associated with low levels of homocysteine6 and supplementing with these vitamins lowers homocysteine levels.7, 8

While several trials have consistently shown that B6, B12, and folic acid lower homocysteine, the amounts used vary from study to study. Many doctors recommend 50 mg of vitamin B6, 100-300 mcg of vitamin B12, and 500-800 mcg of folic acid. Even researchers finding only inconsistent links between homocysteine and heart disease have acknowledged that a B vitamin might offer protection against heart disease independent of the homocysteine-lowering effect.9 In one trial, people with normal homocysteine levels had demonstrable reversal of atherosclerosis when supplementing B vitamins (2.5 mg folic acid, 25 mg vitamin B6, and 250 mcg of vitamin B12 per day).10 Similar results were seen in another study.11

For the few cases in which vitamin B6, vitamin B12, and folic acid fail to normalize homocysteine, adding 6 grams per day of betaine (trimethylglycine) may be effective.12 Of these four supplements, folic acid appears to be the most important.13 Attempts to lower homocysteine by simply changing the diet rather than by using vitamin supplements have not been successful.14

References

1. Stampfer MJ, Malinow R, Willett WC, et al. A prospective study of plasma homocyst(e)ine and risk of myocardial infarction in US physicians. JAMA 1992;268:877-81.

2. Bostom AG, Silbershatz H, Rosenberg IH, et al. Nonfasting plasma total homocysteine levels and all-cause and cardiobascular disease mortality in elderly Framingham men and women. Arch Intern Med 1999;159:1077-80.

3. Folsom AR, Nieto FJ, McGovern PG, et al. Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins. Circulation 1998;98:204-10.

4. Kuller LH, Evans RW. Homocysteine, vitamins, and cardiovascular disease. Circulation 1998;98:196-9 [editorial/review].

5. Stolzen berg-Solomon RZ, Miller ER III, Maguire MG, et al. Association of dietary protein intake and coffee consumption with serum homocysteine concentrations in an older population. Am J Clin Nutr 1999;69:467-75.

6. Selhub J, Jacques PF, Wilson PW, et al. Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. JAMA 1993;270:2693-8.

7. Ubbink JB, Vermaak WJH, ven der Merwe A, et al. Vitamin requirements for the treatment of hyperhomocysteinemia in humans. J Nutr 1994;124:1927-33.

8. Manson JB, Miller JW. The effects of vitamin B12, B6, and folate on blood homocysteine levels. Ann NY Acad Sci 1992;669:197-204 [review].

9. Folsom AR, Nieto FJ, McGovern PG, et al. Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins. Circulation 1998;98:204-10.

10. Hackam DG, Peterson JC, Spence JD. What level of plasma homocyst(e)ine should be treated? Am J Hypertens 2000;13:105-10.

11. Till U, Rohl P, Jentsch A, et al. Decrease of carotid intima-media thickness in patients at risk to cerebral ischemia after supplementation with folic acid, vitamins B6 and B12. Atherosclerosis2005;181:131-5.

12. Franken DG, Boers GHJ, Blom HJ, et al. Treatment of mild hyperhomocysteinemia in vascular disease patients. Arterioscler Thromb 1994;14:465-70.

13. Ubbink JB, Vermaak WJH, ven der Merwe A, et al. Vitamin requirements for the treatment of hyperhomocysteinemia in humans. J Nutr 1994;124:1927-33.

14. Ubbink JB, van der Merwe A, Vermaak WJH, Delport R. Hyperhomocysteinemia and the response to vitamin supplementation. Clin Investig 1993;71:993-8.

Heart Attack
Dose: Refer to label instructions

High blood levels of the amino acid homocysteine have been linked to an increased risk of heart attack in most,1, 2, 3, 4 though not all,5, 6 studies. A blood test screening for levels of homocysteine, followed by supplementation with 400 mcg of folic acid and 500 mcg of vitamin B12 per day could prevent a significant number of heart attacks, according to one analysis.7Folic acid8, 9 and vitamins B6 and B12 are known to lower homocysteine.10

There is a clear association between low blood levels of folate and increased risk of heart attacks in men.11 Based on the available research, some doctors recommend 50 mg of vitamin B6, 100-300 mcg of vitamin B12, and 500-800 mcg of folic acid per day for people at high risk of heart attack.

References

1. Israelsson B, Brattstrom LE, Hultberg BL. Homocysteine and myocardial infarction. Atherosclerosis 1988;71:227-33.

2. Ridker PM, Manson JE, Buring JE, et al. Homocysteine and risk of cardiovascular disease among postmenopausal women. JAMA 1999;281:1817-21.

3. Bots ML, Launer LJ, Lindemans J, et al. Homocysteine and short-term risk of myocardial infarction and stroke in the elderly: the Rotterdam Study. Arch Intern Med 1999;159:38-44.

4. Stampfer MJ, Malinow R, Willett WC, et al. A prospective study of plasma homocyst(e)ine and risk of myocardial infarction in US physicians. JAMA 1992;268:877-81.

5. Folsom AR, Nieto FJ, McGovern PG, et al. Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins. Circulation 1998;98:204-10.

6. Kuller LH, Evans RW. Homocysteine, vitamins, and cardiovascular disease. Circulation 1998;98:196-9 [editorial/review].

7. Nallamothu BK, Fendrick AM, Rubenfire M, et al. Potential clinical and economic effects of homocyst(e)ine lowering. Arch Intern Med 2000;160:3406-12.

8. Landgren F, Israelsson B, Lindgren A, et al. Plasma homocysteine in acute myocardial infarction: homocysteine-lowering effect of folic acid. J Intern Med 1995;237:381-8.

9. Ward M, McNulty H, McPartlin J, et al. Plasma homocysteine, a risk factor for cardiovascular disease, is lowered by physiological doses of folic acid. QJM 1997;90:519-24.

10. Lobo A, Naso A, Arheart K, et al. Reduction of homocysteine levels in coronary artery disease by low-dose folic acid combined with vitamins B6 and B12. Am J Cardiol 1999;83:821-5.

11. Voutilainen S, Lakka TA, Porkkala-Sarataho E, et al. Low serum folate concentrations are associated with an excess incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. Eur J Clin Nutr 2000;54:424-8.

Stroke and High Homocysteine
Dose: Refer to label instructions

Elevated blood levels of homocysteine, a toxic amino acid byproduct, have been linked to risk of stroke in most studies.1, 2, 3 Supplementation with folic acid, vitamin B6, and vitamin B12 generally lowers homocysteine levels in humans.4, 5, 6 In a pooled analysis (meta-analysis) of eight randomized trials, folic acid supplementation in varying amounts (usually 0.5 mg to 5 mg per day) reduced stroke risk by 18%.7

References

1. Lalouschek W, Aull S, Serles W, et al. Genetic and nongenetic factors influencing plasma homocysteine levels in patients with ischemic cerebrovascular disease and in healthy control subjects. J Lab Clin Med 1999;133:575-82.

2. Ridker PM, Manson JE, Buring JE, et al. Homocysteine and risk of cardiovascular disease among postmenopausal women. JAMA 1999;281:1817-21.

3. Perry IJ. Homocysteine, hypertension and stroke. J Hum Hypertens 1999;13:289-93 [review].

4. Genest J Jr. Hyperhomocyst(e)inemia-determining factors and treatment. Can J Cardiol 1999;15:35B-38B [review].

5. Ubbink JB, Vermaak WJH, ven der Merwe A, et al. Vitamin requirements for the treatment of hyperhomocysteinemia in humans. J Nutr 1994;124:1927-33.

6. Manson JB, Miller JW. The effects of vitamin B12, B6, and folate on blood homocysteine levels. Ann NY Acad Sci 1992;669:197-204 [review].

7. Wang X, Qin X, Demirtas H, et al. Efficacy of folic acid supplementation in stroke prevention: a meta-analysis. Lancet 2007;369:1876-82.

Morning Sickness
Dose: 10 to 25 mg three times daily

In two double-blind trials, supplementation with vitamin B6 (10 or 25 mg three times per day) significantly reduced the severity of morning sickness.1, 2

References

1. Sahakian V, Rouse D, Sipes S, et al. Vitamin B6 is effective therapy for nausea and vomiting of pregnancy: a randomized, double-blind placebo-controlled study. Obstet Gynecol 1991;78:33-6.

2. Vutyavanich T, Wongtra-ngan S, Ruangsri R. Pyridoxine for nausea and vomiting of pregnancy: a randomized, double blind, placebo-controlled trial. Am J Obstet Gynecol 1995;173:881-4.

Celiac Disease
Dose: 3 mg vitamin B6, 0.8 mg folic acid, and 0.5 mg vitamin B12In one trial, 11 people with celiac disease suffered from persistent depression despite being on a gluten-free diet for more than two years. However, after supplementation with vitamin B6 (80 mg per day) for six months, the depression disappeared.1 Daily supplementation with a combination of vitamin B6 (3 mg), folic acid (0.8 mg), and vitamin B12 (0.5 mg) for 6 months also improved psychological well-being in people with long-standing celiac disease who had poor psychological well-being despite being on a strict gluten-free diet.2
References

1. Hallert C, Astrom J, Walan A. Reversal of psychopathology in adult celiac disease with the aid of pyridoxine (vitamin B6). Scand J Gastroenterol 1983;18:299-304.

2. Hallert C, Svensson M, Tholstrup J, Hultberg B. Clinical trial: B vitamins improve health in patients with coeliac disease living on a gluten-free diet. Aliment Pharmacol Ther 2009;29:811-6.

Celiac Disease
Dose: Refer to label instructionsIn one trial, 11 people with celiac disease suffered from persistent depression despite being on a gluten-free diet for more than two years. However, after supplementation with vitamin B6 (80 mg per day) for six months, the depression disappeared.1
References

1. Hallert C, Astrom J, Walan A. Reversal of psychopathology in adult celiac disease with the aid of pyridoxine (vitamin B6). Scand J Gastroenterol 1983;18:299-304.

Premenstrual Syndrome
Dose: 100 to 200 mg per day on a regular basis

Many,1, 2, 3, 4, 5 though not all,6 clinical trials show that taking 50-400 mg of vitamin B6 per day for several months help relieve symptoms of PMS. A composite analysis of the best designed controlled trials shows that vitamin B6 is more than twice as likely to reduce symptoms of PMS as is placebo.7 Many doctors suggest 100-400 mg per day for at least three months. However, intakes greater than 200 mg per day can cause side effects and should never be taken without the supervision of a healthcare professional.Vitamin B6 has also been reported to relieve cyclic breast pain.8

References

1. Barr W. Pyridoxine supplements in the premenstrual syndrome. Practitioner 1984;228:425-7.

2. Gunn ADG. Vitamin B6 and the premenstrual syndrome (PMS). Int J Vitam Nutr Res 1985;(Suppl 27):213-24 [review].

3. Kleijnen J, Riet GT, Knipschild P. Vitamin B6 in the treatment of the premenstrual syndrome-a review. Br J Obstet Gynaecol 1990;97:847-52.

4. Williams MJ, Harris RI, Deand BC. Controlled trial of pyridoxine in the treatment of premenstrual syndrome. J Int Med Res 1985;13:174-9.

5. Brush MG, Perry M. Pyridoxine and the premenstrual syndrome. Lancet 1985;i:1399 [letter].

6. Hagen I, Nesheim B-I, Tuntland T. No effect of vitamin B6 against premenstrual tension. Acta Obstet Gynecol Scand 1985;64:667-70.

7. Wyatt KM, Dimmock PW, Jones PW, Shaughn O'Brien PM. Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: systematic review. BMJ 1999;318:1375-81.

8. Smallwood J, Ah-Kye D, Taylor I. Vitamin B6 in the treatment of pre-menstrual mastalgia. Br J Clin Pract 1986;40:532-3.

Pregnancy and Postpartum Support and High Homocysteine
Dose: 750 mg daily taken under the supervision of a doctorThe relationship between folate status and the risk of miscarriage is also somewhat unclear. In some studies, women who have had habitual miscarriages were found to have elevated levels of homocysteine (a marker of folate deficiency).1, 2, 3, 4 In a preliminary study, 22 women with recurrent miscarriages who had elevated levels of homocysteine were treated with 15 mg per day of folic acid and 750 mg per day of vitamin B6, prior to and throughout their next pregnancy. This treatment reduced homocysteine levels to normal and was associated with 20 successful pregnancies.5 It is not known whether supplementing with these vitamins would help prevent miscarriages in women with normal homocysteine levels. As the amounts of folic acid and vitamin B6 used in this study were extremely large and potentially toxic, this treatment should be used only with the supervision of a doctor.
References

1. Sutterlin M, Bussen S, Ruppert D, Steck T. Serum levels of folate and cobalamin in women with recurrent spontaneous abortion. Hum Reprod 1997;12:2292-6.

2. Wouters MG, Boers GH, Blom HJ, et al. Hyperhomocysteinemia: a risk factor in women with unexplained recurrent early pregnancy loss. Fertil Steril 1993;60:820-5.

3. Steegers-Theunissen RP, Boers GH, Blom HJ, et al. Hyperhomocysteinaemia and recurrent spontaneous abortion or abruptio placentae. Lancet 1992;339:1122-3 [letter].

4. Quere I, Bellet H, Hoffet M, et al. A woman with five consecutive fetal deaths: case report and retrospective analysis of hyperhomocysteinemia prevalence in 100 consecutive women with recurrent miscarriages. Fertil Steril 1998;69:152-4.

5. Quere I, Mercier E, Bellet H, et al. Vitamin supplementation and pregnancy outcome in women with recurrent early pregnancy loss and hyperhomocysteinemia. Fertil Steril 2001;75:823-5.

Amenorrhea
Dose: Refer to label instructions

Prolactin is a hormone that may be elevated in some cases of amenorrhea. A preliminary trial of 200 to 600 mg daily of vitamin B6 restored menstruation and normalized prolactin levels in three amenorrheic women with high initial prolactin levels; however, 600 mg daily of vitamin B6 had no effect on amenorrheic women who did not have high prolactin levels.1 A number of other small, preliminary trials have not demonstrated an effect of either oral or injected vitamin B6 on prolactin levels,2, 3, 4, 5, 6 and they also have reported inconsistent effects on restoring menstruation.7, 8, 9 Larger, controlled trials are needed to better determine the usefulness of vitamin B6 in amenorrhea.

References

1. McIntosh EN. Treatment of women with the galactorrhea-amenorrhea syndrome with pyridoxine (vitamin B6). JClin Endocrinol Metab 1976;42:1192-5.

2. Kidd GS, Dimond R, Kark JA, et al. The effects of pyridoxine on pituitary hormone secretion in amenorrhea-galactorrhea syndromes. J Clin Endocrinol Metab 1982;54:872-5.

3. Spiegel AM, Rosen SW, Weintraub BD, Marynick SP. Effect of intravenous pyridoxine on plasma prolactin in hyperprolactinemic subjects. J Clin Endocrinol Metab 1978;46:686-8.

4. Lehtovirta P, Ranta T, Seppala M. Pyridoxine treatment of galactorrhoea-amenorrhoea syndromes. Acta Endocrinol (Copenh) 1978;87:682-6.

5. Tolis G, Laliberte R, Guyda H, Naftolin F. Ineffectiveness of pyridoxine (B6) to alter secretion of growth hormone and prolactin and absence of therapeutic effects on galactorrhea-amenorrhea syndromes. J Clin Endocrinol Metab 1977;44:1197-9.

6. Goodenow TJ, Malarkey WB. Ineffectiveness of pyridoxine in evaluation and treatment of the hyperprolactinemic amenorrhea-galactorrhea syndrome. Am J Obstet Gynecol 1979;133:161-4.

7. Tolis G, Laliberte R, Guyda H, Naftolin F. Ineffectiveness of pyridoxine (B6) to alter secretion of growth hormone and prolactin and absence of therapeutic effects on galactorrhea-amenorrhea syndromes. J Clin Endocrinol Metab 1977;44:1197-9.

8. Lehtovirta P, Ranta T, Seppala M. Pyridoxine treatment of galactorrhoea-amenorrhoea syndromes. Acta Endocrinol (Copenh) 1978;87:682-6.

9. Kidd GS, Dimond R, Kark JA, et al. The effects of pyridoxine on pituitary hormone secretion in amenorrhea-galactorrhea syndromes. J Clin Endocrinol Metab 1982;54:872-5.

Bulimia
Dose: Refer to label instructions

People with eating disorders who restrict their food intake are at risk for multiple nutrient deficiencies, including protein, calcium, iron, riboflavin, niacin,1folic acid,2vitamin A, vitamin C,3 and vitamin B6,4 and essential fatty acids.5 A general multivitamin-mineral formula can reduce the detrimental health effects of these deficiencies.

Serotonin, a hormone that helps regulate food intake and appetite, is synthesized in the brain from the amino acid L-tryptophan. Preliminary data suggest that some people with bulimia have low serotonin levels.6 Researchers have reported that bulimic women with experimentally induced tryptophan deficiency tend to eat more and become more irritable compared to healthy women fed the same diet,7, 8 though not all studies have demonstrated these effects.9

Weight-loss diets result in lower L-tryptophan and serotonin levels in women,10 which could theoretically trigger bingeing and purging in susceptible people. However, the benefits of L-tryptophan supplementation are unclear. One small, double-blind trial reported significant improvement in eating behavior, feelings about eating, and mood among women with bulimia who were given 1 gram of L-tryptophan and 45 mg of vitamin B6 three times per day.11 Other double-blind studies using only L-tryptophan have failed to confirm these findings.12, 13 L-tryptophan is available by prescription only; most drug stores do not carry it, but "compounding" pharmacies do. Most cities have at least one compounding pharmacy, which prepares customized prescription medications to meet individual patient's needs.

References

1. Thibault L, Roberge AG. The nutritional status of subjects with anorexia nervosa. Int J Vitam Nutr Res 1987;57:447-52.

2. Abou-Saleh MT, Coppen A. The biology of folate in depression: implications for nutritional hypotheses of the psychoses. J Psychiatr Res 1986;20:91-101 [review].

3. Beaumont PJ, Chambers TL, Rouse L, Abraham SF. The diet composition and nutritional knowledge of patients with anorexia nervosa. J Hum Nutr 1981;35:265-73.

4. Rock CL, Vasantharajan S. Vitamin status of eating disorder patients: relationship to clinical indices and effect of treatment. Int J Eat Disord 1995;18:257-62.

5. Langan SM, Farrell PM. Vitamin E, vitamin A and essential fatty acid status of patients hospitalized for anorexia nervosa. Am J Clin Nutr 1985;41:1054-60.

6. Kaye WH, Weltzin TE. Serotonin activity in anorexia and bulimia nervosa: relationship to the modulation of feeding and mood. J Clin Psychiatry 1991;52 Suppl:41-8 [review].

7. Smith KA, Fairburn CG, Cowen PJ. Symptomatic relapse in bulimia nervosa following acute tryptophan depletion. Arch Gen Psychiatry 1999;56:171-6.

8. Weltzin TE, Fernstrom MH, Fernstrom JD, et al. Acute tryptophan depletion and increased food intake and irritability in bulimia nervosa. Am J Psychiatry 1995;152:1668-71.

9. Oldman AD, Walsh AES, Salkovskis P, et al. Biochemical and behavioural effects of acute tryptophan depletion in abstinent bulimic subjects: a pilot study. Psychol Med 1995;25:995-1001.

10. Anderson IM, Parry-Billings M, Newsholme EA, et al. Dieting reduces plasma tryptophan and alters brain 5-HT function in women. Psychol Med 1990;20:785-91.

11. Mira M, Abraham S. L-tryptophan as an adjunct to treatment of bulimia nervosa. Lancet 1989;ii:1162-3 [letter].

12. Krahn D, Mitchell J. Use of L-tryptophan in treating bulimia. Am J Psychiatry 1985;142:1130 [letter].

13. Brewerton TD, Murphy DL, Jimerson DC. Testmeal responses following m-chlorophenylpiperazine and L-tryptophan in bulimics and controls. Neuropsychopharmacology 1994;11:63-71.

Premenstrual Syndrome
Dose: 100 to 200 mg per day on a regular basis

Many,1, 2, 3, 4, 5 though not all,6 clinical trials show that taking 50-400 mg of vitamin B6 per day for several months help relieve symptoms of PMS. A composite analysis of the best designed controlled trials shows that vitamin B6 is more than twice as likely to reduce symptoms of PMS as is placebo.7 Many doctors suggest 100-400 mg per day for at least three months. However, intakes greater than 200 mg per day can cause side effects and should never be taken without the supervision of a healthcare professional.Vitamin B6 has also been reported to relieve cyclic breast pain.8

References

1. Barr W. Pyridoxine supplements in the premenstrual syndrome. Practitioner 1984;228:425-7.

2. Gunn ADG. Vitamin B6 and the premenstrual syndrome (PMS). Int J Vitam Nutr Res 1985;(Suppl 27):213-24 [review].

3. Kleijnen J, Riet GT, Knipschild P. Vitamin B6 in the treatment of the premenstrual syndrome-a review. Br J Obstet Gynaecol 1990;97:847-52.

4. Williams MJ, Harris RI, Deand BC. Controlled trial of pyridoxine in the treatment of premenstrual syndrome. J Int Med Res 1985;13:174-9.

5. Brush MG, Perry M. Pyridoxine and the premenstrual syndrome. Lancet 1985;i:1399 [letter].

6. Hagen I, Nesheim B-I, Tuntland T. No effect of vitamin B6 against premenstrual tension. Acta Obstet Gynecol Scand 1985;64:667-70.

7. Wyatt KM, Dimmock PW, Jones PW, Shaughn O'Brien PM. Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: systematic review. BMJ 1999;318:1375-81.

8. Smallwood J, Ah-Kye D, Taylor I. Vitamin B6 in the treatment of pre-menstrual mastalgia. Br J Clin Pract 1986;40:532-3.

Amenorrhea
Dose: Refer to label instructions

Prolactin is a hormone that may be elevated in some cases of amenorrhea. A preliminary trial of 200 to 600 mg daily of vitamin B6 restored menstruation and normalized prolactin levels in three amenorrheic women with high initial prolactin levels; however, 600 mg daily of vitamin B6 had no effect on amenorrheic women who did not have high prolactin levels.1 A number of other small, preliminary trials have not demonstrated an effect of either oral or injected vitamin B6 on prolactin levels,2, 3, 4, 5, 6 and they also have reported inconsistent effects on restoring menstruation.7, 8, 9 Larger, controlled trials are needed to better determine the usefulness of vitamin B6 in amenorrhea.

References

1. McIntosh EN. Treatment of women with the galactorrhea-amenorrhea syndrome with pyridoxine (vitamin B6). JClin Endocrinol Metab 1976;42:1192-5.

2. Kidd GS, Dimond R, Kark JA, et al. The effects of pyridoxine on pituitary hormone secretion in amenorrhea-galactorrhea syndromes. J Clin Endocrinol Metab 1982;54:872-5.

3. Spiegel AM, Rosen SW, Weintraub BD, Marynick SP. Effect of intravenous pyridoxine on plasma prolactin in hyperprolactinemic subjects. J Clin Endocrinol Metab 1978;46:686-8.

4. Lehtovirta P, Ranta T, Seppala M. Pyridoxine treatment of galactorrhoea-amenorrhoea syndromes. Acta Endocrinol (Copenh) 1978;87:682-6.

5. Tolis G, Laliberte R, Guyda H, Naftolin F. Ineffectiveness of pyridoxine (B6) to alter secretion of growth hormone and prolactin and absence of therapeutic effects on galactorrhea-amenorrhea syndromes. J Clin Endocrinol Metab 1977;44:1197-9.

6. Goodenow TJ, Malarkey WB. Ineffectiveness of pyridoxine in evaluation and treatment of the hyperprolactinemic amenorrhea-galactorrhea syndrome. Am J Obstet Gynecol 1979;133:161-4.

7. Tolis G, Laliberte R, Guyda H, Naftolin F. Ineffectiveness of pyridoxine (B6) to alter secretion of growth hormone and prolactin and absence of therapeutic effects on galactorrhea-amenorrhea syndromes. J Clin Endocrinol Metab 1977;44:1197-9.

8. Lehtovirta P, Ranta T, Seppala M. Pyridoxine treatment of galactorrhoea-amenorrhoea syndromes. Acta Endocrinol (Copenh) 1978;87:682-6.

9. Kidd GS, Dimond R, Kark JA, et al. The effects of pyridoxine on pituitary hormone secretion in amenorrhea-galactorrhea syndromes. J Clin Endocrinol Metab 1982;54:872-5.

Macular Degeneration
Dose: 2.5 mg folic acid, 50 mg vitamin B6, and 1 mg vitamin B12

In a double-blind study of female health professionals who had cardiovascular disease or cardiovascular disease risk factors, daily supplementation with folic acid (2.5 mg), vitamin B6 (50 mg), and vitamin B12 (1 mg) for 7.3 years significantly decreased the incidence of age-related macular degeneration.1

References

1. Christen WG, Glynn RJ, Chew EY, et al. Folic acid, pyridoxine, and cyanocobalamin combination treatment and age-related macular degeneration in women: the Women's Antioxidant and Folic Acid Cardiovascular Study. Arch Intern Med 2009;169:335-41.

Age-Related Cognitive Decline
Dose: 20 mg daily

Vitamin B6 (pyridoxine) deficiency is common among people over age 65.1 A Finnish study demonstrated that approximately 25% of Finnish and Dutch elderly people are deficient in vitamin B6 as compared to younger adults. In a double-blind trial, correcting this deficiency with 2 mg of pyridoxine per day resulted in small psychological improvements in the elderly group. However, the study found no direct correlation between amounts of vitamin B6 in the cells or blood and psychological parameters.2 A more recent double-blind trial of 38 healthy men, aged 70 to 79 years, showed that 20 mg pyridoxine per day improved memory performance, especially long-term memory.3

References

1. Madigan SM, Tracey F, McNulty H, et al. Riboflavin and vitamin B-6 intakes and status and biochemical response to riboflavin supplementation in free-living elderly people. Am J Clin Nutr 1998;68(2):389-95.

2. Tolonen M, Schrijver J, Westermarck T, et al. Vitamin B6 status of Finnish elderly. Comparison with Dutch younger adults and elderly. The effect of supplementation. Int J Vitam Res 1988;58(1):73-7.

3. Deijen JB, van der Beek EJ, Orlebeke JF, et al. Vitamin B-6 supplementation in elderly men: effects on mood, memory, performance and mental effort. Psychopharmacology (Berl) 1992;109(4):489-96.

Age-Related Cognitive Decline
Dose: Refer to label instructions

In a study of female health professionals who had cardiovascular disease or cardiovascular disease risk factors, daily supplementation with folic acid (2.5 mg), vitamin B6 (50 mg), and vitamin B12 (1 mg) for 5.4 years had no effect on cognitive function. However, supplementation appeared to prevent age-related cognitive decline in the 30% of women who had low dietary intake of B vitamins.1

Supplementation with homocysteine-lowering B vitamins (folic acid, vitamin B12, and vitamin B6) also slowed the rate of brain atrophy in elderly people who had mild cognitive impairment and high homocysteine levels.2

References

1. Kang JH, Cook N, Manson J, Buring JE, Albert CM, Grodstein F. A trial of B vitamins and cognitive function among women at high risk of cardiovascular disease. Am J Clin Nutr 2008;88:1602-10.)

2. Smith AD, Smith SM, de Jager CA, et al. Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment: a randomized controlled trial. PLoS One 2010;5(9):e12244.

Alzheimer's Disease
Dose: Refer to label instructions

In a preliminary report, two people with a hereditary form of Alzheimer's disease received daily: coenzyme Q10 (60 mg), iron (150 mg of sodium ferrous citrate), and vitamin B6 (180 mg). Mental status improved in both patients, and one became almost normal after six months.1

References

1. Imagawa M, Naruse S, Tsuji S, et al. Coenzyme Q10, iron, and vitamin B6 in genetically-confirmed Alzheimer's disease. Lancet 1992;340:671 [letter].

Low Back Pain
Dose: Take under medical supervision: 50 to 100 mg each of vitamins B1 and B6, and 250 to 500 mcg of vitamin B12, all taken three times per day

A combination of vitamin B1, vitamin B6, and vitamin B12 has proved useful for preventing a relapse of a common type of back pain linked to vertebral syndromes,1 as well as reducing the amount of anti-inflammatory medications needed to control back pain, according to double-blind trials.2 Typical amounts used have been 50-100 mg each of vitamins B1 and B6, and 250-500 mcg of vitamin B12, all taken three times per day.3, 4 Such high amounts of vitamin B6 require supervision by a doctor.

References

1. Schwieger G, Karl H, Schonhaber E. Relapse prevention of painful vertebral syndromes in follow-up treatment with a combination of vitamins B1, B6, and B12. Ann NY Acad Sci 1990;585:54-62.

2. Kuhlwein A, Meyer HJ, Koehler CO. Reduced diclofenac administration by B vitamins: results of a randomized double-blind study with reduced daily doses of diclofenac (75 mg diclofenac versus 75 mg diclofenac plus B vitamins) in acute lumbar vertebral syndromes. Klin Wochenschr 1990;68:107-15 [in German].

3. Bruggemann G, Koehler CO, Koch EM. Results of a double-blind study of diclofenac + vitamin B1, B6, B12 versus diclofenac in patients with acute pain of the lumbar vertebrae. A multicenter study. Klin Wochenschr 1990;68:116-20 [in German].

4. Vetter G, Bruggemann G, Lettko M, et al. Shortening diclofenac therapy by B vitamins. Results of a randomized double-blind study, diclofenac 50 mg versus diclofenac 50 mg plus B vitamins, in painful spinal diseases with degenerative changes. Z Rheumatol 1988;47:351-62 [in German].

Carpal Tunnel Syndrome
Dose: 100 to 300 mg daily for no more than three months; 50 to 100 mg daily after that

Some, but not all, studies have found vitamin B6 deficiency to be common in people with CTS.1 Supplementation with vitamin B6 has reportedly relieved the symptoms of CTS,2 but some researchers have not found this treatment to be beneficial.3, 4

Several studies report that people with CTS are helped when given 100 mg of vitamin B6 three times per day.5, 6 Although some researchers have found benefits with lesser amounts,7, 8, 9, 10 using less than 100 mg taken three times per day for several months has often failed.11, 12, 13 Most doctors assume that people with CTS who respond to vitamin B6 supplementation do so because of an underlying deficiency. However, at least one group of researchers has found vitamin B6 to "dramatically" reduce pain in people with CTS who did not appear to be B6-deficient.14 Some doctors believe that B6 is therapeutic because it reduces swelling around the carpal tunnel in the wrist; this theory remains completely undocumented.

Very high levels of vitamin B6 can damage sensory nerves, leading to numbness in the hands and feet as well as difficulty in walking; supplementation should be stopped if these symptoms develop after beginning vitamin B6 supplementation. Vitamin B6 is usually safe in amounts of 200 to 500 mg per day,15 although occasional problems have been reported in this range.16 Higher amounts are clearly toxic.17 Any adult taking more than 200 mg of vitamin B6 per day for more than a few months should consult a doctor.

In order to be effective, vitamin B6 must be transformed in the body to pyridoxal-5'-phosphate (PLP). Some doctors have suggested that people who do not respond well to vitamin B6 supplements should try 50 mg of PLP three times per day. There is no clear evidence that using PLP provides any advantage in reducing symptoms of CTS.

References

1. Fuhr JF, Farrow A, Nelson HS. Vitamin B6 levels in patients with carpal tunnel syndrome. Arch Surg 1989;124:1329-30.

2. Keniston RC, Nathan PA, Leklem JE, Lockwood RS. Vitamin B6, vitamin C, and carpal tunnel syndrome. J Occup Environ Med 1997;39:949-59.

3. Franzblau A, Rock CL, Werner RA, et al. The relationship of vitamin B6 status to median nerve function and carpal tunnel syndrome among active industrial workers. J Occup Environ Med 1996;38:485-91.

4. Smith GP, Rudge PJ, Peters TJ. Biochemical studies of pyridoxal and pyridoxal phosphate status and therapeutic trial of pyridoxine in patients with carpal tunnel syndrome. Ann Neurol 1984;15:104-7.

5. Ellis JM, Azuma J, Watanbe T, Folkers K. Survey and new data on treatment with pyridoxine of patients having a clinical syndrome including the carpal tunnel and other defects. Res Comm Chem Path Pharm 1977;17(1):165-77.

6. Ellis JM. Vitamin B6 deficiency in patients with a clinical syndrome including the carpal tunnel defect. Biochemical and clinical response to therapy with pyridoxine. Res Comm Chem Path Pharm 1976;13(4):743-57.

7. D'Souza M. Carpal tunnel syndrome: clinical or neurophysiological diagnosis. Lancet 1985;i:1104-5.

8. Driskell JA, Wesley RL, Hess IE. Effectiveness of pyridoxine hydrochloride treatment on carpal tunnel syndrome patients. Nutr Rep Internat 1986;34(4):1031-9.

9. Ellis JM. Treatment of carpal tunnel syndrome with vitamin B6. Southern Med J 1987;80(7):882-4.

10. Browning DM. Carpal tunnel syndrome: clinical or neurophysiological diagnosis? Lancet 1985;i:1104-5 [letter].

11. Smith GP, Rudge PJ, Peters TJ. Biochemical studies of pyridoxal and pyridoxal phosphate status and therapeutic trial of pyridoxine in patients with carpal tunnel syndrome. Ann Neurol 1984;15:104-7.

12. Amadio PC. Pyridoxine as an adjunct in the treatment of carpal tunnel syndrome. J Hand Surg 1985;10A(2):237-41.

13. Stransky M, Rubin A, Lava NS, Lazaro RP. Treatment of carpal tunnel syndrome with vitamin B6: a double-blind study. Southern Med J 1989;82(7):841-2.

14. Bernstein AL, Dinesen JS. Brief communication: effect of pharmacologic doses of vitamin B6 on carpal tunnel syndrome, electronencephalographic results, and pain. J Am Coll Nutri 1993;12:73-6.

15. Gaby AR. Literature review & commentary. Townsend Letter for Doctors and Patients.1990;Jun:338-9.

16. Parry G, Bredesen DE. Sensory neuropath with low-dose pyridoxine. Neurology 1985;35:1466-8.

17. Schaumburg H, Kaplan J, Windebank A, et al. Sensory neuropathy from pyridoxine abuse. N Engl J Med 1983;309(8):445-8.

Type 2 Diabetes
Dose: 1,800 mg pyridoxine alpha-ketoglutarate daily or 50 mg daily pyridoxine daily

Many people with diabetes have low blood levels of vitamin B6.1, 2 Levels are even lower in people with diabetes who also have nerve damage (neuropathy).3 Vitamin B6 supplementation has improved glucose tolerance in women with diabetes caused by pregnancy.4, 5 Vitamin B6 supplementation is also effective for glucose intolerance induced by birth control pills.6 In a trial that included people with type 2 diabetes, 1,800 mg per day of a special form of vitamin B6-pyridoxine alpha-ketoglutarate-improved glucose tolerance dramatically.7 Standard vitamin B6 has helped in some,8 but not all, trials.9

References

1. Wilson RG, Davis RE. Serum pyridoxal concentrations in children with diabetes mellitus. Pathology 1977;9:95-9.

2. Davis RE, Calder JS, Curnow DH. Serum pyridoxal and folate concentrations in diabetics. Pathology 1976;8:151-6.

3. McCann VJ, Davis RE. Serum pyridoxal concentrations in patients with diabetic neuropathy. Aust N Z J Med 1978;8:259-61.

4. Spellacy WN, Buhi WC, Birk SA. Vitamin B6 treatment of gestational diabetes mellitus. Am J Obstet Gynecol 1977;127:599-602.

5. Coelingh HJT, Schreurs WHP. Improvement of oral glucose tolerance in gestational diabetes by pyridoxine. BMJ 1975;3:13-5.

6. Spellacy WN, Buhi WC, Birk SA. The effects of vitamin B6 on carbohydrate metabolism in women taking steroid contraceptives: preliminary report. Contraception 1972;6:265-73.

7. Passariello N, Fici F, Giugliano D, et al. Effects of pyridoxine alpha-ketoglutarate on blood glucose and lactate in type I and II diabetics. Int J Clin Pharmacol Ther Toxicol 1983;21:252-6.

8. Solomon LR, Cohen K. Erythrocyte O2 transport and metabolism and effects of vitamin B6 therapy in type II diabetes mellitus. Diabetes 1989;38:881-6.

9. Rao RH, Vigg BL, Rao KSJ. Failure of pyridoxine to improve glucose tolerance in diabetics. J Clin Endocrinol Metab 1980;50:198-200.

Type 1 Diabetes
Dose: 1,800 mg daily of of pyridoxine alpha-ketoglutarate or 50 mg daily pyridoxine

Blood levels of vitamin B1 (thiamine) have been found to be low in people with type 1 diabetes.1 A controlled trial in Africa found that supplementing with both vitamin B1 (25 mg per day) and vitamin B6 (50 mg per day) led to significant improvement of symptoms of diabetic nerve damage (neuropathy) after four weeks.2 However, since this was a trial conducted among people in a vitamin B1-deficient developing country, these improvements might not occur in other people with diabetes. Another trial found that combining vitamin B1 (in a special fat-soluble form) and vitamin B6 plus vitamin B12 in high but variable amounts led to improvement in some aspects of diabetic neuropathy in 12 weeks.3 As a result, some doctors recommend that people with diabetic neuropathy supplement with vitamin B1, though the optimal level of intake remains unknown.4

Many people with diabetes have low blood levels of vitamin B6.5, 6 Levels are even lower in people with diabetes who also have neuropathy.7 In a trial that included people with type 1 diabetes, 1,800 mg per day of a special form of vitamin B6-pyridoxine alpha-ketoglutarate-improved glucose tolerance dramatically.8 Vitamin B6 may also reduce the amount of glycosylation, so taking adequate amounts of this vitamin may be beneficial for all people with diabetes.9
References

1. Haugen HN. The blood concentration of thiamine in diabetes. Scand J Clin Lab Invest 1964;16:260-6.

2. Abbas ZG, Swai ABM. Evaluation of the efficacy of thiamine and pyridoxine in the treatment of symptomatic diabetic peripheral neuropathy. East African Med J 1997;74:804-8.

3. Stracke H, Lindemann A, Federlin K. A benfotiamine-vitamin B combination in treatment of diabetic polyneuropathy. Exp Clin Endocrinol Diabetes 1996;104:311-6.

4. Visalli N, Cavallo MG, Signore A, et al. A multi-centre randomized trial of two different doses of nicotinamide in patients with recent-onset type 1 diabetes (The IMDIAB VI). Diabetes Metab Res Rev 1999;15:181-5.

5. Wilson RG, Davis RE. Serum pyridoxal concentrations in children with diabetes mellitus. Pathology 1977;9:95-9.

6. Davis RE, Calder JS, Curnow DH. Serum pyridoxal and folate concentrations in diabetics. Pathology 1976;8:151-6.

7. McCann VJ, Davis RE. Serum pyridoxal concentrations in patients with diabetic neuropathy. Aust N Z J Med 1978;8:259-61.

8. Passariello N, Fici F, Giugliano D, et al. Effects of pyridoxine alpha-ketoglutarate on blood glucose and lactate in type I and II diabetics. Int J Clin Pharmacol Ther Toxicol 1983;21:252-6.

9. Solomon LR, Cohen K. Erythrocyte O2 transport and metabolism and effects of vitamin B6 therapy in type II diabetes mellitus. Diabetes 1989;38:881-6.

Type 2 Diabetes and Diabetic Neuropathy
Dose: 25 mg of vitamin B1 daily, with 50 mg of vitamin B6 daily

A controlled trial in Africa found that supplementing with both vitamin B1 (25 mg per day) and vitamin B6 (50 mg per day) led to significant improvement of symptoms of diabetic neuropathy after four weeks.1 However, since this was a trial conducted among people in a vitamin B1-deficient developing country, these improvements might not occur in other people with diabetes. Another trial found that combining vitamin B1 (in a special fat-soluble form) and vitamin B6 plus vitamin B12 in high but variable amounts led to improvement in some aspects of diabetic neuropathy in 12 weeks.2 As a result, some doctors recommend that people with diabetic neuropathy supplement with vitamin B1, though the optimal level of intake remains unknown.

References

1. Abbas ZG, Swai ABM. Evaluation of the efficacy of thiamine and pyridoxine in the treatment of symptomatic diabetic peripheral neuropathy. East African Med J 1997;74:804-8.

2. Stracke H, Lindemann A, Federlin K. A benfotiamine-vitamin B combination in treatment of diabetic polyneuropathy. Exp Clin Endocrinol Diabetes 1996;104:311-6.

Hypoglycemia
Dose: Refer to label instructions

Research has shown that supplementing with chromium (200 mcg per day)1 or magnesium (340 mg per day)2 can prevent blood sugar levels from falling excessively in people with hypoglycemia. Niacinamide (vitamin B3) has also been found to be helpful for hypoglycemic people.3 Other nutrients, including vitamin C, vitamin E, zinc, copper, manganese, and vitamin B6, may help control blood sugar levels in diabetics.4 Since there are similarities in the way the body regulates high and low blood sugar levels, these nutrients might be helpful for hypoglycemia as well, although the amounts needed for that purpose are not known.

References

1. Anderson RA et al. Chromium supplementation of humans with hypoglycemia. Fed Proc 1984;43:471.

2. Stebbing JB et al. Reactive hypoglycemia and magnesium. Magnesium Bull 1982;2:131-4.

3. Shansky A. Vitamin B3 in the alleviation of hypoglycemia. Drug Cosm Ind 1981;129(4):68-69,104-5.

4. Gaby AR, Wright JV. Nutritional regulation of blood glucose. J Advancement Med 1991;4:57-71.

Age-Related Cognitive Decline
Dose: 20 mg daily

Vitamin B6 (pyridoxine) deficiency is common among people over age 65.1 A Finnish study demonstrated that approximately 25% of Finnish and Dutch elderly people are deficient in vitamin B6 as compared to younger adults. In a double-blind trial, correcting this deficiency with 2 mg of pyridoxine per day resulted in small psychological improvements in the elderly group. However, the study found no direct correlation between amounts of vitamin B6 in the cells or blood and psychological parameters.2 A more recent double-blind trial of 38 healthy men, aged 70 to 79 years, showed that 20 mg pyridoxine per day improved memory performance, especially long-term memory.3

References

1. Madigan SM, Tracey F, McNulty H, et al. Riboflavin and vitamin B-6 intakes and status and biochemical response to riboflavin supplementation in free-living elderly people. Am J Clin Nutr 1998;68(2):389-95.

2. Tolonen M, Schrijver J, Westermarck T, et al. Vitamin B6 status of Finnish elderly. Comparison with Dutch younger adults and elderly. The effect of supplementation. Int J Vitam Res 1988;58(1):73-7.

3. Deijen JB, van der Beek EJ, Orlebeke JF, et al. Vitamin B-6 supplementation in elderly men: effects on mood, memory, performance and mental effort. Psychopharmacology (Berl) 1992;109(4):489-96.

Age-Related Cognitive Decline
Dose: Refer to label instructions

In a study of female health professionals who had cardiovascular disease or cardiovascular disease risk factors, daily supplementation with folic acid (2.5 mg), vitamin B6 (50 mg), and vitamin B12 (1 mg) for 5.4 years had no effect on cognitive function. However, supplementation appeared to prevent age-related cognitive decline in the 30% of women who had low dietary intake of B vitamins.1

Supplementation with homocysteine-lowering B vitamins (folic acid, vitamin B12, and vitamin B6) also slowed the rate of brain atrophy in elderly people who had mild cognitive impairment and high homocysteine levels.2

References

1. Kang JH, Cook N, Manson J, Buring JE, Albert CM, Grodstein F. A trial of B vitamins and cognitive function among women at high risk of cardiovascular disease. Am J Clin Nutr 2008;88:1602-10.)

2. Smith AD, Smith SM, de Jager CA, et al. Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment: a randomized controlled trial. PLoS One 2010;5(9):e12244.

Schizophrenia
Dose: Consult a qualified healthcare practitioner

The term "orthomolecular psychiatry" was coined by Linus Pauling in 1968 to refer to the treatment of psychiatric illnesses with substances (such as vitamins) that are normally present in the body. In orthomolecular psychiatry, high amounts of vitamins are sometimes used, not to correct a deficiency per se, but to create a more optimal biochemical environment. The mainstay of the orthomolecular approach to schizophrenia is niacin or niacinamide (vitamin B3) in high amounts. In early double-blind trials, 3 grams of niacin daily resulted in a doubling of the recovery rate, a 50% reduction in hospitalization rates, and a dramatic reduction in suicide rates.1 In a preliminary trial, some schizophrenic patients continued a course of vitamins (4 to 10 grams of niacin or niacinamide, 4 grams of vitamin C, and 50 mg or more of vitamin B6) after being discharged from the hospital, while another group of patients discontinued the vitamins upon discharge. Both groups continued to take their psychiatric medications. Those who continued to take the vitamins had a 50% lower re-admission rate compared with those who did not.2 Several later double-blind trials, including trials undertaken by the Canadian Mental Health Association, have been unable to reproduce these positive results.3, 4 Early supporters of niacin therapy contend that many of these trials were poorly designed.5 One clinical trial reported no greater improvement in a group of schizophrenic patients given 6 grams of niacin than in others given 3 mg of niacin; all patients were also being treated with psychiatric medications.6

There are potential side-effects of niacin therapy, including an uncomfortable flushing sensation, dermatitis (skin inflammation), heartburn, aggravation of peptic ulcers, increased blood sugar, increased panic and anxiety, and elevation of liver enzymes, which may indicate damage to liver cells. A positive side effect of niacin therapy is reduction of cholesterol levels. Some of these effects, such as flushing, gastric upset, and reduction of serum cholesterol, do not occur with the use of niacinamide.7 Because of the seriousness of some of these side effects, high amounts of niacin should not be used without the supervision of a healthcare practitioner.

Vitamin B6 has been used in combination with niacin in the orthomolecular approach to schizophrenia. Pioneers of orthomolecular medicine reported benefits from this combination. However, although two placebo-controlled trials found significant improvement when schizophrenic patients were given either 3 grams of niacin or 75 mg of pyridoxine along with their psychiatric medications, this improvement was lost when the two vitamins were combined.8, 9 In a double-blind trial, schizophrenic patients were given either a vitamin program based on their individual laboratory tests or a placebo (25 mg of vitamin C) in addition to their psychiatric medications. The vitamin program included large amounts of various B vitamins, as well as vitamin C and vitamin E. After five months, the number of patients who improved was not different in the vitamin group compared with the placebo group.10

Clinical trials of the effects of vitamin B6 have yielded differing results. The results of supplementation with 100 mg daily in one schizophrenic patient included dramatic reduction in side effects from medication, as well as reduction in schizophrenic symptoms.11 In a preliminary trial, 60 mg per day of vitamin B6 resulted in symptomatic improvement in only 5% of schizophrenic patients after four weeks.12 Another preliminary trial, however, found that a higher amount of vitamin B6-50 mg three times daily given for eight to twelve weeks-in addition to psychiatric medications, did bring about significant improvements in schizophrenic patients. These patients experienced a better sense of well-being, increased motivation, and greater interest in their "personal habits and their environment."13

L-tryptophan is the amino acid precursor of serotonin, a neurotransmitter (chemical messenger in the brain). There is evidence that L-tryptophan levels in schizophrenic people are lower than in non-schizophrenics14 and the way the body uses L-tryptophan is altered in people with schizophrenia.15, 16 In a preliminary trial, patients with schizophrenia were given 2-8 grams of L-tryptophan and 100 mg of vitamin B6 daily. This resulted in decreased agitation and less fear and anxiety, but these improvements were not as great as those achieved with psychiatric medications.17 It is not clear whether the benefits seen in this trial were due to vitamin B6, L-tryptophan, or a combination of the two. No other clinical trials using L-tryptophan have been published. L-tryptophan is currently available by prescription only.

References

1. Hawkins DR, Bortin AW, Runyon RP. Orthomolecular psychiatry: niacin and megavitamin therapy. Psychosomatics 1970;11:517-21 [review].

2. Hawkins DR, Bortin AW, Runyon RP. Orthomolecular psychiatry: niacin and megavitamin therapy. Psychosomatics 1970;11:517-21 [review].

3. Autry JH. Workshop on orthomolecular treatment of schizophrenia: a report. Schizophr Bull 1975:94-103.

4. Petrie WM, Ban TA. Vitamins in psychiatry. Do they have a role? Drugs 1985;30:58-65 [review].

5. Hoffer A. Megavitamin B-3 therapy for schizophrenia. Can Psychiatr Assoc J 1971;16:499-504.

6. Wittenborn JR, Weber ES, Brown M. Niacin in the long-term treatment of schizophrenia. Arch Gen Psychiatry 1973;28:308-15.

7. Newbold HL, Mosher LR. Niacin and the schizophrenic patient. Am J Psychiatry 1970;127:535-6.

8. Petrie WM, Ban TA, Ananth JV. The use of nicotinic acid and pyridoxine in the treatment of schizophrenia. IntPharmacopsychiatry 1981;16:245-50.

9. Ananth JV, Ban TA, Lehmann HE. Potentiation of therapeutic effects of nicotinic acid by pyridoxine in chronic schizophrenics. Can Psychiatr Assoc J 1973;18:377-83.

10. Vaughan K, McConaghy N. Megavitamin and dietary treatment in schizophrenia: a randomised, controlled trial. Aust N Z J Psychiatry 1999;33:84-8.

11. Sandyk R, Pardeshi R. Pyridoxine improves drug-induced parkinsonism and psychosis in a schizophrenic patient. Int J Neurosci 1990;52:225-32.

12. Yamauchi M. Effects of L-dopa and vitamin B6 on electroencephalograms of schizophrenic patients: a preliminary report. Folia Psychiatr Neurol Jpn 1976;30:121-51.

13. Bucci L. Pyridoxine and schizophrenia. Br J Psychiatry 1973;122:240 [letter].

14. Manowitz P, Gilmour DG, Racevskis J. Low plasma tryptophan levels in recently hospitalized schizophrenics. Biol Psychiatry 1973;6:109-18.

15. Payne IR, Walsh EM, Whittenburg EJ. Relationship of dietary tryptophan and niacin to tryptophan metabolism in schizophrenics and nonschizophrenics. Am J Clin Nutr 1974;27:565-71.

16. Gilka L. Schizophrenia, a disorder of tryptophan metabolism. Acta Psychiatr Scand Suppl 1975;258:1-83.

17. Bowers MB Jr. Cerebrospinal fluid 5-hydroxyindoles and behavior after L-tryptophan and pyridoxine administration to psychiatric patients. Neuropharmacology 1970;9:599-604.

Low Back Pain
Dose: Take under medical supervision: 50 to 100 mg each of vitamins B1 and B6, and 250 to 500 mcg of vitamin B12, all taken three times per day

A combination of vitamin B1, vitamin B6, and vitamin B12 has proved useful for preventing a relapse of a common type of back pain linked to vertebral syndromes,1 as well as reducing the amount of anti-inflammatory medications needed to control back pain, according to double-blind trials.2 Typical amounts used have been 50-100 mg each of vitamins B1 and B6, and 250-500 mcg of vitamin B12, all taken three times per day.3, 4 Such high amounts of vitamin B6 require supervision by a doctor.

References

1. Schwieger G, Karl H, Schonhaber E. Relapse prevention of painful vertebral syndromes in follow-up treatment with a combination of vitamins B1, B6, and B12. Ann NY Acad Sci 1990;585:54-62.

2. Kuhlwein A, Meyer HJ, Koehler CO. Reduced diclofenac administration by B vitamins: results of a randomized double-blind study with reduced daily doses of diclofenac (75 mg diclofenac versus 75 mg diclofenac plus B vitamins) in acute lumbar vertebral syndromes. Klin Wochenschr 1990;68:107-15 [in German].

3. Bruggemann G, Koehler CO, Koch EM. Results of a double-blind study of diclofenac + vitamin B1, B6, B12 versus diclofenac in patients with acute pain of the lumbar vertebrae. A multicenter study. Klin Wochenschr 1990;68:116-20 [in German].

4. Vetter G, Bruggemann G, Lettko M, et al. Shortening diclofenac therapy by B vitamins. Results of a randomized double-blind study, diclofenac 50 mg versus diclofenac 50 mg plus B vitamins, in painful spinal diseases with degenerative changes. Z Rheumatol 1988;47:351-62 [in German].

Asthma
Dose: 100 to 200 mg daily

Vitamin B6 deficiency is common in asthmatics.1 This deficiency may relate to the asthma itself or to certain asthma drugs (such as theophylline and aminophylline) that deplete vitamin B6.2 In a double-blind trial, 200 mg per day of vitamin B6 for two months reduced the severity of asthma in children and reduced the amount of asthma medication they needed.3 In another trial, asthmatic adults experienced a dramatic decrease in the frequency and severity of asthma attacks while taking 50 mg of vitamin B6 twice a day.4 Nonetheless, the research remains somewhat inconsistent, and one double-blind trial found that high amounts of B6 supplements did not help asthmatics who required the use of steroid drugs.5

References

1. Collipp PJ, Chen SY, Sharma RK, et al. Tryptophane metabolism in bronchial asthma. Ann Allergy 1975;35:153-8.

2. Weir MR, Keniston RC, Enriquez JI, McNamee GA. Depression of vitamin B6 levels due to theophylline. Ann Allergy 1990;65:59-62.

3. Collipp PJ, Goldzier S III, Weiss N, et al. Pyridoxine treatment of childhood bronchial asthma. Ann Allergy 1975;35:93-7.

4. Reynolds RD, Natta CL. Depressed plasma pyridoxal phosphate concentrations in adult asthmatics. Am J Clin Nutr 1985;41:684-8.

5. Sur S, Camara M, Buchmeier A, et al. Double-blind trial of pyridoxine (vitamin B6) in the treatment of steroid-dependent asthma. Ann Allergy 1993;70:141-52.

Schizophrenia and High Homocysteine
Dose: Take folic acid (2 mg), vitamin B6 (25 mg), and vitamin B12 (400 mcg) dailyIn another double-blind study, daily supplementation with folic acid (2 mg), vitamin B6 (25 mg), and vitamin B12 (400 mcg) for three months improved symptoms of schizophrenia compared with a placebo.1 All of the participants in this study had elevated blood levels of homocysteine, which can be decreased by taking these three B vitamins. Based on this study, it would seem reasonable to measure homocysteine levels in people with schizophrenia and, if they are elevated, to supplement with folic acid, vitamin B6, and vitamin B12.
References

1. Levine J, Stahl Z, Sela BA, et al. Homocysteine-reducing strategies improve symptoms in chronic schizophrenic patients with hyperhomocysteinemia. Biol Psychiatry 2006;60:265-9.

Tooth Decay
Dose: For adults: 20 mg per day in capsules or lozenges; for children: 9 mg daily

Test tube studies show that vitamin B6 increases growth of beneficial mouth bacteria and decreases growth of cavity-causing bacteria.1 A double-blind study found that pregnant women who supplemented with 20 mg per day of vitamin B6 had significantly fewer new caries and fillings during pregnancy.2 Lozenges containing vitamin B6 were more effective than capsules in this study, suggesting an important topical effect. Another double-blind study gave children oral lozenges containing 3 mg of vitamin B6 three times per day for eight months, but reported only insignificant reductions in new cavities.3

References

1. Palazzo A, Cobe HM, Ploumis E. The effect of pyridoxine on the oral microbial populations. NY State Dent J 1959;25:303-7.

2. Hillman RW, Cabaud PG, Schenone RA. The effects of pyridoxine supplements on the dental caries experience of pregnant women. Am J Clin Nutr 1962;10:512-5.

3. Cohen A, Rubin C. Pyridoxine supplementation in the suppression of dental caries. Bull Phila County Dent Soc 1958;22:84.

Macular Degeneration
Dose: 2.5 mg folic acid, 50 mg vitamin B6, and 1 mg vitamin B12

In a double-blind study of female health professionals who had cardiovascular disease or cardiovascular disease risk factors, daily supplementation with folic acid (2.5 mg), vitamin B6 (50 mg), and vitamin B12 (1 mg) for 7.3 years significantly decreased the incidence of age-related macular degeneration.1

References

1. Christen WG, Glynn RJ, Chew EY, et al. Folic acid, pyridoxine, and cyanocobalamin combination treatment and age-related macular degeneration in women: the Women's Antioxidant and Folic Acid Cardiovascular Study. Arch Intern Med 2009;169:335-41.

Vertigo
Dose: Consult a qualified healthcare practitioner

Two preliminary human studies reported that vitamin B6 supplementation reduced symptoms of vertigo produced with drugs in a laboratory setting.1 Vitamin B6 supplementation has not been studied in BPPV or other forms of vertigo and may not share the same causative mechanism as experimentally induced vertigo.

References

1. Claussen CF, Claussen E. Antivertiginous action of vitamin B 6 on experimental minocycline-induced vertigo in man. Arzneimittelforschung 1988;38:396-9 [in German].

Autism
Dose: 30 mg daily per 2.2 lbs (1 kg) of body weight; doctor's supervision recommended

Uncontrolled and double-blind research shows that vitamin B6 can be helpful for autistic children.1, 2, 3 In these trials, children typically took between 3.5 mg and almost 100 mg of B6 for every 2.2 pounds of body weight, with some researchers recommending 30 mg per 2.2 pounds of body weight. Although toxicity was not reported, such amounts are widely considered to have potential toxicity that can damage the nervous system; these amounts should only be administered by a doctor. One prominent researcher has suggested that vitamin B6 is better supported by research than is drug treatment in dealing with autism.4

References

1. Lelord G, Muh JP, Barthelemy C, et al. Effects of pyridoxine and magnesium on autistic symptoms: Initial observations. J Autism Developmental Disorders 1981;11:219-29.

2. Martineau J, Garreau B, Barthelemy C, et al. Effects of vitamin B6 on averaged evoked potentials in infantile autism. Biol Psychiatr 1981;16:627-39.

3. Rimland B, Callaway E, Dreyfus P. The effect of high doses of vitamin B6 on autistic children: a double-blind crossover study. Am J Psychiatr 1978;135:472-5.

4. Rimland B. Vitamin B6 versus Fenfluramine: a case-study in medical bias. J Nutr Med 1991;2:321-2.

Attention Deficit-Hyperactivity Disorder
Dose: Refer to label instructions

B vitamins, particularly vitamin B6, have also been used for ADHD. Deficient levels of vitamin B6 have been detected in some ADHD patients.1 In a study of six children with low blood levels of the neurotransmitter (chemical messenger) serotonin, vitamin B6 supplementation (15-30 mg per 2.2 pounds of body weight per day) was found to be more effective than methylphenidate (Ritalin(R)). However, lower amounts of vitamin B6 were not beneficial.2 The effective amount of vitamin B6 in this study was extremely large and could potentially cause nerve damage, although none occurred in this study. A practitioner knowledgeable in nutrition must be consulted when using high amounts of vitamin B6. High amounts of other B vitamins have shown mixed results in relieving ADHD symptoms.3, 4

References

1. Bhagavan HN, Coleman M, Coursin DB. The effect of pyridoxine hydrochloride on blood serotonin and pyridoxal phosphate contents in hyperactive children. Pediatrics 1975;55:437-41.

2. Coleman M, Steinberg G, Tippett J, et al. A preliminary study of the effect of pyridoxine administration in a subgroup of hyperkinetic children: a double-blind crossover comparison with methylphenidate. Biol Psychiatry 1979;14:741-51.

3. Brenner A. The effects of megadoses of selected B complex vitamins on children with hyperkinesis: controlled studies with long term followup. J Learning Dis 1982;15:258-64.

4. Haslam RHA. Is there a role for megavitamin therapy in the treatment of attention deficit hyperactivity disorder? Adv Neurol 1992;58:303-10.

Osgood-Schlatter Disease
Dose: Refer to label instructions

Another group of doctors has reported good results using a combination of zinc, manganese, and vitamin B6 for people with Osgood-Schlatter disease; however, the amounts of these supplements were not mentioned in the report.1 Most physicians would consider reasonable daily amounts of these nutrients for adolescents to be 15 mg of zinc, 5 to 10 mg of manganese, and 25 mg of vitamin B6. Larger amounts might be used with medical supervision.

References

1. Aston B. Manganese and man. J Orthomolec Psychiatry 1980;9:237-49.

Kidney Stones
Dose: Refer to label instructions

Both magnesium and vitamin B6 are used by the body to convert oxalate into other substances. Vitamin B6 deficiency leads to an increase in kidney stones as a result of elevated urinary oxalate.1 Vitamin B6 is also known to reduce elevated urinary oxalate in some stone formers who are not necessarily B6 deficient.2, 3

Years ago, the Merck Manual recommended 100-200 mg of vitamin B6 and 200 mg of magnesium per day for some kidney stone formers with elevated urinary oxalate.4 Most trials have shown that supplementing with magnesium5, 6, 7 and/or vitamin B68, 9 significantly lowers the risk of forming kidney stones. Results have varied from only a slight reduction in recurrences10 to a greater than 90% decrease in recurrences.11

Optimal supplemental levels of vitamin B6 and magnesium for people with kidney stones remain unknown. Some doctors advise 200-400 mg per day of magnesium. While the effective intake of vitamin B6 appears to be as low as 10-50 mg per day, certain people with elevated urinary oxalate may require much higher amounts, and therefore require medical supervision. In some cases, as much as 1,000 mg of vitamin B6 per day (a potentially toxic level) has been used successfully.12

Doctors who do advocate use of magnesium for people with a history of stone formation generally suggest the use of magnesium citrate because citrate itself reduces kidney stone recurrences. As with calcium supplementation, it appears important to take magnesium with meals in order for it to reduce kidney stone risks by lowering urinary oxalate.13

References

1. Nath R, Thind SK, Murthy MSR, et al. Role of pyridoxine in oxalate metabolism. Ann NY Acad Sci 1990;585:274-84 [review].

2. Watts RW, Veall N, Purkiss P, et al. The effect of pyridoxine on oxalate dynamics in three cases of primary hyperoxaluria (with glycollic aciduria). Clin Sci 1985;69:87-90.

3. Mitwalli A, Ayiomamitis W, Grass L, Oreopoulos DG. Control of hyperoxaluria with large doses of pyridoxine in patients with kidney stones. Int Urol Nephrol 1988;20:353-9.

4. Berkow R, Talbott JH, et al. The Merck Manual of Diagnosis and Therapy, 13th ed. Rahway, NJ: Merck Sharp & Dohme, 1977, 732.

5. Gershoff SN, Prien EL. Effect of daily MgO and vitamin B6 administration to patients with recurring calcium oxalate kidney stones. Am J Clin Nutr 1967;20(5)393-9.

6. Prien EL, Gershoff SF. Magnesium oxide-pyridoxine therapy for recurrent calcium oxalate calculi. J Urol 1974;112:509-12.

7. Johansson G, Backman U, Danielson BG, et al. Effects of magnesium hydroxide in renal stone disease. J Am Coll Nutr 1982;1:179-85.

8. Gershoff SN, Prien EL. Effect of daily MgO and vitamin B6 administration to patients with recurring calcium oxalate kidney stones. Am J Clin Nutr 1967;20(5)393-9.

9. Curhan GC, Willett WC, Speizer FE, Stampfer MJ. Intake of vitamins B6 and C and the risk of kidney stones in women. J Am Soc Nephrol 1999;10:840-5.

10. Ettiniger B, Citron JT, Livermore B, Dolman LI. Chlorthalidone reduces calcium oxalate calculus recurrence but magnesium hydroxide does not. J Urol 1988;139:679-84.

11. Prien EL, Gershoff SF. Magnesium oxide-pyridoxine therapy for recurrent calcium oxalate calculi. J Urol 1974;112:509-12.

12. Will EJ, Bijvoet OL. Primary oxalosis: clinical and biochemical response to high-dose pyridoxine therapy. Metabolism 1979;28:542-8.

13. Lindberg J, Harvey J, Pak CYC. Effect of magnesium citrate and magnesium oxide on the crystallization of calcium salts in urine: changes produced by food-magnesium interaction. J Urol 1990;143:248-51.

Acne Vulgaris
Dose: Refer to label instructions

A preliminary report suggested that vitamin B6 at 50 mg per day may alleviate premenstrual flare-ups of acne experienced by some women.1 While no controlled research has evaluated this possibility, an older controlled trial of resistant adolescent acne found that 50-250 mg per day decreased skin oiliness and improved acne in 75% of the participants.2 However, another preliminary report suggested that vitamin B6 supplements might exacerbate acne vulgaris.3

References

1. Snider B, Dietman DF. Pyridoxine therapy for premenstrual acne flare. Arch Dermatol 1974;110:130-1 [letter].

2. Joliffe N, Rosenblum LA, Sawhill J. Effects of pyridoxine (vit B6) on resistant adolescent acne. J Invest Dermatol 1942;5:143-8.

3. Braun-Falco O, Lincke H. The problem of vitamin B6/B12 acne. A contribution on acne medicamentosa. MMW Munch Med Wochenschr 1976;118(6):155-60 [in German].

Photosensitivity
Dose: Refer to label instructions

Cases have been reported of people with photosensitivity who responded to vitamin B6 supplementation.1, 2 Amounts of vitamin B6 used to successfully reduce reactions to sunlight have varied considerably. Some doctors suggest a trial of 100 to 200 mg per day for three months. People wishing to take more than 200 mg of vitamin B6 per day should do so only under medical supervision.

References

1. Kaufman G. Pyridoxine against amiodarone-induced photosensitivity. Lancet 1984;i:51-2 [letter].

2. Ross JB, Moss MA. Relief of the photosensitivity of erythropoietic protoporphyria by pyridoxine. J Am Acad Dermatol 1990;22:340-2.

Seborrheic Dermatitis in Adults
Dose: Refer to label instructions

One physician reported that injections of B-complex vitamins were useful in the treatment of seborrheic dermatitis in infants.1 A preliminary trial found that 10 mg per day of folic acid was helpful in 17 of 20 cases of adult seborrheic dermatitis.2 However, this study also found that oral folic acid did not benefit infants with cradle cap. A preliminary study found that topical application of vitamin B6 ointment (containing 10 mg B6 per gram of ointment) to affected areas improved adult seborrheic dermatitis.3 However, oral vitamin B6 (up to 300 mg per day) was ineffective. Injections of vitamin B12 were reported to improve in 86% of adults with seborrheic dermatitis in a preliminary trial.4 Oral administration of vitamin B12 for seborrheic dermatitis has not been studied.

References

1. Nisenson A. Treatment of seborrheic dermatitis with biotin and vitamin B complex. J Pediatr 1972;81:630-1 [letter].

2. Callaghan TJ. The effect of folic acid on seborrheic dermatitis. Cutis 1967;3:583-8.

3. Schreiner AW, Rockwell E, Vilter RW. A local defect in the metabolism of pyridoxine in the skin of persons with seborrheic dermatitis of the "sicca" type. J Invest Derm 1952;19:95-6.

4. Andrews GC, Post CF, Domnkos AN. Seborrheic dermatitis: supplemental treatment with vitamin B12. NY State Med J 1950;50:1921-5.

Osteoporosis and High Homocysteine
Dose: Refer to label instructionsFolic acid, vitamin B6, and vitamin B12 are known to reduce blood levels of the amino acid homocysteine, and homocystinuria, a condition associated with high homocysteine levels, frequently causes osteoporosis. Therefore, some researchers have suggested that these vitamins might help prevent osteoporosis by lowering homocysteine levels.1 In a double-blind study of people who had suffered a stroke and had high homocysteine levels, daily supplementation with 5 mg of folic acid and 1,500 mcg of vitamin B12 for two years reduced the incidence of fractures by 78%, compared with a placebo.2 The reduction in fracture risk appeared to be due to an improvement in bone quality, rather than to a change in bone mineral density. However, supplementation with these vitamins did not reduce fracture risk in people who had only mildly elevated homocysteine levels and relatively high pretreatment folic acid levels.3 For the purpose of lowering homocysteine, amounts of folic acid and vitamins B6 and B12 found in high-potency B-complex supplements and multivitamins should be adequate.
References

1. Gaby AR. Preventing and Reversing Osteoporosis. Rocklin, CA: Prima Publishing, 1994, 88-9 [review].

2. Sato Y, Honda Y, Iwamoto J, et al. Effect of folate and mecobalamin on hip fractures in patients with stroke: a randomized controlled trial. JAMA 2005;293:1082-8.

3. Sawka AM, Ray JG, Yi Q, et al. Randomized clinical trial of homocysteine level lowering therapy and fractures. Arch Intern Med 2007;167:2136-9.

Pregnancy and Postpartum Support and High Homocysteine
Dose: 750 mg daily taken under the supervision of a doctorThe relationship between folate status and the risk of miscarriage is also somewhat unclear. In some studies, women who have had habitual miscarriages were found to have elevated levels of homocysteine (a marker of folate deficiency).1, 2, 3, 4 In a preliminary study, 22 women with recurrent miscarriages who had elevated levels of homocysteine were treated with 15 mg per day of folic acid and 750 mg per day of vitamin B6, prior to and throughout their next pregnancy. This treatment reduced homocysteine levels to normal and was associated with 20 successful pregnancies.5 It is not known whether supplementing with these vitamins would help prevent miscarriages in women with normal homocysteine levels. As the amounts of folic acid and vitamin B6 used in this study were extremely large and potentially toxic, this treatment should be used only with the supervision of a doctor.
References

1. Sutterlin M, Bussen S, Ruppert D, Steck T. Serum levels of folate and cobalamin in women with recurrent spontaneous abortion. Hum Reprod 1997;12:2292-6.

2. Wouters MG, Boers GH, Blom HJ, et al. Hyperhomocysteinemia: a risk factor in women with unexplained recurrent early pregnancy loss. Fertil Steril 1993;60:820-5.

3. Steegers-Theunissen RP, Boers GH, Blom HJ, et al. Hyperhomocysteinaemia and recurrent spontaneous abortion or abruptio placentae. Lancet 1992;339:1122-3 [letter].

4. Quere I, Bellet H, Hoffet M, et al. A woman with five consecutive fetal deaths: case report and retrospective analysis of hyperhomocysteinemia prevalence in 100 consecutive women with recurrent miscarriages. Fertil Steril 1998;69:152-4.

5. Quere I, Mercier E, Bellet H, et al. Vitamin supplementation and pregnancy outcome in women with recurrent early pregnancy loss and hyperhomocysteinemia. Fertil Steril 2001;75:823-5.

Preeclampsia
Dose: Refer to label instructions

Women with preeclampsia have been shown to have elevated blood levels of homocysteine.1, 2, 3, 4 Research indicates elevated homocysteine occurs prior to the onset of preeclampsia.5 Elevated homocysteine damages the lining of blood vessels,6, 7, 8, 9, 10, 11, 12 which can lead to the preeclamptic signs of elevated blood pressure, swelling, and protein in the urine.13

In one preliminary trial, women with a previous pregnancy complicated by preeclampsia and high homocysteine supplemented with 5 mg of folic acid and 250 mg of vitamin B6 per day, successfully lowering homocysteine levels.14 In another trial studying the effect of vitamin B6 on preeclampsia incidence, supplementation with 5 mg of vitamin B6 twice per day significantly reduced the incidence of preeclampsia. Women in that study were not, however, evaluated for homocysteine levels.15 In fact, no studies have yet determined whether lowering elevated homocysteine reduces the incidence or severity of preeclampsia. Nevertheless, despite a lack of proof that elevated homocysteine levels cause preeclampsia, many doctors believe that pregnant women with elevated homocysteine should attempt to reduce those levels to normal.

References

1. Leeda M, Riyazi N, de Vries JI, et al. Effects of folic acid and vitamin B6 supplementation on women with hyperhomocysteinemia and a history of preeclampsia or fetal growth restriction. Am J Obstet Gynecol 1998;179:135-9.

2. Powers RW, Evans RW, Majors AK, et al. Plasma homocysteine concentration is increased in preeclampsia and is associated with evidence of endothelial activation. Am J Obstet Gynecol 1998;179:1605-11.

3. Rajkovic A, Catalano PM, Malinow MR. Elevated homocyst(e)ine levels with preeclampsia. Obstet Gynecol 1997;90:168-71.

4. Laivuori H, Kaaja R, Turpeinen U, et al. Plasma homocysteine levels elevated and inversely related to insulin sensitivity in preeclampsia. Obstet Gynecol 1999;93:489-93.

5. Sorensen TK, Malinow MR, Williams MA, et al. Elevated second-trimester serum homocyst(e)ine levels and subsequent risk of preeclampsia. Gynecol Obstet Invest 1999;48:98-103.

6. Powers RW, Evans RW, Majors AK, et al. Plasma homocysteine concentration is increased in preeclampsia and is associated with evidence of endothelial activation. Am J Obstet Gynecol 1998;179:1605-11.

7. Ray JG, Laskin CA. Folic acid and homocyst(e)ine metabolic defects and the risk of placental abruption, pre-eclampsia and spontaneous pregnancy loss: A systematic review. Placenta 1999;20:519-29 [review].

8. Sorensen TK, Malinow MR, Williams MA, et al. Elevated second-trimester serum homocyst(e)ine levels and subsequent risk of preeclampsia. Gynecol Obstet Invest 1999;48:98-103.

9. Roberts JM. Endothelial dysfunction in preeclampsia. Semin Reprod Endocrinol 1998;16:5-15.

10. Hayman R, Brockelsby J, Kenny L, Baker P. Preeclampsia: the endothelium, circulating factor(s) and vascular endothelial growth factor. J Soc Gynecol Investig 1999;6:3-10.

11. Lyall F, Greer IA. The vascular endothelium in normal pregnancy and pre-eclampsia. Rev Reprod 1996;1:107-16.

12. Roberts JM, Redman CWG. Pre-eclampsia: more than pregnancy-induced hypertension. Lancet 1994;341:1447-54.

13. Taylor RN, de Groot CJ, Cho YK, Lim KH. Circulating factors as markers and mediators of endothelial cell dysfunction in preeclampsia. Semin Reprod Endocrinol 1998;16:17-31.

14. Leeda M, Riyazi N, de Vries JI, et al. Effects of folic acid and vitamin B6 supplementation on women with hyperhomocysteinemia and a history of preeclampsia or fetal growth restriction. Am J Obstet Gynecol 1998;179:135-9.

15. Wachstein M, Graffeo LW. Influence of Vitamin B6 on the incidence of preeclampsia. Obstet Gynecol 1956;8:177-80.

Pre- and Post-Surgery Health
Dose: Refer to label instructions

Vitamin B1, given as intramuscular injections of 120 mg daily for several days before surgery, resulted in less reduction of immune system activity after surgery in a preliminary trial.1 In a controlled trial, an oral B vitamin combination providing 100 mg of B1, 200 mg of vitamin B6, and 200 mcg of vitamin B12 daily given for five weeks before surgery and for two weeks following surgery also prevented post-surgical reductions in immune activity.2 However, no research has explored any other benefits of B vitamin supplementation in surgery patients.

References

1. Vinogradov VV, Tarasov IuA, Tishin VS, et al. Thiamin prevention of the corticosteroid reaction after surgery. Probl Endokrinol (Mosk) 1981;27:11-6 [in Russian].

2. Lettko M, Meuer S. Vitamin B-induced prevention of stress-related immunosuppression. Ann NY Acad Sci 1990;585:513-5.

HIV and AIDS Support
Dose: Refer to label instructions

In HIV-positive people with B-vitamin deficiency, the use of B-complex vitamin supplements appears to delay progression to and death from AIDS.1 Thiamine (vitamin B1) deficiency has been identified in nearly one-quarter of people with AIDS.2 It has been suggested that a thiamine deficiency may contribute to some of the neurological abnormalities that are associated with AIDS. Vitamin B6 deficiency was found in more than one-third of HIV-positive men; vitamin B6 deficiency was associated with decreased immune function in this group.3 In a population study of HIV-positive people, intake of vitamin B6 at more than twice the recommended dietary allowance (RDA is 2 mg per day for men and 1.6 mg per day for women) was associated with improved survival.4 Low blood levels of folic acid and vitamin B12 are also common in HIV-positive people.5

References

1. Kanter AS, Spencer DC, Steinberg MH, et al. Supplemental vitamin B and progression to AIDS and death in black South African patients infected with HIV. J Acquir Immune Defic Syndr 1999;21:252-3 [letter].

2. Butterworth RF, Gaudreau C, Vincelette J, et al. Thiamine deficiency in AIDS. Lancet 1991;338:1086.

3. Baum MK, Mantero-Atienza E, Shor-Posner G, et al. Association of vitamin B6 status with parameters of immune function in early HIV-1 infection. J Acquir Immune Defic Syndr 1991;4:1122-32.

4. Tang AM, Graham NMH, Saah AJ. Effects of micronutrient intake on survival in human immunodeficiency type 1 infection. Am J Epidemiol 1996;143:1244-56.

5. Boudes P, Zittoun J, Sobel A. Folate, vitamin B12, and HIV infection. Lancet 1990;335:1401-2.

Vitamin B6 is the master vitamin for processing amino acids-the building blocks of all proteins and some hormones. Vitamin B6 helps to make and take apart many amino acids and is also needed to make the hormones, serotonin, melatonin, and dopamine.

Copyright 2014 Aisle7. All rights reserved. Aisle7.com

The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2015.

Label
To view the Label you will need Adobe Acrobat Reader installed. You can download a free copy of the Adobe Acrobat Reader at: http://www.adobe.com/acrobat/readstep.html
Ratings and Reviews
Ask A Question