WHAT IS VITAMIN B6 TOXICITY

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VITAMIN B6 (Pyridoxine Hydrochloride or Pyridoxal-5-Phosphate) TOXICITY is a very unrecognized but emerging epidemic that can cause widespread neurological damage to the body. It is not commonly recognized by most of the medical community and is often misdiagnosed. B6 toxicity can cause multiple different symptoms that can vary from person to person. Vitamin B6 is added to a variety of supplements and common food and drinks in amounts that would not normally be consumed in an average person’s diet. The (Recommended Daily Amount) RDA for B6 is around 1.3mg with much larger amounts being added to foods, drinks, and supplements. This large increase in fortification and supplement usage over the past decade or more has caused many to develop Vitamin B6 Toxicity. Since much of the medical community is not knowledgeable or even aware of the dangers of Vitamin B6 usage, many are never tested for it or even questioned on their current or past supplement usage when symptoms present. Many are misdiagnosed or never diagnosed at all (Idiopathic). For this reason, this group exists, as a place to increase awareness and share facts and experiences about Vitamin B6 Toxicity.
• TYPICAL SYMPTOMS OF B6 TOXICITY Not everyone experiences the same symptoms and these can vary dramatically from person to person. NEURO: Peripheral neuropathy or nerve damage to the feet, legs or hands is one of the most common symptoms of Vitamin B6 Toxicity. -Tingling, shocks/zaps, vibrations, ataxia, burning, numbness of feet, calves and/or hands, and headaches are also commonly reported. Other areas of the body sometimes affected are: OCULAR: Visual disturbances, ocular mirgraines (or migraine with aura), blurry vision (in one eye or both), “Visual Snow.” SENSORY /MOTOR: Trouble walking, heaviness of legs, sudden dizziness, ataxia, feeling like you are walking aboard a boat, proprioceptive difficulties. SKIN: rashes, itchy skin, goosebumps, hair Loss, tingling scalp/face. GASTROINTESTINAL ISSUES: Acid reflux, heartburn, indigestion, burning upper chest area, burning sensation of throat, mouth, tongue and/or lips. PSYCHOLOGICAL: Anxiety, restlessness, insomnia, depression, OCD disorder, possible agoraphobia NOTE: Vitamin B6 Toxicity can very much mirror symptoms of Diabetes or Multiple Sclerosis (MS), so do not be surprised if your doctor wants to test you for these when you present with your symptoms. We are not saying you should forego testing for these, as you should always heed what your doctor suggests. Many, however, upon testing negative for these, have been able to talk to their doctor about Vitamin B6 Toxicity as a possibility, test for it, and become relieved when they find out they do not have such a life-long and progressive disease to cope with. • IF YOU THINK YOU HAVE B6 TOXICITY, GET TESTED! Vitamin B6 levels can be tested by a doctor or in many countries, by oneself through a private lab. VITAMIN B6 LEVELS DO NOT STAY ELEVATED FOR LONG after stopping supplements due to the short half-life of 15-20 days. (Two to four weeks for most). For this reason, it is important to immediately obtain Vitamin B6 blood levels if one suspects B6 Toxicity. Each day after stopping supplements, levels will fall rapidly IN MOST people. For an accurate reading of your B6 levels, a lab draw should be completed as soon as possible, or the toxicity may be quickly missed and not recorded properly in your medical records. This can be important for leaves of absence from work, short term disability, social security disability and most importantly, for the peace of mind that the Vitamin B6 diagnosis is correct. If you have stopped supplements for a month or more, it may be too late to pull levels. Sometimes, levels will fall to normal in only 2 weeks of stopping supplements and fortified foods. TESTING OPTIONS If your doctor refuses to test you, here are some links to labs in the Australia that will allow you to test yourself. Fees can vary, but they are typically around $65-$100 AUD. Sometimes private labs will offer coupons for discounts if your are a first time customer, or offer them if your sign up for Email announcements or offers. **It takes an average of a week to get results back.** AFTER DIAGNOSIS • IF YOU ARE SUPPLEMENTING AND HAVE/HAD HIGH LEVELS Stop taking ALL supplements with B6 immediately. If you have not been tested, please see section above on GETTING TESTED and the details of getting an accurate B6 level reading. If you already have been tested and have a high level of B6, it is important to eliminate EXCESS b6 in one’s diet. The main concern is added Vitamin B6 to foods and drinks. Pyridoxine is added not only to vitamin supplements but to many other foods, drinks and supplements that most people don’t even realize. Make sure you check every label of your supplements for either “Vitamin B6” or “Pyridoxine HCI” or “Pyridoxine Hydrochloride.” Another form sometimes added is “P5P” or “Pyridoxal 5 Phosphate”. Check all labels and eliminate all food and drinks that contain synthetic B6 / pyridoxine! For those supplementing, usually just stopping the excess B6 in fortified foods, drinks and supplements allows the levels to return to normal within about 2 weeks to a month. • IF YOU ARE NOT SUPPLEMENTING AND HAVE/HAD HIGH LEVELS In our experience of watching members over time, there are two frequent causes of having high levels of B6, but no history of supplementing with B6 Vitamins. -The person is supplementing and doesn’t know it. Even small amounts in multivitamins and other supplements can cause toxicity. In addition, fortification of things like Red Bull, Powerade, and Vitamin Water can even cause or contribute to toxicity. Many members realize they were taking more B6 than they realized after checking their foods, drinks, and supplements. See CHECK ALL LABELS. -The person is on a high meat diet. Frequently, some of these members are on some type of a Paleo diet with a lot of meat, fish, vegetables, and fruits that are high in Vitamin B6. The ability to become toxic off food alone and not from a synthetic source has been doubted by some medical practitioners, but the trend among members leaves it undetermined. There are many theories on how this can happen, but none have been proven. NOTE- ***Upon stopping and getting levels down, symptoms gets worse before better. There is usually a period of time (a few weeks to a few months) where people feel an increase of symptoms upon stopping. This usually correlates with a large decrease in B6 blood levels. According to studies and member experiences, B6 levels return to normal and then can drop low for a small period of time before again returning to normal.*** Although we do not have a protocol for detoxing other than to remove excess and unnecessary added B6 in one’s diet, some members benefit from staying hydrated and keeping other vitamins and minerals at normal levels. Some choose to eliminate other unnecessary supplements as they can cause an increase in symptoms. Moderate exercise, sweating, massage, eating adequate protein, using magnesium, and drinking adequate electrolytes are just a few of the ways people try to calm symptoms and aid in their improvement. Trying any specific protocol is done at one’s own risk. Probiotics can also serve as a B-Complex vitamin in the gut. If you are not supplementing with any vitamins that contain Vitamin B6, or consuming any fortified foods containing Vitamin B6 – but are taking LIVE probiotics or consuming fermented foods or beverages, try eliminating them for a while and see if that helps alleviate symptoms and lowers serum levels of B6 upon further testing. Some members have had issues tolerating probiotics after toxicity. CHECK ALL LABELS Anything that you consume or put in your mouth might have synthetic pyridoxine added to it and could have caused/contributed to toxicity. Therefore, it is very important to check all labels of anything you eat, drink, or you take/took. It is VERY OFTEN hidden in things that one would not expect to have vitamins added to it. Examples include Melatonin, Emergen-C, Sleep Aids, Magnesium, Protein Shakes, prescribed hormonal supplements like Estrogen, Metanx, Anti-Nausea medications for pregnancy, and many more etc. So, check everything! NOTE–Some benefit from avoiding very high B6 foods like Avocados and Bananas, but everyone is different. We do not recommend limiting normal foods with B6 in them. Please see “A Few Warnings” below. WHAT CAUSES VITAMIN B6 TOXICITY? The exact cause for B6 Toxicity and what occurs in the body to cause damage to the nervous system has not been identified completely. Several theories have been proposed by doctors and researchers over the years, but there is yet to be one certain and identified cause of it. PROPOSED CAUSES Autoimmune reaction – This has been mainly proposed by the great Katharina Dalton and her study on women taking B6 for PMS. Katharina noted the increase in levels of her patients upon supplementing and the correlation with neurological symptoms. She also noted that her patients would have symptoms subsequently return on even very low doses in the future, indicating an autoimmune response. Her follow up of her study patients who took B6 and became toxic – vs her patients who never took B6 – showed a large increase in the diagnosis of autoimmune disorders in the years that followed (32% vs 3% in the control). This autoimmune theory could also explain why some can take B6 in large amounts or for long periods of time and then suddenly develop symptoms of toxicity. This original Dalton study can be found in the files section under “Dalton and Dalton Article.” A link to the follow-up debate on autoimmunity: http://www.thelancet.com/…/lan…/PIIS0140-6736(98)26027-2.pdf Enzyme blockage – A recent in vitro study (2017) showed results of a blockage or reduction in enzymes due to too much pyridoxine hydrochloride (B6). According to the study, this reduction in enzymes caused a deficiency of pyridoxal-5-phosphate in the cells leading to nerve cell damage and death. Unfortunately, this study excluded possible toxicity from other forms of Vitamin B6 and so has not been deemed to be completely accurate. Several forms of B6 have been implicated in causing toxicity. More research is needed. This study can be found in the files section. A link to the study: https://www.ncbi.nlm.nih.gov/pubmed/28716455 Direct neurological affects- This has also been suggested in an in vitro study that showed nerve cell death upon direct exposure to Pyridoxine Hydrochloride. The study is in the files section. HYPOPHOSPHATASIA: Hypophosphatasia is a very rare genetic disorder but in fact a genetic problem. This genetic problem can cause also just very mild symptoms or even you can be a carrier and never have a problem. If your ALP is mostly low just below the normal range (your entire life), it shows already very possible genetic problem. Again in severe cases, it causes soft bones but it presents in new borns or children. If anything happens in adulthood, it can be mild, no noticeable physical symptoms or simply loosing tooth in early adulthood and presents with short root canals on X ray. There are though other possibilities why ALP is low: low zinc, excessive D vitamin intake, low B vitamins. Firstly this needs to corrected and checked if ALP stays low. If you had chronically low ALP, it won’t go up so significantly like to 100 or something just sufficiently. Low ALP causes high B6 indeed, but high B6 do not cause low ALP. A link to the study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC423894/ MTHFR/Gene Mutation – This has been suggested by some, but NO DEFINITE LINK has ever been identified between MTHFR and B6 Toxicity. We have had many members who had B6 Toxicity who did not have the MTHFR gene and many that did. Unfortunately, many websites have jumped to link MTHFR with B6 Toxicity, even going so far as to suggest Pyridoxal-5-Phosphate (P5P), another version of Vitamin B6, as a remedy. This is dangerous. There has never been any verified link between MTHFR and Vitamin B6 Toxicity. Please see the files section for additional information on genetic research and B6 Toxicity. • THE REAL CAUSE**************************************** No matter the metabolic or autoimmune process that causes damage within the body, the outside cause remains the same, too much Vitamin B6 intake. PLEASE SEE “JOEY’S STORY” archived in the files section for some additional information and other theories. Since we were founded as an “Exploring” group with so little medical research on Vitamin B6 Toxicity available, the quest to find causes, remedies, and truth to B6 Toxicity is still an ongoing endeavor. A FEW MYTHS P5P OR PYRIDOXAL 5 PHOSPHATE – Some websites claim that P5P cannot cause toxicity. This is incorrect. Many people have become toxic off P5P and ended up with resulting neurological symptoms. P5P is not safer than Pyridoxine Hydrochloride and according to some sources, may actually be stronger. UPPER LIMITS – Some health practitioners and other sources claim that one cannot become toxic off small amounts of B6 and only very large amounts of B6 can cause toxicity. This is completely and totally incorrect and many people have become toxic off amounts as low as 1mg in their multivitamins or from other sources of fortification. Some countries have taken notice to the increased reports of toxicity on low amounts of B6 in supplements and have considered lowering their upper limits. More awareness is needed, but it is important to note that many people become toxic off small amounts of B6 in addition to their normal diet. A FEW WARNINGS I  DO NOT PROMOTE ANY PROTOCOLS OR SUPPLEMENTS. -Ingesting anything involves risk. For this reason, if you want to take any of the supplements that are mentioned in our group by members, we take no responsibility for the outcome and we would strongly advise you to do your own research first. If you’re under the care of a doctor, we strongly advise you to consult with your doctor or health care professional FIRST, to see if there are any conflicts with other medications or if any supplements can alter any treatment plans you are currently on. It is also a good idea to start with very small amounts to see how the body reacts. Always keep in mind that, just because something says “natural,” doesn’t mean it’s safe. -Once you have B6 intoxication, it is very important to stay away from all synthetic pyridoxine in supplements, food and drinks. Because taking synthetic Vitamin B6 again, even in the smallest of doses, may cause a relapse of symptoms or toxicity in the future. This is supported in the Dalton study: http://www.thelancet.com/…/lan…/PIIS0140-6736(98)26027-2.pdf I do NOT support avoiding organic or natural Vitamin B6 found naturally in food. I recommend eating real foods with moderate amounts of organic B6 while you are recovering because our body still needs B6. Avoiding ALL B6 can lead to deficiencies of other vitamins. Ironically, Vitamin B6 deficiency, which is very rare, mirrors many of the symptoms of Vitamin B6 Toxicity.
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Benjamin McAvoy

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    2 Comments

  1. Blanaid Meade
    September 24, 2020
    Reply

    Hi Benjamin,

    What is your opinion on prognosis? Do the nerves heal, and specifically the ocular disturbances?

    Also, if neurologist has diagnosed as migraine, what tests should be requested? I took 20mgs for 27 days before experiencing neuropathy symptoms. Since then my symptoms have changed and my main concern now is the visual disturbances.

    It’s great to find someone with so much knowledge on the topic.

    Thanks
    Blanaid

    • Benjamin McAvoy
      September 25, 2020
      Reply

      Hi there…
      Just some small info about me, I had levels that were unseen in Australia “normal range” <160 my levels were 2998. ! very high indeed. My GP prescribed me with 100mg of B6 per day, I already had 280mg in all of my other products that I was taking. I had all those symptoms that you were getting, crawling down my face, dizziness, feeling like fainting all the time.

      First thing first was the obvious, I stopped taking ALL Vitamins and minerals. I detoxed my liver and kidneys. Bicarb soda and water 1/4 tea spoon 4 x per day. 3.5 ltrs min of water per day.
      after 2 months my levels came down to 998, after 4 months all up I was down to 160, now I am at 120, I take a small does of B6 per day now (5mg) and this amount is plenty indeed, unless you have B6 lacking in your system. I do now make a good anti anxiety product, with P5P, 5 HTP, DL phenenaline, and a few minerals added. The reason I found most people were taking B6 was for depression and anxiety and found most had serotonin issues not lack of B6.

      Thank you for you comment
      Benjamin

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