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Pyridoxine (Vitamin B6)


What is it?

Pyridoxine is a vitamin. It can be found in certain foods such as cereals, beans, vegetables, liver, meat, and eggs. It can also be made in a laboratory.

Pyridoxine is used for preventing and treating low levels of pyridoxine (pyridoxine deficiency) and the “tired blood” (anemia) that may result. It is also used for heart disease; high cholesterol; reducing blood levels of homocysteine, a chemical that might be linked to heart disease; and helping clogged arteries stay open after a balloon procedure to unblock them (angioplasty).

Women use pyridoxine for premenstrual syndrome (PMS) and other menstruation problems, "morning sickness" (nausea and vomiting) in early pregnancy, stopping milk flow after childbirth, depression related to pregnancy or using birth control pills, and symptoms of menopause.

Pyridoxine is also used for Alzheimer's disease, attention deficit-hyperactivity disorder (ADHD), Down syndrome, autism, diabetes and related nerve pain, sickle cell anemia, migraine headaches, asthma, carpal tunnel syndrome, night leg cramps, muscle cramps, arthritis, allergies, acne and various other skin conditions, and infertility. It is also used for dizziness, motion sickness, preventing the eye disease age-related macular degeneration (AMD), seizures, convulsions due to fever, and movement disorders (tardive dyskinesia, hyperkinesis, chorea), as well as for increasing appetite and helping people remember dreams.

Some people use pyridoxine for boosting the immune system, eye infections, bladder infections, and preventing cancer and kidney stones.

Pyridoxine is also used to overcome certain harmful side effects related to radiation treatment and treatment with medications such as mitomycin, procarbazine, cycloserine, fluorouracil, hydrazine, isoniazid, penicillamine, and vincristine.

Pyridoxine is frequently used in combination with other B vitamins in vitamin B complex products.

You may remember a prescription medication called Bendectin that was used for morning sickness in pregnancy. Bendectin contained pyridoxine and a sleep-inducing antihistamine called doxylamine. The makers of Bendectin took it off the market in 1983 because they were running up expensive legal bills in defense of their product. Opponents charged it might be responsible for birth defects. Meanwhile, a product called Diclectin that is similar to Bendectin remained available in Canada, and there was research showing that neither pyridoxine nor Bendectin seems to cause birth defects in animals. After Bendectin was removed from the market, there was no reduction in birth defects, but hospitalization rates for pregnancy-related nausea and vomiting doubled.

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for PYRIDOXINE (VITAMIN B6) are as follows:

Effective for...

  • Treatment and prevention of pyridoxine deficiency.
  • Treating a type of anemia called sideroblastic anemia.
  • Treating some types of seizures in infants when given intravenously (by IV).

Likely effective for...

  • Reducing high blood levels of homocysteine, a substance thought to be involved in heart disease.

Possibly effective for...

  • Upset stomach and vomiting in pregnancy. Some research suggests pyridoxine does not improve symptoms of mild to moderate nausea as much as severe nausea. The American College of Obstetrics and Gynecology considers pyridoxine a first-line treatment for nausea and vomiting caused by pregnancy. Pyridoxine plus the medication doxylamine is recommended for women who don't get better when treated with just pyridoxine.
  • Premenstrual syndrome (PMS) symptoms such as breast pain and depression. The lowest effective dose should be used. Higher doses will increase the chance of side effects.
  • Kidney stones. There is some evidence that taking pyridoxine alone or combined with magnesium can decrease the risk of kidney stones in people with type I primary hyperoxaluria, a hereditary disorder. But, it doesn't appear to help people with other kinds of kidney stones.
  • Movement disorders (tardive dyskinesia) in people taking medicines for mental disorders.
  • Behavior disorders in children with low levels of a brain chemical called serotonin.
  • Reducing lung cancer risk in men who smoke.
  • Macular degeneration. Some research shows that taking pyridoxine with other vitamins including folic acid and vitamin B12 might help prevent getting the eye disease called macular degeneration.

Possibly ineffective for...

  • Autism.
  • Carpal tunnel syndrome.
  • Preventing another stroke.
  • Alzheimer's disease.
  • Improving thinking and memory in people aged 65 and older, when used in combination with folic acid and vitamin B12.

Insufficient evidence to rate effectiveness for...

  • Preventing re-blockage of blood vessels after angioplasty.
  • Boosting the immune system.
  • Muscle cramps.
  • Eye problems.
  • Kidney problems.
  • Night leg cramps.
  • Arthritis.
  • Allergies.
  • Asthma.
  • Attention deficit-hyperactivity disorder (ADHD).
  • Lyme disease.
  • Nerve problems caused by diabetes.
  • Nerve problems after treatment with vincristine.
  • Other conditions.
More evidence is needed to rate pyridoxine for these uses.

How does it work?

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Pyridoxine is required for the proper function of sugars, fats, and proteins in the body. It is also required for the proper growth and development of the brain, nerves, skin, and many other parts of the body.

Are there safety concerns?

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Pyridoxine is LIKELY SAFE for most people. In some people, pyridoxine might cause nausea, vomiting, stomach pain, loss of appetite, headache, tingling, sleepiness, and other side effects.

Long-term use of high doses is POSSIBLY UNSAFE. It might cause certain brain and nerve problems.

Special precautions & warnings:

Pregnancy and breast-feeding: Pyridoxine is LIKELY SAFE for pregnant women when taken under the supervision of their healthcare provider. It is sometimes used in pregnancy to control morning sickness. High doses are UNSAFE. High doses can cause newborns to have seizures.

Pyridoxine is LIKELY SAFE for breast-feeding women when used in amounts not larger than 2 mg per day (the recommended dietary allowance). Avoid using higher amounts. Not enough is known about the safety of pyridoxine at higher doses in breast-feeding women.

Are there interactions with medications?

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Major

Do not take this combination.

Phenytoin (Dilantin)
The body breaks down phenytoin (Dilantin) to get rid of it. Pyridoxine (vitamin B6) might increase how quickly the body breaks down phenytoin. Taking pyridoxine (vitamin B6) and taking phenytoin (Dilantin) might decrease the effectiveness of phenytoin (Dilantin) and increase the possibility of seizures. Do not take large doses of pyridoxine (vitamin B6) if you are taking phenytoin (Dilantin).

Moderate

Be cautious with this combination.

Amiodarone (Cordarone)
Amiodarone (Cordarone) might increase your sensitivity to sunlight. Taking vitamin B6 (pyridoxine) along with amiodarone (Cordarone) might increase the chances of sunburn, blistering, or rashes on areas of skin exposed to sunlight. Be sure to wear sunblock and protective clothing when spending time in the sun.

Phenobarbital (Luminal)
The body breaks down phenobarbital (Luminal) to get rid of it. Pyridoxine might increase how quickly the body breaks down phenobarbital (Luminal). This could decrease the effectiveness of phenobarbital (Luminal).

Minor

Be watchful with this combination.

Levodopa
The body breaks down levodopa to get rid of it. Vitamin B6 (pyridoxine) can increase how quickly the body breaks down and gets rid of levodopa. But this is only a problem if you are taking levodopa alone. Most people take levodopa along with carbidopa (Sinemet). Carbidopa prevents this interaction from occurring. If you are taking levodopa without carbidopa, do not take vitamin B6.

Are there interactions with herbs and supplements?

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There are no known interactions with herbs and supplements.

Are there interactions with foods?

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There are no known interactions with foods.

What dose is used?

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The following doses have been studied in scientific research:

BY MOUTH:
  • For vitamin B6 deficiency in adults: the typical dose is 2.5-25 mg daily for three weeks, then 1.5-2.5 mg per day as maintenance treatment.
  • For vitamin B6 deficiency in women taking birth control pills: the dose is 25-30 mg per day.
  • For symptoms of premenstrual syndrome (PMS): the daily dose is 50-100 mg. Doses as high as 500 mg per day have been used, but daily doses over 100 mg don't appear to have additional benefit, and may increase the risk for harmful side effects.
  • For hereditary sideroblastic anemia: initially 200-600 mg per day is used, decreasing to 30-50 mg daily after improvement.
  • For kidney stones: 25-500 mg daily has been used.
  • For treating tardive dyskinesia: 100 mg per day has been increased weekly up to 400 mg per day, given in two divided doses.
  • For preventing macular degeneration: 50 mg daily in combination with vitamin B12 (cyanocobalamin) 1000 mcg, and folic acid 2500 mcg.
  • For nausea during pregnancy: 10-25 mg pyridoxine three or four times daily has been used; alternatively, 75 mg of sustained-release pyridoxine combined with 12 mcg vitamin B12 (cyanocobalamin), 1 mg folic acid, and 200 mg calcium (PremesisRx) is used daily as an FDA-approved prescription product for nausea during pregnancy.
The daily recommended dietary allowances (RDAs) of vitamin B6 are: Infants 0-6 months, 0.1 mg; Infants 7-12 months, 0.3 mg; Children 1-3 years, 0.5 mg; Children 4-8 years, 0.6 mg; Children 9-13 years, 1 mg; Males 14-50 years, 1.3 mg; Males over 50 years, 1.7 mg; Females 14-18 years, 1.2 mg; Females 19-50 years, 1.3 mg; Females over 50 years, 1.5 mg; Pregnant women, 1.9 mg; and breast-feeding women, 2 mg. Some researchers think the RDA for women 19-50 years should be increased to 1.5-1.7 mg per day. The recommended maximum daily intake is: Children 1-3 years, 30 mg; Children 4-8 years, 40 mg; Children 9-13 years, 60 mg; Adults, pregnant and breast-feeding women, 14-18 years, 80 mg; and Adults, pregnant and breast-feeding women, over 18 years, 100 mg.

Other names

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Adermine Chlorhydrate, Adermine Hydrochloride, B Complex Vitamin, B6, Chlorhydrate de pyridoxine, Complexe de Vitamines B, Phosphate de Pyridoxal, Piridoxina, Pyridoxal, Pyridoxal Phosphate, Pyridoxal 5 Phosphate, Pyridoxal-5-Phosphate, Pyridoxamine, Pyridoxine HCl, Pyridoxine Hydrochloride, Pyridoxine-5-Phosphate, P5P, P-5-P, Vitamin B-6, Vitamina B6, Vitamine B6.

Methodology

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To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).

References

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To see all references for the Pyridoxine (Vitamin B6) page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/934.html.

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