There’s rising consciousness of uncommon, however doubtlessly critical unwanted effects from excessive doses of vitamin B6, a nutrient that’s turn out to be standard in a spread of dietary dietary supplements, electrolyte drinks and fortified meals.
Vitamin B6, or pyridoxine, is a nutrient important to many bodily capabilities, together with nerve well being, protein metabolism and blood sugar regulation. As a result of vitamin B6 can be very important to mind growth, it’s essential throughout being pregnant and infancy. It’s typically promoted to assist increase vitality, in addition to relieve stress.
It naturally happens in lots of meals and is added to various ready-to-eat merchandise, particularly cereals. Most multivitamins comprise B6, in keeping with the Nationwide Institutes of Well being’s Workplace of Dietary Dietary supplements.
Some vitality drinks additionally comprise it as a caffeine different, stated Jamie Alan, an affiliate professor of pharmacology and toxicology at Michigan State College.
“Folks is perhaps shocked, the variety of locations B nutritional vitamins happen,” she stated.
That’s a part of the issue.
In excessive doses, B6 can accumulate in physique tissues and trigger nerve injury, neurologist Dr. Norman Latov, director of the Peripheral Neuropathy Medical and Analysis Middle at Weill Cornell Drugs in New York, stated.
In November, suspected vitamin B6 poisonings prompted the Australian authorities to tighten restrictions on dietary supplements containing excessive quantities of the nutrient. Starting mid-2027, merchandise containing greater than 50 milligrams per day by day dose will likely be offered behind the counter at pharmacies; these exceeding 200 mg already require a prescription.
Nonetheless, vitamin B6 merchandise proceed to surge in recognition. Their international market share is projected to exceed $712 million by 2030, with a 5.8% compound annual progress fee from 2024 to 2030, in keeping with analysis analytics agency IndustryArc.
Poisoning is uncommon, though incidences are rising. Nationwide, 439 instances of vitamin B6 publicity had been reported in 2024, none of which was deadly, up from 369 in 2019 and 311 in 2014, Nationwide Poison Knowledge System information present.
Joanne Slavin, a registered dietitian and professor of meals science and diet on the College of Minnesota, stated many individuals assume that water-soluble nutritional vitamins, together with B6, are innocent. In contrast to fat-soluble nutritional vitamins, that are saved within the liver, muscle groups and fatty tissue, water-soluble nutritional vitamins are launched within the urine and due to this fact should be consumed frequently.
“Folks want to know that nutritional vitamins will not be inert — they’re chemical substances,” Slavin stated. “You don’t must overdo them.”
B6 toxicity could also be underreported as a result of signs construct regularly and shoppers will not be conscious they’re getting an excessive amount of. “It sneaks up on you,” stated Latov, estimating that 5% to 10% of sufferers with neuropathy on the Weill Cornell middle have excessive ranges of B6.
Early indicators are occasional numbness within the toes, which is perhaps ignored, adopted by the feeling of warmth, chilly, stinging or tingling that begins within the toes and might transfer up the leg, Latov stated.
Different signs might embody nerve ache, numbness, imbalance, muscle weak point and blood strain adjustments, in addition to fatigue, heartburn and nausea.
A blood take a look at can decide if ranges of B6 are extreme.
“There’s a reasonably large margin of security for B6, which suggests you may take a good quantity over the beneficial dose and nonetheless be high quality,” Alan stated. “However something at a excessive sufficient dose goes to have dangerous unwanted effects — even water.”
Colorado lady recounts ‘scary’ vitamin B6 poisoning
When Blair Huddy moved from California to Colorado in 2024, she stated everybody suggested her to remain hydrated, partially as a result of dehydration can worsen the consequences of altitude illness.
So Huddy, now 36, started utilizing an electrolyte drink combine in December of that yr. She stated she consumed the product as soon as day by day as directed, mixing one packet with 16 ounces of water. The label stated every packet incorporates 1.93 mg, or 110% of the beneficial day by day quantity, of vitamin B6.
Straight away, Huddy stated she started experiencing unexplained signs of vertigo, coronary heart palpitations and adrenaline surges. Unaware of a potential hyperlink, she stored utilizing the electrolyte packets. By January 2025, she additionally was having seasonal allergy-like signs and shortly after started having hassle sleeping. In March, she tried hen liver for the primary time — organ meats are wealthy in vitamin B6 — and was hospitalized with suspected anaphylaxis and coronary heart problems. She’d by no means earlier than had an allergic response to meals and stated docs couldn’t clarify it.
“It was actually scary. I had no thought what was taking place to me,” Huddy stated. “I used to be persevering with to devour one [drink mix packet] day-after-day, considering I used to be simply hydrating myself.”
After she received out of the hospital, Huddy developed peripheral neuropathy, an umbrella time period for ailments affecting the nervous system exterior the mind and spinal wire, and tinnitus.
“I stored going again to the physician simply time and again and over and was like, ‘one thing is admittedly fallacious,’” Huddy stated, including that she was instructed her signs had been a figment of her generalized anxiousness dysfunction. “I stored getting dismissed and stored getting despatched house.”
In Could, Huddy stated she begged a health care provider to run blood exams.
“A nurse from the physician’s workplace referred to as me and stated, ‘Your vitamin B6 ranges are greater than twice the higher restrict,’” Huddy stated. “‘No matter it’s that you just’re taking that has B6 in it, it’s worthwhile to cease.’”
What’s a protected quantity of vitamin B6?
The beneficial day by day requirement of B6 ranges from 1.3 mg for youthful adults to 1.5 mg for girls over 50 and 1.7 mg for older males.
Vitamin B6-rich meals embody poultry, fish, beef liver and different organ meats, potatoes and different starchy greens, and noncitrus fruits. Most individuals get sufficient from their food regimen, consultants say.
The U.S. has a comparatively excessive higher restrict of vitamin B6 for adults: 100 mg. The European Meals Security Authority, for instance, set a most of 12 mg per day. The restrict is 50 mg in Australia.
The Council for Accountable Vitamin, a commerce affiliation representing complement producers, established its personal supplemental B6 higher restrict of 100 mg per day. That is the quantity that may be safely consumed by the final wholesome inhabitants, stated Andrea Wong, the group’s senior vp and chief science officer. Folks with sure well being circumstances might have or tolerate kind of.
“It would rely upon the person and your physique’s metabolism and skill to course of the vitamin,” Wong stated, later including, “There are such a lot of different components that may contribute to no matter potential impact you’re having.”
A small 2020 research printed within the journal PharmaNutrition discovered that components equivalent to food regimen, genetics and medicine use might have an effect on vitamin B6 toxicity — even on the beneficial day by day quantity.
Vitamin B6 might seem on diet labels as pyridoxine, pyridoxal or pyridoxamine, referring to its totally different chemical varieties.
“You’ll want to take a look at all of the totally different sources that you just’re taking and add up that complete quantity to just remember to are getting what’s best for you,” Wong stated.
Vitamin B6 can stay within the physique for 30 to 40 days. If you happen to cease taking it, signs ought to get higher, Latov stated, though “relying on how a lot injury, the nerves might not regenerate utterly.”
Huddy attributes her poisoning to the electrolyte drink combine, which she consumed day by day for six months. She doubts her food regimen was an element and stated she didn’t take different dietary supplements.
She continues to get better, though she has some lingering tinnitus and is in bodily remedy for nerve points. She’s resumed working and brought on one other, unofficial job: offering assist for others with vitamin B6 toxicity.
“I want that I had someone who might stroll me by means of it the best way that I’m now capable of stroll different folks by means of it,” Huddy stated.
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