Vitamin B6

Uses

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.

What Are Star Ratings?

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

Used for Why
3 Stars
Anemia
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.

Deficiencies of iron, vitamin B12, and folic acid are the most common nutritional causes of anemia. Although rare, severe deficiencies of several other vitamins and minerals, including vitamin A,vitamin B2,,vitamin C, and copper, 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.
3 Stars
Anemia and Genetic Vitamin B6-Responsive Anemia
50 to 200 mg per day
Taking vitamin B6 may partially correct sideroblastic anemia, although they must be taken for life.

Sideroblastic anemia refers to a category of anemia featuring a buildup of iron-containing immature red blood cells (sideroblasts). One type of sideroblastic anemia is due to a genetic defect in an enzyme that uses as a cofactor. Vitamin B6 supplements of 50 to 200 mg per day partially correct the anemia, but must be taken for life.
3 Stars
Autism
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.

Uncontrolled and double-blind research shows that can be helpful for autistic children. 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.
3 Stars
Depression
20 mg twice daily
Oral contraceptives can deplete the body of vitamin B6, a nutrient needed for normal mental functioning. In such cases, vitamin B6 supplementation may improve mood.

Oral contraceptives can deplete the body of , a nutrient needed for maintenance of normal mental functioning. Double-blind research shows that women who are depressed and who have become depleted of vitamin B6 while taking oral contraceptives typically respond to vitamin B6 supplementation. In one trial, 20 mg of vitamin B6 were taken twice per day. Some evidence suggests that people who are depressed—even when not taking the oral contraceptive—are still more likely to be B6 deficient than people who are not depressed.

Several clinical trials also indicate that vitamin B6 supplementation helps alleviate depression associated with premenstrual syndrome (PMS), although the research remains inconsistent. Many doctors suggest that women who have depression associated with PMS take 100–300 mg of vitamin B6 per day—a level of intake that requires supervision by a doctor.
3 Stars
High Homocysteine (Folic Acid, Vitamin B12)
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.

, 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, 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. It also effectively lowers homocysteine in people on kidney dialysis. In 1996, the FDA required that all enriched flour, rice, pasta, cornmeal, and other grain products contain 140 mcg of folic acid per 3½ ounces. This level of fortification has led to a measurable decrease in homocysteine levels. However, even higher levels of food fortification with folic acid have been reported to be more effective in lowering homocysteine, 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.
3 Stars
Morning Sickness
10 to 25 mg three times daily
In two double-blind trials, supplementation with vitamin B6 significantly reduced the severity of morning sickness.

In two double-blind trials, supplementation with (10 or 25 mg three times per day) significantly reduced the severity of morning sickness.
3 Stars
Neuropathy (Folic Acid, Vitamin B12)
2,000 mcg methylcobalamin (B12); 3,000 mcg methylfolate (B9); and 35 mg pyridoxal 5-phosphate once to twice daily
B vitamins, and vitamin B12 in particular, may be helpful in treating various types of neuropathies. People with type 2 diabetes taking metformin should be monitored for B12 deficiency.
Vitamin B12 has demonstrated neuroprotective and analgesic effects and has been found to have benefits in treating peripheral neuropathy from various causes. Vitamin B12 deficiency is common in people with type 2 diabetes, and a widely used anti-diabetes medication, metformin, has been found to induce vitamin B12 deficiency. Vitamin B12 deficiency has been associated in some, but not all, studies with increased risk of diabetic neuropathy. A possible link between low folate levels and diabetic neuropathy has also been reported. Preliminary trials using combinations of active forms of oral vitamin B12, folate, and vitamin B6 found they have a positive effect on diabetic neuropathy symptoms and quality of life. In a comparison trial, vitamin B12 injections were found to be more effective than the pain medication, nortriptyline, for reducing diabetic neuropathy symptoms. One meta-analysis of 17 clinical trials found the combination of intramuscular or intravenous vitamin B12 plus intravenous alpha-lipoic acid may be more effective than vitamin B12 alone. The possible role of vitamin B12 and other B vitamins in preventing or treating chemotherapy-induced neuropathy is suggested by laboratory and animal research, but findings from human trials have not been conclusive.
3 Stars
Premenstrual Syndrome
100 to 200 mg per day on a regular basis
Many clinical trials show that taking vitamin B6 helps relieve PMS symptoms.

Many, though not all, clinical trials show that taking 50–400 mg of 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. 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.
3 Stars
Type 1 Diabetes
100 to 200 mg vitamin B6 daily
People with diabetes may have an increased need for vitamin B6. Supplementing with the vitamin may help maintain normal levels and prevent type 1 diabetes complications.
People with type 1 diabetes may have impaired vitamin B6 metabolism, resulting in increased susceptibility to deficiency. Vitamin B6, along with other B vitamins, is critical for homocysteine metabolism and may thereby reduce their risk of vascular complications of diabetes, particularly diabetes-related kidney disease. Research in people with type 1 diabetes showed supplementation with B1, B6, and B12 lowered elevated homocysteine levels and improved kidney function. Vitamin B6 alone, at doses of 100 to 500 mg per day, also improved kidney function in a group of people with type 1 diabetes-related kidney impairment. In children with type 1 diabetes, taking 100 mg of B6 per day for eight weeks led to improvements in blood vessel function. The benefits of B6 in people with diabetes may also be related to its apparent ability to prevent the formation of damaging advanced glycation end-products (AGEs).
2 Stars
Age-Related Cognitive Decline
20 mg daily
There is evidence that supplementing with vitamin B6 (pyridoxine) may improve memory performance, especially in people who are deficient.

(pyridoxine) deficiency is common among people over age 65. 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. 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.
2 Stars
Age-Related Cognitive Decline (Folic Acid, Vitamin B12)
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.

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.

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 Stars
Asthma
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.

deficiency is common in asthmatics. This deficiency may relate to the asthma itself or to certain asthma drugs (such as theophylline and aminophylline) that deplete vitamin B6. 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. 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. 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.
2 Stars
Carpal Tunnel Syndrome
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.

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

Several studies report that people with CTS are helped when given 100 mg of vitamin B6 three times per day. Although some researchers have found benefits with lesser amounts, using less than 100 mg taken three times per day for several months has often failed. 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. 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, although occasional problems have been reported in this range. Higher amounts are clearly toxic. 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.
2 Stars
Celiac Disease (Folic Acid, Vitamin B12)
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.
In 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. 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 Stars
Depression and Premenstrual Syndrome
Take under medical supervision: 100 to 300 mg daily
Several studies indicate that supplementing with vitamin B6 helps alleviate depression, including depression associated with PMS.

Oral contraceptives can deplete the body of , a nutrient needed for maintenance of normal mental functioning. Double-blind research shows that women who are depressed and who have become depleted of vitamin B6 while taking oral contraceptives typically respond to vitamin B6 supplementation. In one trial, 20 mg of vitamin B6 were taken twice per day. Some evidence suggests that people who are depressed—even when not taking the oral contraceptive—are still more likely to be B6 deficient than people who are not depressed.

Several clinical trials also indicate that vitamin B6 supplementation helps alleviate depression associated with premenstrual syndrome (PMS), although the research remains inconsistent. Many doctors suggest that women who have depression associated with PMS take 100–300 mg of vitamin B6 per day—a level of intake that requires supervision by a doctor.
2 Stars
Intermittent Claudication (Alpha-Linolenic Acid, Fish Oil, Folic Acid, Oleic Acid, Vitamin E)
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.

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 , 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.
2 Stars
Low Back Pain (Vitamin B1, Vitamin B12)
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.

A combination of vitamin B1, , and vitamin B12 has proved useful for preventing a relapse of a common type of back pain linked to vertebral syndromes, as well as reducing the amount of anti-inflammatory medications needed to control back pain, according to double-blind trials. 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. Such high amounts of vitamin B6 require supervision by a doctor.
2 Stars
Macular Degeneration (Folic Acid, Vitamin B12)
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.

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. 

2 Stars
MSG Sensitivity
Refer to label instructions
In one study, eight out of nine people stopped reacting to MSG when given vitamin B6. Many doctors suggest that people having MSG-sensitivity symptoms try supplementing with vitamin B6 for three months as a trial.

Years ago, researchers discovered that animals who were deficient in could not properly process MSG. Typical reactions to MSG have also been linked to vitamin B6 deficiency in people. In one study, eight out of nine such people stopped reacting to MSG when given 50 mg of vitamin B6 per day for at least 12 weeks.

The actual percentage of people with MSG sensitivity who are deficient in vitamin B6 and who respond to B6 supplementation is unknown. Nonetheless, many doctors suggest that people having MSG-sensitivity symptoms try supplementing with vitamin B6 for three months as a trial.
2 Stars
Pregnancy and Postpartum Support and High Homocysteine
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.
The 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). 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 , prior to and throughout their next pregnancy. This treatment reduced homocysteine levels to normal and was associated with 20 successful pregnancies. 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.
2 Stars
Schizophrenia
Consult a qualified healthcare practitioner
Vitamin B6 has been used in combination with niacin in the treatment of schizophrenia with some reported benefits.

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. 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 ) 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. Several later double-blind trials, including trials undertaken by the Canadian Mental Health Association, have been unable to reproduce these positive results. Early supporters of niacin therapy contend that many of these trials were poorly designed. 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.

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. 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.

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. 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.

Clinical trials of the effects of 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. In a preliminary trial, 60 mg per day of vitamin B6 resulted in symptomatic improvement in only 5% of schizophrenic patients after four weeks. 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.”

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-schizophrenics and the way the body uses L-tryptophan is altered in people with schizophrenia. In a preliminary trial, patients with schizophrenia were given 2–8 grams of L-tryptophan and 100 mg of daily. This resulted in decreased agitation and less fear and anxiety, but these improvements were not as great as those achieved with psychiatric medications. 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.
2 Stars
Schizophrenia and High Homocysteine (Folic Acid, Vitamin B12)
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.
In another double-blind study, daily supplementation with folic acid (2 mg), (25 mg), and vitamin B12 (400 mcg) for three months improved symptoms of schizophrenia compared with a placebo. 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.
2 Stars
Tooth Decay
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.

Test tube studies show that increases growth of beneficial mouth bacteria and decreases growth of cavity-causing bacteria. 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. 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.
2 Stars
Type 2 Diabetes
35 mg of pyridoxal 5-phosphate twice daily
People with type 2 diabetes, and especially those with diabetes complication, tend to have low levels of active vitamin B6, a nutrient needed for healthy metabolism.
Pyridoxal 5-phosphate (PLP), the active form of vitamin B6, is needed in the body for a wide array of metabolic processes. It also serves as an antioxidant and reduces formation of advanced glycation end-products (AGEs), which cause widespread damage to proteins and DNA. Laboratory and animal research suggests PLP inhibits enzymes involved in carbohydrate digestion and absorption, resulting in lower spikes in blood glucose levels after eating. Many people with diabetes have low blood levels of PLP, and levels are even lower in people with diabetes complications such as nerve damage (neuropathy) and kidney damage (nephropathy). In a preliminary trial, subjects with neuropathy due to type 2 diabetes were treated with 35 mg of PLP, along with 3 mg of methylfolate and 2 mg of methylcobalamin (B12), twice per day for four weeks, followed by the same regimen once per day for the rest of a full year. Nerve function was significantly improved after six months and further improved after one year of treatment. This same combination of B vitamins was found helpful in people with mild-to-moderate type 2 diabetes-related retinopathy after six months.
2 Stars
Type 2 Diabetes and Diabetic Neuropathy (Vitamin B1)
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.

A controlled trial in Africa found that supplementing with both vitamin B1 (25 mg per day) and (50 mg per day) led to significant improvement of symptoms of diabetic neuropathy after four weeks. 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. As a result, some doctors recommend that people with diabetic neuropathy supplement with vitamin B1, though the optimal level of intake remains unknown.

2 Stars
Vertigo
Consult a qualified healthcare practitioner
Studies have shown vitamin B6 to be effective at reducing symptoms.

Two preliminary human studies reported that supplementation reduced symptoms of vertigo produced with drugs in a laboratory setting. 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.
1 Star
Acne Vulgaris
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.

A preliminary report suggested that at 50 mg per day may alleviate premenstrual flare-ups of acne experienced by some women. 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. However, another preliminary report suggested that vitamin B6 supplements might exacerbate acne vulgaris.
1 Star
Alcohol Withdrawal
Refer to label instructions
Alcohol-related anxiety may be improved by a combination of vitamin B6, vitamin C, niacin, and vitamin E, though the high amounts of niacin and vitamin B6 used in the study need a doctor’s supervision.

The daily combination of 3 grams of vitamin C, 3 grams of niacin, 600 mg of , and 600 IU of vitamin E has been used by researchers from the University of Mississippi Medical Center in an attempt to reduce anxiety and depression in alcoholics. Although the effect of vitamin supplementation was no better than placebo in treating alcohol-associated depression, the vitamins did result in a significant drop in anxiety within three weeks of use. Because of possible side effects, anyone taking such high amounts of niacin and vitamin B6 must do so only under the care of a doctor.
1 Star
Alzheimer’s Disease (Coenzyme Q10, Iron)
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.

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 (180 mg). Mental status improved in both patients, and one became almost normal after six months.
1 Star
Amenorrhea
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.

Prolactin is a hormone that may be elevated in some cases of amenorrhea. A preliminary trial of 200 to 600 mg daily of 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. A number of other small, preliminary trials have not demonstrated an effect of either oral or injected vitamin B6 on prolactin levels, and they also have reported inconsistent effects on restoring menstruation. Larger, controlled trials are needed to better determine the usefulness of vitamin B6 in amenorrhea.
1 Star
Atherosclerosis
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.

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

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. 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). Similar results were seen in another study.

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. Of these four supplements, folic acid appears to be the most important. Attempts to lower homocysteine by simply changing the diet rather than by using vitamin supplements have not been successful.
1 Star
Attention Deficit–Hyperactivity Disorder
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.

B vitamins , particularly , have also been used for ADHD. Deficient levels of vitamin B6 have been detected in some ADHD patients. 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®). However, lower amounts of vitamin B6 were not beneficial. 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.
1 Star
Bulimia (L-Tryptophan)
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.

People with eating disorders who restrict their food intake are at risk for multiple nutrient deficiencies, including protein, calcium, iron, riboflavin, niacin,folic acid,vitamin A, vitamin C, and , and essential fatty acids. 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. 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, though not all studies have demonstrated these effects.

Weight-loss diets result in lower L-tryptophan and serotonin levels in women, 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 three times per day. Other double-blind studies using only L-tryptophan have failed to confirm these findings. 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.
1 Star
Celiac Disease
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.
In 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 Star
Epilepsy
Refer to label instructions
Vitamin B6 has helped children with seizures related to a genetic enzyme defect. However, it is not known whether supplementation would benefit people with epilepsy.

has been used to treat infants and small children who have seizures related to a genetic enzyme defect. However, this condition is not considered true epilepsy, and whether people with epilepsy would benefit from taking vitamin B6 supplements is unknown.
1 Star
Heart Attack
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.

High blood levels of the amino acid homocysteine have been linked to an increased risk of heart attack in most, though not all, 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.Folic acid and vitamins and B12 are known to lower homocysteine.

There is a clear association between low blood levels of folate and increased risk of heart attacks in men. 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.

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HIV and AIDS Support
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.

In HIV-positive people with B-vitamin deficiency, the use of B-complex vitamin supplements appears to delay progression to and death from AIDS. Thiamine (vitamin B1) deficiency has been identified in nearly one-quarter of people with AIDS. It has been suggested that a thiamine deficiency may contribute to some of the neurological abnormalities that are associated with AIDS. deficiency was found in more than one-third of HIV-positive men; vitamin B6 deficiency was associated with decreased immune function in this group. 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. Low blood levels of folic acid and vitamin B12 are also common in HIV-positive people.
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Hypoglycemia
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.

Research has shown that supplementing with chromium (200 mcg per day) or magnesium (340 mg per day) 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. Other nutrients, including vitamin C, vitamin E, zinc, copper, manganese, and , may help control blood sugar levels in diabetics. 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.
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Kidney Stones
Refer to label instructions
Taking vitamin B6 with magnesium can inhibit oxalate stone formation.

Both magnesium and 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. Vitamin B6 is also known to reduce elevated urinary oxalate in some stone formers who are not necessarily B6 deficient.

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. Most trials have shown that supplementing with magnesium and/or vitamin B6 significantly lowers the risk of forming kidney stones. Results have varied from only a slight reduction in recurrences to a greater than 90% decrease in recurrences.

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.

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.
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Osgood-Schlatter Disease (Manganese, Zinc)
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.

Another group of doctors has reported good results using a combination of zinc, manganese, and for people with Osgood-Schlatter disease; however, the amounts of these supplements were not mentioned in the report. 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.
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Osteoporosis and High Homocysteine
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.
Folic acid , , 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. 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. 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. 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.
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Parkinson’s Disease
Refer to label instructions
Vitamin B6 has been reported to improve Parkinson’s symptoms. It can be used in conjunction with L-dopa plus carbidopa (Sinemet) or selegiline (Eldepryl, Atapryl), rather than with L-dopa alone.
Although vitamin B6 was reported many years ago in preliminary research to improve symptoms of Parkinson’s disease, it must not be used by people taking L-dopa alone. Taking vitamin B6 with L-dopa increase the conversion of L-dopa to dopamine outside the brain, thereby reducing delivery of dopamine to the brain., However, vitamin B6 can be used in conjunction with L-dopa plus carbidopa (Sinemet) or seglegiline (Eldepryl, Atapryl).
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Photosensitivity
Refer to label instructions
Vitamin B6 has been used to successfully reduce reactions to sunlight.

Cases have been reported of people with photosensitivity who responded to supplementation. 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.
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Pre- and Post-Surgery Health
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.

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. In a controlled trial, an oral B vitamin combination providing 100 mg of B1, 200 mg of , 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. However, no research has explored any other benefits of B vitamin supplementation in surgery patients.
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Preeclampsia
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.

Women with preeclampsia have been shown to have elevated blood levels of homocysteine. Research indicates elevated homocysteine occurs prior to the onset of preeclampsia. Elevated homocysteine damages the lining of blood vessels, which can lead to the preeclamptic signs of elevated blood pressure, swelling, and protein in the urine.

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 per day, successfully lowering homocysteine levels. 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. 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.
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Seborrheic Dermatitis in Adults
Refer to label instructions
Topical applied vitamin B6 ointment improved adult seborrheic dermatitis in one study. However, oral vitamin B6 was ineffective.

One physician reported that injections of B-complex vitamins were useful in the treatment of seborrheic dermatitis in infants. A preliminary trial found that 10 mg per day of folic acid was helpful in 17 of 20 cases of adult seborrheic dermatitis. However, this study also found that oral folic acid did not benefit infants with cradle cap. A preliminary study found that topical application of ointment (containing 10 mg B6 per gram of ointment) to affected areas improved adult seborrheic dermatitis. 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. Oral administration of vitamin B12 for seborrheic dermatitis has not been studied.
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Sickle Cell Anemia
Refer to label instructions
Vitamin B6 has been shown to have anti-sickling effects on the red blood cells. It can also correct vitamin B6 deficiency, which is common in people with sickle cell anemia.

Preliminary research has found that patients with sickle cell anemia are more likely to have elevated blood levels of homocysteine compared to healthy people. Elevated homocysteine is recognized as a risk factor for cardiovascular disease. In particular, high levels of homocysteine in sickle cell anemia patients have been associated with a higher incidence of stroke. Deficiencies of , vitamin B12, and folic acid occur more frequently in people with sickle cell anemia than in others and are a cause of high homocysteine levels. A controlled trial found homocysteine levels were reduced 53% in children with sickle cell anemia receiving a 2–4 mg supplement of folic acid per day, depending on age, but vitamin B6 or B12 had no effect on homocysteine levels. A double-blind trial of children with sickle cell anemia found that children given 5 mg of folic acid per day had less painful swelling of the hands and feet compared with those receiving placebo, but blood abnormalities and impaired growth rate associated with sickle cell anemia were not improved. In the treatment of sickle cell anemia, folic acid is typically supplemented in amounts of 1,000 mcg daily. Anyone taking this amount of folic acid should have vitamin B12 status assessed by a healthcare professional.

In test tube studies, has been shown to have anti-sickling effects on the red blood cells of people with sickle cell anemia. Vitamin B6 deficiency has been reported in some research to be more common in people with sickle cell anemia than in healthy people. In a controlled trial, five sickle cell anemia patients with evidence of vitamin B6 deficiency were given 50 mg of vitamin B6 twice daily. The deficiency was reversed with this supplement, but improvement in anemia was slight and considered insignificant. Therefore, evidence in support of vitamin B6 supplementation for people with sickle cell anemia remains weak.
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Stroke and High Homocysteine
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.

Elevated blood levels of homocysteine, a toxic amino acid byproduct, have been linked to risk of stroke in most studies. Supplementation with folic acid, , and vitamin B12 generally lowers homocysteine levels in humans. 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%.
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Tardive Dyskinesia
Refer to label instructions
In some studies, taking vitamin B6 along with other nutrients appeared to prevent the development of tardive dyskinesia.

During a ten-year period, doctors at the North Nassau Mental Health Center in New York treated approximately 11,000 people with schizophrenia with a megavitamin regimen that included vitamin C (up to 4 grams per day), vitamin B3—either as niacin or niacinamide—(up to 4 grams per day), (up to 800 mg per day), and vitamin E (up to 1,200 IU per day). During that time, not a single new case of TD was seen, even though many of the people were taking neuroleptic drugs. Another psychiatrist who routinely used niacinamide, vitamin C, and vitamin B-complex over a 28-year period rarely saw TD develop in her patients. Further research is needed to determine which nutrients or combinations of nutrients were most important for preventing TD. The amounts of niacinamide and vitamin B6 used in this research may cause significant side effects and may require monitoring by a doctor.

How It Works

How to Use It

The most common supplemental intake is 10–25 mg per day. However, high amounts (100–200 mg per day or even more) may be recommended for certain conditions.

Where to Find It

Potatoes, bananas, raisin bran cereal, lentils, liver, turkey, and tuna are all good sources of vitamin B6.

Possible Deficiencies

Vitamin B6 deficiencies are thought to be very rare. Vitamin B6 deficiency can cause impaired immunity, skin lesions, and mental confusion. A marginal deficiency sometimes occurs in alcoholics, patients with kidney failure, and women using oral contraceptives. Some doctors believe that most diets do not provide optimal amounts of this vitamin. People with kidney failure have an increased risk of vitamin B6 deficiency.1 Vitamin B6 has also been reported to be deficient in some people with chronic fatigue syndrome.2

Best Form to Take

Vitamin B6 occurs naturally in three forms: pyridoxine, pyridoxal, and pyridoxamine. Pyridoxine and the phosphate ester of pyridoxal (pyridoxal 5’-phosphate, abbreviated PLP) are the most commonly used supplement forms of vitamin B6. Because nearly all studies showing a beneficial effect of vitamin B6 have used pyridoxine, it is generally preferred over PLP, even though PLP is the major biologically active form of vitamin B6. However, there may be some cases where PLP is more effective than pyridoxine, such as in cases of vitamin B6-responsive anemia, vitamin B6-dependent epilepsy, infantile spams, autism, and carpal tunnel syndrome.3

Interactions

Interactions with Supplements, Foods, & Other Compounds

Since vitamin B6 increases the bioavailability of magnesium, these nutrients are sometimes taken together.

Interactions with Medicines

Certain medicines interact with this supplement.

What Are Drug Interactions
Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • Amikacin

    Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K. Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

  • Amikacin Liposomal-Neb.Accessr

    Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K. Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

  • Carbidopa

    Test tube, animal, and preliminary human studies suggest that carbidopa may cause depletion of vitamin B6. However, the use of carbidopa with levodopa reduces the vitamin B6-depleting effects of levodopa. More research is needed to determine whether vitamin B6 supplementation is advisable when taking carbidopa.

  • Cortisone

    Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

  • Cycloserine

    Cycloserine may interfere with calcium and magnesium absorption. The clinical significance of these interactions is unclear.

    Cycloserine may interfere with the absorption and/or activity of folic acid, vitamin B6, and vitamin B12. The clinical importance of this interaction is unclear.

  • Demeclocycline

    Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, , vitamin B12, vitamin C, and vitamin K. This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study. The importance of this interaction is unknown.

  • Desogestrel-Ethinyl Estradiol
    Laboratory evidence of vitamin B6 deficiency is common in women taking oral contraceptives.
  • Dexamethasone

    Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

  • Dexamethasone Sod Phosphate-PF

    Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

  • Dexamethasone Sodium Phosphate

    Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

  • Doxycycline

    Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, , vitamin B12, vitamin C, and vitamin K. This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study. The importance of this interaction is unknown.

  • Drospirenone (Contraceptive)
    Laboratory evidence of vitamin B6 deficiency is common in women taking oral contraceptives.
  • Eravacycline

    Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, , vitamin B12, vitamin C, and vitamin K. This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study. The importance of this interaction is unknown.

  • Erythromycin

    Erythromycin may interfere with the absorption and/or activity of calcium, folic acid, magnesium, and vitamin B12, which may cause problems, especially with long-term erythromycin treatment. Until more is known, it makes sense for people taking erythromycin for longer than two weeks to supplement with a daily multivitamin-multimineral.

  • Erythromycin Stearate

    Vitamin B6 can bind to hydralazine to form a complex that is excreted in the urine, increasing vitamin B6 loss. This may lead to vitamin B6 deficiency. People taking hydralazine should consult with their doctor to discuss the possibility of vitamin B6 supplementation.

  • Estradiol-Drospirenone
    Laboratory evidence of vitamin B6 deficiency is common in women taking oral contraceptives.
  • Ethinyl Estradiol and Norethindrone
    Laboratory evidence of vitamin B6 deficiency is common in women taking oral contraceptives.
  • Ethinyl Estradiol and Norgestimate
    Laboratory evidence of vitamin B6 deficiency is common in women taking oral contraceptives.
  • Ethinyl Estradiol and Norgestrel
    Laboratory evidence of vitamin B6 deficiency is common in women taking oral contraceptives.
  • Gabapentin

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

  • Gentamicin

    Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K. Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

  • Gentamicin (Pediatric)

    Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K. Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

  • Gentamicin in Normal Saline

    Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K. Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

  • Gentamicin in Saline (Iso-osm)

    Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K. Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

  • Gentamicin Sulfate (Ped-PF)

    Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K. Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

  • Hydralazine

    Vitamin B6 can bind to hydralazine to form a complex that is excreted in the urine, increasing vitamin B6 loss. This may lead to vitamin B6 deficiency. People taking hydralazine should consult with their doctor to discuss the possibility of vitamin B6 supplementation.

  • Hydrocortisone Acetate

    Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

  • Hydrocortisone Sod Succinate

    Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

  • Hydromorphone

    Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

  • Isocarboxazid

    Phenelzine has a chemical structure similar to other drugs (isoniazid and hydralazine) that can cause vitamin B6 deficiency. One case of phenelzine-induced vitamin B6 deficiency has been reported. Little is known about this interaction. People taking phenelzine should ask their doctor about monitoring vitamin B6 levels and considering supplementation.

  • Isoniazid
    Supplementation with vitamin B6 is thought to help prevent isoniazid-induced niacin deficiency; however, small amounts of vitamin B6 (e.g. 10 mg per day) appear to be inadequate in some cases.

    Isoniazid can interfere with the activity of vitamin B6. Vitamin B6 supplementation is recommended, especially in people with poor nutritional status, to prevent development of isoniazid-induced peripheral neuritis (inflamed nerves). One case is reported in which injectable vitamin B6 reversed isoniazid-induced coma. In another case, however, 10 mg per day of vitamin B6 failed to reverse isoniazid-induced psychosis. The author suggested that higher amounts (e.g., 50 mg per day) may be needed. Although the optimal amount remains unknown, some doctors suggest that adults taking isoniazid supplement with 100 mg of vitamin B6 per day to prevent side effects. However, as animal studies suggest that very large amounts of vitamin B6 can interfere with the effect of isoniazid,people taking isoniazid should consult their doctor to determine the appropriate amount of vitamin B6 to take.

  • Levonorgestrel-Ethinyl Estrad
    Laboratory evidence of vitamin B6 deficiency is common in women taking oral contraceptives.
  • Mestranol and Norethindrone
    Laboratory evidence of vitamin B6 deficiency is common in women taking oral contraceptives.
  • Methylprednisolone

    Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

  • Methylprednisolone Acetate

    Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

  • Methylprednisolone Sodium Succ

    Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

  • Minocycline

    Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, , vitamin B12, vitamin C, and vitamin K. This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study. The importance of this interaction is unknown.

  • Minoxidil

    Vitamin B6 can bind to hydralazine to form a complex that is excreted in the urine, increasing vitamin B6 loss. This may lead to vitamin B6 deficiency. People taking hydralazine should consult with their doctor to discuss the possibility of vitamin B6 supplementation.

  • Neomycin

    Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K. Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

  • Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K. Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

  • Norethindrone (Contraceptive)
    Laboratory evidence of vitamin B6 deficiency is common in women taking oral contraceptives.
  • Norethindrone Ac-Eth Estradiol
    Laboratory evidence of vitamin B6 deficiency is common in women taking oral contraceptives.
  • Norgestimate-Ethinyl Estradiol
    Laboratory evidence of vitamin B6 deficiency is common in women taking oral contraceptives.
  • Norgestrel
    Laboratory evidence of vitamin B6 deficiency is common in women taking oral contraceptives.
  • Omadacycline

    Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, , vitamin B12, vitamin C, and vitamin K. This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study. The importance of this interaction is unknown.

  • Oxcarbazepine

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

  • Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, , vitamin B12, vitamin C, and vitamin K. This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study. The importance of this interaction is unknown.

  • Penicillamine

    Penicillamine may increase vitamin B6 excretion, reduce activity, and increase the risk for vitamin B6 deficiency. It makes sense for people taking penicillamine to supplement with small (5–20 mg per day) amounts of vitamin B6. Some researchers have suggested that as much as 50 mg per day of vitamin B6 may be necessary.

  • Phenelzine

    Phenelzine has a chemical structure similar to other drugs (isoniazid and hydralazine) that can cause vitamin B6 deficiency. One case of phenelzine-induced vitamin B6 deficiency has been reported. Little is known about this interaction. People taking phenelzine should ask their doctor about monitoring vitamin B6 levels and considering supplementation.

  • Phenobarbital

    One controlled study revealed that supplementing with 200 mg of vitamin B6 daily for four weeks resulted in a 45% reduction in phenobarbital blood levels. Therefore, people taking phenobarbital should probably avoid supplementing with large amounts of vitamin B6.

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

  • Plazomicin

    Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K. Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

  • Prednisolone

    Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

  • Prednisolone Acetate

    Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

  • Prednisolone Sodium Phosphate

    Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

  • Prednisone

    Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

  • Sarecycline

    Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, , vitamin B12, vitamin C, and vitamin K. This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study. The importance of this interaction is unknown.

  • Selegiline

    Phenelzine has a chemical structure similar to other drugs (isoniazid and hydralazine) that can cause vitamin B6 deficiency. One case of phenelzine-induced vitamin B6 deficiency has been reported. Little is known about this interaction. People taking phenelzine should ask their doctor about monitoring vitamin B6 levels and considering supplementation.

  • Streptomycin

    Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K. Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

  • Sulfamethoxazole

    Sulfonamides, including sulfamethoxazole, can interfere with the activity of folic acid, vitamin B6, and vitamin K. This is generally not a problem when taking sulfamethoxazole for two weeks or less. People taking sulfamethoxazole for longer than two weeks should ask their doctor about nutrient monitoring and supplementation.

    Note: Since sulfamethoxazole is often prescribed in combination with trimethoprim (for example, in Bactrim or Septra), it may be easy to associate this interaction with trimethoprim. However, this interaction is not known to occur with trimethoprim alone.

  • Tetracycline

    Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, , vitamin B12, vitamin C, and vitamin K. This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study. The importance of this interaction is unknown.

  • Theophylline

    Theophyline has been associated with depressed serum vitamin B6 levels in children with asthma and adults with chronic obstructive pulmonary disease. In a short-term study of healthy adults, theophylline reduced serum vitamin B6 levels and supplementation with vitamin B6 (10 mg per day) normalized vitamin B6 levels. Some doctors believe that it makes sense for people taking this drug to accompany it with 10 mg of vitamin B6 per day.

  • Tigecycline

    Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, , vitamin B12, vitamin C, and vitamin K. This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study. The importance of this interaction is unknown.

  • Tobramycin

    Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K. Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

  • Tobramycin Sulfate

    Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K. Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

  • Tranylcypromine

    Phenelzine has a chemical structure similar to other drugs (isoniazid and hydralazine) that can cause vitamin B6 deficiency. One case of phenelzine-induced vitamin B6 deficiency has been reported. Little is known about this interaction. People taking phenelzine should ask their doctor about monitoring vitamin B6 levels and considering supplementation.

  • Triamcinolone

    Corticosteroids may increase the loss of vitamin B6. One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids. Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

  • Trimethoprim/ Sulfamethoxazole

    Sulfonamides, including sulfamethoxazole, can interfere with the activity of folic acid and vitamin B6. This is generally not a problem when taking sulfamethoxazole for two weeks or less. People taking sulfamethoxazole for longer than two weeks should ask their doctor about nutrient monitoring and supplementation.

  • Valproate

    Preliminary research has linked anticonvulsant therapy with possible depletion of vitamin B6 in children. One preliminary study found that a combination of 10–50 mg per 2.2 pounds of body weight of vitamin B6 plus valproic acid was more effective than valproic acid or vitamin B6 alone at treating children with recurrent seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

Reduce Side Effects

  • Desogestrel-Ethinyl Estradiol
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Docetaxel

    Docetaxel may cause a reddening, swelling, and pain in hands and feet. Two cases have been reported of people suffering these drug-induced symptoms and responding to 50 mg of vitamin B6 given three times per day. Symptoms began to resolve in 12 to 24 hours and continued to improve for several weeks.

  • Drospirenone (Contraceptive)
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Ethinyl Estradiol and Levonorgestrel
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Ethinyl Estradiol and Norethindrone
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Ethinyl Estradiol and Norgestimate
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Ethinyl Estradiol and Norgestrel
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Fenofibrate

    Increased blood levels of homocysteine are associated with increased risk of atherosclerosis and heart disease. One study revealed that fenofibrate dramatically increases blood homocysteine levels, though blood levels of vitamins were not reduced. In one study, supplementation with 10 mg per day of folic acid prevented the increase in homocysteine levels resulting from fenofibrate therapy. Further research is needed to determine whether supplemental  vitamin B6 and vitamin B12, which are also capable of lowering homocysteine levels, might lower fenofibrate-induced elevations in homocysteine levels.

  • Fluorouracil

    Fluorouracil occasionally causes problems on the skin of the palms and soles. Preliminary reports have appeared showing that 100 mg per day of vitamin B6 can sometimes eliminate the pain associated with this drug-induced condition.

  • Levonorgestrel-Ethinyl Estrad

    Oral contraceptives have been associated with vitamin B6 depletion and clinical depression. In a small, double-blind study of women with depression taking oral contraceptivess, vitamin B6 (20 mg twice per day) improved depression. Half of the women in the study showed laboratory evidence of vitamin B6 deficiency.

  • Norethindrone (Contraceptive)
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Norgestimate-Ethinyl Estradiol
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Norgestrel
    In a double-blind trial, supplementation with 20 mg of vitamin B6 twice a day for 2 months improved depression in women taking oral contraceptives who had laboratory evidence of vitamin B6 deficiency. However, vitamin B6 did not relieve depression in women who did not have vitamin B6 deficiency.
  • Risperidone

    Vitamin E along with vitamin B6 was used to treat a side effect of risperidone called neuroleptic malignant syndrome in a 74-year-old woman, and results were encouraging. However, whether vitamin E and vitamin B6 supplementation might help prevent this condition in people taking risperidone is unknown.

Support Medicine

  • Amitriptyline

    Giving 10 mg per day each of vitamins B1, B2, and to elderly, depressed persons already on tricyclic antidepressants improved their depression and ability to think more than placebo did. The subjects in this study were institutionalized, so it is unclear if these results apply to persons living at home.

  • Clomipramine

    Giving 10 mg per day each of vitamins B1, B2, and to elderly, depressed persons already on tricyclic antidepressants improved their depression and ability to think more than placebo did. The subjects in this study were institutionalized, so it is unclear if these results apply to persons living at home.

  • Desipramine

    Giving 10 mg per day each of vitamins B1, B2, and to elderly, depressed persons already on tricyclic antidepressants improved their depression and ability to think more than placebo did. The subjects in this study were institutionalized, so it is unclear if these results apply to persons living at home.

    Combination of 6 grams per day L-tryptophan and 1,500 mg per day niacinamide (a form of vitamin B3) with imipramine has shown to be more effective than imipramine alone for people with bipolar disorder. These levels did not improve the effects of imipramine in people with depression. Lower amounts (4 grams per day of L-tryptophan and 1,000 mg per day of niacinamide) did show some tendency to enhance the effect of imipramine.

    The importance of the amount of L-tryptophan was confirmed in other studies, suggesting that if too much L-tryptophan (6 grams per day) is used, it is not beneficial, while levels around 4 grams per day may make tricyclic antidepressants work better.

  • Doxepin

    Giving 10 mg per day each of vitamins B1, B2, and to elderly, depressed persons already on tricyclic antidepressants improved their depression and ability to think more than placebo did. The subjects in this study were institutionalized, so it is unclear if these results apply to persons living at home.

  • Folic Acid

    Folic acid and vitamin B6 have been used to reduce elevated blood levels of homocysteine, which has been associated with atherosclerosis. One controlled study showed that taking 0.3 mg of folic acid together with 120 mg of vitamin B6 reduced homocysteine levels more than taking either vitamin alone. The study also revealed that long-term supplementation with vitamin B6 alone might reduce blood folic acid levels. Therefore, people with elevated blood homocysteine levels should supplement with both folic acid and vitamin B6.

  • Hydroxychloroquine

    An individual who took hydroxychloroquine and vitamin B6 together for nine years experienced a complete disappearance of skin nodules caused by rheumatoid arthritis. Controlled study is needed to determine whether taking vitamin B6 with or without hydroxychloroquine might help eliminate nodules in people with rheumatoid arthritis.

  • Imipramine

    Giving 10 mg per day each of vitamins B1, B2, and to elderly, depressed persons already on tricyclic antidepressants improved their depression and ability to think more than placebo did. The subjects in this study were institutionalized, so it is unclear if these results apply to persons living at home.

  • Nortriptyline

    Giving 10 mg per day each of vitamins B1, B2, and to elderly, depressed persons already on tricyclic antidepressants improved their depression and ability to think more than placebo did. The subjects in this study were institutionalized, so it is unclear if these results apply to persons living at home.

  • Protriptyline

    Giving 10 mg per day each of vitamins B1, B2, and to elderly, depressed persons already on tricyclic antidepressants improved their depression and ability to think more than placebo did. The subjects in this study were institutionalized, so it is unclear if these results apply to persons living at home.

  • Trimipramine

    Giving 10 mg per day each of vitamins B1, B2, and to elderly, depressed persons already on tricyclic antidepressants improved their depression and ability to think more than placebo did. The subjects in this study were institutionalized, so it is unclear if these results apply to persons living at home.

Reduces Effectiveness

  • Phenobarbital

    One controlled study revealed that supplementing with 200 mg of vitamin B6 daily for four weeks resulted in a 45% reduction in phenobarbital blood levels. Therefore, people taking phenobarbital should probably avoid supplementing with large amounts of vitamin B6.

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

Potential Negative Interaction

  • none

Explanation Required

  • Carbamazepine

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

  • Carbidopa-Levodopa

    Vitamin B6 supplementation above 5–10 mg per day reduces the effectiveness of levodopa. However, combining levodopa with carbidopa prevents this adverse effect, so vitamin B6 supplements may safely be taken with Sinemet® (carbidopa/levodopa).

  • Felbamate

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

  • Gentamicin

    Gentamicin administration has been associated with vitamin B6 depletion in rabbits. The authors of this study mention early evidence that vitamin B6 administration may protect against gentamicin-induced kidney damage.

  • Levetiracetam

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

  • Phenytoin

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

  • Primidone

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

  • Topiramate

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

  • Zonisamide

    One controlled study revealed that taking anticonvulsant drugs dramatically reduces blood levels of vitamin B6. A nutritional deficiency of vitamin B6 can lead to an increase in homocysteine blood levels, which has been associated with atherosclerosis. Vitamin B6 deficiency is also associated with symptoms such as dizziness, fatigue, mental depression, and seizures. On the other hand, supplementation with large amounts of vitamin B6 (80–200 mg per day) has been reported to reduce blood levels of some anticonvulsant drugs, which could theoretically trigger seizures. People taking multiple anticonvulsant drugs should discuss with their doctor whether supplementing with vitamin B6 is advisable.

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.

Side Effects

Side Effects

Vitamin B6 is usually safe, at intakes up to 200 mg per day in adults.4 However, neurological side effects can sometimes occur at that level.5 Levels higher than 200 mg are more likely to cause such problems. Vitamin B6 toxicity can damage sensory nerves, leading to numbness in the hands and feet as well as difficulty walking. The National Academy of Sciences performed an analysis of vitamin B6 studies. They determined the safe upper limit for long-term use is 100 mg per day. However, under supervision of a healthcare professional, up to 200 mg per day of vitamin B6 can be safely taken by most men and nonpregnant women for limited periods of time. Pregnant and breast-feeding women should not take more than 100 mg of vitamin B6 per day without a doctor’s supervision.

In a double-blind trial, people with diabetes who also had with kidney disease received a daily placebo or 2.5 mg of folic acid, 1 mg of vitamin B12, and 25 mg of vitamin B6 for three years. Compared with the placebo, vitamin supplementation accelerated the decline in kidney function and increased the incidence of cardiovascular events (such as heart attacks) and heart disease-related deaths.6 Based on this study, diabetics with kidney disease should not take these vitamins without a doctor's supervision.

References

1. Makoff R. Vitamin replacement therapy in renal failure patients. Miner Electrolyte Metab 1999;25:349-51 [review].

2. Heap LC, Peters TJ, Wessely S. Vitamin B status in patients with chronic fatigue syndrome. J R Soc Med 1999;92:183-5.

3. Gaby, AR. Nutritional Medicine. Concord, NH: Fritz Perlberg Publishing, 2011.

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

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

6. House AA, Eliasziw M, Cattran DC, et al. Effect of B-vitamin therapy on progression of diabetic nephropathy. A randomized controlled trial. JAMA 2010;303:1603-9.

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