Vitamin B6 Deficiency

What Is Vitamin B6?

Vitamin B6 is a naturally available and water-soluble vitamin. Also known as Pyridoxine, it can be made available through the diet. Vitamin B6 has two active coenzymes: Pyridoxamine 5' phosphate and Pyridoxal 5' phosphate.

Hundreds of enzymatic reactions require vitamin B6 for carrying out various metabolisms of the body. Vitamin B6 is needed for the proper functioning of the immune system and conditions like pregnancy and lactation.

What Is the Recommended Intake of Vitamin B6?

The recommended intake of vitamin B6 is given in milligrams. The following table shows the recommended daily intake of vitamin B6 depending on the age:

What Are the Sources of Vitamin B6?

Vitamin B6 can be made available through either food or dietary supplements.

Food:

Vitamin B6 is available in several daily foods like organ meats, potatoes, starch vegetables, beef liver, and fruits.

The following are some important sources of vitamin B6:

• Breakfast cereals.

• Chickpeas.

• Tina fish.

• Potatoes.

• Turkey meat.

• Tofu.

• Salmon fish.

• Nuts.

• Watermelon.

• Onions.

• Cottage cheese.

• Banana.

• Chicken breast.

• Beef liver.

• Raisins.

• Spinach.

Dietary Supplements:

Vitamin B6 supplements can also be made available through supplements. Vitamin B complex tablets and several multivitamin tablets contain this vitamin. It is available in different forms like oral tablets, either chewable or sublingual, oral capsules, and liquids.

Use of vitamin B6 supplements is recommended in children below the age of 9 years or people above 51 years.

Pyridoxine hydrochloride is the available form of Vitamin B6 in dietary supplements.

What Are the Health Benefits of Vitamin B6?

1. Vitamin B6 helps in the production of hemoglobin and hence is useful in the treatment and prevention of anemia.

2. It regulates mood by helping in the synthesis of neurotransmitters like gamma-aminobutyric acid (GABA), dopamine, and serotonin. It thereby helps in reducing depression.

3. Because of its effect on neurotransmitters, vitamin B6 helps treat the emotional symptoms associated with premenstrual syndromes like irritability, depression, and anxiety.

4. Vitamin B6 also reduces the chances of cardiac diseases by preventing the clogging of arteries. This is because of the fact that increased homocysteine levels which are linked with heart diseases are reduced by vitamin B6.

5. There is ongoing research to support the role of Vitamin B6 in promoting brain function. If it can prevent the occurrence of Alzheimer’s disease is also under study.

6. It reduces the level of inflammation, hence it is also useful in treating the symptoms associated with rheumatoid arthritis.

7. Vitamin B6 also has a role in treating gestational nausea and vomiting.

8. Diseases of the eye can be prevented by taking vitamin B6. In particular, it helps in preventing age-related macular degeneration.

What Happens if I Take In Excess Vitamin B6?

While vitamin B6 toxicity does not usually occur by taking excessive foods that contain the vitamin, taking excessive dietary supplements can cause it.

The below table shows the daily threshold value of vitamin B6 in various groups of people:

The following are the signs of Vitamin B6 toxicity:

• Loss of nervous control.

• Nausea.

• Ugly-looking and painful skin patches.

• Photosensitivity.

• Heartburn.

What Are the Interactions of Vitamin B6?

• Phenytoin:

Vitamin B6 has significant drug interaction with Phenytoin, so vitamin B6 supplements should not be taken with Phenytoin. This is because Pyridoxine (vitamin B6) rapidly breaks down Phenytoin, thereby reducing its efficacy and increasing the chances of epileptic (unusual behavior due to abnormal brain activity) attacks.

• Amiodarone:

Vitamin B6 has moderate interactions with Amiodarone. When taken with Amiodarone, it increases sensitivity to sunlight and causes the formation of blisters, sunburn, and rashes. When taking these tablets, adequate protective measures should be taken while going out in the sun.

• Antihypertensive Drugs:

Vitamin B6 should be taken with caution with antihypertensive drugs as vitamin B6 itself has a lowering effect on blood pressure, and taking these two drugs together might highly reduce your blood pressure.

• Phenobarbital:

Vitamin B6 increases the speed at which Phenobarbital breaks down in the body, thus reducing the drug effects.

• Levodopa:

Vitamin B6 also breaks down and excretes Levodopa rapidly from the body, thereby decreasing its efficacy. However, when Levodopa is taken together with Carbidopa, these interactions do not occur.

While you are on any of these drugs, do not take Vitamin B6 on your own without the doctor's advice. To avoid serious drug interactions, inform your doctor about all the medications you take, including the vitamin or herbal supplements, before starting any drug.

What Causes Vitamin B6 Deficiency?

• Alcoholism.

• Malabsorption disorders.

• Intake of drugs that causes vitamin B6 depletion.

• Loss of vitamin B6 due to hemodialysis (artificial kidney to filter the waste from the blood in renal failure patients).

Who Is More Prone to Get Vitamin B6 Deficiency?

• People with kidney dysfunction.

• Individuals having alcohol dependence.

• People having autoimmune disorders like rheumatoid arthritis.

What Are the Signs of Vitamin B6 Deficiency?

1. Seborrheic Dermatitis: It is a manifestation of vitamin B6 deficiency characterized by red and itchy rashes in the areas of the face, scalp, upper part of the trunk, and neck. Disruption in collagen synthesis due to vitamin deficiency is responsible for this sign.

2. Glossitis: Glossitis is a condition in which your tongue loses its papillae (small bumps present on the tongue surface, which gives the tongue a rough surface) and appears painful, swollen, smooth, reddish, and shows signs of inflammation. Difficulty in chewing, speaking, and swallowing are associated with glossitis.

3. Cheilosis: The lip becomes reddish, painful, and swollen, and the corners of the lip exhibit cracks in a condition called cheilosis. These might bring about discomfort while taking food or speaking. At times, infection and bleeding can occur in these cracked areas.

4. Compromised Immune Function: Vitamin B6 deficiency decreases antibody and white blood cell production, which are needed to fight against infection and produce an immune response. Thus, it weakens the immune system making it difficult for the body to fight against inflammation, cancers, and infection.

5. Microcytic Anemia: Vitamin B6 is essential for the synthesis of hemoglobin. A reduced level of this vitamin decreases the level of RBC proteins which carry oxygen. When there is little oxygen due to decreased hemoglobin, anemia occurs. Fatigue and weakness are associated with anemia.

6. Mood Swings: Neurotransmitters (chemical messengers of the body) responsible for mood stabilization like gamma-aminobutyric acid (GABA) and serotonin require vitamin B6 for their synthesis. When there is a disruption in the level of vitamin B6, there is a drop in these neurotransmitters leading to mood changes like anxiety, depression, and irritability.

7. Seizures: The GABA neurotransmitters are needed to calm down the overstimulated brain. In vitamin B6 deficiency, there is a reduced level of this neurotransmitter which increases the risk of developing seizures.

8. Peripheral Neuropathy: Damage to the peripheral nerves is seen in vitamin B6 deficiency that produces pain and tingling sensation in the extremities. It is usually known by the name, 'pin and needle sensation'.

9. Increased Level of Homocysteine: Vitamin B6 is needed for the removal of Homocysteine, a protein byproduct, from the body. In vitamin B6 deficiency, homocysteine level may be abnormally increased which increases the risk of Alzheimer's disease and the damage caused to blood vessels and nerves.

How Can We Treat Vitamin B6 Deficiency?

Just like any other vitamin deficiency, administering vitamin B6 helps in reducing the signs and symptoms associated with this deficiency. The dosage and the route of administration are dependent on the symptom severity. In addition, treating the cause of vitamin B6 deficiency is essential.

In less severe cases, 25 mg to 600 mg of vitamin B6 can be given orally.

If there is an occurrence of seizures in infants below four weeks of age due to vitamin B6 deficiency, then 10 mg to 100 mg of Vitamin B6 is given intravenously.

Conclusion:

In vitamin B6 deficiency, the supplements can be helpful along with some dietary modifications. However, do not take vitamin B6 supplements without the doctor's advice, especially if you are on other drugs. While consulting a doctor, inform them about all the drugs you take, including the supplements, to avoid drug interactions. Vitamin B6 deficiency can be easily prevented by adding good sources of vitamins to our daily diet.