Vitamin B6

Introduction:
Vitamin B6 or pyridoxine is an essential, water soluble nutrient which is required for protein metabolism and body immunity. It has shown potential to reduce risk for cardiovascular events and seizures.

Required Daily amount:


Sources
a. Natural: Meat, poultry, fish, eggs, seeds and nuts, potatoes, green vegetables are good sources of vitamin B6. In India, soya bean, legumes (dals) peanuts, bananas and whole grain are also rich in pyridoxine.
b. Supplements: Cereals may be fortified with Vitamin B6 and it is also available as oral supplements as part of B complex medications. Isolated vitamin B6 is also available as a stand-alone medication in the form of pyridoxine hydrochloride.

Health Benefits of Vitamin B6

• Pyridoxine helps with the synthesis of neurotransmitters which leads to smooth functioning of the central nervous system and cognitive development
• It also helps in the formation of Red blood cells, which transport oxygen and nutrients to the body
• Aids in protein and amino acid metabolism
• Studies show that it lowers homocysteine levels and therefore decreases the risk of cardiovascular disease. It has also been used to decrease severe vomiting and nausea in pregnancy and relieves symptoms of pre-menstrual syndrome

Deficiency of Vitamin B6

• This may occur along with general nutritional deficiencies due to inadequate intake in diet.
• Chronic renal conditions
• Malabsorption of nutrients in the gut like ulcerative colitis or Crohn’s disease may cause decreased uptake of the vitamin from food sources.
• Alcohol dependence and autoimmune disorders like rheumatoid arthritis
• Long term use of drugs like anti-epileptic medications used for the treatment of seizures
• Rare genetic metabolic disease (Pyridoxal5-phosphate-dependent epilepsy) that causes seizures soon after babies are born (neonatal onset seizures) because of their inability to produce vitamin B6 in the body. Regular anticonvulsants do not work in this scenario and seizures can be controlled with pyridoxal 5 phosphate or pyridoxine, which are different forms of vitamin B6, provided as external supplements.

Individuals with Vitamin B6 deficiency may exhibit:

• Mood swings and irritability
• Decreased immune function with higher susceptibility to infections
• Cheilosis: cracked and core lips, at the corners of the mouths making chewing and talking difficult
• Skin rashes
• Glossitis: sore, red inflamed tongue, smooth due to the loss of raised papillae on the surface.
• Pins and Needles or tingling numbness in hands and feet
• Increased incidence of seizures

Excessive Intake of Pyridoxine

• Patients on prolonged administration vitamin B6 supplements, may exhibit signs of neuropathy with ataxia or loss of control of body movements
• Individuals may also exhibit photosensitivity, nausea and heartburn.

Interactions with other medications

1. Anti-epileptic drugs like valproic acid or carbamazepine and phenytoin cause increased metabolism of pyridoxine, causing low levels of vitamin B6 and elevated levels of homocysteine. These intensity and duration of these drugs may also be decreased. Patients on long term treatment with these medications may need pyridoxine supplements
2. Patients using theophylline, taken for asthma, bronchitis and emphysema, or using cycloserine (antibiotic) taken for tuberculosis, may also have lowered vitamin B6 levels, leading to neurological effects like seizures.

Diagnosis
Levels of pyridoxine can be determined from plasma or urine

Management
Patients who may be predisposed to low levels of pyridoxine due to concurrent drug interactions should be given supplements of vitamin b6. Individuals exhibiting general symptoms of vitamin deficiency or nutritional anemia are usually recommended changes in diet as well as total vitamin supplements.

Disclaimer: The above information is for awareness and education purposes only and cannot be used for diagnosis or treatment of any condition. Please consult with a physician for any concerns or questions