Vitamin B6 Pyridoxine/P-5-P information:
 

I've been meaning to start an informational thread here for Vitamin B6 Pyridoxine. So here it is.

Please feel free to post here anything you feel is helpful to the subject, or ask questions. I will be adding to this thread frequently as I consolidate data that I find.

Many years ago, over 10 actually, I started posting about P-5-P on various health boards. This is an activated form of pyridoxine which is the form the body actually uses. Pyridoxine in most vitamins has to be converted to this form. That process may be inhibited by liver damage, or use of certain drugs (theophylline). Those interested in chemistry can view Pyridoxine here:
http://web.indstate.edu/thcme/mwking/vitamins.html

Today we have a new RX vitamin that contain P-5-P. It is called Metanx (promoted for neuropathies and homocysteine defense).
When looking at labels, look for the words coenzymated B6 as an ingredient.
The best manufacturers enteric coat their P-5-P like NOW brand does.

For now I'd like to give some links to B6 information.
This one is very good, and run by NIH
http://ods.od.nih.gov/factsheets/vitaminb6.asp

Another great source is The Linus Pauling Institute:
http://lpi.oregonstate.edu/infocente...nB6/index.html
This link provides alot of medical information about B6. It gives RDA recommendations, Toxicity warnings, and examples of food sources.

The University of Maryland has a great Alternative website, that cross references to drug use also.
http://www.umm.edu/altmed/articles/v...-b6-000337.htm

Vitamin B6 is really critical today. The lowering of homocysteine by conversion to SAM in the body is crucial for hundreds of chemical methylation reactions.
B6 works with B12 and folic acid to accomplish this.
So because of this focus, we hear more about B6 than we used to.
B6 is also used to prevent nausea in pregnancy. (the FDA approved its use a couple of years ago).

And B6 does so much, it is really very important to us. Over 100 drugs interfere with B6 in the body or deplete it.
Estrogens, many antibiotics, diuretics, INH, theophylline, penicillamine, Evista,
hydralazine are the families studied so far.

There has been an increased interest in a condition Pyroluria recently. This is a genetic trait that has an error in heme synthesis that creates a by-product called kryptopyrrole. While this is relatively harmless to the body, and is excreted in the urine, it complexes B6 and zinc while doing so and removes those nutrients from the body as well. We have an experienced poster who has done the testing here and I have invited her to come on this thread. Until then, the link below provides some information. I know there are others here, I just can't recall at this moment...so please feel free to post on this thread.
This can be tested using a urine sample, and requires a specialized laboratory to do it accurately. You can read more about that here:
http://www.pyroluriatesting.com/ This is the Pfeiffer Treatment Center

Vitamin B6 is a huge subject, so I will be adding to this thread as I gather data on various medical and alternative uses for it.

Mrs. D--
 

--just a question about the post--did you mean to put in a url link after the line "We have a long thread on Pyroluria here:" ? If you did, it didn't come up (at least for me).

Thanks Glenn...
 

I recalled that long thread by Ona...then after looking here, I realized it was
on "that other forum"... :o This happens when you get old you know...thoughts fly right out of your
brain sometimes and land somewhere else!

I'll edit the wording to reflect that.
I have asked a Pyroluria experienced person to come on...hope she does.

Pyridoxine B6 toxicity potential:
 

This thread will have information about this complex subject.

B6 is the most documented B vitamin in regards to toxicity. It is ironic that B6 deficiency causes a neuropathy. And that extreme excess of this vitamin also causes nerve damage.

I've gathered some links to illustrate both points.
I hope those interested here will read them carefully.

Here is a typical PubMed monograph about toxicity:
Because some people cannot activate B6 because pyridoxal kinase is damaged or not working for some genetic reason, B6 doses in that very low range may be indicative of NO active pyridoxal reaching the tissues.

Here is a good link I found at a nutrition website:
http://drirene.healthandage.com/qa3/qa280132.htm

And this one explains P-5-P and states that P-5-P has yet to have reported toxicities:
http://www.encyclopedia.com/doc/1G1-71948217.html

There have been over the years posters here and at another similar site,
asking why their plasma values of B6 are elevated, even though they do not
take supplements. It appears to be a puzzle, and I have always answered that perhaps they are not converting to active pyridoxal normally, and hence the B6 is high in the serum. B6 is however excreted as a water soluble vitamin by the kidneys.
Then I found this paper, that illustrated autistic patients, have elevated B6 levels:
Vitamin B6 is just very critical for our bodies to maintain health.
In the past there were experimental studies giving very high doses daily for PMS (500mg a day) and Carpal Tunnel Syndrome. The actual number of reported toxicities from these megadoses, was in the range of 15-20 patients, which is not really common. Given that people do not know their status of pyridoxal kinase, increasing doses past 100mg a day of regular pyridoxine, is not really going to increase one's response. So if you do not feel better, with B6 or if your homocysteine levels do not go down when you use it in conjunction with B12 and folic acid, then you need to consider taking the activated form called P-5-P. You may have to buy this online, but I have found it in stores, that carry, NOW brand aggressively. It is not as inexpensive as folic acid, but it is not really out of reach of most people, that is it is fair in price. A good quality P-5-P will be enteric coated to protect it from stomach acids.

There are a small number of people with a genetic disorder called pyridoxine dependency.
http://www.emedicine.com/ped/byname/...-syndromes.htm
This typically manifests in infancy as intractable seizures. And is reversed with very high doses of B6. This requires a doctor's supervision to find the dose of pyridoxine that works for each patient.

Also for pyroluria patients, B6 is critical. I suggest for these patients that P-5-P be used, since it is far more efficient biologically. 50mg/day is enough and any further increase in dose should be monitored by a doctor.

I had this link in my older B6 thread, and it is still active on the net:
http://www.nutrition4health.org/NOHAnews/NNSp99B6.html
and in this that link is this quote about P-5-P:
Edit to add: Here is a paper from 1992...where 5 normal people were given massive doses of pyridoxine 1 to 3 grams/day (1000 to 3000mg)--all five reacted with nerve damage:

mrsd, thank yo for this information. My PCP and I have been trying to understand why my B6 has been elevated.

I have discovered that even though my B12 is well within normal (last was over 700) I am functionally deficient in methyl-B12 as evidenced by lowering of my homocystiene levels to below high normal for the first time a week after starting sublingual methyl-B12 mega doses - this was a few weeks ago. I have developed a number of neurological symptoms, especially over the last year and a half that appeared to mimic MS. Many of those symptoms are improving now.

I guess its not such a far stretch of the imagination that my ability to covert B6 into P5P might be impaired as well.

This post is going to expand the P5P concept:
 

Today I am searching for more pyridoxal kinase problems. When I was first on the net 10 yrs + ago the data on pyridoxal kinase was just being released in some nutrition journals. Today there is much more available.

Here is an interesting 2007 paper that found that certain things in Gingko
block the actions of pyridoxal kinase:
And here is a paper on racial differences in red blood cells and pyridoxal kinase:
I don't have access however to the whole paper, to understand the meaning of it.

This paper is from 1997...and mentions alcohol:
This is another version of that paper...
Zinc deficiency may impact B6 metabolism:
This is a huge article and note the date 1982:

help!
 

Dear MrsD.

How would you feel about publishing a book entitled, "Vitamin b6 for dummies"?

I'm lost.

I suppose being six weeks into another neuro flare and loaded for bear with baclofen doesn't help my wee little brain.
But a gigantic THANK YOU to you for your helpful post and info.

b12 started @ 220 now up to 668! after nearly 2 years (big whup.)
b6- 92 ?!?!? what in the world- I don't even take vitamins but occassionally!

neuro is going to test zinc in this boat load of blood work.....he suspects my kidney issues to be partly the culprit..........I/he has no idea where to look for info, he's been asking around in his circles and no one knows anything about it.

This is a huge help, I can email my neuro with a the info you posted.

thanks so much!
lah

ps. Hi therese

Lah,

Sorry if we've already done this, but what type of B12 and how much have you been taking these two years?

rose

bumping up
 

With all the questions on other forums here about antidepressants, I thought it would be helpful to bump up this post, since B6 is so important to serotonin synthesis...

Thanks Mrsd..I did not know about the connection to serotonin. :hug: