This is their link:

http://www.spectracell.com/

I think there are other labs... the order must state intracellular testing (not serum).

I think for you, however, you will have some adjustments to make during treatment. It may take a while to get "stable" and have all the systems that use B6 and zinc operating well. You may have been low for a long time, etc.

I recently read that "jet airline fuel creates airborne carbonyl residues which may block the conversion of B6 to P5P in your body."

I live near an airport...

Does anyone know if the scientific claim quoted above is valid?

Mrs D.

I am fascinated by all of the information you have posted. My story is this: I was diagnosed with neurological lyme disease this summer. After extensive treatment, I took many vitamins to rebuild/reboost my system. Within the past two months, I started to experience neuropathy (tingling, numbness) in my hands and feet. My B6 levels were recently tested and my numbers are over 100 (no exact value was reported). Neuro cited B6 toxicity as the cause. I was taking a B-Complex vitamin daily, as well as a food-based multivitamin (I have since stopped taking both).
Fast forward to a follow up meeting with a lyme disease specialist, who suggested P5P. Is it possible I am not getting enough B6?
I am afraid of worsening the neuropathy and do not know what to do. Any advice? Should I take something? Avoid certain foods? How long will it take for neuropathy to resolve if it is, in fact, caused by B6?
The neuro has requested that I retest my blood levels after one month (this was two weeks ago).
Full disclosure -- the neuro has suggested that it is possible that I have CMT (due to my high arches).
Thank you in advance for any advice you may have. I am uncertain where else to go as this seems to be a poorly understood area.

Can you tell how much B6 you were taking daily?

This link and quote is considered medically accurate today.

from http://lpi.oregonstate.edu/infocente...ins/vitaminB6/

Blood level ranges do not reflect toxicity IMO. They were compiled from "normals" who were not taking vitamins when tested.
This link explains:
http://labtestsonline.org/understand...ranges?start=0

For example, the reference range for B12 in US today, still reports, results below 400 down to 200 as normal. And current medical opinion is that this is WRONG. There can be significant neurological damage in the 200-300 range. And conversely, a result over 850-1000 is considered out of range...but for B12 there is no upper safety limit in existence. High B12 reading in people NOT taking a vitamin supplement may however indicate a rare disease that has high B12 as a sign. But for people taking B12 for improving pernicious anemia, or other neuro reason, being high is desirable.

That is just one example. Being high in something can even be factitious...potassium is one test that can be done wrong and give a false high. If the blood sample is handled in such a way that the red cells burst, then the potassium spills out into the serum and gives that sample a high reading that is not reflective of the serum without burst cells. It is believed that some nutrient testing falls into this category too.

I've looked for papers --the few papers that describe real toxicity from too much B6---which years ago were made in response to PMS treatments that used 500mg-1000mg a day of B6 to treat PMS. I could not find any blood levels on those abstracts to support the neuropathy claims. It was then that the anecdotal reports detailed B6 neuropathy toxic results.
There are just not many in fact, but doctors hold onto to potential of it just the same, as they report low B12 as normal.

The only way to know more accurately if you are really high, is to have intracellular testing. And that information is on this thread before this post.

One would expect anyone taking vitamins to show that in the blood work. Toxic ranges for DRUGS are done however as part of the FDA approval process for animals and humans. Nutrients have not been elucidated in this way for vitamins. The FDA has "recommendations" called upper safety limits for most RDA vitamins today. And the Linus Pauling link I have here gives that.

It is not really necessary for people to go over 50mg a day IMO.
Some athletes go higher because pyridoxal is needed by muscle and people with Pyroluria lose B6 rapidly in the urine, so they tend to go higher, and typically use P5P for that reason. I have not seen ONE paper demonstrating that the active form P5P has the same toxic potential as the regular pyridoxine.(which may build up if not converted to P5P in the body).

So for you it really depends on what total amount you are taking daily. Sometimes nerves "wake up" during healing and give confusing symptoms, which may be interpreted as negative, but only reflect the healing process. That can confuse issues also.

Many antibiotics for Lyme chronic treatment do deplete B6 and other vitamins. So taking "some" is a good idea. But huge amounts are not typically necessary.

Hi,

I was taking 100mg in a B Complex Vitamin, 25 mg in a multivitamin, and I eat many foods rich in B6. I completely stopped taking the vitamins but a doctor suggested that perhaps the B6 was not being absorbed correctly and the P5P could help. I just didn't want to start taking the P5P and make things worse!

So -- as I understand what you have stated in your previous posts, my blood levels could be high but that doesn't mean toxicity...and that, in fact, I could be deficient in B6. Does B6 deficiency cause neuropathy as well?

Thanks in advance for your advice.

Yes, it can be confusing, and most doctors can't tell either.

Too little B6 leads to neuropathies. Then there is the very high doses which over time, can also cause nerve damage...which I believe is a bit different in presentation. A very fine difference.
B6 has this paradoxical problem which makes it very difficult to
diagnose, using symptoms.

If you are not converting pyridoxine to pyridoxal in the body then pyridoxine would build up, not be working biologically for you and show up in serum tests. If you stop the Bcomplex 100mg, and just take the P5P for a while--- most P5P's are not that high dose, you can see if you feel better. A multivit for the rest of the B's, could suffice. NOW brand is enteric coated and not expensive. Available on iherb.com
You'll want enteric coated because P5P is sensitive to stomach acid. Stay below 100mg a day, and you should be okay.
B6 pyridoxine requires B2 riboflavin to convert to active pyridoxal (using the enzyme pyridoxal kinase).
http://www.iherb.com/Now-Foods-P-5-P...blets/740?at=0
(this is an example).'

The hint here is that a study was done on autistic children, who were NOT taking any supplements. And they scored high in serum B6. That suggests something is "wrong", but the answer has not been confirmed as yet. So testing B6 is not like testing Digoxin or phenytoin, or lithium levels. With drugs, there are clear cut protocols that have been put in place before they were put on the market.

There might be an answer in some obscure text somewhere, but I haven't found it yet regarding the B6 lab ranges.
And the bottom line is that there have been very few, rare cases of toxicity documented at all.

Wow, that is really helpful. Do you know how quickly the neuropathy from B6 deficiency reverses? That is to say, how quickly would the neuropathy improve once I start taking the P5P?

Why is this so poorly researched? And may I ask (sorry if this is posted elsewhere), did you have a personal experience with B6 problems?

Hello I'm not sure if this thread is still active but i'll take the chance it's not. A few months ago I was diagnosed with Pyroluria, my Pyrrole levels were 24.6 HPL(ug/dL) Normalised. The strange thing was my b6 P5P levels were exceptionally elevated at 280 nmol/L (35-110), before the test i had never taken b6 supplements. My zinc levels were at the low end at 10.6 umol/L (9-19). I feel I have symptoms of peripheral neuropathy, I now have a constant tingling in my feet, and occasionally in my hands. I have transient numbness in areas of my feet, along with seldom transient pin prick sensations in my feet, hands, arms, and legs.
I understand elevated pyridoxine levels are caused by the inability of the liver to convert it to P5P, but I don't have elevated levels of pyridoxine, I have elevated levels of P5P. Can elevated levels of P5P cause PN? What can cause elevated levels of P5P if you have never supplemented with b6?
Any feedback would be much appreciated.

Thanks.

I don't think the answer to your question is known yet.

There are a few studies that do find elevated B6 levels, in some people who do not supplement. This suggests some genetic error in B6 utilization.

One study was accidentally found in autistic children, who were tested routinely before beginning B6 supplements. This study was to see if B6 helped their cognition and emotional response. What was unexpected was to find elevated B6 levels. They were not taking any supplements when tested.

Most people do not get tested for B6... so there is a huge unknown population out there who may reveal many problems in this area. What is puzzling is why this is not excreted by the kidney, which one would expect. I suspect some genetic error some where that causes this.

An example I found recently was regarding hereditary angioedema. One site suggested that family history for this genetic error, doesn't show up in some people. They suggested some kind of damage to the embryo during early development that damages the enzyme C-1 inhibitor, that removes bradykinin from the body. So that suggests an error during early development of the embryo may occur for other problems too, and those have not been discovered yet.

Do you know for sure that P5P was specifically tested for? My impressions of the B6 test are that it is not that specific.

Another possibility is factititious elevation due to handling by the lab or the blood sample. An example is potassium serum determinations, can be falsely elevated if the red cells burst (lyse) in the sample. I don't know if B6 in the red cells is high, since that is a specific thing only testing labs know IMO. But if your red cells burst and release B6, it could result in a false high reading. The cells can burst from too tight a tourniquet during the draw, or if a butterfly thin needle is used for small veins.
Usually the report will say Lysis of cells, somewhere on it, but not always. I just don't know if B6 can have this false high.

Labs seem to make mistakes also on nutrient testing. They don't seem to calibrate their machines carefully, etc. This happened twice in US with Quest labs, which reported false Vit D levels twice for at least a year each time!

I think you need to ask the lab itself about procedures etc. Often times doctors will re-run tests that are iffy.

Hey thanks for your reply mrsD, I had the test redone to confirm the results and the levels were pretty much the same. The test states it measured p5p levels. I made sure because I had only heard of unexplained elevated levels of Pyridoxine.
I recently learned that Hypophosphatasia(HPP) can cause elevated levels of p5p. Unfortunately I can't post links since I haven't made 10 posts or more, I joined this forum a few days ago. But if you google elevated levels of p5p there's information from the mayoclinic and others on HPP causing high p5p levels.
So there is a possible lead. I'll have tests done to possibly confirm Hypophosphatasia. Again thanks for your reply.