I agree that fluoroquinolones should be in a higher risk category than "minor or uncertain" for people with CMT. "The Annals of Pharmacology" published an article on 8/31/2011 about hereditary neuropathy being unmasked by levofloxacin. I had a similar experience to the patient who is described in this article.

Yes, that paper is posted here somewhere. ( on the Peripheral Neuropathy forum )

It begs the question as to how many other drugs will unmask reveal CMT in otherwise symptom free people.

It is very difficult to find lists of PN triggers that are inclusive.
When I search for them, they all differ in some way.

And the sporadic papers of B6 "toxicity" never give lab range of that patient mentioned either. It is possible it is so high because of calibration limits, etc. I only found one paper mentioning what dose the patient was taking.

Here is an article concerning this.

http://www.theannals.com/content/45/10/1312

However, it appears that this person and some of his family already had symptoms that seemed a bit obvious - at least to me.

In researching P5P products I ran across this review that is critical about the magnesium in the Now P-5-P.

at Amazon search for Now Foods P-5-P

The review was posted on 18 Apr 2013 (only 2 reviews posted)

Is this anything to be worried about?

Thanks

Mike

Solgar Pyridoxal-5-Phosphate (P-5-P) 50 mg Tablets (Specially Coated)

Does the "Specially Coated" mean it is encapsulated?

It lists Other Ingredients: Dicalcium Phosphate, Methacrylic Acid, Vegetable Cellulose, Vegetable Magnesium Stearate, Riboflavin, Titanium Dioxide, Glyceryl Triacetate, Vegetable Glycerin.

The UPC for 100 tabs is 033984023086.

Thanks

Specially coated means, to protect from stomach acids.

NOW also makes one that is a bit more affordable.

http://www.iherb.com/Now-Foods-P-5-P...60-Tablets/740

http://www.iherb.com/Solgar-P-5-P-50...-Tablets/12335

The word encapsulated typically means that something has been put into a capsule. It can be used to describe the tiny time beads found in some long acting products. The little beads are coated individually to change dissolution rates. It might be interesting to open a Metanx capsule and see if there is a little enteric coated pellet inside, containing the P5P?

Back in the olden days!!!... Darvon compound-65, which was a combination product capsule, had a pellet inside mixed into the powder. The pellet (the Darvon part) had a coating, to protect it from the aspirin that was in the powder. At that time I worked in a hospital and we had to make up placebos of Darvon Compound-65, for a specific doctor on the OB/GYN wing. He had many Darvon habituated patients, and typically used the placebos a day or two after hysterectomies. So we emptied out the manufacturer's capsules--removed the pellet, -- and replaced the contents with lactose, leaving the aspirin/caffeine intact.
Darvon was finally reformulated to remove the pellet:
http://www.leagle.com/xmlResult.aspx...985&SizeDisp=7
It became Darvon Napsylate..aka Darvon-N

The amount of magnesium in NOW's brand is really small. 75% is magnesium oxide, and that is not absorbed. It is too small an amount to be really laxative as well. A typical oral magnesium oxide laxative (Phillips brand caplets) is 500mg.
100mg ----of magnesium oxide 75% and mag taurate 25%.
No mag from the oxide will be absorbed and 25mg of mag taurate is a very small amount. But it looks "fancy" doesn't it?
Manufacturers do this to "beef up" they supplement lists to look more important. Many less reputable places use "proprietary mixture" to get away with not putting ingredients quantities on the label. NOW doesn't do that, thank goodness.

I suspect the magnesium is in there as a filler. There isn't much left to use as an inert filler when so many items are listed as NOT included. Magnesium also is used as an anticaking compound to improve flow of the powder inside the tablet pressing machines.
Magnesium stearate also serves this function. Both are not absorbed and instead pass out in the stool.
http://en.wikipedia.org/wiki/Anticaking_agent

Most people replying on "reviews" do not have chemistry/biopharmaceutical training. Please keep that in mind while reading them.

Thank you for the feedback. It looks like either product meets the criteria and are very similar with the price being a wash. I have used Solgar products in the past, but am not familiar with the Now brand. Based on your recommendation, Now Foods quality can be trusted. They also had a U.S. FDA dietary supplement general cGMP inspection in January, 2012 with no observations. See the letter at iherb: /i/info/pic/now_gmp.pdf.


Solgar, P-5-P, 50 mg, 100 Tablets @ $.16/tablet
UPC Code: 033984023086

P-5-P 50 mg - Specially Coated A Coenzyme Derived Form of B6 Pyridoxal-5-Phosphate (P-5-P) is the coenzyme form of vitamin B6. Solgar's P-5-P Tablets are specially coated for protection against degradation from stomach acids.

Other Ingredients
Dicalcium phosphate, methacrylic acid, vegetable cellulose, vegetable magnesium stearate, riboflavin, titanium dioxide, glyceryl triacetate, vegetable glycerin.

FREE OF: Gluten, Wheat, Dairy, Soy, Yeast, Sugar, Sodium, Artificial Flavor, Sweetener and Preservatives.


Now Foods, P-5-P, 50 mg, 60 Tablets @ $.17/tablet
UPC Code: 733739004604

50 mg Coenzyme P-5-P Enteric Coated with Magnesium and B2 Cofactors

Contains
Riboflavin (Vitamin B-2) 17 mg
Vitamin B-6 (from 50 mg Coenzyme Pyridoxal-5-Phosphate) 33 mg
Calcium (from Dicalcium Phosphate) 30 mg
Magnesium (from 75% Magnesium Oxide and
25% Magnesium Taurinate) 100 mg

Other Ingredients:
Croscarmellose Sodium, Cellulose, Stearic Acid (vegetable source), Magnesium Stearate (vegetable source) and Enteric Coating.