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Is there a golden bullet to reduce serum vitamin B6 / pyridoxine?

Since early/mid-June 2013 I know  I have elevated vitamin  B6 in my blood: Pyridoxal phosphate (active B6) at ~150 nmol/l (reference 40-110) and pyridoxal  at ~300 nmol/l (reference <20). The symptoms that I have fit with B6 toxicity: muscle twinkling/facilitations, altered senses, fuzzy headaches, tingling throughout the body (from leg to back, from tongue to finger), numbness, odd skin lesions/acne like rash, diarrhea, sensitive lower ribs,  etc. Earlier I was found to have seriously reduced serum vitamin D at 24 nmol/l (reference 50-150) two months ago, which also my contribute to the long list of symtomps I suffered. I started Vit D supplementation and blood results show that Vitamin D levels are getting higher. I have not been taking any other vitamin supplements. And I don’t consume extraordinary volumes of B6 containing foods or drinks. At this moment it is not known if the B6 value is part of an decreasing or increasing serum B6 trend. At this point I also cannot exclude other health issues are involved that evoke my symptoms.

February/March of this year I became really sick with some sort of hyperventilation episodes (very high heart rate, muscles frozen, cold hands, extremely tired etc) after minimal physical activity, diarrhea, fever, coughing, fatigue etc. And at one point I started to develop the neuromuscular symptoms. Not all at the same time, not all with the same harshness. Nothing specific was found in blood tests, X-rays and examinations by a neurologist, cardiologist and physician: nothing except for these 2 vitamins.  It was on my own advice to have vitamins tested: Blood was tested in April for vitamin D and tested for B6 end of May. Since April my endurance and physical condition is improving, albeit very slowly, and symptoms have not gone _ I must admit I experience more "better" days than 2 months ago. Still, the ups and downs, the slow progress, all is making me frustrated, scared and uncertain at times.

After all,I probably had signs in earlier years which may have been connected to my current condition - but thse signs lasted often short and not severe.  I lived in the fast lane of life, with growing up kids, traveling through time zones, high work load, too little sleep, irregular sleeping times, various traumatic events etc. I hardly exercised. In January 2013 I had flu (at least that’s what I thought it was) followed by intercontinental traveling, as well as in February I had intercontinental traveling. After that I totally broke down. Not knowing what was wrong. Burn out? Postviral syndrome?

In the last years I used antacids since I suffer from a reflux issue due to problem with the gastric valve. Tested negative for Lyme. I am a 44 years old man.

My “recovery” strategy since March of this year so far, regardless of the B6, was to:
• Take sufficient rest and start restructuring my life (needed anyway)
• Focus on other (fun) things, distract myself from the health issues. Constant odd physical sensations make that often difficult
• Exercise (be aware of your limits and take time to recover from exercising)
• Drink sufficient water
• Have higher awareness of food habits. I already had a relatively healthy diet, nevertheless I stopped coffee and snacks and focused more on fruits and vegetables.
• Yoga to relax and strengthen my muscles
• Physical therapy to improve my endurance and strengthen the muscles

Now with the knowledge of having high B6 I adjusted my strategy a little:
• Further avoidance of high B6 containing foods. There are various sites and books that list the B6 content of foods and drinks
• No intake of probiotics – they may produce B6 in your guts. Although I am not sure if this is true. I already had stopped antacids since I thought this was connected to diarhea issues I had.

Unfortunately I have not discovered a golden bullet to reduce B6. Exercising, water and reduction of B6 intake are the most commonly mentioned strategies. Additionally, magnesium and B12 intake was also recommended to reduce B6. I have no idea whether these approaches work or not, and why they would work.

Numerous people have described a similar situation of high serum vitamin B6. Unfortunately most stories stop after some time: Are they healthy again or what happened to these people? It also seems the frequency of this high B6 phenomenon is not high, but on the other hand the group could be larger since GPs not always have vitamins checked.

Is there a commonality between all the high vitamin B6 sufferers (especially the ones who don’t have a high vitamin B6 intake) ? I hope you can respond and share your insights or experiences.
• Connection to stress, viral infection or burn-out? What happened 1-6 months prior the onset of your problems. I believe that the flu and 2 intercontinental flights fired up my condition of which I believe it was already building up in the months before.
• Connection to other vitamin abnormalities, such as reduced vitamin D or changed Vitamin B12 level?  I wonder if my low vitamin D hampered vit B6 clearance or did the high B6 hamper the vitamin D update or production by skin?
• Connection to antacids or other stomach/gastrointestinal problems? Low stomach acid may favor growth of B6 producing bacteria.
• Connection to high sensitivity persons ? It is not  aformal medical term, but ~10-20% of the population appears to be high sensitive, which may also be reflected in physical differences
• Often one checks if an individual parameter is within a normal range, but what is known about the “optimal” ratios between vitamins and minerals in blood serum? And isn’t a normal range or optimal ratio dependent on the individual (one shoe does not fit all)?
• Is there a relation to geography, age, gender, genetics etc?
• What expertise is the best to consult? Neurologist, endocrinologist, orthomolecular therapist etc? Possibly a combination? I believe that B6 is elevated through a cascade of events in your body and a multidisciplinary approach is warranted. To me this area seems to still a very green field.

I am looking forward to responses either in reply to this post or by mail. As a patient and a scientist I am anxious to getter better insight in the elevated B6 situation. I also will share new insights and developments.

Best to you all.
15 Responses
1711789 tn?1361311607
Hi there!

B6 toxicity is unlikely to develop at mildly elevated levels and the symptoms described are unlikely to be related; while a few of these could be related to low vitamin D levels. Other possible causes that may need to be considered include stress. anxiety, metabolic issues. electrolyte imbalance, micronutrient deficiencies, medication side effect, neurological causes, cardiovascular causes, infections/ inflammations etc. I would suggest getting this evaluated by an internist initially and depending on the cause diagnosed/ suspected, it can be managed accordingly or specialist acre may be sought.
Hope this is helpful.

Take care!

I just found out that my B6 is double the normal range although I am considered fit and exercise normally.  But I got curious when you questioned if it is somehow related to either Gastroentestinal problems or Vitamin D.  I am someone who has to take vitamin D and prilosec daily.   I stopped taking the Calcium and magnesium vitamin that did have 5mg of B6 per pill.  I will be retaking the blood test again in couple of months.  If it doesn't go down it means that it was not related to vitamin I was taking.  I will keep you posted.
Avatar universal
Thank you

I think you are right. More specialists have indicated it to me and also my own research leads to that conclusion.

Furthermore one should be careful about reading the blood levels. The levels are often transient and may not reflect the issue in the tissues, as well as normal levels may differ per person. Also i noticed that absolute numbers may differ per lab, oddly enough. Having a second measurement is not a strange thing to do, according to me.

My B6 levels have come down and vitamin D levels are rising. Interestingly, neurologists and neurophysiologists suspect that the low vitamin D levels may have evoked a lot of the issues I suffered and still suffer but to a lower degree. Also they have the experience that usually clinical recovery is lagging from restored levels in the blood. Presumably I am in that phase now.

Most likely multiple factors have impacted my health, but herewith unable to pinpoint the chickens and eggs. Long lasting stress, low vitamin D, irregular life style, my personal physical and neurological profile etc, all may have contributed to a severe imbalance.

I hope the gradual recovery continues, and with sufficient rest and patience hopefully I may embrace a full recovery in the coming time without further serious issues. I'll stick to my 'strategy' of healthy nutrition, exercising etc, since I deeply believe it provides the foundation for recovery and a more balanced life style.
Avatar universal
Hi, My B6 is extremely high too.  It was found to be HYPOPHOSPHATASIA.  If so, Alkaline phosphatase will be low too.  This means that you are missing a bit of gene number one which provides this enzyme, hence unable to metabolise phosphates (B6 is pyridoxil 5 phosphate).

Regards Juliana508
Avatar universal
It is October 2013 and since September 2013 I’ve started to pick up some work again. I had been out since March of 2013. After all, the elevated vitamin B6 seem not to be related to anything obvious. Moreover, the levels had normalized relatively soon after I posted my first message on Medhelp. It is more likely that I have suffered a severe vitamin D shortage, affecting my overall physical condition but especially the neuromuscular performance. D shortage resembles to some degree vitamin B6 toxicity. Whether the vitamin D shortage is the cause of all or a result of something else, probably cannot be determined anymore. Potentially other factors may have affected my health as well, such as an incredible high work load for many years under quite energy absorbing circumstances.
Anyway, I hope my recovery continuous as it does now – I start to feel energy flowing again in my veins. This time I have to listen at all times to the signals my body provides, because it did already before March 2013 but the signals were just denied.

As mentioned above in the previous messages, I had developed some sort of “recovery” strategy, a new life style if you like. I am intending to stick to the scheme:

Adopt healthy food habits (e.g. sufficient vegetables and fruit (eat different colors), mind too high sugar intake, drink sufficient water, minimize caffeine intake, biological food).

Unwind regularly and rest sufficiently (do fun things with family and friends, watch comedy shows, read books, go to bed timely). Put your mind to other things than to your health all the time. Sleep is critical to a good health.

Exercise cardio, strength and balance. Go to a gym, play tennis, go skiing, whatever you like and whatever is possible.

Evaluate your work life and personal life – is it balanced and sustainable ? In my case I was too work focused (perhaps resulting in or at least contributing to my health issues). Working hard is not the issue, but spending too little time with my sons is an issue. They only grow up once. See what’s possible in your situation; not everyone can make (big) changes in order to change their work life balance.

Annual health checks – within  your possibilities and needs. For instance I will pursue yearly vitamin checks. Stay the owner of your own health and you may want to consult different types of therapists or doctors in times of need; their input may give you a more holistic view on yourself.

My experience is that if you want to change your life style (food, rest, exercise etc) take it step by step in order to make it sustainable on the longer term.

If there are no further developments (i.e. new health issues), which I hope of course, than this is my last message on this subject. A good health to everybody!
Avatar universal
I too have low vitamin D (~30) and just got my results for vitamin B's. B6 was high at 146.9nmol/L (range of 20-125 is considered normal). B12 was also low at 0.11nmol/L. For about a year now I have been experiencing mind fog.. its like a feeling of detachment from my surroundings. If you read about depersonalization, that sort of describes it. I know low vitamin D can cause this in people who live in colder climates from lack of sunlight/working indoors. I have been tested for EVERYTHING trying to rule out what is causing me to feel this way. It started after I went on a vacation to St Maarten and drank for a week straight. Some days are worse than others, but I never feel 100%. Ive been tested for STDs, Lyme, anemia, vitamin deficiencies, I had an MRI which showed a 1cm cyst on my pineal gland (which the gland itself is only 0.5cm) but the doctors keep telling patients with these cysts that theyre asymptomatic and benign. We all think otherwise.. but anyways, based on some of my symptoms (dizziness, ringing in my ears, mind fog, sometimes lack of coordination & balance, light headedness especially when I stand up) someone mentioned to look into different types of autonomic disorders. I am convinced I have POTS (postural orthostatic tachycardia syndrome) which is symptoms due to an underlying problem.. could it be low vitamin B12, Vitamin D, yet I have elevated B6? Could it be a combination? Could it be the cyst growing in my brain? Could I have low blood pressure so not enough blood is getting to my head and is causing me to have POTS symptoms? I started taking a B complex vitamin (**prior to my last blood tests) and 5000IU of vitamin D, along with daily vitamins, fish oil, and calcium. I also bought a blood pressure monitor and have started making sure I drink a minimum of 2L of water everyday. There are times during the day that i do feel ok.. I try not to evaluate how I am feeling because I think it is stressing me out.. for a YEAR I have been researching and thinking I had lyme, thinking something was seriously wrong, maybe brain damage.. not sure. But I have noticed my blood pressure (I bought a monitor) has been higher with me drinking more water and that I do feel better than I have in the last year.
This started after a week of drinking? Alcohol (as well as caffeine) raises cortisol levels, and cortisol dumps magnesium and potassium from the body. That would explain why people with high stress from other sources have similar symptoms.

I read somewhere that the potassium capacity of cells may change. One factor in this could be B6 which removes Mg from the cells into the blood stream. Mg seems to play a part in the calcium-gated potassium channels. See if:

a) Supplementing with Mg and K reduces the symptoms (but go easy on the K since an excess can be bad for the heart. Even low level supplementation should show effects if this is the issue.)
b) Omega 6 helps in their absorption? (If so, look into possible prostaglandin E2 excess messing up the function of your stomach lining; and
c) Taurine might help. Taurine does the opposite of B6 to Mg: shepherds it into cells from the blood stream.

Does aspirin increase the ringing in your ears? If so, something here might be causing a salicylate sensitivity. Fortunately such a condition will probably be transient.
Avatar universal
After taking b complex 50 mg for 14 days I became toxic and have had all the pain, pins needles tinnitus, etc....been tested for every disease known to man and nothing..MRI clean, etc....B6 is pure poison and it is a slow recovery....I have good days, and then like today, it all comes back....I even lost hair, and my thyroid has become hypo...wish I had never taken a vitamin in my life...I was just fine before that!
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