Misconceptions About the Safety of Vitamin B6

Posted by John Coppola on 22 Jan, 19

Discover Which B Vitamin is the Most Misunderstood

The importance of B vitamins is widely talked about. Many people may even know that B vitamins play an important role with producing energy for cellular fuel and for nervous system function. Although the most commonly talked about B vitamin is B12 (methylcobalamin), today, we’re going to focus on the significance of Vitamin B6.

Our bodies use B vitamins to convert the food we eat into the energy we need to function. The complex of B vitamins together serve an important role for metabolism, brain and liver function, growth, building red blood cells and for maintaining healthy vision, skin, and hair. Vitamin B6, in particular, plays a crucial role in keeping the brain and nervous system functioning properly. Let’s look at a few of the functions of vitamin B6:

  • Converts carbohydrates, fat and protein into energy for cell function
  • Aids in Metabolism
  • Necessary for Brain and Cognitive Function (for all ages, but especially children and seniors)
  • Supports nervous system health (all nerves-including peripheral nerves)
  • Liver function
  • Muscle function
  • Digestive function
  • Immune System health
  • Growth
  • Building Red Blood Cells
  • Maintaining healthy bones, teeth, hair, skin, nails and vision

Aside from these critical functions, B6 is also necessary to make Serotonin hormone (one of the ‘happy hormones’ that regulate mood) and norepinephrine (hormone that helps you cope with stress). B6 also plays an important role in making Melatonin (regulates sleep and your internal clock).

Vitamin B6 Feared and Misunderstood by Many Doctors and Patients

I’ve had a vast number of patients express a fear of their doctor’s or their own that vitamin B6 may cause nerve damage. So, let’s explore the safety of vitamin B6.
Low levels or deficiency in vitamin B6 can impact your mood, sleep and even pain levels, especially nerve pain.

So the best way to ensure that you get your daily dose of vitamin B6 is by taking a good supplement. Sound easy enough? Well, not quite…many people can’t utilize certain forms of B6 effectively.
Vitamin B6 comes in several different forms.

  • Pyridoxine (Pyridoxine Hydrochloride)
  • Pyridoxal 5 Phosphate (P5P)
  • Pyridoxamine

For this article we will focus on the 2 most common forms used for supplementation, Pyridoxine Hydrochloride (HCl) and Pyridoxal 5 Phosphate (P5P). Both forms are used for vitamin supplementation.

Vitamin B6 in the form of Pyridoxine HCl and Pyridoxal 5 Phosphate (P5P) are both essential to over 100 enzymatic processes in our body. (note: an enzyme is a catalyst that increases the speed of a chemical reaction in the body)

The most frequently used form of Vitamin B6 in supplements is Pyridoxine HCl. This form of B6 is synthetic (meaning - produced in a lab-not extracted from food) and has a longer shelf life. Although this form is artificial, it’s effective for many individuals. There’s one small problem with Pyridoxine HCl. In order for it to become active and taken up or used by the cells, it must be converted in the liver to Pyridoxal 5 Phophate (P5P), which is a 2 step process. Many people do not have the ability to effectively convert Pyridoxine HCl to Pyridoxal 5 Phosphate. If this conversion does not take place, the vitamin B6 supplement you swallowed won’t be used by your body.

However, when taking vitamin B6 in the P5P form, no conversion is necessary. It is already in its active form and can be immediately absorbed through the small intestine where it is ready for use by the cells. This is a very important factor, because several chronic dysfunctions or illnesses, such as Celiac disease, Crohn’s disease, Irritable Bowel Syndrome (IBS), Gastric (peptic) ulcers, and intestinal cancer or obstruction. can prevent Pyridoxine HCL (B6) from being used by the cells.

Regarding the concern about overdosing on Vitamin B6, here is the good news. B6 is a water soluble vitamin. Whatever your body doesn’t need or can’t use will be flushed out of the body, making this supplement safe. The reason for the confusion over the safety of vitamin B6 is due to certain side effects associated with Pyridoxine HCL.

Although Pyridoxine HCl (B6) is generally safe to use, when taken in prolonged high doses, it can become toxic and actually cause nerve damage.

Before you race to the trash can ready to toss your B6, here’s what you need to know. Research has shown taking 1000 mg to 6000 mg daily for 1 year or greater of Pyridoxine Hydrochloride (B6) can result in severe neuropathy symptoms. These are extremely high doses that most people will never achieve. However, it is important to note that when taking 100 mg per day of Pyridoxine HCl (B6) for a period exceeding 2 or more years can possibly result in neuropathy symptoms. This is according to Dr. Rusell Blaylock, MD.

Some side effects associated with taking 100 mg or more of Pyridoxine HCl:

  • Nausea
  • Vomiting
  • Stomach pain
  • Loss of appetite
  • Headache
  • Tingling
  • Drowsiness

On the other hand, numerous research studies have shown no side effects, nor toxicity occurs when taking Pyridoxal 5 Phosphate (P5P) at the same dosages. In fact, studies have shown that a person can safely take up to 7000 mg, daily, of P5P without any neurological damage.

P5P does not interfere with medications, as proven in the research. However, studies have revealed that the Pyridoxine HCl form of B6 can interfere with Anti-seizure medications (Phenytoin, phenobarbital), COPD medications (theophylline/ Aquaphyllin, Elixophyllin, Thofair, Truxophyllin) and NSAIDS (Celebrex, Motrin, Alleve, Naproxen, Cambia, Cataflam, Voltaren-XR).

B6 Deficiency

How common is B6 deficiency? Well, your body cannot make Vitamin B6, so, it is critical to acquire B6 from your dietary intake.

It may excite you to know that B6 can be found in a wide variety of foods like: grains, vegetables, nuts, seeds, eggs, poultry and meats. Because of this, B6 deficiencies were once considered to be rare. However, it’s been recently discovered that B6 deficiencies are actually occurring more frequently. Inadequate vitamin B6 levels are common in individuals eating a ‘Standard American Diet’ (SAD).

In the U.S., 90% of women and 71% of men consume diets deficient in vitamin B6. Even when eating a healthier diet, it’s not always easy to get B6 from your diet, even when consuming the appropriate foods.

Do you know that cooking, freezing, canning, sterilization and processing foods (especially milling of grains) can deplete vitamin B6 content by as much as 50% or more?

Low levels of B6 can result in a myriad of chronic disorders such as:

  • Skin Disorders
  • Depression
  • Dizziness
  • Headaches
  • Peripheral Neuropathy (nerve pain)
  • Heart Attacks and Strokes. 

Are Your Medications Leading to Nutrient Deficiencies?

Long term doses of certain medications can rob you of Folic acid, Calcium and Crucial B vitamins.

Medications are well known for causing side effects like brain fog, nausea, and drowsiness, however a lesser known side effect is nutrient deficiency. With long term use, many medications may deplete you of critical vitamins and minerals.

Many drugs can interfere with your body’s ability to absorb a particular nutrient from the food in your diet. In other cases, medications may interfere with the natural processes needed to produce nutrients. For example, Statin drugs (cholesterol lowering medication) inhibit the production of CoQ10.

Here is a list of common medications that interfere with B6 absorption – leading to deficiencies:

  1. Oral Contraceptives (Birth Control pills)
  2. Blood Pressure medications (Norvasc/amlodipine, nifedipine/Adalat CC, Procardia XL, Verapamil, Cardizem/diltiazem, Plendil/felodipine, Hydralazine)
  3. Proton Pump Inhibitors (PPI’s prescribed for acid Reflux or GERD- Nexium/esomeprazole magnesium, Prevacid/lansoprozole, Protonix/pantoprazole, Prilosec/omepraxole, Aciphex/rabeprazole)
  4. Antacids (Maalox, Mylanta, Pepcid, Zantac)
  5. Antidepressants (SSRI’s- Celexa/citalopram, Lexapro/escitalopram, Zoloft/sertraline, Paxil/paroxetine, Prozac/fluoxetine)
  6. Corticosteroids
  7. Metformin
  8. Diuretics (Lasix/furosemide, HCTZ/hydrochlorothiazide)
  9. Antibiotics (Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin, Augmentin, Keflex/cephalexin, Bactrim, Cycloserine)
  10. Anticonvulsants (gabapentin, Valproic acid)
  11. Parkinson meds (Levodopa)
  12. Bronchodilators (Theophylline)

Chronic Illnesses that Cause B6 Deficiency

According to the National Institutes of Health, many chronic illnesses can decrease or prevent the absorption of vitamin B6. People with certain conditions will have a difficult time converting Pyridoxine HCL (B6) to P5P (B6). If this conversion cannot take place, it will be difficult (if not impossible) for B6 to be utilized by cells. You must take vitamin B6 in the form of Pyridoxal 5 Phosphate if you know or suspect that you suffer from the following conditions:

  • Kidney Disease
  • Thyroid Disease
  • Autoimmune Disorders (Rheumatoid Arthritis, Hashimoto’s Thyroid disease)
  • Celiac Disease or Gluten Sensitivity
  • Crohn’s Disease
  • Ulcerative Colitis
  • Irritable Bowel Syndrome
  • Fatty Liver Disease 
  • Liver Cirrhosis
  • Cancer
  • Chronic Systemic Inflammation

9 Signs and Symptoms of B6 Deficiency

  1. Neuropathy symptoms (numbness, tingling, burning or shooting pain in hands or feet)
  2. Skin rashes (oily flaky appearance on scalp, face, neck and upper chest) 
  3. Cracked lips or cracks in corners of mouth
  4. Weakened Immune System
  5. Fatigue (Low Energy)
  6. Mood instability (depression, anxiety, irritability)
  7. Seizures
  8. Inflamed tongue
  9. Elevated Homocysteine levels

Benefits of B6

The benefits of B6 are far reaching and effect a multitude of physiological symptoms. Not only is it important for the function of healthy nerves but it offers a variety of other benefits:

  • Anti-inflammatory
  • Decreases nerve pain symptoms (neuropathy)
  • Improves Brain Health and Cognitive Function 
  • Alleviates symptoms of Carpal Tunnel Syndrome 
  • Decreases seizures
  • Decreases incidence of Inflammatory Bowel Disease (Chrohn’s, Ulcerative Colitis)
  • Decreases symptoms from IBS
  • Decreases Allergy symptoms
  • Reduces breast pain
  • Reduces PMS symptoms (especially when taken with magnesium)
  • Aids in alleviating mild depression
  • Helps maintain muscle mass (especially during weight loss)
  • Decreases migraines
  • Reduces risk of cancer (cervical, colorectal, lung cancer)
  • Lowers risk of Stroke, Heart disease, Heart Failure
  • Helps balance blood sugar
  • Supports Health red blood cell formation 
  • Strengthens bones and reduces risk of hip fractures in the elderly


In our clinic, we have used both forms of B6 (Pyridoxine HCl and P5P) at high doses (short-term) and have achieved great clinical results. What we did notice is that far less people reported nausea and stomach upset with P5P than those taking the Pyridoxine HCL. We have chosen to use P5P in our NUPHORIA Gold formulation for this reason. Also, since peripheral nerves can take up to 2 years to fully heal, a person can safely stay on NUPHORIA Gold for much longer periods of time without any side effects.

To Learn More or to purchase NUPHORIA Gold, simply click the button.

This blog has been provided by Dr. John Coppola, D.C. and Dr. Valerie Monteiro, D.C. Dr. Coppola and Dr. Monteiro are the founders of the San Antonio Neuropathy Center, and Precision Sport & Spine. They are the leading experts in the field of neuropathy and specifically drug free nerve repair. They are the authors of the critically acclaimed book "Defeat Neuropathy Now .... In Spite of Your Doctor. The doctors have over 25 years of clinical experience.

If you would like to reach the doctors regarding a specific health problem, you may email them at info@bodiesrebuilt.com.