March 26, 2018

Pyridoxine: also known as vitamin B6, is an essential nutrient for the metabolism of carbohydrates, fats and proteins.

It is a water soluble vitamin with a version known as pyridoxal 5 phosphate, P5P or PLP, that is required for 100 enzymatic reactions related to protein metabolism.

We need B6 to release glucose from stored glycogen as well as making glucose from amino acids, gluconeogenesis. Fatty acid metabolism is also a B6 dependent process. B6 is clearly critical for energetic cellular activity.

Neurotransmitters that are involved in mood, specifically Serotonin and Dopamine, are pyridoxine dependent. GABA, an inhibitory neurotransmitter has been shown in clinical studies to be calming. Insufficient volumes of P5P can have adverse effects on mood and agitation.

We need B6 as a cofactor for an enzyme to make heme, the oxygen carrying part of hemoglobin of a red blood cell. Microcytic or small red blood cell anemia is a side effect of low B6 levels.

PLP is also a critical cofactor in the methylation pathways of folate. Remember that this pathway is necessary for appropriate DNA function and the downstream effects of proper DNA reading.

Pyridoxine deficiency is not common. It presents with irritability, depression, mood dysregulation and seizures in certain genetically susceptible individuals. Oral ulcers and cracking lips at the corners can occur. A swollen red tongue is also noted in deficiency states. Fatigue and anemia occur after energy and heme systems are depleted.

Insufficiency is the greater concern in our population. Current literature is showing that inadequate levels of B6 will cause your immune system to function suboptimaly. It is also associated with coronary artery disease where people with the lowest levels of B6 have a higher risk of myocardial infarction.

(I believe that the truth when it comes to heart disease is that all of these B micronutrients are critical for the whole system to work right. After we make it through them all, go back and see how tightly they are all intertwined to protect the heart.)

We know that low B6 levels hamper the function of the transulfuration pathway enzymes and cause elevations in homocysteine which is associated with coronary artery disease. If homocysteine is not converted to glutathione, we have a major problem with detoxifying our system. B2 is also critical in this detox system.

Keeping B6 levels adequate should be a first line therapy coupled with a sleep regimen for anyone with mood issues

In adult populations, there are no known serious side effects of excessive PLP intake below 200 mg daily(200,000 mcg). Mega dosing has been shown to cause peripheral nerve damage and should be avoided.

Food sources of B6 are predominantly from poultry, salmon, spinach, potatoes, nuts and fortified foods. The US government has been fortifying breads and cereals for years as an added source.

Most adults need 1200 to 1600 mcg/day. Incrementally less for kids. This nutrient is easily obtained from a anti inflammatory diet.

People at risk for insufficiency or deficiency have: alcoholism, inflammatory bowel disease, cancer, HIV, eating disorders, celiac disease or consume the following drugs: oral contraceptives, anti tuberculous and anti parkinson drugs, non steroidal anti inflammatory medicines.

Dr. M


*With many of these micronutrients, you will see a pattern that the brain, gut and skin are often affected. These highly metabolic and rapid cell turnover organs are most susceptible to insufficiency states that occur with a modern human processed, government subsidized diet that promotes gut dysfunction, malabsorption and inflammation.