1. Brief on Vitamin B6:
Vitamin B6, a.k.a. pyridoxine (C8H11NO3) is a water-soluble essential vitamin because our body cannot make it. It plays a crucial role in many of the body’s functions. It is an essential cofactor in the metabolism of carbohydrates, proteins, fats, and is involved in the production of neurotransmitters, red blood cells, and DNA. Vitamin B6 knowledge is most important because of its link to numerous health benefits, including reducing the risk of heart disease [1].
For the year 2021…
Heart Disease was the number one cause of death in USA. SCD (Subjective Cognitive Decline) was the number seventh cause of death as Alzheimer’s disease in USA [1].
Among adults aged 65 years and older, SCD [1] is 11.7% compared to 10.8% among adults age 45–64 years old.
Despite vitamin B6’s importance, many people (lay or with medical background) will not be able to associate B6 with its compound name and may not understand the importance of this vital nutrient, leading to the deficiency culminating in a range of health problems and the generation of above stated statistics.
In this paper, we will explore the various functions of vitamin B6 in the body, its sources, and potential health benefits. We will also examine the consequences of deficiency and discuss ways to ensure adequate intake. Whether you are a layperson interested in maintaining good health or a medical professional seeking to deepen your understanding of this important nutrient, this paper will provide valuable insights into the role of vitamin B6 in human health. Vitamin B6 is available in three forms:
Form-1: Pyridoxine hydrochloride or Pyridoxine HCL or p-HCL.
p-HCL B6 made synthetically in labs. It is very cheap and has long shelf life. Mostly used in supplements and used in the fortification process of our foods. For p-HCL form of B6 absorbed by our body, it must first be converted to B6 P5P format, more on this below. This conversion happens in liver and for this conversion, Zinc (Zn), another micronutrient is required. Most people are deficient in Zinc [1], [2] [3] and hence lacking the ability to initiate this [conversion] reaction, leading to B6 deficiency.
Excess p-HCL B6 (not absorbed) can get excreted via urine. However, at times for some reason this pathway fails and p-HCL can accumulate in cells, which may lead to toxicity. This is the leading cause why doctors are telling their patients to stay away from B6, as most of the supplements are p-HCL based, and on the contrary, population is deficient in Zinc [1].
Pyridoxine HCL B6 will also interfere with certain medications for anti-seizure, asthma, high blood pressure, Parkinson’s disease, rheumatoid arthritis, and for COPD (Chronic Obstructive Pulmonary Disease), which is the chronic inflammation of lungs, causing airflow obstruction. The solution to p-HCL B6 is to take P5P B6 and more on this below.
Form-2: Pyridoxal 5 phosphate (P5P or P-5-P or PLP).
P5P is the active form of B6, which is readily absorbed in the cells. No additional conversion is required, hence no burden on liver for conversion and no need for Zinc for this reaction. However, Zinc is very important micronutrient and is used in over 300 [1] enzymatic reactions and plays an important catalytic / co-catalytic role in protein folding [1]. So, Zn deficiency should not be taken lightly.
P5P B6 is extremely safe even when taken in high doses and/or for long terms. Mostly it does not interfere with medications and human body’s tolerance of P5P is extremely good when compared with p-HCL B6 [1].
Form-3: Pyridoxamine.
Pyridoxamine is the third form of vitamin B6, which is based on a pyridine ring structure with hydroxyl, methyl, aminomethyl, and hydroxymethyl substituents [1], [2].
2. Vitamin B6 Role:
Vitamin B6 is a micronutrient that plays an important role in our nerve functions and in over 100 enzymatic reactions [1], [2]. Used in the breakdown and metabolism of amino acids (proteins), glucose (carbohydrates), and lipids (fats). It is vital for neurotransmitter to function, hemoglobin synthesis / functions and gene expressions [1], [2], [3]. It is also known to lowers the risk of Oxalates formation and Hyperoxaluria [1], [2], [3]. It is used to treat seizures, morning sickness, and premenstrual syndrome. It is necessary for the creation of red blood cells and neurotransmitters, especially serotonin and dopamine. It can make your immune system stronger. It can promote a better mood as it elevates your serotonin levels. Some studies have shown that not having enough vitamin B6 in your diet can contribute to depression and anxiety. It diminishes neuropathic symptoms like burning pins and needles or tingling sensations. It helps your body make more melatonin which is important in helping regulate your internal sleep clock. It improves nerve function by speeding reliable signal travel. It is indispensable in the processes associated with brain development and mental health [1], maintaining peripheral nerve health, oxygen transport in our bloodstream, and healthy immune system function. B6 reduces inflammation and maintains healthy nerves. It reduces the risk of Alzheimer’s, the risk of heart disease, the risk of clogged arteries and promotes brain health [1], [2].
Used in the maintenance of normal level of homocysteine, which is an amino acid found in our bodies. Elevated levels of homocysteine indicate heart disease or high-risk for heart disease. Homocysteine breakdown is enabled in the presence of vitamins B6, B9 (Folate) & B12 [1]. Folate (natural) and folic acid (synthesized) are different forms of vitamin B9.
3. B6 deficiency symptoms & causes:
Vitamin B6 deficiency can arise from many direct or indirect reasons. B6 deficiency could lead to peripheral neuropathy [1], [2], [3] and can cause chronic illnesses like gluten sensitivity [1], [2], Irritable Bowel Syndrome (IBS) [1] or inflammatory bowel disease like Crohn’s or ulcerative colitis, kidney disease / renal failure [1], autoimmune disorders like lupus and celiac disease, rheumatoid arthritis, thyroid diseases like hypothyroidism Hashimoto’s and Graves’ disease.
B6 deficiencies are associated with almost all diuretics, all anti-convulsant and anti-seizure medications, oral contraceptives, surgical procedures like bariatric surgeries (for weight loss), because of malnutrition or malabsorption and could be because of small bowel resection [1], [2].
In combination with some of the above or other metabolic diseases [1 common metabolic disease knowledge portal], B6 deficiency can lead to a fatty liver disease, liver cirrhosis, cancer, ulcers, anorexia or bulimia and systemic liver inflammation. Some of the nutrients if not taken in balance can also deplete B6, refer here for details.
Medications that lead to B6 deficiency includes Prednisone [1], [2], Methylprednisolone [1], [2], lisinopril (blood pressure medications) [1], [2], Gabapentin [1], [2], Tegretol [1], [2] and Topamax [1], [2].
Other B6 depletion causes may also include regular consumption of coffee or caffeinated beverages, heavy alcohol consumption, super processed foods containing white sugar and white flour.
4. Foods with natural Vitamin B6:
Vitamin B6 is found in a variety of foods including avocados, bananas, beef, carrots, chicken breast, chicken/beef liver, eggs, green peas, milk, ricotta cheese, salmon, skipjack tuna, spinach, sweet potatoes, wild Atlantic salmon, and a few others. Dairy products and breakfast cereals also contain fortified vitamin B6 p-HCL.
For example, if you want to search pistachio’s mineral contents, in your favorite browser search engine type…
“mineral contents analysis of pistachio”
You will get a clear list of mineral contents, within the first few links, for the food item you searched.
5. Takeaway:
The most crucial takeaway for vitamin B6 is that it is a critical nutrient, which plays a vital role in many of the body’s functions. Associated ill effects of deficiency after middle age and especially at old age are horrendous and are well depicted by the stats in the beginning of this paper.
Vitamin B6 is involved in the metabolism of macronutrients, the production of neurotransmitters and red blood cells, and the maintenance of a healthy immune system. Additionally, it has been linked to numerous health benefits, including reduction of heart disease risk, cognitive decline in old age, and certain types of cancers.
However, despite its importance, many people do not consume enough vitamin B6 in their diets or are not capable of utilizing the available B6 because of the lack of Zinc, which culminates as the starting point for a range of health problems.
As a takeaway, it is important to ensure adequate intake, it is essential to consume a balanced and varied diet that includes vitamin B6-rich foods as listed in this paper. In cases of deficiency or increased need, or in case of certain disease or when taking medications that deplete Vitamin B6, supplementation may also be beneficial and may also reduce high levels of homocysteine. For vitamin B6 RDA (Recommended Dietary Allowance) refer here. While supplementing it is important to take the active form of vitamin B6. If you are planning to buy B6 supplement, search on Amazon for the phrase “Pyridoxal 5 phosphate” or P-5-P.
Subjective Cognitive Decline (SCD) is a self-reported or experienced feeling of increasing forgetfulness or memory lapse or worsening or losing a train of thought or feeling overwhelmed during memory recall situations, all within the previous 12 months. SCD is the earliest noticeable symptoms of Alzheimer’s disease.
Now if you can recall the SCD statistics as highlighted earlier in this paper. If you have reached till here in reading this paper then,
your past 7 minutes have a 22.5% (10.8% + 11.7%) chance of reducing SCD in second half of your life.
If you missed this, you may read it again. Overall, the importance of vitamin B6 in human health cannot be overstated, and greater attention must be paid now, to minimize the deficiency to live a future healthy and active life. Or be prepared to become a part of future statistics.
About The Author:
As the author of this paper, I want to highlight that I am not a doctor or a nutritionist. However, I have extensively researched the topic of vitamin B6 and other nutrients and their roles in human health. The research for this paper drawn from a range of reputable sources referenced in this paper, from where the information is retrieved, analyzed and processed for my writing.
My goal in writing this paper is to share valuable insights into the importance of this crucial nutrient, with the hope of educating and inspiring readers to make positive changes in their diets and lifestyles. My hope is that everyone can benefit from a greater understanding of nutrition and its role in promoting good health, and my wish is this paper will contribute to that goal. Whether you are a layperson or a medical professional, I invite you to read this paper with an open mind and a willingness to learn, and to consider how you might incorporate the lessons it contains into your own and your patient’s life. ■
