toxicity

Why is vitamin B6 toxic for some and why don’t symptoms resolve when vitamin B6 is stopped?

August 17, 2018 By Trudy Scott 140 Comments

In a recent blog post, Vitamin B6 improves dream recall (which can be used to monitor vitamin B6 status), I promised to address concerns about the potential for vitamin B6 toxicity. I have yet to see any signs of toxicity in my clients, but I have also not ever recommended more than 500mg/day.

However, I was recently made aware (thanks to some folks in my community) that there are some individuals who have issues with very small amounts of vitamin B6. As of this writing I don’t know why this occurs but I’m writing about it in the hope we can start to put some of the puzzle pieces together. If you have experienced any issues with using vitamin B6 supplements please do share in the comments.

I’d like to start with what we know from the research and from experts like Dr. Carl Pfeiffer – since B6 is water soluble, excesses are documented to be excreted via the urine so that toxic levels are never reached.

It is common knowledge that amounts of 50 mg or greater are considered therapeutic and a high dose, and you should reduce your dose if you notice any tingling in your fingers and other extremities. This could be a sign of too much vitamin B6 and is called peripheral neuropathy. Because vitamin B6 is water soluble, this condition is reported to be completely reversible if you stop supplementing with vitamin B6 or reduce your dose. In one case report, some patients were using up to 5000mg/day, and once they stopped the vitamin B6 their symptoms improved.

In his book Mental and Elemental Nutrients, published in 1975, Dr. Pfeiffer stated:

excesses are excreted via the urine so that toxic levels are never reached. Pyridoxic acid occurs in the urine of patients who take any excess of vitamin B6. This is a harmless excretion product.

He had some of his patients with pyroluria use 1000mg twice a day but recommended working with a practitioner if using amounts higher than 500mg. I agree with the latter.

You’ll see varied research papers on what is considered too high a dose. In this paper, How much vitamin B6 is toxic?, the authors report that 1000mg per day or more causes neuropathy. They also share that there

have also been occasional reports of toxicity at intakes of 100-300 mg per day [and that a report of] neurotoxicity in 2 patients who had taken 24 mg and 40 mg of vitamin B6 per day respectively, may be coincidence rather than a true toxic effect of such relatively low doses.

In the USA, per this article on the NIH site, the upper limit is set at 100mg/day. This is the rationale:

several reports show sensory neuropathy occurring at doses lower than 500 mg/day, studies in patients treated with vitamin B6 (average dose of 200 mg/day) for up to 5 years found no evidence of [neurological issues].

Based on limitations in the data on potential harms from long-term use, the FNB halved the dose used in these studies to establish a UL [upper limit] of 100 mg/day for adults. ULs are lower for children and adolescents based on body size.

As I mentioned above, I have yet to see any signs of toxicity in my clients, but I have also not ever recommended more than 500mg/day.

Psychosis that resolves when vitamin B6 is stopped

A colleague shared this about 2 patients developing psychosis as a result of using too much vitamin B6:

I have had 2 patients in the past 3 years who developed psychosis as a result of taking too much vitamin B6. I think it’s a fine line between what is enough for some people, and then what becomes too much. While some may be able to handle large doses of B6, we know that at higher doses it can cause severe problems for other people. It’s a nutrient I dose and monitor carefully for sure.

There is no research on acute psychosis and vitamin B6 toxicity but she shares this:

neuropathy and psychosis (or acute mental health symptoms) often co-occur, so to me it makes sense that a person could experience both together as a result of too much vitamin B6. In both the patients the acute psychotic symptoms resolved once they stopped taking high doses of B6. They were both taking pyridoxine HCL at doses above 500mg daily (one because of information she had read online, and the other because another practitioner had recommended it). My guess is there is some genetic factor and/or mediating factor biologically that makes some people susceptible to a negative response.

Serious issues that are not resolved when vitamin B6 is stopped

Clearly there are some individuals who do have serious issues that are not resolved when they stop taking vitamin B6. In the previous blog, Vitamin B6 improves dream recall (which can be used to monitor vitamin B6 status), Ruth shared this feedback about her experience with vitamin B6 toxicity:

Trudy, I appreciate your evidence-based approach to health issues, but I think you need to be aware that there are dangers in taking too much synthetic vitamin B6. B6 toxicity is not always reversible. Individuals vary in their response to B6, and while many do well on supplementation, others experience toxicity. I was diagnosed with pyroluria, but experienced serious toxicity.

Vitamin B6 toxicity is a very unrecognized but emerging epidemic that can cause widespread neurological damage to the body. It is not commonly recognized by most of the medical community and is often misdiagnosed. B6 toxicity can cause multiple different symptoms that can vary from person to person. Peripheral neuropathy or nerve damage to the feet, legs or hands is one of the most common symptoms of vitamin B6 toxicity. Tingling, shocks/zaps, vibrations, ataxia, burning, numbness of feet, calves and/or hands, and headaches are also commonly reported. Other symptoms are: ocular, sensory, skin, gastrointestinal and psychological.

I appreciate Ruth sharing this and am very concerned that this is happening. And yes, vitamin B6 is synthetic, but I am not yet convinced that this could be the only cause as there are other synthetic/man-made supplements (such as GABA) that don’t cause issues like this.

However, we do need to know why some folks have issues and why these issues continue even when the vitamin B6 supplementation is stopped.

Possible clues as to why vitamin B6 toxicity occurs?

If you have had issues that persist I’d ask these questions which may start to give us clues as to why this occurs:

What were/are your symptoms and how quickly did you notice issues?
Have you resolved the symptoms and if yes how?
Did you make any other changes around the same time i.e. stopping and/or other nutritional support?
Was it vitamin B6/pyridoxine or P5P you were taking?
And how much did you take and how often?
If you have pyroluria were you also taking zinc and how much? (Dr. Pfeiffer recommended taking zinc together with vitamin B6).

It seems like this an emerging issue unless there is just now more awareness because of the web and more ability to share on forums, blogs and social media.

If we are to assume this is a new and emerging issue I would ask what has changed since the 1970s when Dr. Carl Pfeiffer used high doses (as I mentioned above, up to 1000mg twice a day) with no adverse effects?

These factors have wide-reaching adverse effects and may be triggering a toxic reaction in certain susceptible individuals:

Past history or current use of certain medications like benzodiazepines, gabapentin, Lyrica, BCP, SSRIs, fluroquinolone antibiotics, PPIs, diabetes medications, statins, blood pressure medications etc.? (If you have not used the above medications have you been exposed to them via drinking water?)
Our increased EMF exposure – WiFi, cell phones, cordless phone and smart meters?
Our increased exposure to GMOs, glyphosate, plastics/phthalates, pesticides etc.?
Interactions with all of the above and/or certain polymorphisms – we know cytochrome P450 polymorphisms make benzodiazepines more toxic and more difficult to taper in about 60% of those prescribed benzodiazepines

Keep in mind that for most individuals, vitamin B6 causes no issues and is an important nutrient for improving the symptoms of pyroluria/social anxiety, reducing inflammation and oxidative stress, easing PMS and hormonal issues and much more. I share links to the research on the many benefits of supplemental vitamin B6 in this blog: Vitamin B6 improves dream recall (which can be used to monitor vitamin B6 status).

That being said, we need to know why some individuals do have issues when using vitamin B6.

Please share in the comments if you have seen adverse issues with vitamin B6 supplementation

If you have been adversely affected and feel comfortable sharing answers to the following questions in the comments this may help us try and piece the puzzle together:

What were/are your symptoms and how quickly did you notice issues?
Have you resolved the symptoms and if yes how?
Did you make any other changes around the same time i.e. stopping and/or other nutritional support?
Was it vitamin B6/pyridoxine or P5P you were taking?
And how much did you take and how often?
If you have pyroluria were you also taking zinc and how much? (Dr. Pfeiffer recommended taking zinc together with vitamin B6).
Past history or current use of medications like benzodiazepines (such as Ativan, Xanax, valium etc.), gabapentin, Lyrica, BCP / birth control pill, SSRIs /antidepressants (such as Prozac, Celexa, Lexapro, Paxil, Zoloft etc.), fluroquinolone antibiotics (such as ciprofloxacin/Cipro, gemifloxacin/Factive, levofloxacin/Levaquin, moxifloxacin/Avelox, norfloxacin/Noroxin and ofloxacin/Floxin), PPIs (proton pump inhibitors such as Nexium for heart-burn), diabetes medications, statins, blood pressure medications etc.?
What kind of EMF exposure do you have – WiFi in the home and/or at work, how much cell phone use in a day, cordless phones at home and/or work and a smart meter at home?
What kind of exposure have you had to GMOs and pesticides (i.e. do you only eat organic food), glyphosate (eg. Roundup exposure from lawns, golf courses, parks etc.), plastics/phthalates (do you avoid plastics)?
What polymorphisms do you have: cytochrome P450 polymorphisms (we know some of these make benzodiazepines more toxic and more difficult to taper in about 60% of those prescribed these meds), and/or MTHFR polymorphism (may affect our detox ability if it’s expressing) and others you know about?
Did you take a B complex (or a multivitamin that contains all the B vitamins) with the vitamin B6?
Did you also take magnesium with the vitamin B6 and if yes how much? (Bernie Rimland reported that taking vitamin B6 together with magnesium resulted in an improved behavior of ASD (autism spectrum patients))
Have you observed any correlation with intake of dietary oxalates i.e. worsening symptoms when consuming medium or high oxalate foods (such as spinach, kale, berries, nuts, kiwi fruit, eggplant etc.) or using vitamin C or milk thistle, and less severe symptoms when consuming a low oxalate diet? (Susan Owens is founder of www.lowoxalate.info and shares that vitamin B6 is the most efficacious vitamin for reducing oxalates and that we also don’t know if the classic signs of vitamin B6 toxicity has anything to do with oxalate dumping symptoms.)
Do you have a thyroid disease? “peripheral diseases frequently include polyneuropathy”
Have you been diagnosed with an autoimmune condition and if yes, which one?

Is there anything else that you have discovered that you suspect may be a factor?

I plan to add to this list of questions as we get feedback and as I learn more.

To be clear, I’m not dismissing the fact that vitamin B6 toxicity is a real issue for certain individuals. I’m simply trying to figure out if there are some common factors that may be making symptoms worse in some individuals or setting someone up to be predisposed to symptoms or even preventing healing/recovery from toxicity.

Copper toxicity: anxiety, phobias, ADHD on the Heavy Metals Summit

December 23, 2017 By Trudy Scott 28 Comments

One of my favorite functional medicine practitioners, Ann Louise Gittleman covers the issue of excess copper on the Heavy Metals Summit, which airs online Jan 29 to Feb 5, 2018.

The topic is – Copper: The Double-Edged Sword – and she shares how copper is probably the most insidious of the toxic metals:

I think what lead was to the ancient Romans, copper is to modern day Americans. And I think it may be the fundamental cause of many of our orphan illnesses, our mystery illnesses, and debilitating and aging biochemical imbalances.

She shares some of the sources of copper that are most prevalent in contributing to excess copper levels and toxicity:

I think first and foremost we have to look at copper plumbing, copper cookware, which is all the rage in this day and time. There’s naturally occurring copper in water. Birth control pills can be a source of copper, because of excessive amounts of estrogen and estrogen is connected to copper the way zinc is connected to progesterone.

There are copper IUDs that are very popular amongst so many of our young women. Even dental amalgams, if they are put in your mouth post 1976 can have a very high copper amalgam percentage. And then, of course, there are fungicides for swimming pools and foods. So that’s just the beginning.

Then there’s the copper that you’re getting in common foods. Whether it’s soy; whether it’s GMO soy or not. You’re getting that in tempeh, tofu, soy protein powders. Nuts and seeds, like cashew nuts and sesame seeds. Avocados; a very healthy fat, but high in copper nevertheless. And some of our shellfish. Then you’ve got your regular tea, your green tea, your white tea, your black tea, your bran, and even your brewer’s yeast.

One of the biggest factors that I see contributing to high copper in my clients who have low zinc and anxiety, is all the baking being done with nuts flours such as almond flour! The next two areas I see as being most problematic for women, is the birth control pill and copper IUDs.

Ann Louise talks about how excess copper can affect you: hyperactivity and ADD, thyroid issues, tooth decay, dementia, urinary tract infections, candida and functional hypoglycemia.

She also covers the following anxiety symptoms, which I commonly see in my clients and community: nervousness, phobias and unresolved fears, depression and even stuttering.

Here are my contributions to this important discussion:

High copper and low zinc (because these two balance each other out), is one of the most common imbalances I see in my community of anxious individuals, and especially in women because of the hormonal influence.
Other than removing the source of the copper, one way to address this is via zinc supplementation. If anxiety is a factor, addressing low serotonin and low GABA with amino acids like tryptophan and GABA helps until zinc increases and copper decreases.
Good levels of zinc are also needed to make the neurotransmitters so once levels rise (as we get rid of excess copper) we can start to make our own.

Wendy Myers, Christine Schaffner, ND, and Dietrich Klinghardt, MD, PhD, have spent the last few months gathering the right experts, information and protocols to help you understand the danger of heavy metals like copper, mercury, lead, cadmium and others, and what to do about them.

Every day, they help their patients regain health, in some part through heavy metal detoxification. People with incorrect diagnoses of multiple sclerosis, fibromyalgia, anxiety and depression, insomnia, or thyroid issues, just to name a few, have found relief through innovative and individualized protocols to reduce the burden of heavy metals.

Register here to join us on The Heavy Metals Summit January 29 – February 5, 2018. See you on the summit! I know I’m going to learn a lot too!

Have you had issues with high copper and low zinc?

Feel free to comment or post a question below.

The Anxiety Summit – Your hidden mercury burden: A likely root cause of the other root causes of anxiety – part 2

November 10, 2014 By Trudy Scott 42 Comments

Kris Homme, MPH retired engineer turned science writer was interviewed by host of the Anxiety Summit, Trudy Scott, Food Mood Expert and Nutritionist, author of The Antianxiety Food Solution.

Your hidden mercury burden: A likely root cause of the other root causes of anxiety – part 2

how to get rid of your mercury burden: dental amalgams, mercury in fish
how a special diet can help
important supplements to include: antioxidants; essential fatty acids; minerals
foods and supplements to avoid
concerns around chelation
chronic mercury poisoning resources

Here is a snippet from our interview:

I’d really like to emphasize the toxicity of mercury and just how insidious it is and how important prevention is because, once you have toxicity, it can be pretty hard to get rid of. The first thing to do is address your exposures, and one big one is dental amalgams. If you are inclined to think you may have a mercury burden, then consider safe dental amalgam removal. It’s not an emergency, but put it into your five-year plan. You can read about this on IAOMT/ International Academy of Oral Medicine and Toxicology web site. They’re the pro-science dental association that has been working to fund and disseminate the science since 1983. They have developed a safe amalgam removal protocol. You can find a dentist who appreciates the toxicity of mercury and takes every precaution. Your old dentist may have an office full of mercury vapor, so you may want to find a new dentist and discuss the details of the procedure with the new dentist and decide for yourself whether the procedure is adequate. You got into trouble by trusting your old dentist to do what the old dentist thought was right, so it’s a good idea not to trust, but to figure out what you think is the right protocol for amalgam removal

Kris asked the following in the interview:

if you believe that your dental amalgams have affected your health, please report this to the FDA on the FDA MedWatch web site. They have a form to report adverse events, and dental amalgams are considered a medical device, so if you’ll use that form, it may help. In the last go-round against the FDA’s amalgam rule, the 2009 statement by the FDA said that they had received very few adverse event reports on amalgam, so let’s not let them say that again.

Here is the Environmental Working Group January 2014 report we mentioned: US Seafood Advice Flawed on Mercury, Omega-3s

Kris has some additional fish information here – Fish mercury: Some inconvenient truths

Here is short video of Kris talking about genetic susceptibility to mercury toxicity

This was a 2-part interview – here is the link to the blog for part 1

Here are links to the resources Kris shared:

Amalgam Illness by Andrew Cutler

Mercury Exposure

DAMS – Dental Amalgam Mercury Solutions

IAOMT/International Association of Oral Medicine and Toxicology

Kern 2012 article on brain pathology in mercury poisoning: Evidence of parallels between mercury intoxication and the brain pathology in autism

Kris’s website MercuryandMore

Kris’ paper published earlier this year: New science challenges old notion that mercury dental amalgam is safe

Here is a link to part 1 of this mercury discussion – chronic mercury poisoning effects at the molecular level, the cellular and organ level, effects on hormone imbalance and neurotransmitters and how to test.

If you are not already registered for the Anxiety Summit you can get live access to the speakers of the day here www.theAnxietySummit.com

The Anxiety Summit – Your hidden mercury burden: A likely root cause of the other root causes of anxiety part 1

November 7, 2014 By Trudy Scott 39 Comments

Kris Homme, MPH retired engineer turned science writer was interviewed by host of the Anxiety Summit, Trudy Scott, Food Mood Expert and Nutritionist, author of The Antianxiety Food Solution.

Your hidden mercury burden: A likely root cause of the other root causes of anxiety – part 1

chronic mercury poisoning effects at the molecular level: blocks enzymes, displaces minerals
chronic mercury poisoning effects the cellular and organ level: mineral transport, destroys barriers like gut and brain, mitochondrial dysfunction
effects on hormone imbalance, blood sugar regulation, food sensitivities, GABA/serotonin levels, autoimmunity
why mercury toxicity is complicated and hard to test for
subjective signs of chronic mercury poisoning

Here are some snippets from our interview:

Mercury inhibits methylation, which is the biochemical process that affects the production of many hormones and neurotransmitters. It also causes a selective loss of Purkinje neurons in the brain which produce GABA.

Mercury is known to concentrate in glands, including the thyroid and blocks the enzyme that converts T4 to T3. Also, your mercury burden is a chronic stressor that seems to provoke symptoms of adrenal fatigue.

Erethism: It’s the mercury personality, and that involves excessive timidity, diffidence, shyness, conflict avoidance, loss of self-confidence, anxiety, a desire to remain unobserved and unobtrusive, a pathological fear of ridicule and explosive loss of temper when criticized. There are different versions of this definition and they’re all fun and they really resonated with me, so that can be interesting to look that up on the internet.

Here is the link to Kris Homme’s publication in Biometals, published earlier this year: New science challenges old notion that mercury dental amalgam is safe

Kris has gathered some additional information into this document – Chronic mercury poisoning: A brief summary of the science

It was lovely to recently meet Kris. After enjoying a nice cup of herbal tea with her, she shared a few things about mercury toxicity in her pretty back garden. Here is one of the videos we did – enjoy!

Here is a link to part 2 of this discussion- what to do and additional resources.

If you are not already registered for the Anxiety Summit you can get live access to the speakers of the day here www.theAnxietySummit.com