Vitamin B6 Toxicity Level

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The US authorities set the no-observed-adverse-effect-level at 200 mg per day and the safe upper limit at 100 mg per day. 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. However, physicians need to remain alert to high intakes of vitamin B6 as a cause of unexplained neuropath.

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Motor and central nervous systems are usually intac.

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Background: B-Complex vitamins are essential for functioning of the nervous system, and supplementation is generally well tolerated. Herein, we report a case of reversible pyridoxine induced sensorimotor neuropathy and disequilibrium in an octogenarian.
Case: 87-year-old right-handed Caucasian female with a four-year history of supplementing with B-Complex vitamins for chronic gastrointestinal illness, presents with five months of progressively worsening fatigue, left lower extremity weakness, numbness, and ataxia. Neurologic examination was notable for pronounced atrophy of foot intrinsics (right >left) and hand interossei. Sensory examination was notable for length dependent multimodal sensory loss in a stocking-glove pattern, and diminished joint position sense.
She had absent deep tendon reflexes in both upper and lower extremities, and a steppage gait on the left. Nerve conduction studies of the left lower extremity were notable for evidence of chronic, length-dependent, sensorimotor, axonal, peripheral polyneuropathy with extensive active denervation in distal muscles. Intervention: Pyridoxine supplementation was discontinued and the patient underwent intensive physiotherapy.
In a two-month follow up visit, her balance was markedly improved on the Berg Balance Test and Timed Up and Go tests. Conclusions: In conclusion, sensorimotor neuropathy secondary to pyridoxine toxicity can be debilitating, but is potentially reversible with timely cessation of vitamin B6 supplementation and intensive physiotherapy. Disclosure: Dr. Moudgal has nothing to disclose.

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When you exceed the UL, you start increasing your chances of side effects Since supplements are required to provide at least 100% of their listed amounts of ingredients at the time you purchase them and, if properly maintained, until a listed expiration date, it is customary and acceptable for companies to put in a bit more (an “overage”) than the listed amount of an ingredient to compensate for normal degradation. This is because your supplement provided an amount of B6 close to the upper limit (and much more than normally needed) and there is an allowable manufacturing overage, as noted above. Foods also contribute B6, but non-fortified foods would be unlikely to put you over the UL since foods naturally rich in B6 (like liver, other meats, potatoes, and bananas) provide about only about 0.25 to 1 mg of B6 per serving.

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