7 Signs & Symptoms of Pyridoxine (Vitamin B6) Deficiency & Treatment – Research Studies 

What is Vitamin B6?

Vitamin B6, also called pyridoxine, is a water-soluble vitamin that forms various essential coenzymes in the human body, integral to the functioning of enzymes catalyzing metabolic processes. The three natural forms of vitamin B6 include pyridoxamine, pyridoxine, and pyridoxal. All these three forms are converted into an active form, known as pyridoxal 5-phosphate, functioning as a coenzyme. In the three natural forms, vitamin B6 is absorbed from the small intestine via the process of passive diffusion. [1]

Why Vitamin B6 is Important?

Vitamin B6 is derived from various food sources including vegetables, fruits, meat, fish, grains, and nuts. Functioning as a coenzyme, vitamin B6 facilitates various enzymatic reactions such as the metabolism of lipids, amino acids, and carbohydrates. Vitamin B6 is important for the production of hemoglobin, interleukin-2, and neurotransmitters. The synthesis of neurotransmitters and interleukin-2 is implicated in cognitive development and immune function, respectively. The development of the brain in the intrauterine and infancy stages is also dependent on sufficient levels of vitamin B6. [2]

7 Signs & Symptoms of Pyridoxine (Vitamin B6) Deficiency

1. Seizures 

Neonates and adults suffering from vitamin B6 or pyridoxine deficiency may report the occurrence of seizures. As discussed previously, the active form of pyridoxine is important for the production and metabolism of neurotransmitters, particularly Gamma-Aminobutyric Acid (GABA), which is an inhibitory neurotransmitter. The deficiency of vitamin B6 and its active form results in decreased concentration of GABA in the brain, contributing to an increased risk for seizures in susceptible individuals. [3] 

2. Changes in Mental Status 

Vitamin B6 or pyridoxine is important for the regulation of mood and mental function of individuals. The lack of re-methylation of homocysteine in vitamin B6 deficiency results in increased levels of homocysteine in the blood. This has direct toxic outcomes on the central nervous system neurons and also increases the risk for cerebrovascular disease. Besides the development of seizures, other neuropsychiatric disorders associated with vitamin B6 deficiency include migraine and chronic pain. Poor vitamin B6 status and increased homocysteine levels are also implicated in the development of dementia and Alzheimer’s disease. [4]

3. Depression

 Pyridoxal 5-phosphate serves as a cofactor in the metabolism of tryptophan, which promotes the conversion of tryptophan into a monoamine neurotransmitter, called serotonin. The regulation of mood is significantly determined by the metabolism of tryptophan and the production of serotonin. Low plasma levels of pyridoxal 5-phosphate are inversely related to the development of depressive symptoms. The combination of vitamin B6 and anti-depressive medications are effective in the treatment of depressed patients. [5]

4. Glossitis 

Pyridoxine and other nutrients are important for the proliferation, repair, and normal functioning of epithelial cells in the oral cavity. Besides deficiency in pyridoxine, increased homocysteine levels also result in the atrophy of mucosa on the dorsal surface of the tongue. This results in the development of atrophic glossitis. Vitamin B6 deficiency patients suffering from atrophic glossitis may experience dry mouth, taste dysfunction, burning sensation on the tongue, and tongue numbness. [6]

5. Pruritus Rash and Dermatitis

The cutaneous manifestations of vitamin B6 or pyridoxine deficiency include seborrheic eruptions in different areas of the body. These comprise the shoulders, perineum, face, scalp, neck, and buttocks. A pellagra-like dermatitis is also observed on the dorsal extremities in individuals suffering from vitamin B6 deficiency. Such individuals may also develop photo-distributed dermatitis. [7]

6. Cheilitis 

Angular cheilitis or angular stomatitis is described as the inflammation of skin and mucosa at the angles of the mouth. While fungal and bacterial infections contribute to the development of angular cheilitis, nutritional deficiencies including those of vitamin B6 also result in the development of this condition. [8]

7. Anemia 

Pyridoxal 5-phosphate is a delta-aminolevulinate synthase, which is a rate-limiting enzyme in the synthesis of heme. In individuals suffering from vitamin B6 deficiency, the production of heme is depressed. This leads to the limited synthesis of heme and the resultant production of smaller red blood cells, which is called microcytic anemia. [9] 

Vitamin B6 Deficiency Treatment 

Measuring the concentration of vitamin B6 in real time is a difficult process in different clinical scenarios. Therefore, direct biomarkers or B6 vitamers present in the urine, serum, plasma, and erythrocyte are utilized. The clinical alternative to the measurement of vitamin B6 in the body is the concentration of xanthurenic acid in the urine. Increased excretion of xanthurenic acid is indicative of abnormal tryptophan metabolism associated with a deficiency of vitamin B6. [2]

The dosage of vitamin 6 is based on the severity of vitamin B6 deficiency symptoms. The therapeutic formulations comprise oral and parenteral administration of vitamin B6 in individuals. Neonates suffering from B6 deficiency seizures are treated using intravenous administration of vitamin B6. Conversely, oral formulations of vitamin B6 are used in the treatment of less severe presentations of vitamin B6 deficiency. [2]

Take advantage of free consultation with one of our Health Coach through the chat icon on the website to determine of vitamin B6 deficiency along with the identification of appropriate dosages for patients. ASTR program recommends taking all types of vitamins together because they depend on each other for absorption. Too much of one vitamin may cause a deficiency of another, which is why it is recommended that all vitamin Bs are taken together in a single capsule.

संदर्भ 

1. Abosamak NER, Gupta V. Vitamin B6 (Pyridoxine) [Updated 2023 Feb 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557436/
2. Brown MJ, Ameer MA, Beier K. Vitamin B6 Deficiency. [Updated 2022 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470579/
3. Tong Y. (2014). Seizures caused by pyridoxine (vitamin B6) deficiency in adults: A case report and literature review. Intractable & rare diseases research, 3(2), 52–56. https://doi.org/10.5582/irdr.2014.01005
4. Malouf, R., & Grimley Evans, J. (2003). The effect of vitamin B6 on cognition. The Cochrane database of systematic reviews, (4), CD004393. https://doi.org/10.1002/14651858.CD004393
5. Merete, C., Falcon, L. M., & Tucker, K. L. (2008). Vitamin B6 is associated with depressive symptomatology in Massachusetts elders. Journal of the American College of Nutrition, 27(3), 421–427. https://doi.org/10.1080/07315724.2008.10719720
6. Chiang, C. P., Chang, J. Y., Wang, Y. P., Wu, Y. H., Wu, Y. C., & Sun, A. (2020). Atrophic glossitis: Etiology, serum autoantibodies, anemia, hematinic deficiencies, hyperhomocysteinemia, and management. Journal of the Formosan Medical Association = Taiwan yi zhi, 119(4), 774–780. https://doi.org/10.1016/j.jfma.2019.04.015
7. Wong, C. Y., & Chu, D. H. (2021). Cutaneous signs of nutritional disorders. International journal of women’s dermatology, 7(5Part A), 647–652. https://doi.org/10.1016/j.ijwd.2021.09.003 
8. Bhutta BS, Hafsi W. Cheilitis. [Updated 2023 Feb 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470592/
9. da Silva, V. R., & Gregory III, J. F. (2020). Vitamin B6. In Present knowledge in nutrition (pp. 225-237). Academic Press https://www.sciencedirect.com/science/article/abs/pii/B9780323661621000135