What you ACTUALLY need to know about B6 & Toxicity

And so if you look at vitamin B6, once it goes inside of a mammal, especially a human, it can metabolize through all these different pathways and become different vitamers of vitamin B6. Hey, it's Dr. A. I'm answering your questions today, and this question was really a good one. We get this a lot, and it's about vitamin B6 toxicity. Why would that happen? What happens when you get vitamin B6 toxic? And why would a nutrient that is critical for your life to keep going on, and like your brain to function, everything else, create a problem. So we get comments, especially when certain, you know, I think we were talking about maybe long COVID or mast cells or something like that. Go check those playlists out over on YouTube if you want. But got a lot of comments around B6 and people saying, well, I'd stop taking B6 because I got a toxicity syndrome from it. So first thing, every nutrient has a potential deficit problem and a potential toxicity or excess problem. We humans are sort of set up to work in the middle where we, we don't want too little and, you know, get some deficiency disease. We don't want too much. Now, water-soluble vitamins usually leave your body roughly the same day they come in, so we have to, you know, eat them or get them every day. But vitamin B6 is a little bit unique. Now, there's other vitamins similar, but B6 is a little unique, and this is where the toxicity usually comes from. So I just want to talk about that in an effort to answer this particular question. How do people get B6 toxic? Well, the first thing is most well-recognized vitamin B6 toxicity is more of a neurotoxicity— peripheral nerves, maybe central nerves, etc. And in the literature, when they were first describing it, it tended to be in people taking very large doses of vitamin B6. So they were taking, you know, 500 or more milligrams a day for long periods of time, which short-term you might need a lot of B6. Long-term, that's way too much. Okay. But here's the problem, because you might say, well, you know, a lot of people take vitamin B6 every day and they don't get toxic. If human biochemistry were really simple, then every B vitamin, for example, would metabolize exactly the same way. The problem with vitamin B6 is it's a Pool of what we call vitamin B6 vitamers. Okay, so vitamin is an unusual name unless you're into nutrient biochemistry, but you might have heard of something like called an isomer, right? So there might be two forms of a chemical. Well, a vitamin is multiple forms of a of a vitamin, hence the name. So vitamin B6 has a lot of different forms, and I almost did one of my little graphs I was going to show you, but it's, it's a little bit busy. But here's a problem: there are pathways for vitamin B6 to metabolize inside of a human. The first one generally is being activated. One of the active forms which you can take as a supplement is pyridoxal-5-phosphate, or P5P, and then there's pyridoxine, and that is the normal B6 vitamin that's given, and it's a little step above, so it has more Metabolism options, but even P5P being quote unquote more active has a bunch of places it can go. And so if you look at vitamin B6, once it goes inside of a mammal, especially a human, it can metabolize through all these different pathways and become different vitamers of vitamin B6. And one of the pathways that tends to pool the vitamers that are not friendly to your nervous system is triggered by Inflammation. It's triggered by peroxide radicals and other inflammatory things. So the evil in the system and the actual trigger is not the vitamin B6. It is the inflammatory reaction that the vitamin B6 undergoes. There's a different type of reaction, it's related, that happens if someone is a smoker and their vitamin B6 will metabolize, you know, inappropriately because of the inflammatory and some of the epigenetic changes from smoking. But you don't have to be a smoker. Yeah. smoker to have this happen. And this is the reason why you can have 1,000 people taking vitamin B6, they don't have a problem, the 1,001st person gets vitamin B6 toxic. Now, it has an overlay in many people, not everybody, of genomic problems, single nucleotide polymorphisms, imbalances in the enzymes that metabolize all these different pathways of vitamins, etc. But the bottom line is, is that we tend to pool and increase the vitamers that are more unfriendly to the nervous system in people who have B6 toxicity syndromes. So then you might say to yourself, well, should everyone not take B6 anymore? No, it's not how it works. This is just for particular people that are B6 toxic. If you are B6 toxic, obviously one of the things is not to take any extra until you get this sorted out. But if you think about it, if I take away B6 and you're not taking that anymore, that's great because you're not getting extra B6. But then if you have this underlying inflammatory problem and that is never dealt with, or the genomic problem's never dealt with, you are always going to have this nutrient that is used to run your body, when it gets over a certain level, trigger this unfortunate buildup of the vitamers of B6 that are Uh, you know, nasty to your nervous system. So decreasing B6 intake is the acute thing that you do. Long term, if you are to work with somebody who's working on all these other things and your inflammatory state, etc., and they look at your, uh, say, genomics, and you, you see maybe I've got metabolism issues that need some help here, or I need to avoid certain things. Long term, a person with B6 toxicity Who works on the underlying problems can have it in their food and maybe a little bit in supplements. They are not affected by it. But what tends to happen is— remember I said the initial reports were all people taking, you know, stupid high amounts of vitamin B6 long term. All right, stupid high short term is used therapeutically for particular things. We do that all the time. But long term, you don't leave people on super high doses. But they were taking it long term at high dose. So if you take that group out, Then you get people who are maybe taking a moderate dose or a medium dose of B6 or P5P and they get toxic with it. That is because they're metabolizing it and it's having this inflammatory cascade problem. Now, if the person was or is a smoker, there's different things to do there. But if the person's not a smoker and has no history of smoking, then what we really have to look at is what is the real cause of the problem? The real cause of the problem is not actually the B6. That's the trigger, but the real cause of the problem is the inflammatory buildup of the B6 vitamers that are not friendly to the, to the nervous system in particular. So in that case, then we have to take away the exogenous, the extra vitamin B6, and then we have to work on the inflammatory conditions underlying what's going on with you. And like we talked about with long COVID and other stuff, That can be different things for different people. If we subtract smoking away from it, it could be any number of things. You can have genetics that make you more inflammatory, and the first trigger you notice is B6. It can be a bunch of other stuff. You can have genetic polymorphisms, you know, that are giving you a problem like rebalancing your inflammatory cascade. You can have chronic deficiencies in some of your primary antioxidants like vitamin and vitamin E and glutathione and some of their support molecules, you can have an imbalance where you have good amounts of 2 of those antioxidants and not good amounts of others, and that can be sort of dynamite for you. So the big thing is, if you had B6 toxicity, the first thing is you don't take any more until you sort all this stuff out. But the next thing is you have to get down, you have to work on the underlying inflammatory problems, maybe look at the genomics, all of this. stuff that needs to be done. And so when we're thinking about that, the next thing that happens is people will say, well, I had a blood test for B6 and it was really high. Well, it may be, but what you need to remember is that blood test for B6 is not measuring just one kind of vitamin B6. It's measuring at least 6 vitamers, maybe more, in a pool. So the problem with that as a diagnostic tool is not that maybe it's elevated, but also it's not telling you, am I metabolizing it to the good ones or the bad Totally different, very important, critical thing to know. The other thing about the test for vitamin B6 is even with a little bit more updated technology, it's very hard to do that test correctly, meaning if they draw your blood the wrong way, the test will be inaccurate. If they don't stabilize the tube and the blood and they don't process the blood exactly correctly, it's going to be inaccurate. And even if they do all that correct, you can have variation in the chemistry reading that they actually do at the lab where you can have variation there. And so having a B6 test that is elevated is a piece of the puzzle, but it is a very shaky piece of the puzzle because number one, it doesn't tell you what vitamers you have that are in excess. And number two, it's a test that is very fraught with, you know, false positive readings and false negative readings. So the test is a little sliver of the pie. Mostly what you have to do is look at the underlying inflammation. You take away the offending substance, the B6, and then you figure out what the inflammatory cascade is messed up, where it's messed up, and what it's doing. Well, to whoever asked this question, I think it was 3 or 4 of you, I hope this helps at least give you a start for the intellectual understanding of what's going on. We do it in the show notes or the description box on YouTube. We usually have links to Healthcare provider associations, people that do more chronic illness care, that sort of thing. So sometimes that's helpful. What I always say is I'm just telling you my experience as a clinician for a few decades doing this, and this is for your information and your edification. It's not for your healthcare decision-making. That's done with your healthcare provider or providers. But check us out on dranow.com, D-R-A-N-O-W dot com. That's my hub website where you can get to the YouTube page pod burners. You can see the newsletter that comes out, all that stuff. And check us out there. If you're listening on one of the pod burners, please like, share, subscribe. I'd love you to check out the YouTube channel if you're not on that listening to this. And again, like, share, subscribe. Notifications are important. And also comment on the video. That helps us with the algorithm, and we're getting back in the good graces of the algorithm, so we're happy about that. All right, this has been Dr. Paul Anderson for Medicine and Health with Dr. Paul Anderson, and it's been my pleasure answering this question. I'm gonna answer some more in a little bit. Thank you.