Vitamin B6 Discussion

Vitamin B6 Update

Vitamin B6 has been receiving increased attention recently. As a result, updates may be made to products and prescriptions within the clinic, as well as by companies producing supplements that contain B6.

One of the main concerns is the growing number of multivitamins and supplements being self-prescribed, often leading to unintentional duplication. From 2026, the clinic will be reviewing products more closely and adjusting supplements or dosages where necessary. Any changes will be based on individual circumstances, clinical presentation, and symptoms.

This serves as an important reminder to always inform your practitioner of any products you are prescribed or self-administering  outside of the clinic. It is best practice to bring all supplements and medications to every appointment, including protein powders, collagen products, multivitamins, energy drinks, and pre-workout formulas. This allows for informed discussion around both the potential benefits and risks of what you are consuming.

Symptoms of the wrong type or dose of Vitamin B6

The primary concern associated with excessive or inappropriate B6 intake is peripheral neuropathy, which affects nerves outside the brain and spinal cord. While the TGA has stated that peripheral neuropathy is rare, it is still important to be aware of the potential symptoms.

Symptoms may include:

• Gradual onset of numbness, tingling, or prickling in the hands or feet, which may spread to the arms and legs

• Sharp, jabbing, burning, or throbbing pain

• Extreme sensitivity to touch

• Pain during activities that should not cause discomfort (e.g. pain in the feet when standing or when covered by a blanket)

• Poor coordination or frequent falls

• Muscle weakness

• A sensation of wearing gloves or socks when you are not

• Difficulty moving if motor nerves are affected

If autonomic nerves are involved, symptoms may also include:

• Heat intolerance

• Excessive sweating or reduced ability to sweat

• Digestive, bowel, or bladder issues

• Drops in blood pressure leading to dizziness or light-headedness

If you are experiencing any of these symptoms, please discuss them with your practitioner.

Key take-home B6 points:

• The NIH has established a tolerable upper intake level for Vitamin B6 in adults at 100 mg per day, with a more conservative recommendation of under 50 mg per day. This total may come from one or multiple products.

• Further changes to B6 supplementation regulations may occur as more data becomes available. The TGA is expected to finalise decisions in the coming months.

• The form of Vitamin B6 matters. Not all forms appear to contribute equally to the reported issues. A 2017 study by Vrolijk et al. compared the nerve toxicity of the main forms of Vitamin B6: Pyridoxine, Pyridoxamine and Pyridoxal-5-Phosphate (P5P), being the most biologically active form. The study found that only pyridoxine caused nerve cell damage, while the other forms did not. Although pyridoxine is converted to active forms in the body, excessive supplementation may overwhelm the body’s ability to convert and utilise B6 effectively.

• If any symptoms of peripheral neuropathy please discuss with your practitioners

• While oral risk differences between B6 forms are still being explored due to their distinct metabolic pathways, current evidence suggests that pyridoxal forms (such as P5P) may present as a  lower risk than pyridoxine. It is important to know which form of B6 is in your supplements.

Should you stop taking your Vitamin B6?

If your B6 supplement or supplement contains B6  has not been professionally prescribed, it is advisable to pause use until you discuss it with your practitioner. In some cases, a practitioner may recommend continuing B6 supplementation if there is a clear and individualised clinical benefit—preferably using the active pyridoxal form.

Higher doses should only be used under professional guidance.

If you have concerns, consider requesting Vitamin B6 and B12 testing with your next blood work. Maedy believes and perhaps with emerging research it may suggest that elevated B6 levels may contribute to imbalances in Vitamin B12, and B12 deficiency itself can cause the peripheral neuropathy. Ideally, B12 levels should be maintained between 400–750 pmol/L. There are quite a few medicines that lower your B12 levels. 

At Possum Hollow, we will continue to monitor developments and share updates as new information becomes available. In the meantime, please do not hesitate to discuss any concerns with your naturopath.

ref: Based on Nutrition Practitioner Darren Maginns’ article:
“ANTA’s Insights on the TGA’s Report on Vitamin B6”