From keeping inflammation down and your
blood sugar up, to staying mentally sharp,
sleeping well, and staying happy,
vitamin B6 is an incredibly important nutrient.
And this is how to make sure that you
are getting enough.
Hi. I'm Dr. Chris Masterjohn of
chrismasterjohnphd.com. And this is
Chris Masterjohn Lite, where the name of the game is
"Details? Shmeetails. Just tell me what works!"
And today we're going to talk about how
to manage your vitamin B6 status. Now, in
its most severe form, which you and I
are unlikely to encounter,
vitamin B6 deficiency causes convulsive
seizures. And when you look at that level
of deficiency, you're also seeing irritability,
depression, confusion, very severe
vulnerability to infection, and skin
lesions that look the same as what you
get in deficiencies of riboflavin, or
vitamin B2, where you have
a reddened tongue, a reddened inside of
the mouth, and you have lesions around
the corners of your mouth as well.
Now, the depression and irritability and
those things, we may see in more
moderate deficiencies of B6.
In fact, although the evidence isn't
really strong, we might expect
problems with moderate deficits of
vitamin B6 to include cognitive decline
over time with age, depression, anxiety,
insomnia, and hypoglycemia. In fact, in the
case of hypoglycemia, 80% of the
vitamin B6 in your body is used to make
sure that you can store enough
carbohydrate in your liver so that when
you don't eat, your blood sugar stays stable.
And so if not eating overnight or
for a long period of time during the day
is causing you to crash, that could be a
sign that you need more vitamin B6.
We might also expect vitamin B6 moderate
deficits to contribute to kidney stones.
And so if you're at risk for kidney
stones, you should be checking your
vitamin B6 status. And there's increasing
evidence that vitamin B6 is involved in
protecting against the morning sickness
of pregnancy. There is also a
specific vitamin B6-dependent anemia
called sideroblastic anemia, and that's
where you have normal hemoglobin
concentrations, but if you look under a
microscope, you see the hemoglobin
accumulating around the edges of the red
blood cells. It's not that common, so it's
not regularly screened for, but basically
it makes you unable to carry oxygen in a
normal capacity because your red blood
cells aren't working correctly, even
though you have normal amounts of red
blood cells in your blood. More moderate
deficits of vitamin B6 also contribute
to high homocysteine, which contributes
to cardiovascular disease and is
something that's usually tested in
regular blood testing. And B6 probably
generally contributes to chronic,
low-level inflammation and to the risk of
cardiovascular disease. So, we want to
make sure that we're getting enough vitamin B6.
How do we do that?
Although vegetarianism and veganism
don't necessarily contribute to vitamin
B6 deficiency, consuming animal foods
makes you more robust to B6 deficiency,
and the reason is basically as follows:
there are two different types of B6 in
plant foods and in animal foods.
The vitamin B6 that is found in animal foods
is in the form that you need it, and you
can consistently absorb good amounts of it.
On the other hand, the vitamin B6
that's found in plant foods is often
bound up to sugars, and whether you
absorb it and how much you absorb is
entirely dependent on your gut flora
because we don't have the enzymes to
liberate that B6 from the plant foods,
and we are dependent on our gut flora doing
it for us, so there can be wide
variability in whether you absorb it.
Furthermore, once you absorb the form of
B6 in plant foods, it's got to go to
your liver and it's got to be converted
to the active form using another
B vitamin, riboflavin, or vitamin B2. So if
your gut flora is off, or your liver
health is off, or your riboflavin status
is off, you may not
get enough vitamin B6 from plant foods.
Cooking foods not only destroys some of
the vitamin B6, but it actually converts
it into an anti-B6 that can actually
antagonize the B6 that is in the food.
Overall, when you're looking at cooking
foods, you're generally looking at a 40%
loss of bioavailability, meaning between
what you aren't getting and the
antagonist that you are getting, it's
equivalent to getting 40% less B6 in
your diet than if those same foods were raw.
High intakes of protein, especially
animal protein, can raise your need for
vitamin B6, and low levels of other
nutrients, like riboflavin or molybdenum,
a mineral, can also raise your needs for
vitamin B6. And putting diet aside for a
moment, oral contraceptives, high estrogen
status, even when you are making your own
estrogen in high amounts, and inflammation,
as well as non-steroidal anti-inflammatory
drugs, the NSAIDS, the over-the-counter
anti-inflammatories, and some of the drugs used
to treat tuberculosis and Parkinson's, can
all contribute to B6 deficiencies. So when
you put that all together, a diet that is
low in animal foods or high in proteins
when you don't have the accompanying B6,
for example, if you're consuming a very
large amount of protein powder instead
of getting your protein from the animal
foods that have the B6 in it, or diets
low in riboflavin, or just
overwhelmingly cooked and overcooked
foods without any raw foods, as well
as use of estrogens and the drugs that I
just mentioned, are all potential
contributing factors to B6 deficiency.
Well, how can you test for it?
How would you know?
Plasma B6 is a very good test and easy
to get, and it tends to be low in deficiency.
If you want to get a little
bit more nuanced, if you have an organic
acids test—and the organic acids test that
has the most number of these markers is
the Genova ION Panel, but on any urinary
organic acids test, you will probably see at
least one of the markers of vitamin B6
deficiency. And those include xanthurenate,
kynurenate, and quinolinate.
Out of all of those, the one that
is most likely to be elevated in early
B6 deficiency is xanthurenate. Usually
quinolinate is the last to rise.
One thing that's not clear is that high
estrogen levels and use of oral
contraceptives can raise these urinary
markers of vitamin B6 status, but the
science isn't quite there to be able to
say that supplementing B6 or raising B6
levels in the diet gets rid of that
effect and any of the potential
consequences. So it's not clear whether
estrogen in high amounts is just
distorting your metabolism or is
actually raising your needs for vitamin B6,
but I will say anecdotally,
there does seem to be a sort of syndrome
or pattern where women with very high
estrogen levels may have symptoms such
as insomnia that are at least helped,
maybe not cured, but at least helped by
using supplemental vitamin B6. I will
also say anecdotally that there seem to
be a number of people who have some
symptoms of vitamin B6 deficiency or
some markers of vitamin B6 deficiency
that don't go away, unless they take
relatively high doses of vitamin B6 in
the form of pyridoxal 5'-phosphate, or P5P,
at doses between 30 and 100
milligrams. So in general, I would say if you have
the symptoms and you have the markers,
or you have one or the other, I think it's
safe to experiment with vitamin B6
supplementation providing you have first
looked at your diet and made sure that
you've fixed any dietary problems. But if
you're going to supplement, I would not
use pyridoxine. I would use
pyridoxal 5'-phosphate, P5P, and I think
it's safe to experiment first with doses of
5 to 10 milligrams. If that's not
getting you results, try going in the
30- to 100-milligram per day range.
I would not go over 100 milligrams
per day. That is set as the
upper limit by the Institute of Medicine
on the basis that doses of 500
milligrams per day or more are
associated with neurological problems
from toxicity. The good news is those
neurological problems, according to
what's out there in the literature, go
away when you take out the B6, and
keeping your B6 no higher than 100 milligrams
should provide a very significant
margin of safety so that
that's not something you need to worry about.
Managing B6 status is something
that you can get information on in more
detail and better integrated into the
overall context for managing your
dietary nutrients in my ebook
Testing Nutritional Status: The Ultimate Cheat Sheet.
Signing off, this is Chris Masterjohn of
chrismasterjohnphd.com. And this has
been Chris Masterjohn Lite.