Elevated b6
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Elevated Vitamin B6: Causes, Effects, and Implications
Causes of Elevated Vitamin B6 Levels
Multivitamin Supplementation and Energy Drinks Elevated plasma vitamin B6 levels are commonly observed in individuals who regularly consume multivitamin supplements and energy drinks. A study on post-bariatric patients revealed that 50% of the participants had vitamin B6 levels up to four times higher than the upper normal limit, with the highest levels found in those consuming energy drinks daily1. This suggests that both multivitamin supplements and energy drinks significantly contribute to elevated vitamin B6 levels.
Dialysis in Pediatric Patients In pediatric patients undergoing long-term dialysis, elevated vitamin B6 levels were also prevalent. A review of 28 children on maintenance dialysis found that over 50% had raised vitamin B6 concentrations, with supplementation being a common factor3. This indicates that routine supplementation in these patients may lead to elevated levels.
Effects of Elevated Vitamin B6 Levels
Neuropathy and Sensory Complaints Elevated levels of vitamin B6 have been linked to sensory neuropathy. A study involving patients with elevated B6 levels reported that 80.8% experienced sensory complaints such as numbness, burning pain, and tingling5. However, another study found no correlation between moderately elevated B6 levels and the severity of neuropathy in patients with chronic idiopathic axonal polyneuropathy, suggesting that only very high levels might be problematic6.
Modulation of Gene Expression Vitamin B6 plays a role in modulating gene expression, particularly through steroid hormone receptors. Elevated B6 levels have been shown to suppress transcriptional activation by glucocorticoid, androgen, progesterone, and estrogen receptors by 30-65%2 7. This modulation can affect a wide array of hormonally responsive genes, indicating that high B6 levels might have broader implications on gene expression and hormonal balance.
Implications and Recommendations
Monitoring and Supplementation Given the potential for elevated vitamin B6 levels to cause sensory neuropathy and affect gene expression, it is crucial to monitor B6 levels in individuals taking supplements or consuming energy drinks regularly. In post-bariatric patients and pediatric dialysis patients, routine follow-up and critical evaluation of vitamin B6 supplementation are recommended to prevent excessive levels1 3.
Potential Therapeutic Role and Risks While high levels of vitamin B6 are associated with neuropathy, low levels have also been implicated in various health issues, including cardiovascular diseases and inflammation8. However, the therapeutic role of B6 supplementation in treating neuropathy remains unconfirmed, and further research is needed to establish safe and effective guidelines9.
Conclusion
Elevated vitamin B6 levels are primarily caused by excessive intake through supplements and energy drinks. These elevated levels can lead to sensory neuropathy and modulate gene expression, affecting hormonal balance. Regular monitoring and careful management of vitamin B6 intake are essential to prevent adverse effects, especially in vulnerable populations such as post-bariatric and pediatric dialysis patients. Further research is needed to fully understand the therapeutic potential and risks associated with vitamin B6 supplementation.
Sources and full results
Most relevant research papers on this topic
Regular intake of energy drinks and multivitamin supplements is associated with elevated plasma vitamin B6 levels in post-bariatric patients
Elevated plasma vitamin B6 levels are common in post-bariatric patients, with higher levels found after biliopancreatic diversion and in patients who consume daily energy drinks.
Observational Study
Rigorous JournalVitamin B6 modulates transcriptional activation by multiple members of the steroid hormone receptor superfamily.
Vitamin B6 influences transcriptional activation by multiple steroid hormone receptors, affecting gene expression in various hormonally responsive genes.
In Vitro Study
Highly CitedVitamin B6 blood concentrations in paediatric dialysis patients
No children on long-term dialysis had vitamin B6 deficiency, but over 50% had elevated vitamin B6 concentrations, suggesting no need for routine supplementation and monitoring.
Observational StudyRigorous JournalEstimation of vitamin B6 compounds in human blood and urine.
The method developed accurately estimates vitamin B6 compounds in blood and urine, with no significant variation found in normal female subjects at different stages of the menstrual cycle.
Non-RCTElevated B6 levels and peripheral neuropathies.
Elevated pyridoxine levels should be considered in the differential diagnosis of sensory or sensorimotor polyneuropathy.
Case ReportVitamin B6 levels do not correlate with severity of neuropathy in chronic idiopathic axonal polyneuropathy
Moderately elevated vitamin B6 levels, even in the 100 to 200 g/L range, are not associated with significantly worse neuropathy signs or symptoms in chronic idiopathic axonal polyneuropathy patients.
Observational StudyModulation of gene expression by vitamin B6
Vitamin B6 acts as a physiological modulator of gene expression, affecting steroid hormone-responsive enzymes and unrelated proteins, offering a new dimension to its role as a cofactor in enzyme action.
Low Circulating Vitamin B6 Is Associated With Elevation of the Inflammation Marker C-Reactive Protein Independently of Plasma Homocysteine Levels
Low vitamin B6 levels are associated with higher inflammation markers, potentially explaining the decreased vitamin B6 levels in cardiovascular disease.
Observational StudyHighly CitedThe Role of Vitamin B6 in Peripheral Neuropathy: A Systematic Review
High vitamin B6 levels may cause neurotoxic peripheral neuropathy, while low B6 levels may be a potential risk factor for peripheral neuropathy, but further studies are needed.
Systematic ReviewVitamin B6 and Cancer Risk: A Field Synopsis and Meta-Analysis
High intake of dietary vitamin B6 and pyridoxal-5'-phosphate (PLP) is associated with lower cancer risk, particularly for gastrointestinal tumors.
Meta-AnalysisRigorous JournalHighly Cited