Differential Diagnosis for Elevated B6

• Single most likely diagnosis
  • Vitamin B6 supplementation: This is the most straightforward reason for elevated B6 levels, as individuals taking supplements will naturally have higher levels of the vitamin in their system.
• Other Likely diagnoses
  • Multivitamin use: Many multivitamins contain vitamin B6, and regular consumption can lead to elevated levels.
  • High dietary intake: Foods rich in vitamin B6, such as meat, fish, and some fortified cereals, can contribute to elevated levels if consumed in large quantities.
  • Liver disease: Certain liver conditions can affect the metabolism and storage of vitamin B6, potentially leading to elevated levels.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Hyperthyroidism: Although less common, hyperthyroidism can be associated with increased levels of vitamin B6 due to the accelerated metabolism of the condition.
  • Certain cancers: Some types of cancer, like hepatocellular carcinoma, can lead to abnormalities in vitamin B6 metabolism, resulting in elevated levels.
• Rare diagnoses
  • Genetic disorders affecting vitamin B6 metabolism: Conditions such as pyridoxine-dependent epilepsy or hyperoxaluria type 1 can lead to abnormal vitamin B6 levels due to genetic defects in its metabolism.
  • Medication interactions: Certain medications can interact with vitamin B6, either by increasing its levels or affecting its activity, though this is less common and highly dependent on the specific medication and context.