From the Guidelines
To treat high vitamin B6 levels, the most effective approach is to discontinue any supplements containing vitamin B6 and reduce consumption of B6-rich foods. This is based on the understanding that excessive supplementation of B6 can produce painful neuropathy and skin lesions owing to axonal degeneration of sensory nerve fibres 1. The optimal parenteral B6 dose for infants and children is not clear, but it is known that intakes of more than 1.0 mg/kg/d should be avoided owing to possible toxicity 1.
Key Considerations
- High vitamin B6 levels are often caused by excessive supplementation rather than dietary sources alone
- The body naturally eliminates excess B6 through urine, so levels typically normalize within 1-2 months after stopping supplementation
- Monitor for symptoms like tingling, numbness, or burning sensations in hands and feet, which should gradually improve
- In rare cases where high B6 is caused by an underlying medical condition rather than supplements, consult a healthcare provider for appropriate treatment
Treatment Approach
- Discontinue any supplements containing vitamin B6
- Reduce consumption of B6-rich foods
- Consider switching to a B6-free multivitamin alternative
- Complete cessation of B6 intake is crucial for those with severe toxicity symptoms like nerve damage (peripheral neuropathy)
- No specific medication exists to lower B6 levels faster; time and elimination of excess intake are the primary treatments 1
From the Research
Treating High Vitamin B6 Levels
To treat high vitamin B6 levels, the following steps can be taken:
- Discontinue or reduce vitamin B6 supplements, as high doses can lead to neurotoxicity 2, 3, 4
- Monitor plasma B6 levels to ensure they return to a safe range (between 30 and 60 nmol/L or 7.4 and 15 μg/L) 2
- Consider weekly administration of low-dose PLP-based supplements (50-100 mg) to maintain stable serum PLP levels 2
- Be aware that high vitamin B6 levels may not always correlate with neuropathy severity, but can still cause neurotoxicity 5, 3, 4
Potential Risks and Considerations
- High vitamin B6 levels can cause peripheral neuropathy, particularly sensory neuropathy of the axonal type 3, 4
- Pyridoxine toxicity can occur at levels >100 nmol/L or 25 μg/L, leading to neurotoxicity 2, 4
- PLP-based supplements are preferred over pyridoxine supplements due to minimal neurotoxicity observed in neuronal cell viability tests 2
- Vitamin B6 metabolites have a long half-life, making weekly administration preferred over daily use to prevent toxicity 2