To B or not to B6

combination with other drugs, supplements or (at times) even foods.

If you have a headache & take 2 paracetamol tablets, it may relieve the headache. If you take the whole box of tablets, it may cause liver failure & even death. I’m not aware of any class actions against the makers of paracetamol & thus believe all of these decisions need to be consistent & always public safety in these matters is paramount. To use the often-quoted Hippocratic Oath-First, do no harm.

Lawyers are launching a class action investigation against a supplement company due to excessive levels of vitamin B6 in some of their supplements, which may have led to serious health issues for consumers. The lead plaintiff, Dominic Noonan-O’Keeffe, began taking Blackmores Super Magnesium+ (which contains Vitamin B6 (pyridoxine)-50mg and Ashwagandha+ (B6-25mg) in May 2023 in preparation for the birth of his child, unaware that these products contained vitamin B6 levels approximately 29 times higher than the recommended daily intake.

By August 2023, Noonan-O’Keeffe developed debilitating symptoms, including severe fatigue, headaches, muscle spasms, and neuropathy, which medical professionals attributed to excessive vitamin B6 levels in the supplements. Despite ceasing consumption of the products in February 2024, he continues to suffer from ongoing symptoms.

The lawyers aim to not only seek justice for Noonan-O’Keeffe but also to advocate for regulatory changes regarding the sale of vitamin B6 supplements to protect consumer safety. The firm emphasizes that incidents like Noonan-O’Keeffe’s highlight a broader concern regarding the high levels of vitamin B6 found in over-the-counter supplements in Australia.

Recent studies have pointed to potential health issues from excessive vitamin B6 intake, including neurological symptoms similar to those experienced by Noonan-O’Keeffe. These findings underline the urgent need for stricter regulations and consumer awareness regarding vitamin supplementation, particularly concerning those that contain high levels of B6, to prevent similar health complications.

Peripheral neuropathy & other non-specific or even specific neurological symptoms associated with excessive vitamin B6 (pyridoxine) intake may occur in genetically predisposed individuals who consume high doses of vitamin B6 in supplement form.

Here are some key points to consider regarding this issue:

1. Genetic Predisposition: Some individuals may have genetic factors that affect how their bodies metabolise vitamin B6. Genetic variations can influence enzymes involved in vitamin B6 metabolism, leading to an increased risk of toxicity and adverse effects when high doses are consumed by those, but not all individuals.

2. Dose-Dependent Toxicity: While vitamin B6 is essential for various bodily functions, excessive intake—especially in supplement form—may lead to toxicity. Chronic consumption of high doses (often considered above 100 mg per day) may cause sensory neuropathy, resulting in symptoms such as numbness, tingling, and pain in the extremities.

3. Symptoms of Peripheral Neuropathy: Individuals with vitamin B6-related peripheral neuropathy may experience a range of symptoms, including:

– Tingling or burning sensations

– Numbness in the hands and feet

– Muscle weakness

– Difficulty with coordination and balance

4. Duration and Severity of Supplement Use: The risk of developing peripheral neuropathy increases with the duration and amount of vitamin B6 supplementation. Those who take high doses over long periods, especially if they are genetically predisposed, may be at a higher risk.

5. Clinical Recommendations: Healthcare providers often advise against high-dose vitamin B6 supplementation unless specifically indicated and monitored. It is crucial for individuals considering supplementation to consult with healthcare professionals, particularly those with a personal or family history of neuropathy or genetic conditions affecting metabolism.

6. Reversibility: In some cases, symptoms of peripheral neuropathy caused by excessive vitamin B6 intake can improve or resolve after discontinuing supplementation. However, recovery may vary depending on the individual and the extent of nerve damage.

There are, however, a number of trials suggesting lower doses of B6 in combination with other B group vitamins may offer some benefit for the management of mild cognitive impairment, potentially slowing the progression to dementia. A major trial from Professor David Smith’s Oxford group, VITACOG investigated the effects of nutritional interventions on individuals with mild cognitive impairment (MCI).

VITACOG Trial

1. Objective: The VITACOG trial sought to determine whether supplements containing B vitamins, specifically B6-20mg, B12-500mcgs, and folic acid-800mcgs, could slow cognitive decline in older adults with mild cognitive impairment.

2. Design: The Vitacog study was a randomized, double-blind, placebo-controlled trial, providing strong evidence for the findings by minimizing bias.

3. Participants: The study included older participants diagnosed with MCI and aimed to assess how B vitamin supplementation affects various cognitive functions.

4. Outcomes: The primary outcome measure was cognitive function over time, evaluated using neuropsychological assessments & MRI brain volumes. The study also monitored homocysteine levels, as high levels are associated with cognitive decline, and aimed to determine whether reducing these levels through B vitamin supplementation could be beneficial.

5. Results and Implications: The Vitacog trial found that B vitamin supplementation led to reduced homocysteine levels and may have a modest effect on slowing cognitive decline. These findings support the idea that nutritional interventions, specifically targeting B vitamins, may have potential benefits in managing MCI and possibly delaying progression to dementia.

Genetically predisposed individuals who consume high doses of vitamin B6 supplements may be at greater risk for developing peripheral neuropathy due to the interplay between genetic factors, dose dependence, and the duration of exposure to high levels of the vitamin.

But there does appear to be a dose dependent benefit for assisting in reducing cognitive decline in the elderly for B6 & therefore I believe that the main issues raised here are awareness and education. All pharmaceuticals also have the potential for harm either used alone or in combination with other drugs, supplements or (at times) even foods.

If you have a headache and take two paracetamol tablets, it may relieve the headache. If you take the whole box of tablets, it may cause liver failure and even death. I’m not aware of any class actions against the makers of paracetamol and thus believe all of these decisions need to be consistent and always public safety in these matters is paramount. To use the often-quoted Hippocratic Oath: first, do no harm.