Vitamin B6 has multiple mechanisms of action in humans. Additionally, its biochemistry is complex with multiple vitamers, all having potential effects in the body. Added to this complexity is the known effect of low B6 causing neuropathy, but also a bimodal “B6 toxicity state” where low or high levels of supplementation may trigger neuropathy as well. While there are many publications regarding the biochemistry, pharmacology, and toxicology of B6 a clear understanding of its toxicity is elusive in the data. This CME is designed to lay out the known science and give clinical guidelines for the safe use of vitamin B6, as well as strategies for dealing with potential toxicity.

Objectives:

⭑ Define vitamers

⭑ Describe the biochemistry of B6 vitamer metabolism

⭑ Outline the possible antioxidant and prooxidant effects of B6

⭑ Discuss possible causes for B6 toxicity

⭑ Describe the treatment and diagnosis / DDX of B6 toxicity