Vitamin B6 (Pyridoxine)

Vitamin B6, also known as pyridoxine, is an essential nutrient involved in many everyday processes in the body, including how food is converted into energy, how nerves function, and how red blood cells are formed. Because it is found in a wide range of common foods, most people in the UK get enough through their diet.

Interest in vitamin B6 often arises when people experience symptoms such as tiredness, nerve sensations, or nausea during pregnancy, or when supplements are taken long term. While vitamin B6 is essential, it is also a nutrient where excessive intake-specifically from supplements-can cause harm.

What Is Vitamin B6?

Vitamin B6 refers to a group of related compounds that the body uses for essential metabolic functions. Pyridoxine is the form most commonly found in supplements and fortified foods. Once consumed, it is converted into an active form that the body can use.

Vitamin B6 is water-soluble, meaning it is not stored in large amounts. Regular intake from food is therefore necessary, but this does not mean that high-dose supplementation is required for most people.

Why the Body Needs Vitamin B6

Vitamin B6 is involved in hundreds of enzyme-driven reactions, which explains why its effects are wide-ranging.

One of its core roles is in energy metabolism. Vitamin B6 helps the body process carbohydrates, fats, and proteins so energy can be released from food. This function supports normal energy levels but does not increase energy beyond what the body is already capable of producing.

Vitamin B6 also supports normal nervous system function. It is involved in the production of neurotransmitters, which allow nerve cells to communicate, and it contributes to maintaining healthy nerve tissue. Low levels can be associated with neurological symptoms, although such symptoms have many possible causes.

Another important role is in red blood cell formation. Vitamin B6 helps the body make haemoglobin, the protein that allows red blood cells to carry oxygen. When intake is inadequate, this process can be impaired, contributing to tiredness and weakness.

Vitamin B6 also supports immune function and is involved in the metabolism of homocysteine, an amino acid found in the blood. Although high homocysteine levels are associated with cardiovascular risk, studies have not consistently shown that lowering them with B vitamins improves cardiovascular outcomes.

Dietary Sources of Vitamin B6

Vitamin B6 is widely available in everyday foods. Animal sources include poultry, pork, and fish, while plant-based sources include potatoes, chickpeas and other pulses, nuts, seeds, wholegrains, bananas, and avocados. Many breakfast cereals are fortified with vitamin B6.

Cooking and processing can reduce vitamin B6 content, particularly when foods are boiled and the cooking water is discarded. In practice, regularly eating a varied diet provides sufficient intake without the need to focus on specific preparation methods.

Who May Be More Likely to Have Low Vitamin B6 Levels

Although deficiency is uncommon in the general population, certain situations increase the likelihood of low vitamin B6 status.

Older adults, particularly those with reduced appetite or limited diets
People with conditions that affect nutrient absorption, such as coeliac disease or inflammatory bowel disease
People with chronic kidney disease or those undergoing dialysis
Individuals with long-term heavy alcohol use
People taking certain medicines, including isoniazid

Symptoms of Low Vitamin B6

Symptoms tend to develop gradually and are often non-specific. Early signs may include cracked lips, soreness at the corners of the mouth, a sore or inflamed tongue, and skin changes. Neurological symptoms such as irritability, low mood, difficulty concentrating, tingling, or numbness in the hands and feet can also occur.

Because these symptoms overlap with many other conditions, they should not be assumed to indicate vitamin B6 deficiency without proper assessment.

What Vitamin B6 Is Known to Help With

Vitamin B6 has well-established roles in normal energy metabolism, nervous system function, immune function, red blood cell formation, and hormonal regulation. These functions are recognised by regulatory authorities and reflect its essential role in maintaining normal physiology.

Supplementation has also been studied in specific situations. Vitamin B6 is commonly used to help manage nausea and vomiting in pregnancy, where evidence suggests it can reduce symptoms for some people. It is often considered a first option, though responses vary.

Some studies suggest vitamin B6 may reduce certain premenstrual symptoms, particularly mood-related symptoms, but the quality of evidence is mixed and the doses used are often higher than those suitable for long-term use.

Interest in vitamin B6 for mood and anxiety has increased, but current evidence does not support routine supplementation for mental health in people with adequate nutritional intake.

Recommended Intakes and Supplementation

Recommended intakes for adults are generally around 1–2 mg per day, depending on age and sex. Average dietary intakes in the UK typically meet these levels.

Supplementation is usually appropriate only when there is a specific reason, such as diagnosed deficiency, known medication interactions, malabsorption, or pregnancy-related nausea under guidance. Many supplements contain doses far higher than daily requirements, which is why attention to dose is important.

Safety and Upper Limits

Vitamin B6 from food has not been associated with harm. The primary safety concern relates to long-term use of high-dose supplements, which can cause peripheral neuropathy. Symptoms may include tingling, numbness, burning sensations, reduced coordination, and difficulty walking. Recovery can be slow, and symptoms may persist if exposure has been prolonged.

Avoid long-term use of high-dose vitamin B6 unless advised by a healthcare professional
Be aware that multivitamins, fortified foods, and energy drinks can all contribute to total intake
Stop supplementation and seek advice if numbness or tingling develops

Pharmacist comment

"Vitamin B6 is essential, and most people get enough from food alone. Where problems arise is with long-term use of higher-dose supplements, especially when people are also consuming fortified foods or energy drinks without realising how much they’re getting in total. Keeping doses sensible is important, and any symptoms such as tingling or numbness should always be checked."
Alessandro Grenci Superintendent Pharmacist

Conclusion

Vitamin B6 plays an essential role in energy metabolism, nerve function, red blood cell formation, immune health, and hormonal regulation. For most people, a balanced diet provides sufficient amounts. Supplements may be useful in specific circumstances, but high doses taken over time can cause nerve damage.

Vitamin B6 is best viewed as a nutrient that supports normal function when intake is appropriate-not one that provides additional benefit when taken in excess.