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Much higher doses mg per day of the related substance pantothenate have been used in improving cholesterol profile especially reducing triglyceride levels Upper Limit: No UL has been established for pantothenic acid. See the Encyclopedia article on Pantothenic Acid for more information about clinical use. B-6 Pyridoxine hydrochloride, Pyridoxalphosphate, PP is important in many aspects of metabolism and in maintaining the immune and nervous systems. Symptoms of pyridoxine deficiency may not manifest in people with borderline or mild deficiency, but in more severe deficiency can include seborrheic dermatitis scaling red patches on the skin , cracks at the corners of the mouth, swollen tongue, microcytic anemia often diagnosed by low mean corpuscular volume MCV in a blood test weakened immune function, depression, confusion, EEG abnormalities, and seizures Institute of Medicine U.
People with alcohol dependence, impaired kidney function or conditions which cause malabsorption i. Use of certain medications, including antibiotics cycloserine Seromycin and isoniazid Laniazid , penicillamine Cuprimine and antiepileptic drugs, especially enzyme-inducing antiepileptic drugs AEDs such as phenytoin or carbamazepine, can cause B-6 deficiency Merck Manual ; Mintzer, Epilepsy Behav Pyridoxine hydrochloride is converted in the body to pyridoxalphosphate, the active form of B Most supplements in the U.
Although supplements providing pyridoxalphosphate also called PP or PLP provide the "active form" of vitamin B6, this form must still undergo conversion in the intestine in order to be absorbed, so bioavailability may be no better than that of pyridoxine for most people European Food Safety Authority People with certain conditions that prevent the body from converting pyridoxine into pyridoxalphosphate such as pyridoxal 5'-phosphate-dependent epilepsy , however, may be prescribed the pyridoxalphosphate form of B6.
Very preliminary research has found pyridoxalphosphate may be more effective than other forms of vitamin B6 in slowing kidney damage, neuropathy, and lipid oxidation in animal models of diabetes, however there do not appear to be any studies of these uses in people Nakamura, J Am Soc Nephrol ; Higuchi, J Lipid Res Pyridoxine in amounts that meet the RDAs is easily available from the diet e. However, no association was found with the intake of vitamin B-6 -- that is, taking more B-6 was not shown to reduce the risk of lung cancer Johansson, JAMA For males 14 to 50 the RDA is 1.
For females 14 to 18 it is 1. However, the RDA for pregnant women it is 1. Other proposed uses of pyridoxine such as treating asthma, autism, carpal tunnel syndrome, diabetic neuropathy, tardive dyskinesia and PMS may involve doses higher than the ULs; however, none of these uses has good scientific support.
The UL for pyridoxine is 30 mg for children 1 to 3, 40 mg for those 4 to 8, 60 mg for those 9 to 13, 80 mg for those 14 to 18, and mg for individuals 19 years and older. All sources of B-6 count toward these upper limits, including that from food sources and multivitamins.
The European Food Safety Authority suggests an even lower UL for all forms of vitamin B6 of 25 mg per day for adults and 5 to 20 mg per day for children depending on their body weight European Food Safety Authority Too much pyridoxine can cause nerve damage and skin lesions.
These severe effects are generally seen at doses over 1, mg per day, though rare cases have been seen at mg daily and even at doses of 50 mg or less. There was no improvement in her symptoms one year after she stopped consuming both products, and it is currently not known whether nerve damage caused by excessive pyridoxine can be reversed Bacharach, J Clin Neuromuscul Dis Similarly, a year-old man experienced progressive numbness, nerve damage, and imbalance over several years of taking up to 30 mg per day of supplemental vitamin B-6 and heavy consumption of energy drinks containing high amounts of B-6 Malek, Acta Neurol Belg Some cases of gastrointestinal disturbances such as heartburn, nausea and indigestion, and photosensitivity have been reported at doses between and mg per day Bendich, Ann N Y Acad Sci Some evidence suggests pyridoxalphosphate may not cause the nerve damage or skin lesions associated with excessive doses of pyridoxine, although high doses of pyridoxalphosphate have been reported to cause an increase in seizure frequency and liver damage in infants Clayton, J Inherit Metab Dis A study of the effects of different forms of vitamin B-6 on human nerve cells showed the highest toxicity with pyridoxine, the form most commonly in supplements and foods but which is inactive until converted in the body to an active form.
The research indicated that pyridoxine inhibits the active form, PP, possibly explaining why high-dose vitamin B-6 supplementation with pyridoxine has sometimes caused the same neurological symptoms seen in B-6 deficiency. The researchers suggested that PP or pyridoxal an intermediate form also present in foods may be safer to take than pyridoxine Vrolijk, Tox in Vitro One clinical study found that a daily dose of 25 mg B-6 taken as part of a B-vitamin complex doubled the risk of heart attack, stroke and death in diabetes patients with advanced kidney disease See Cautions and Concerns section below.
However, as the original studies were not primarily designed to study hip fracture risk, i. Although no serious adverse events were reported during the treatment period, the researchers noted that higher daily doses of B-6 have been reported to cause nerve damage, loss of coordination and muscle weakness, which could contribute to the risk of falling.
Also be aware that preliminary evidence suggests B-6 could potentially increase the effects of antihypertensive drugs such as diltiazem Cardizem , amlodipine Norvasc , and may interfere with some drugs for Parkinson disease. A dose of mg daily B-6 may reduce the effectiveness of the anti-seizure drug phenytoin Dilantin Hansson, Lancet See the Encyclopedia article on Vitamin B-6 for more information about clinical use.
Biotin B-7 is needed for the metabolism of nutrients. Symptoms of deficiency include thinning or loss of hair, loss of hair color, red rash around the eyes, nose, and mouth, depression, listlessness, hallucinations, and tingling in the arms and legs NIH However, deficiency is rare under normal circumstances, because biotin can be produced in the gut by bacteria and is also found in organ meats, oatmeal, egg yolk, mushrooms, bananas, peanuts and brewer's yeast.
Deficiency might occur with long-term use of antibiotics or anti-seizure medications and, conversely, use of biotin might impair absorption of some anti-seizure medications — so people taking such medications should only use biotin supplements under the supervision of a healthcare professional. Biotin does not, however, further strengthen healthy nails. A study in Switzerland suggested that biotin deficiency may be common in women complaining of hair loss Trueb, Int J Trichology ; however there are no studies to suggest biotin supplementation improves hair growth or texture in people who are not deficient.
High doses of biotin e. The FDA has seen an increase in the number of reported adverse events related to biotin interference with lab tests.
Unfortunately, there is typically no mention of this potential interference in laboratory reports. Biotin supplementation can fully mimic the typical laboratory pattern of Graves' disease a form of hyperthyroidism and this can persist for several days after biotin application.
This may lead to unnecessary antithyroid treatment and thereby cause unrecognized hypothyroidism that might be deleterious, especially in young children. In addition, biotin treatment can potentially interfere with other streptavidin—biotin immunoassays Kummer, N Engl J Med A study in healthy adults without thyroid disease found that a single, 10 mg 10, mcg dose of biotin which is many times more than the daily requirement of 0.
Although TSH levels remained within the normal range and all thyroid hormone levels returned to their pre-supplementation levels after 24 hours, the researchers recommended that in people with laboratory findings indicating hyperthyroidism but without clinical symptoms, possible interference from biotin supplementation should be considered Biscolla, Thyroid Non-biotin based laboratory tests revealed her hormone levels were within normal ranges Stieglitz, J Endocr Soc Additionally, a small study found that 10 mg of biotin taken daily for seven days falsely increased the results of a biotin-based vitamin D blood test using the Roche Cobas system by an average of 9.
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