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Vitamin B6

Metabolism, nerve function, and neurotransmitter synthesis

Evidence · Grade BSafety · Generally safe
Meta-analysis availableSystematic review availableHuman trial evidenceTraditional useInteraction risk

Vitamin B6 is an essential water-soluble vitamin vital for metabolism, neurotransmitter synthesis, and red blood cell formation.

Vitamin B6, also known as pyridoxine, is a water-soluble vitamin essential for numerous bodily functions. It plays a crucial role in protein, fat, and carbohydrate metabolism, as well as the creation of red blood cells and neurotransmitters. It is involved in over 100 enzyme reactions, primarily acting as a coenzyme. Dietary sources include poultry, fish, potatoes, chickpeas, bananas, and fortified cereals. Deficiency can lead to a range of symptoms affecting the skin, nerves, and blood.

Quick answer

What it is: Vitamin B6, also known as pyridoxine, is a water-soluble vitamin essential for numerous bodily functions.

May support:Anxiety, Carpal Tunnel Syndrome, PMDD, PMS, Gastroparesis, Kidney Stones, Menstrual Cramps, Folate Deficiency, Depression

Evidence:Evidence · Grade B

Safety:Safety · Generally safe

Evidence Summary

Evidence · Grade B

Vitamin B6 is an essential nutrient with well-established roles in numerous metabolic pathways. Its efficacy for treating deficiency is clear. For conditions like PMS and nausea in pregnancy, there is a moderate body of evidence from clinical trials supporting its use. However, for many other proposed uses, the evidence is less robust or requires further research. The safety profile is generally good at recommended doses, but high doses carry risks.

Last reviewed · Jun 2026

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Why It Works

Vitamin B6, primarily in its active form pyridoxal 5'-phosphate (PLP), acts as a coenzyme for over 100 enzymes involved in amino acid, glucose, and lipid metabolism.

How it works in more detail

Pyridoxal 5'-phosphate (PLP) is the active coenzyme form of Vitamin B6. PLP is involved in transamination, decarboxylation, racemization, and elimination reactions. Key functions include the synthesis of neurotransmitters like serotonin, dopamine, norepinephrine, and GABA, which are crucial for mood regulation and nerve function. It also plays a role in heme synthesis, gluconeogenesis, glycogenolysis, and lipid metabolism. Furthermore, PLP is involved in homocysteine metabolism, helping to convert it into other amino acids, which is important for cardiovascular health.

How to use

Always consult a qualified clinician.

Editorial guidance

Suggested dosage
For general supplementation, 1.3-2 mg daily. For specific conditions, doses may range from 25-100 mg daily, often in capsule or tablet form.
Commonly combined with
  • Magnesium

    Combined administration of magnesium and vitamin B6 has shown efficacy in reducing the severity of premenstrual syndrome symptoms, including anxiety and depression.

    RCT
  • Magnesium

    Magnesium and vitamin B6 co-supplementation has been found to be effective in reducing hyperactivity, anxiety, and improving school attention in children with attention deficit hyperactivity disorder (ADHD) who have marginal magnesium deficiency.

    RCT
Research dosage range
Studies have used a wide range, typically 2-100 mg daily for various conditions. For PMS, doses of 50-100 mg daily have been studied. For nausea in pregnancy, 10-25 mg three to four times daily.
Typical onset
Effects may be noticed within days to weeks, depending on the condition and individual deficiency status.
Dosing citations
Typical forms
capsule, tablet, liquid
Quality markers
Look for products that specify the form of Vitamin B6 (e.g., pyridoxine HCl or pyridoxal 5'-phosphate (P5P)). Choose reputable brands that provide third-party testing for purity and potency.
Medication interactions
  • Anticonvulsants
  • Levodopa
  • Isoniazid
  • Hydralazine
  • Penicillamine
  • Oral contraceptives
Avoid if
  • Known allergy to Vitamin B6
Pregnancy / lactation
Vitamin B6 is generally considered safe and often recommended during pregnancy for nausea, typically at doses of 10-25 mg, three to four times daily. Consult a healthcare provider before taking any supplements during pregnancy or lactation.

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Suggested dosage

For general supplementation, 1.3-2 mg daily. For specific conditions, doses may range from 25-100 mg daily, often in capsule or tablet form.
Sources:[1]Meta-analysis[2]RCT[3]RCT

Active medicinal compounds

Pyridoxine, Pyridoxal, Pyridoxamine, and their phosphorylated forms (Pyridoxal 5'-phosphate (PLP), Pyridoxamine 5'-phosphate (PMP), Pyridoxine 5'-phosphate (PNP)). PLP is the primary active form.

Traditional use

As an isolated vitamin, Vitamin B6 does not have a history of traditional use in the same way as whole herbs. Its importance was discovered through modern nutritional science in the 20th century. However, foods rich in B vitamins have been part of traditional diets globally.

Safety

Safety warnings

High doses of Vitamin B6 (typically above 200 mg daily for extended periods) may lead to peripheral neuropathy, characterized by numbness, tingling, and nerve damage. This is generally reversible upon discontinuation. It is important to adhere to recommended dosages.

Avoid if

  • Known allergy to Vitamin B6

Medication interactions

  • Anticonvulsants
  • Levodopa
  • Isoniazid
  • Hydralazine
  • Penicillamine
  • Oral contraceptives

Reported side effects

  • Peripheral neuropathy (high doses)
  • Nausea
  • Headache
  • Stomach pain
  • Loss of appetite

Pregnancy & lactation

Vitamin B6 is generally considered safe and often recommended during pregnancy for nausea, typically at doses of 10-25 mg, three to four times daily. Consult a healthcare provider before taking any supplements during pregnancy or lactation.
Sources:[1]Meta-analysis[2]RCT[3]RCT

Evidence ecosystem

Scientific literature, clinical guidance, government sources, ongoing research, traditional use, and lived experience — grouped by source type and quality.

Overall grade (B)

Vitamin B6 is an essential nutrient with well-established roles in numerous metabolic pathways. Its efficacy for treating deficiency is clear. For conditions like PMS and nausea in pregnancy, there is a moderate body of evidence from clinical trials supporting its use. However, for many other proposed uses, the evidence is less robust or requires further research. The safety profile is generally good at recommended doses, but high doses carry risks.

Filter by source type

Meta-Analyses(3)

Pooled analyses across multiple human trials.

Very High Quality

  • Associations between Diet and Cognitive Function in Stroke Survivors: A Systematic Review and Meta-analysis.

    Amanat S, Dordevic AL, Brodtmann A, Cardoso BR · Advances in nutrition (Bethesda, Md.) · 2025

    Poststroke cognitive decline is a major form of disability in stroke survivors. Although dietary interventions have shown potential in improving cognitive outcomes in stroke-free populations, their effects on stroke survivors remain unclear. This review aimed to evaluate associations between diet and cognitive function in stroke survivors. MEDLINE, Embase, Scopus, and CINHAL were searched for studies from inception to 16 December, 2024. Eligible articles were observational and interventional studies on adult stroke survivors that evaluated the association/effect of any nutritional exposure/intervention on cognitive performance and dementia risk. Studies were excluded when an intervention was combined with nonnutritional treatment. Random-effects meta-analysis was used for similar randomized clinical trials. This review included 20 clinical trials and 14 observational studies assessing the intake of energy and proteins and a variety of single nutrients, as well as dietary patterns, sing

    Meta-AnalysisPubMedVery High Quality

  • A systematic review on the impact of nutrition and possible supplementation on the deficiency of vitamin complexes, iron, omega-3-fatty acids, and lycopene in relation to increased morbidity in women after menopause.

    Wylenzek F, Bühling KJ, Laakmann E · Archives of gynecology and obstetrics · 2024

    A balanced and healthy diet during the menopausal transition and after menopause is crucial for women to reduce the risk for morbidities and chronic diseases due to deficiency of essential nutrients. The objective of this study was to conduct a systematic review of studies that analyzed the impact of vitamin and nutrient deficiencies in postmenopausal women in relation to increased morbidities and chronic conditions. Observational studies were searched in the databases PubMed, UpToDate, and Google Scholar. We searched 122 studies, of which 90 were included in our analysis. The meta-analysis of the data could not be performed because of the heterogeneity of the statistical methods in the included studies. In our study, we focused on the aspects of vitamin B6, vitamin B12, vitamin D, iron, omega-3-fatty acids, and lycopene, belonging to the family of carotenoids. Postmenopausal women with deficiencies of these nutrients are more vulnerable to comorbidities such as cardiovascular

    Meta-AnalysisPubMedVery High Quality

  • Effects of Vitamin B12 Supplementation on Cognitive Function, Depressive Symptoms, and Fatigue: A Systematic Review, Meta-Analysis, and Meta-Regression.

    Markun S, Gravestock I, Jäger L, Rosemann T, Pichierri G, Burgstaller JM · Nutrients · 2021 · n=6276

    Vitamin B12 is often used to improve cognitive function, depressive symptoms, and fatigue. In most cases, such complaints are not associated with overt vitamin B12 deficiency or advanced neurological disorders and the effectiveness of vitamin B12 supplementation in such cases is uncertain. The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) is to assess the effects of vitamin B12 alone (B12 alone), in addition to vitamin B12 and folic acid with or without vitamin B6 (B complex) on cognitive function, depressive symptoms, and idiopathic fatigue in patients without advanced neurological disorders or overt vitamin B12 deficiency. Medline, Embase, PsycInfo, Cochrane Library, and Scopus were searched. A total of 16 RCTs with 6276 participants were included. Regarding cognitive function outcomes, we found no evidence for an effect of B12 alone or B complex supplementation on any subdomain of cognitive function outcomes. Further, meta-regression showed n

    Meta-AnalysisPubMedVery High Quality

Systematic Reviews(3)

Structured reviews of the full body of evidence (incl. Cochrane).

Very High Quality

  • Effect of nutritional interventions on the psychological symptoms of premenstrual syndrome in women of reproductive age: a systematic review of randomized controlled trials.

    Robinson J, Ferreira A, Iacovou M, Kellow NJ · Nutrition reviews · 2025 · n=3254

    Premenstrual syndrome (PMS) affects approximately 48% of women of reproductive age worldwide. It can lead to functional impairment, lower quality of life, and decreased work productivity. Despite the availability of medical treatment options, women are seeking alternative interventions because of concerns of harmful side effects and limited evidence of efficacy associated with pharmacological treatments. To date, high-quality research investigating the effects of dietary and nutrient intervention on PMS is limited. This systematic review investigated the effect of nutritional interventions on the psychological symptoms of PMS. Five electronic databases were searched for randomized controlled trials (RCTs) published in English from inception to October 2022. Trials eligible for inclusion were nutritional intervention studies involving women of reproductive age that measured PMS-associated psychological outcomes. Articles were selected using prespecified inclusion criteria. Data scree

    Systematic ReviewPubMedVery High Quality

  • The impact of essential fatty acid, B vitamins, vitamin C, magnesium and zinc supplementation on stress levels in women: a systematic review.

    McCabe D, Lisy K, Lockwood C, Colbeck M · JBI database of systematic reviews and implementation reports · 2017

    Women juggling multiple roles in our complex society are increasingly experiencing psychological stress. Dietary supplementation to manage stress is widespread despite limited supporting evidence. A systematic review of the available literature was undertaken to investigate the efficacy of specific dietary supplements in managing female stress and anxiety. To identify the impact of essential fatty acids (EFAs), B vitamins, vitamin C, magnesium and/or zinc, consumed as dietary supplements to the daily diet, on female stress and anxiety levels. Women aged 18 years and over, who had participated in a study where stress and/or anxiety were assessed. Dietary supplementation with EFAs, B vitamins, vitamin C, magnesium and/or zinc. Supplements, either alone or combined, were compared with either no intervention or placebo. Randomized controlled and pseudo-randomized trials were included. Stress and anxiety were assessed using self-report or physiological outcome measures. Published and

    Systematic ReviewPubMedVery High Quality

  • A systematic review of conservative treatment of carpal tunnel syndrome.

    Piazzini DB, Aprile I, Ferrara PE, Bertolini C, Tonali P, Maggi L · Clinical rehabilitation · 2007

    To assess the effectiveness of conservative therapy in carpal tunnel syndrome. A computer-aided search of MEDLINE and the Cochrane Collaboration was conducted for randomized controlled trials (RCTs) from January 1985 to May 2006. RCTs were included if: (1) the patients, with clinically and electrophysiologically confirmed carpal tunnel syndrome, had not previously undergone surgical release, (2) the efficacy of one or more conservative treatment options was evaluated, (3) the study was designed as a randomized controlled trial. Two reviewers independently selected the studies and performed data extraction using a standardized form. In order to assess the methodological quality, the criteria list of the Cochrane Back Review Group for systematic reviews was applied. The different treatment methods were grouped (local injections, oral therapies, physical therapies, therapeutic exercises and splints). Thirty-three RCTs were included in the review. The studies were analysed to determine

    Systematic ReviewPubMedVery High Quality

Clinical Guidelines(1)

Recommendations from medical societies (NICE, AHA, ADA, ACG, Endocrine Society…).

High Quality

  • AGA Clinical Practice Update on Pregnancy-Related Gastrointestinal and Liver Disease: Expert Review.

    Kothari S, Afshar Y, Friedman LS, Ahn J · Gastroenterology · 2024

    The purpose of this American Gastroenterological Association (AGA) Institute Clinical Practice Update is to review the available published evidence and expert advice regarding the clinical management of patients with pregnancy-related gastrointestinal and liver disease. This expert review was commissioned and approved by the AGA Institute Clinical Practice Updates Committee and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership and underwent internal peer review by the Clinical Practice Updates Committee and external peer review through the standard procedures of Gastroenterology. This article provides practical advice for the management of pregnant patients with gastrointestinal and liver disease based on the best available published evidence. The Best Practice Advice statements were drawn from a review of the published literature and from expert opinion. Because formal systematic reviews were not performed, these Best Prac

    Clinical GuidelinePubMed (Practice Guideline)Very High Quality

Randomized Human Trials(1)

Controlled human studies with random assignment.

High Quality

  • Regression of gastroesophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins and aminoacids: comparison with omeprazole.

    Pereira Rde S · Journal of pineal research · 2006 · n=176

    The prevalence of gastroesophageal reflux disease (GERD) is increasing. GERD is a chronic disease and its treatment is problematic. It may present with various symptoms including heartburn, regurgitation, dysphagia, coughing, hoarseness or chest pain. The aim of this study was to investigate if a dietary supplementation containing: melatonin, l-tryptophan, vitamin B6, folic acid, vitamin B12, methionine and betaine would help patients with GERD, and to compare the preparation with 20 mg omeprazole. Melatonin has known inhibitory activities on gastric acid secretion and nitric oxide biosynthesis. Nitric oxide has an important role in the transient lower esophageal sphincter relaxation (TLESR), which is a major mechanism of reflux in patients with GERD. Others biocompounds of the formula display anti-inflammatory and analgesic effects. A single blind randomized study was performed in which 176 patients underwent treatment using the supplement cited above (group A) and 175 received treatm

    Randomized TrialPubMedHigh Quality

Observational Studies(7)

Cohort, case-control, and cross-sectional human studies.

Moderate Quality

  • Intake of one-carbon metabolism nutrients and risk of rheumatoid arthritis: a prospective UK biobank cohort study.

    Zhang S, Xia B, Kang Y, Wang Y, Liang Z, He Q · European journal of nutrition · 2025 · n=440

    One-carbon metabolism (OCM) nutrients are essential for methylation processes and may be involved in the pathogenesis of rheumatoid arthritis (RA), but prospective evidence remains limited. This study aimed to investigate the association between dietary OCM nutrients and RA risk, and their interactions with genetic and lifestyle factors. A total of 189,440 participants from the UK Biobank were included. Dietary intake was assessed using repeated 24-hour recalls. Nutrient levels were estimated based on McCance and Widdowson's The Composition of Foods and the USDA Food and Nutrient Database for Dietary Studies. Cox proportional hazards models were used to evaluate the independent and joint associations of OCM nutrients, genetic risk, and RA risk. Nonlinear associations were examined using restricted cubic spline. During a median follow-up of 13.43 years, 1,751 RA cases were identified. Participants in the highest quartile of OCM nutrient intake had a significantly lower risk of RA comp

    Observational StudyPubMedModerate Quality

  • Correlation between serum vitamin levels and gestational diabetes mellitus.

    Qin Y, Song Q, Jiang X, Su Y, Chen H, Ji X · Frontiers in endocrinology · 2025

    Gestational diabetes mellitus (GDM) is a common clinical complication during pregnancy, with its pathogenesis not yet fully elucidated. Vitamin D contributes to GDM pathogenesis by regulating pancreatic β-cell function, immune responses, and lipid metabolism. Vitamin D deficiency may contribute to GDM through these mechanisms. Vitamin E levels in GDM patients are lower than those in normal pregnant women, and its deficiency may increase the risk of GDM, potentially due to its antioxidant properties, although the specific mechanisms remain unclear. The relationship between vitamin A levels and GDM is controversial. Additionally, the occurrence of GDM is closely associated with one-carbon metabolism, involving folic acid (vitamin B9), vitamin B12, and vitamin B6. Deficiencies in these vitamins may lead to homocysteine metabolism disorders, thereby contributing to GDM. Vitamin B3 plays a protective role against GDM by regulating redox reactions. Vitamin C deficiency has also been li

    Observational StudyPubMedLow Quality

  • Nutrients in prevention, treatment, and management of viral infections; special focus on Coronavirus.

    BourBour F, Mirzaei Dahka S, Gholamalizadeh M, Akbari ME, Shadnoush M, Haghighi M · Archives of physiology and biochemistry · 2023

    The coronavirus disease 2019 (COVID-19) is a pandemic caused by coronavirus with mild to severe respiratory symptoms. This paper aimed to investigate the effect of nutrients on the immune system and their possible roles in the prevention, treatment, and management of COVID-19 in adults. This Systematic review was designed based on the guideline of the Preferred Reporting for Systematic Reviews (PRISMA). The articles that focussed on nutrition, immune system, viral infection, and coronaviruses were collected by searching databases for both published papers and accepted manuscripts from 1990 to 2020. Irrelevant papers and articles without English abstract were excluded from the review process. Some nutrients are actively involved in the proper functioning and strengthening of the human immune system against viral infections including dietary protein, omega-3 fatty acids, vitamin A, vitamin D, vitamin E, vitamin B1, vitamin B6, vitamin B12, vitamin C, iron, zinc, and selenium. Few studi

    Observational StudyPubMedLow Quality

Clinical Trial Registries(7)

Registered ongoing or completed trials (ClinicalTrials.gov).

Moderate Quality

  • The Vitamin B Status in Type 2 Diabetes (VITA) Study

    n=174 · NCT03447275 · COMPLETED · COMPLETED

    The objective of this study was to evaluate vitamin B deficiency (particularly vitamin B6 deficiency) in diabetic patients in Germany in relation to the presence or absence of proteinuria, and global vascular risk.

    Clinical TrialClinicalTrials.govModerate Quality

  • Assesment of Vitamin B6 Level in Patients With Major Depressive Disorder

    n=94 · NCT05649293 · UNKNOWN · UNKNOWN

    Estimation of vitamin B 6 levels in diagnosed major depressive disorder patients and their relation to the severity of the disease

    Clinical TrialClinicalTrials.govModerate Quality

  • Combined Effect of Tryptophan Rich Diet and Acupuncture on Depression Related to Premenstrual Dysphoric Disorder

    n=39 · NCT05813366 · UNKNOWN · UNKNOWN

    Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome (PMS) affecting up to 8% of reproductive age women. It is characterized by physical and psychological symptoms that occur in the luteal phase of the menstrual cycle, prior to the onset of menses, and leads to negative impact on the psychosocial functioning of affected individuals. Selective serotonin reuptake inhibitors are usually used to treat PMDD but they have several side effects so it is important to use complementary treatment such as tryptophan-rich diet and acupuncture for women with PMDD . The purpose of the current study is to determine the combined effect of tryptophan-rich diet and acupuncture on depression related to premenstrual dysphoric disorder

    Clinical TrialClinicalTrials.govModerate Quality

Limitations: While Vitamin B6's role as an essential nutrient is undisputed, the evidence for its efficacy in treating various specific ailments beyond deficiency and certain well-studied conditions (like PMS and pregnancy-related nausea) is often limited by small study sizes, methodological inconsistencies, or lack of long-term data. More high-quality, large-scale clinical trials are needed for many applications.

This page is educational. Statements use phrases like "may support" and "has been studied for"because no remedy here is approved to cure, treat, or reverse any condition. Discussion happens on the ailment pages — community statistics here are derived from those reports. Always consult a qualified clinician.

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