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Beretich, Kaitlan. Vitamin B6. KNH 413 – Medical Nutrition Therapy II. Miami University, Oxford, Ohio, Spring 2013. Vitamin B6 1. What is the nutrient? Vitamin B6 Also know as pyridoxine Water soluble vitamin Dissolve in water Body cannot store them Leftover amounts of the vitamin leave body through the urine Need a continuous supply of B6 in the diet Makes antibodies which are needed to fight many diseases Maintain normal nerve function Make hemoglobin which carries oxygen in the red blood cells to the tissues A vitamin B6 deficiency can cause a form of anemia Break down proteins Keep blood sugar in normal ranges (MedlinePlus & Mayo Clinic) 2. What is the RDA/DRI for the nutrient? Adequate Intake Infants 0 - 6 months: 0.1 mg Infants 7 months – 1 year: 0.3 mg RDA Children 1 – 3 years: 0.5 mg Children 4 – 8 years: 0.6 mg Children 9 -13 years: 1 mg Children 14 – 18 years: 1.3 mg Children 14 – 18 years: 1.2 mg Adults 19 – 50 years: 1.3 mg Men 51 years and older: 1.7 mg Women 51 years and older: 1.5 mg Pregnant women: 1.9 mg Breastfeeding women: 2.0 mg (University of Maryland Medical Center) 3. How is the nutrient metabolized? All B vitamins help the body convert food (carbohydrates) into fuel (glucose) All B vitamins are water-soluble, meaning that the body does not store them B complex vitamins also help metabolize fats and protein B6 is readily absorbed in the small intestine The forms of vitamin B6 found in food are converted to active forms in the liver Vitamin B6 helps the body make several neurotransmitters Chemicals that carry signals from one nerve cell to another Serotonin and norepinephrine Helps control levels of homocysteine in the blood Body needs vitamin B6 in order to absorb vitamin B12 and to make red blood cells and cells of the immune system (University of Maryland Medical Center) 4. What are food sources of the nutrient? Chicken Turkey Tuna Salmon Shrimp Beef liver Milk Cheese Lentils Beans Spinach Carrots Brown rice Bran Sunflower seeds Wheat germ Whole-grain flour (University of Maryland Medical Center) 5. What disease states alter the nutrients metabolism? Alcoholism Increased destruction and reduced formation of vitamin B6 Cirrhosis Due to the loss of liver function, vitamin B6 cannot be converted to its active form from foods Chronic Kidney Disease Stage Five Cofactors involved in homocysteine metabolism, including vitamin B6 are less available due to dialysis losses and overall decreased dietary intake due to dietary restrictions People with autoimmune disorders Rheumatoid arthritis Celiac disease Crohn’s disease Ulcerative colitis inflammatory bowel disease (Nutrition Therapy & Pathophysiology & National Institues of Health) 6. What are the tests or procedures to assess the nutrient level in the body? While a vitamin B6 deficiency is uncommon in the U.S., a simple blood test can be administered to determine B6 levels in the body. (National Institues of Health) 7. What are the drug–nutrient interactions? Drugs that reduce levels of B6 in the body Cycloserine (Seromycin): used to treat tuberculosis Hydralazine (Apresoline): used to treat high blood pressure Isoniazid: used to treat tuberculosis Penicillamine: used to treat rheumatoid arthritis Theophylline (TheoDur): used to treat asthma Antibiotics, Tetracycline All B complex vitamins, including vitamin B6, interfere with the absorption and effectiveness of antibiotic tetracycline. You should take tetracycline at different times from vitamin B6 and other B vitamins. Antidepressant Medications Taking vitamin B6 supplements may improve the effectiveness of some tricyclic antidepressants such as nortriptyline (Pamelor), especially in elderly people. Other tricyclic antidepressants include amitriptyline (Elavil), desipramine (Norpramin), and imipramine (Tofranil). On the other hand, antidepressants called monoamine oxidase inhibitors (MAOIs) may reduce blood levels of vitamin B6. Examples of MAOIs include phenelzine (Nardil) and tranylcypromine (Parnate). Amiodarone (Cordarone) This drug, used to treat an irregular heartbeat, makes your skin more sensitive to sunlight. Taking vitamin B6 along with this drug may increase your risk of sunburn, blistering, or a rash. Chemotherapy drugs Vitamin B6 may reduce certain side effects of 5-fluorouracil and doxorubicin, medications used to treat cancer. Talk to your doctor before taking any supplement if you are undergoing chemotherapy. Erythropoietin (EPO) Erythropoietin therapy, used to treat severe anemia, may decrease vitamin B6 levels in red blood cells. Levodopa (L-dopa) Vitamin B6 reduces the effectiveness of levodopa, a medication used to treat Parkinson's disease. However, it does not seem to have the same effect on the combination of levodopa and carbidopa. Your doctor may be able to determine a dose of B6 that can safely help reduce side effects of levodopa. Taking vitamin B6 along with levodopa should be done only under your doctor’s supervision. Phenytoin (Dilantin) Vitamin B6 makes phenytoin, a medication used to treat seizures, less effective. (University of Maryland Medical Center) 8. How is the nutrient measured? Vitamin B6 is measured in milligrams per day (mg/day) (Nutrition Therapy & Pathophysiology) 9. What are the Upper Tolerable Limits? UL Infants 0 – 6 months: No data Infants 7 – 12 months: No data Children 1 – 3 years: 30 mg/d Children 4 – 8 years: 40 mg/d Males, Females 9 – 13 years: 60 mg/d Males, Females 14 – 18 years: 80 mg/d Males, Females 19 – 70 years: 100 mg/d Males, Females > 70 years: 100 mg/d Pregnancy ≤ 18 years: 80 mg/d Pregnancy 19 – 50 years: 100 mg/d (Nutrition: An Applied Approach) 10. What are the physical signs of deficiency? Confusion Depression Irritability Mouth and tongue sores (MedlinePlus) 11. What are physical signs of toxicity? Difficulty coordinating movement Numbness Sensory changes (MedlinePlus)