Vitamins
Vitamin B6
Vitamin B6 is a water-soluble vitamin. Its active forms support many metabolic processes, particularly amino-acid metabolism.
Vitamin B6 is the name for a family of related compounds, rather than a single substance. These include pyridoxine, pyridoxal and pyridoxamine, together with their phosphate forms. A principal active form is pyridoxal 5′-phosphate, or PLP. Vitamin B6 occurs in foods of both plant and animal origin and can also be added to fortified foods and supplements. Although “pyridoxine” is often used as another name for vitamin B6, it strictly refers to just one form. Water-soluble does not mean harmless: excessive intake can damage peripheral nerves.
Vitamin B6: a family with many roles
Vitamin B6 is a water-soluble vitamin. The name covers several related compounds, including pyridoxine, pyridoxal and pyridoxamine and their phosphate forms. Strictly speaking, pyridoxine is therefore just one form of vitamin B6. A principal active form is pyridoxal-5′-phosphate, or PLP. As a coenzyme, B6 supports many metabolic processes, particularly the metabolism of amino acids – the building blocks of protein.
What vitamin B6 does in your body
Vitamin B6 contributes to normal energy-yielding metabolism and the normal functioning of the nervous system and immune system. It also supports normal protein and glycogen metabolism and normal red blood cell formation. These functions are recognised as authorised EU health claims under Regulation (EU) No 432/2012. They do not mean that extra supplements give you more energy, improve concentration or protect you against infections when your intake is already adequate.
Getting B6 from food
Vitamin B6 occurs in foods of both plant and animal origin. It can also be added to fortified foods and supplements. Some B6 in plant foods is present in glycosylated forms with lower bioavailability. Plant foods still contribute to your intake; this does not establish a single absorption rate for all plant foods. Isolated B6 deficiency is uncommon. Low B6 status often occurs alongside low status of other B vitamins, such as folate and vitamin B12.
With supplements, the total amount matters
Check multivitamins and magnesium or zinc supplements for vitamin B6, and add up the amounts in their daily doses. The upper limit does not apply to each product separately. Children have lower age-specific limits; for example, EFSA's upper limit for children aged 4–6 years is 4.5 mg daily. Do not give children high-dose adult products without medical advice.
Individual susceptibility and the time until nerve damage develops vary. The 12 mg upper limit is therefore not a precise threshold at which symptoms begin. There is also insufficient evidence that the form marketed as “active”, P-5-P or PLP, is safer than pyridoxine at high supplemental doses. EFSA's upper limits apply to all B6 forms. Do not self-treat existing neuropathy with B6: evidence is insufficient to support B6 alone as a general neuropathy treatment.
How nutrition works
Energy metabolism
Vitamin B6 contributes to normal energy-yielding metabolism. [1]
Nervous system
Psychological function
Vitamin B6 contributes to normal psychological function. [1]
Statements & evidence
Vitamin B6 contributes to normal cysteine synthesis [1]
This authorised claim may only be used for foods that meet at least the conditions for the nutrition claim ‘source of vitamin B6’.
Vitamin B6 contributes to normal homocysteine metabolism [1]
The food must meet at least the conditions for ‘source of vitamin B6’. The claim concerns normal metabolism, not the prevention of cardiovascular disease.
Vitamin B6 contributes to normal protein and glycogen metabolism [1]
This authorised claim may only be used for foods that meet at least the conditions for the nutrition claim ‘source of vitamin B6’.
Vitamin B6 contributes to normal psychological function [1]
The food must meet at least the conditions for ‘source of vitamin B6’. This does not mean that additional supplements improve mood or concentration.
Vitamin B6 contributes to normal red blood cell formation [1]
The food must meet at least the conditions for ‘source of vitamin B6’. This is not a claim about treating anaemia.
Vitamin B6 contributes to the normal function of the immune system [1]
The food must meet at least the conditions for ‘source of vitamin B6’. The claim does not promise enhanced immunity beyond normal function or protection against infections.
Vitamin B6 contributes to the reduction of tiredness and fatigue [1]
The food must meet at least the conditions for ‘source of vitamin B6’. The claim does not mean that B6 supplements address every cause of tiredness.
Vitamin B6 contributes to the regulation of hormonal activity [1]
The food must meet at least the conditions for ‘source of vitamin B6’. This is not a claim about treating hormonal disorders.
Vitamin B6 is a water-soluble vitamin comprising six related compounds. [3]
These are pyridoxine, pyridoxal and pyridoxamine, together with their respective phosphate forms. Pyridoxal-5′-phosphate (PLP) and pyridoxamine-5′-phosphate (PMP) are active coenzyme forms.
Some naturally occurring vitamin B6 in plant foods is present in glycosylated forms with lower bioavailability. [3]
This includes fruits, vegetables and grains. Plant foods can still contribute to vitamin B6 intake; this finding does not establish a single absorption rate for all plant foods.
EFSA sets population reference intakes for vitamin B6 of 1.6 mg per day for adult women and 1.7 mg per day for adult men. [4]
The reference intake is 1.8 mg per day during pregnancy and 1.7 mg per day during lactation. These values concern total daily intake, not supplement doses or an exact individual requirement. Some values were derived by extrapolation.
Isolated vitamin B6 deficiency is uncommon; inadequate B6 status often occurs alongside low status of other B vitamins. [3]
These include folate and vitamin B12. This general finding does not establish whether an individual has a deficiency.
Excessive vitamin B6 intake can damage peripheral nerves. [2]
The causal relationship with peripheral neuropathy is well established. Water solubility does not make high-dose supplements harmless. Individual susceptibility and the time until symptoms develop vary.
In 2023, EFSA established a tolerable upper intake level for vitamin B6 of 12 mg per day for adults, including during pregnancy and lactation. [2]
The value covers foods and supplements combined and all vitamin B6 forms. Lower age-specific limits apply to children. It is a safety ceiling for long-term intake, not an intake target or a precise threshold at which nerve damage begins.
Safety information
Side effect
Excess vitamin B6 can damage nerves
Excess B6 intake, particularly from prolonged high-dose supplementation, can cause peripheral sensory neuropathy. Symptoms can include tingling, burning or numbness in the hands and feet and impaired coordination. If these develop, stop non-prescribed B6 supplements and seek prompt medical assessment; for prescribed products, contact the prescriber. Recovery may be incomplete. [2][6][7]
Caution
Add up B6 from all supplements
If you use supplements, check multivitamins and magnesium or zinc products for B6 as well. TGA reports neuropathy with supplemental intakes below 50 mg daily and with overlapping products. These reports do not establish how often harm occurs at a particular dose; 50 mg is not a safety threshold. [6]
Upper level · Adults
EFSA adult upper limit: 12 mg daily
EFSA sets the adult tolerable upper intake level at 12 mg B6 daily, including during pregnancy and breastfeeding. It covers habitual total intake from foods, fortified foods and supplements, and all B6 forms. It is not a recommended intake target or a blanket treatment limit for medically supervised therapy. [2]
Upper level
Infants and children have lower upper limits
EFSA upper limits for total daily intake are: 2.2 mg at 4–6 months, 2.5 mg at 7–11 months, 3.2 mg at 1–3 years, 4.5 mg at 4–6 years, 6.1 mg at 7–10 years, 8.6 mg at 11–14 years and 10.7 mg at 15–17 years. Do not give children high-dose adult products without medical advice. These values are not recommended intakes. [2]
Caution
“Active” B6 forms are not proven safer
If you take B6 as pyridoxal-5′-phosphate, also called P-5-P or PLP, the same EFSA upper limits apply. Evidence is insufficient to show that this form is safer than pyridoxine at high supplemental doses. Being water-soluble does not prevent toxicity. [2]
Side effect
Other possible effects of excessive intake
Nausea, heartburn, photosensitivity and painful skin lesions have also been described with excessive B6 intake. Reliable frequency estimates are unavailable; these are not presented as typical effects of ordinary food intake. [3]
Interaction
Interaction with levodopa without carbidopa or benserazide
If you take levodopa without carbidopa or benserazide, supplemental pyridoxine can reduce its effect. Discuss B6 supplements with your prescriber. A peripheral decarboxylase inhibitor prevents this interaction, so it should not be generalised to all levodopa combinations. [8]
Interaction
Carbidopa/levodopa can be associated with B6 deficiency
B6 deficiency can occur during carbidopa/levodopa treatment and may be associated with seizures. Clinician-led assessment of B6 status may be appropriate, particularly with high doses or suspected deficiency. Use supplementation when advised rather than choosing high doses yourself. [9]
Interaction
High B6 doses can affect certain antiseizure medicines
If you take phenytoin or phenobarbital, discuss B6 supplements with your prescriber. Research has found reduced medicine concentrations with 200 mg B6 daily. Whether lower B6 doses have the same effect is unknown; 200 mg is well above the EFSA upper limit. [3][2]
Interaction
Some antiseizure medicines can lower B6 status
Valproate, carbamazepine and phenytoin can increase B6 breakdown and lower B6 status. If you take one of these medicines, discuss any need for supplementation with your prescriber. This does not justify preventive high-dose B6 use. [3]
Interaction
Coordinate B6 use with cycloserine or isoniazid treatment
Cycloserine increases B6 loss; supervised supplementation may help prevent associated neurotoxicity. B6 is also used for isoniazid-associated peripheral neuritis. If you receive either medicine, let your treatment team determine the need, dose and duration. [3][10]
Interaction
Theophylline can be associated with low B6 status
People taking theophylline can have lower B6 status, which may contribute to neurological adverse effects. Discuss possible deficiency or supplementation with your clinician rather than taking high-dose B6 yourself. [3]
Contraindication
Avoid the relevant product if you have a known allergy
If you have known hypersensitivity to pyridoxine or an ingredient in a B6 medicine, do not use that product. Check its specific ingredients and product information. This is not a blanket reason to avoid foods containing B6. [10]
Caution
Individualise supplementation in kidney disease
Low B6 status can occur with kidney disease, dialysis or after kidney transplantation. Have any supplementation need assessed clinically. An increased deficiency risk does not automatically make high B6 doses appropriate or safe. [3]
Caution
Do not self-treat existing neuropathy with B6
If you already have neuropathy, extra B6 is not automatically helpful. Evidence is insufficient to support B6 alone as a general neuropathy treatment, while excess B6 can itself damage nerves. Have the cause and any possible deficiency assessed. [7]
Caution · Pregnant women
Seek medical advice on higher medicinal doses in pregnancy
Pregnancy is not a general contraindication to B6. EFSA's upper limit for habitual total intake remains 12 mg daily. Use higher-dose medicines only following medical assessment of the specific product; product-specific advice is also important during breastfeeding. [2][10]
Found in
Frequently asked questions
What does your body need vitamin B6 for?
Vitamin B6 contributes to normal energy-yielding metabolism and normal nervous system and immune system function. It also supports normal protein and glycogen metabolism; extra supplements do not automatically give you more energy when your intake is already adequate.
How much vitamin B6 do you need each day?
EFSA sets population reference intakes of 1.6 mg daily for adult women and 1.7 mg for adult men. The values are 1.8 mg during pregnancy and 1.7 mg during breastfeeding. These refer to total intake, not supplement doses or an exact individual requirement.
Can too much vitamin B6 be harmful?
Yes: excessive intake can damage peripheral nerves, causing symptoms such as tingling, burning or numbness in the hands and feet. EFSA's adult upper limit is 12 mg daily from foods and supplements combined, including during pregnancy and breastfeeding. It is not an intake target or a precise threshold at which nerve damage begins.
What should you check if you take several supplements?
Check multivitamins and magnesium or zinc supplements for vitamin B6, and add up the amounts in their daily doses. EFSA's adult upper limit of 12 mg daily applies to total intake, including foods, not to each supplement separately.
Is the “active” B6 form P-5-P safer than pyridoxine?
There is insufficient evidence that pyridoxal-5′-phosphate, also called P-5-P or PLP, is safer than pyridoxine at high supplemental doses. EFSA's upper limits apply to all vitamin B6 forms.
Sources
- 01European Commission · 2012Commission Regulation (EU) No 432/2012 establishing a list of permitted health claims made on foods, other than those referring to the reduction of disease risk and to children's development and healthOpen source
- 02EFSA Journal · 2023Scientific opinion on the tolerable upper intake level for vitamin B6DOI 10.2903/j.efsa.2023.8006
- 03National Institutes of Health, Office of Dietary SupplementsVitamin B6 - Health Professional Fact SheetOpen source
- 04EFSA Journal · 2016Dietary Reference Values for vitamin B6EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA)DOI 10.2903/j.efsa.2016.4485
- 05European Parliament and Council of the European Union · 2011Regulation (EU) No 1169/2011 on the provision of food information to consumersOpen source
- 06Therapeutic Goods AdministrationPeripheral neuropathy with supplementary vitamin B6 (pyridoxine)Open source
- 07Nutrients · 2023The role of vitamin B6 in peripheral neuropathy: a systematic reviewOpen source
- 08How to Optimize the Effectiveness and Safety of Parkinson’s Disease Therapy? – A Systematic Review of Drugs Interactions with Food and Dietary SupplementsOpen source
- 09European Medicines AgencyHopledo, INN-levodopa, carbidopa: public assessment reportOpen source
- 10Health Products Regulatory AuthorityPyridoxine medicine: Summary of Product CharacteristicsOpen source
- 11U.S. Department of Agriculture, Agricultural Research Service – FoodData Central · 2019Bananas, raw (FDC ID 173944, SR Legacy)Open source
- 122019A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and ‘At-Risk’ IndividualsOpen source
- 132025Efficacy of B Vitamin Supplementation on Global Cognitive Function in Older Adults: A Systematic Review and Meta-analysisPubMed 40966571Open source
- 14BMJ · 1999Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: systematic reviewOpen source
- 15Cochrane · 2017Homocysteine-lowering interventions (B-complex vitamin therapy) for preventing cardiovascular eventsOpen source
- 16CochraneNo evidence of benefit from vitamin B6 supplementation on mood or cognition of older people with normal vitamin B6 status or with vitamin B6 deficiencyOpen source
- 172023The effects of pyridoxine (vitamin B6) supplementation in nausea and vomiting during pregnancy: a systematic review and meta-analysisPubMed 36719452Open source
- 18Journal of the National Cancer Institute · 2017Vitamin B6 and Cancer Risk: A Field Synopsis and Meta-AnalysisOpen source
- 19Istituto Superiore di SanitàVitamina B6: a cosa serve, dove si trova, carenza e eccessiOpen source