high doses of vitamin B6, excess vitamin B6

Whether you utilize pharmaceutical medicines or look to natural remedies such as vitamins and minerals, you must make sure the treatment is not worse than the ailment. That is a significant danger of taking excess vitamin B6 to try to treat neuropathy or carpal tunnel syndrome.

Easing Carpal Tunnel Syndrome:

Q. I believe my friend has carpal tunnel syndrome from doing repetitive work at his job. Is there anything he can take for it that’s a natural anti-inflammatory?

A. Carpal tunnel syndrome occurs when the median nerve in the wrist is pinched, often from repetitive motions. Symptoms can include numbness, tingling, burning and weakness in the hand or arm.

Doctors often recommend anti-inflammatory drugs like ibuprofen. Acupuncture was shown in one small study to be as good or better than ibuprofen for relieving pain, numbness and tingling at night (Hadianfard et al, Journal of Acupuncture and Meridian Studies, Oct. 2015). A review concludes that acupuncture “may be beneficial for CTS” [carpal tunnel syndrome] (Cox et al, Journal of Orthopaedic and Sports Physical Therapy, June 2016).

Physical Therapy for Carpal Tunnel Syndrome:

When doctors want to treat this painful problem without surgery, they often recommend a brace or splint. A recent study found that people who did hand exercises squeezing a foam ball with rubber cords attached had slight improvement in their symptoms (Unver & Akyolcu, Asian Journal of Neurosurgery, Jan-Mar. 2018). A physical therapist would be able to instruct your friend on the best exercises for this problem.

Does Vitamin B6 Help Carpal Tunnel Syndrome?

Vitamin B6 (pyridoxine) has been a controversial treatment for carpal tunnel syndrome. Some clinicians maintain it is ineffective (Wipperman & Goerl, American Family Physician, Dec.15, 2016). Others say it works to ease symptoms (Talebi et al, Advanced Pharmaceutical Bulletin, online Aug. 20, 2013).

Beware Excess Vitamin B6:

We offer a word of caution about this nutrient, though. Large doses or prolonged treatment can cause nerve damage, as this reader discovered:

“I found out 30 years ago that taking Vitamin B6 helped me get rid of carpal tunnel syndrome. However, I made the mistake of continuing to take it for decades.

“I eventually developed B6 toxicity. By then it was having the opposite effect of making my hands AND feet numb. It took me a long time to figure out what was going wrong, since my doctor insisted there was no such thing as B6 toxicity. By trial and error I found that stopping the B6 made the numbness go away.”

Doctors have written about numerous cases of excess vitamin B6 causing nerve damage (Bacharach, Lowden & Ahmed, Journal of Clinical Neuromuscular Disease, Sep. 2017; Scott, Zeris & Kothari, Electromyography and Clinical Neurophysiology, Jun-Jul. 2008).

Usually any damage to the nerves caused by excess vitamin B6 is reversible once the vitamin is stopped. That is not always the case, however (Kulkantrakorn, Neurological Sciences, Nov. 2014). According to the Office of Dietary Supplements, adults should not take more than 100 mg a day. The recommended daily allowance is much less–1.3 mg per day for adults up to age 50 and a little bit higher than that for people over 51.

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  1. Fabienne

    I got B6 toxicity only by taking 25mg pyridoxine HCI per day. I’ve been unknowingly poisoning my body for many years, and my blood levels came up 11 x the upper limit with many neurological symptoms. Been off synthetic B6 now for 8 months but the toxicity has damaged my nerves, and recovery will not happen. Even got new neurological symptoms. Please be aware that many people can get toxicity with low levels. It is called the chronic B6 toxicity, and recovery is very hard when you are a chronic B6 toxicity victim. Acute B6 toxicity does indeed occur on high dose B6 for a short(-er) period of time, and recovery is most likely. Thank you.

  2. mary

    Looking at your article about raisins and gin, what time should it be taken, morning or night or does it make any difference?

  3. Jane

    I took 50mg B6 for 5.5 years and developed nerve damage symptoms after 4 years.

  4. DF
    Pennsylvania (USA)

    I know many people (including myself) who would disagree with the stated “safe” upper limit of 100 mg of B6 daily. I became toxic after switching to a multi-vitamin with 25 mg of B6 (pyroxidine). It took more than a year after I developed first symptoms to be diagnosed (via a blood test that showed a level of 113 with a safe range of 2 – 21) . It was the worst year of my life — with symptoms that progressed from tingling in the extremities to internal trembling throughout my body (legs, arms, chest, face, head) coupled with intense anxiety, “lump in throat” feeling, issues with proprioception and more. Imagine being in “flight” mode constantly. It has taken more than two years to recover from the nerve damage — and I can still get “flares” if I eat too much of certain foods or experience mild dehydration or stress.

    There are multiple Facebook groups populated by people who have experienced similar issues with the synthetic form of B6. Some have been misdiagnosed with other issues (including MS). Many (including myself) were initially treated as neurotic before ultimately finding a physician who provided a correct diagnosis.

    This is an issue that deserves greater attention. The impact of B6 toxicity can be large and long-lasting.

  5. Elle
    boone nc

    I wonder if Garden of Life multiple vitamin would provide a safer outcome.

  6. Starr M

    An overlooked cause of Carpal Tunnel Syndrome is being hypothyroid. It is a common symptom of being hypothyroid.

  7. Chris N.
    Minneapolis, MN

    I just checked the Solotron multi-vitamins I take and also some B-complex capsules. I never take them together, but both of them have high amounts of B6. While I have taken different types of B-complex for years, I developed mild numbness and tingling in my feet a couple of years ago. I related it to a very high dose of antibiotic that I had taken previously, but now I wonder if it’s not from the B6? Guess I will have to do some tests. :-)

  8. marian

    re carpal tunnel if like me your fingers go numb and hurt at night-to the point of by morning much pain- i am using this product-“carpal aid” its a rigid butterfly shape ‘bandaid type item to stick on the central palm at night- spandex arthritis glove over it.(i have reused them)o can now sleep at night with much lessened pain-

  9. Mark
    North Carolina

    Several years ago I had a slightly pinched nerve in my neck. My (now former) doctor prescribed very large doses of B6, saying it helps nerves. Almost immediately I experienced numbness and tingling over large parts of my body. I discontinued the B6, but the symptoms persisted for a month. I honestly thought I was dying.

    The rationale doctors use for prescribing large doses is that B vitamins are water-soluble, and therefore your body will eliminate any excess before it causes damage. That is patently absurd. Potassium cyanide is highly water-soluble, and you’ll be dead long before your body purges it.

  10. Dale
    Austin, Texas

    I have known of 4 people including a brother-in-law who previously had carpal tunnel syndrome and were dramatically helped by taking 100mg of B6; anything less, and the problem would come back. Am quite sure all 4 lived and worked in Los Alamos, NM.

  11. Joanna

    I too, unwittingly suffered terrible peripheral neuropathy for five years from Vitamin B6 toxicity. Unfortunately, this toxicity is not common knowledge among doctors. I ultimately saw a neurologist who suggested I be tested for B6 toxicity. Even when a blood test confirmed high levels of B6 in my blood, it took months to return to normal B6 levels before the neuropathy actually subsided. It’s inconceivable that supplement manufacturers include such high levels of B6 in their B complex formulas!

  12. Carey

    Years ago I got permanent relief from numbness and tingling in my wrists from acupuncture.

  13. Don

    My medical website for my hmo recommended a holistic treatment for CTS of 300 mg of b6 for 90 days to reduce the symptoms which has helped me.

  14. Anne
    Seattle, WA, USA

    My MD functional medicine physician prescribed Metanx (a Vitamin B combo) for neuropathy two years ago. I take one caplet every day, and the symptoms were alleviated (electric, shooting pains in my legs, random). When I ask the pharmacy if I can take it indefinitely, they usually say there are no known side effects from continuing it. Is there a way to test if I’m getting too much? I don’t seem to have adverse effects that I know of.

    • Terry Graedon

      The doctor who prescribed it can and should test your B vitamin levels periodically.

  15. Kris

    I just started taking B6. I was diagnosed with foot drop. My neurologist ordered a blood test for B6. I was very low. The foot drop problem has gone away & I continue to take it, but now I’m wondering if I should stay on it.

  16. karin
    new jersey

    March 6, 2018
    Your July 2017 post on Vit B6 (pyridoxine) overdoses made me realize that the tingling I’d felt in my toes and feet over the past year or so might be due to that. I immediately changed my vitamin B complex supplement.

    For years, I had been taking daily a “Balanced B-100 Complex” with 100mg Vitamin B6, which = 1667% RDA. (Yes, 1667% !) I found a different supplement without Vitamin B6.

    The tingling stopped within a week and hasn’t come back.

    Note: I also have polyneuropathy (paresthesia) in lower legs that seems to be due to a different vitamin B problem — not absorbing Vitamin B12 properly.

    Thank you very much for the alert!

  17. Barry
    New Hampshire

    Once again, People Pharmacy ignores chiropractic, which can take care of carpal tunnel syndrome without drugs.

  18. BBBob

    What about vitamin B12 for peripheral neuropathy? I began to have numbness and tingling in my feet about 15 years ago, with enough feeling remaining to be able to walk and drive a car but reduced feeling of heat or objects touching my toes or the top of my feet. In 2011, a neurologist said that my blood serum B12 level was low and prescribed 1000 mcg of B12 per day to restore the level to normal, with the hope that this might also restore some of the feeling in my feet. After two or three years, the B12 level number was essentially normal, and I asked if I should cut back on the B12 dose. I was told to stay with the 1000 mcg dose. Incidentally, the neuropathy in my feet is basically unchanged today from 2011.

    • Carey

      I got peripheral neuropathy from taking B12. I think the dose was like 1400, which I later discovered was way too much. This happened quickly and went away quickly. I tested taking them less frequently, but the neuropathy came back after one pill.

  19. Susan

    I took only 50 mg. a day of vitamin B-6 and developed vitamin B-6 toxicity. I was walking like Frankenstein. Fortunately my doctor tested me and called right away. It took more than a year to recover and I still have “plastic” soles on my feet.

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