Vitamin B6 deficiency leads to social deficits and cognitive impairment | Hacker News Reader

Vitamin B6 deficiency leads to social deficits and cognitive impairment

nature.com

65 pointsbelltaco44 comments

And B6 overdose causes small fiber neuropathy. It’s advisable to get levels checked before supplementing. I‘d consider getting the active form (P5P) as it also works when metabolism is impaired. Another thing to note is that those supplements often come in very high doses (eg 100x the DRI), which I personally wouldn’t take to avoid toxicity.

B6 toxicity is absolutely no joke. https://understandingb6toxicity.com/b6-toxicity/symptoms/

Can take months to years to recover from. I've had it myself, had all kinds of symptoms including peripheral neuropathy. Couldn't feel my fingers. Took me ~6 months to recover full feeling in my fingers and toes. It's literally the reason I don't take supplements now.

Sorry to learn about your bad experience. Toxicity is vastly different for the different minerals and vitamins though, just need to inform yourself up front.

Yeah I agree, I was being hyperbolic because I wrote that from my phone while walking around so didn't want to spend the time elaborating.

I still take two supplements nearly daily. Those being choline and d3. Every now and then magnesium. However my first hand experience with toxicity as a result of nothing more than my attempt at gaining some type of insurance policy against bad health really caused me to reevaluate supplements and respect them in the same vein as any other drug.

So now, I refuse to supplement anything until I can prove deficiency and a need with a blood test. In other words, spending the 50-100$ on a blood test is now my insurance against repeating my mistake.

Unfortunately I can't test for choline status however I still supplement it based on my genomics and because it makes a clear difference in my cognitive function.

Interesting, choline isn’t something that I can take indefinitely. It can induce depression actually, depending on metabolism.

Yes yes yes. B6 levels can get extremely high with the amounts in many B complex capsules, let alone the B6 specific. Take it easy on B6 unless you actually know your levels. More is not always better.

I'd say always supplement with P5P, never with B6. Although some may argue it's safe in small amounts.

Warning: study is in mice and is quite specifically about schizophrenia. Your mileage may vary.

And n=20.

If you can't trust a study of 20 clone mice to be representative of general impact of a vitamin deficiency in the wider human population, what can you trust?

I'm not sure you could find twenty clones of humans.

/? b6 b12 male smokers https://www.google.com/search?q=b6+b12+male+smokers

"Long-Term, High-Dose Vitamin B6/B12 Use Associated With Increased Lung Cancer Risk Among Men" (2023) https://cancer.osu.edu/news/long-term-high-dose-vitamin-b6-b... :

> Risk was further elevated in male smokers taking more than 20 milligrams of B6 or 55 micrograms of B12 a day for 10 years. Male smokers taking B6 at this dose were three times more likely to develop lung cancer. Male smokers taking B12 at such doses were approximately four times more likely to develop the disease compared to non-users.

Those are very high doses of each. An average multivitamin has 1.8 mg of B6 (vs. 20 mg in the study) and 6 mcg of B12 (vs. 55 mcg in the study).

I am surprised anyone wants to take that much, but I guess the smokers were trying anything they could (short of actually quitting) to compensate for the effect their habit has on their health.

Aren’t standalone B12 supplements typically measured in 3-4 digits (mcg)?

I’m currently taking 1000mcg daily but I’ve seen up to 2500 at the local pharmacy.

Absorption is poor sublingually and is limited by https://en.m.wikipedia.org/wiki/Intrinsic_factor so I wouldn’t be surprised if most of those doses just get destroyed in the stomach

I have exactly that problem - malabsorption. The sublingual tablets have helped considerably.

I’m just trying to understand why the other commenter considers the dose mention as “high”. I’ve never heard that claimed before.

I was referring to multivitamin levels which are typically ~100% RDA, so to get the levels the study considered harmful, you have to be intentionally taking large doses of B Vitamins which is easy not to do.

Some Caffeine Shots include very high doses of B6 and B12 vitamins.

## 2023-12: B6/B12 RDVs, RDV % Supplement Facts inconsistencies

5-Hour Energy nutrition facts: https://www.google.com/search?q=5+hour+energy+nutrition+fact... :

> B6: 40mg: 2000% RDV

> B12: 500mcg: 8333% RDV

5-Hour Energy Extra Strength:

> B6: 40mg: 2353%

> B12: 500mcg: 20833%

Summit Red Thunder Energy Shot nutrition facts: https://www.google.com/search?q=Summit+Red+Thunder+Energy+Sh...

> Kirkland Signature Extra Strength:

> B6: 40mg: 2533% RDV

> B12: 500mcg: 20833% RDV

...

Again,

/? b6 b12 male smokers https://www.google.com/search?q=b6+b12+male+smokers

"Long-Term, High-Dose Vitamin B6/B12 Use Associated With Increased Lung Cancer Risk Among Men" (2023) https://cancer.osu.edu/news/long-term-high-dose-vitamin-b6-b...

I wish there was some way to just know what minerals/vitamins/... I currently need the most (or, which could still have a positive effect even if already a sufficient amount), and which I already have enough of so could skip.

So it'd be possible to supplement what's needed, and not the rest.

A blood test supposedly should show this, but I only get one of those very rarely, and a snapshot of one such test doesn't tell much.

Blood tests are pretty quick and reveal a lot. Especially vitamin levels, inflammation, some cancer markers, …

We get our teeth checked once or twice a year. I honestly think we’d catch a lot if we did the same with blood tests. We’d probably save a lot on healthcare with early detections and corrections.

> I honestly think we’d catch a lot if we did the same [biennial testing] with blood tests. We’d probably save a lot on healthcare with early detections and corrections.

That is definitely not clear. Also every procedure has iatrogenic risk.

Look at cancer screenings in the USA: they have gotten more precise and more frequent, so more cancers are caught earlier and survival time increased.

Or has it? Since we find smaller tumors, we find ones that might never have metastasized at all, but intervene anyway. Even for the dangerous ones, earlier detection means earlier treatment, but was the patient going to at 50 either way? That just means they are a cancer patient for a longer period, which by the metrics counts as longer survival.

All the grumbling about too much screening doesn’t pass my sniff test. No one can convince me that detecting cancer earlier isn’t, on average, a good thing. The real problem is how expensive our healthcare system is - the cost of even basic screening procedures makes them into a much bigger deal than they need to be.

> No one can convince me that detecting cancer earlier isn’t, on average, a good thing.

Since no one can convince you, indeed you should not bother to read any of the extensive literature on the subject.

But consider that if indeed it does not extend lifespan, but does extend treatment span, patients will suffer a worse quality of life on painful treatment that does not help and the concomitant fear.

A shame, because you finger health care expense and this phenomenon increases health care expense.

Ah, the plebeians are the problem. With more information, the plebeians will make incorrect decisions that make them more miserable. It is better to keep them in the veil of ignorance for their own good.

These are the over-diagnosis bias and the lead-time bias for anyone interested in learning more.

The book Risk Savvy by Gerd Gigerenzer has a chapter that does a good job of covering these. The entire book is worth a read.

> I honestly think we’d catch a lot if we did the same with blood tests.

Don't we? The blood tests seem to be the main point of an annual checkup when nothing else is obviously wrong.

Your own comment already gives the answer you're looking for. Blood tests, of which you can have multiple done over a time period.

You're complaining a test doesn't exist because it's a test you only get done rarely...?

The frequency would need to be quite high to know what you need each day, and such tests are expensive, slow (has to go to a lab etc...), a hassle, and not part of standard health insurance where I live

Doing them daily would be useless -- it generally takes a month or more for supplements to start to show effects. 6x or 4x a year is the most you need. These will tell you if your vitamin D supplementation is working fine, or if you need to double it, or if you should halve it, for example.

The tests aren't that expensive. At insurance rates, it'll run you maybe $75-150 for the whole standard set in the US if you're paying 100%. And the first one is mostly covered as part of your free annual checkup anyways.

Are they slow and a hassle? Sure, but what do you expect? They're also a minor miracle, that they can detect so much about your health from little vials.

Point is, if you want to do it, you can.

Day-to-day levels don’t matter for a lot of the compounds of interest at the levels we’re talking about. In fact it generally takes a while for levels to adjust in any measurable or meaningful way.

Things like a headache or a bad sleep night are only for 1 day or so though, so those must be something that's lacking for just a day, not something that needs months to build up

Those aren't being caused by vitamin deficiencies then.

Headaches and lack of sleep can be caused by hunger, stress, tension, anxiety...

A standard blood panel is relatively cheap to order for yourself. It can actually be cheaper to go this route with cash than through insurance, especially if you need a doctor's visit first to order one. https://www.healthlabs.com/standard-health-testing-panel-cbc...

At only $80 and an easy visit to a local blood draw clinic, I do this twice a year by my own volition and now have several years of data and trends to monitor. I'm still quite young and healthy, but I hypothesize that having this data from my health will be very useful as a baseline as I age. If something concerning crops up, then I would pay to see a doctor for further testing and diagnosis. I also add testosterone and H1C tests for good measure. Considering also adding Apo-B to keep well on top of atherosclerosis risk.

Now, a comprehensive vitamin panel (closer to what you're asking for) is a lot more expensive. Most people are more than fine just taking a multivitamin and calling it good. Luckily, true vitamin deficiency is fairly rare, and the information you get in a standard blood panel will help catch all the heavy hitter mortality risks. https://www.healthlabs.com/comprehensive-vitamin-panel-1

I use LabCorp, but people say good things about https://www.insidetracker.com/ (a bit more pricey). Most on-demand blood tests are HSA eligible.

What does "on-demand" mean here?

It’s where the customer/patient requests a test for themselves, for any or no reason.

As opposed to a doctor ordering a test, as either part of a routine checkup or for a more specific reason.

OK, thanks. In other words: does not require an order from a doctor.

The only vit that I know about that has studies showing supplements helps is D.

Everything else falls under “eat a healthy balanced diet”. And supplementing doesn’t help.

Get your blood tested yearly at s physical to make sure nothing odd is going on and you’ll be doing about as good as you can.

This is super wrong and potentially harmful. If you are deficient in anything a supplement definitely can help. Iron is a good example. A big chunk of the female population is iron deficient. Supplementation is a perfectly valid way of combating this.

Also, if you're taking iron supplements and your levels are still too low, you might have an absorption issue—which either warrants getting the absorption issue checked out or starting direct iron infusion instead of iron supplements. But you gotta get your iron one way or another!

Right. Which is why I said to get your blood tested yearly?

> The only vit that I know about that has studies showing supplements helps is D.

Even that is not clear. We know that sick people often have lower D levels but we don’t know which way the causality runs.

Or there could be no causality at all: low D levels could simply be correlated with a sedentary lifestyle which is the actual problem is some cases. Thus adjusting the level would be a waste of time.

If you're eating a plant based diet B12 supplements are required.

Vegemite FTW!

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