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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. People who consult health care providers about medication side effects might assume that dietary supplements are completely safe. That is a significant danger if someone takes excess vitamin B6 to try to boost immunity, improve mood or treat neuropathy or carpal tunnel syndrome.
Excess Vitamin B6 (Pyridoxine):
Why Overdosing Can Lead to Painful Nerve Damage:
Q. For some time, I’ve had weird tingling feelings in my feet that have been diagnosed as idiopathic peripheral neuropathy. I’m not diabetic, and nobody seems to know why I got this or what to do about it. All the neurologists I saw gave a big shrug.
A blood test showed that my level of B6 was ten times higher than normal, but nobody seemed to think that was relevant. Then a doctor friend of mine sent an article about vitamin B6 causing peripheral neuropathy. The usual source is supplementation. After that, I found corroborating evidence (not anecdotes).
I know a lot of people who have developed this condition. They should take a look at the supplements they are taking to see if they are getting too much vitamin B6–and then stop taking it! It seems the bad effects may be reversible.
A. Scientists have known for more than 20 years that excess vitamin B6 from supplements could harm the nervous system. This was associated with prolonged intake of doses of 50 mg/day or more. The Food and Nutrition Board has established a tolerable upper limit of 100 mg vitamin B6 for adults.
More recently, nutrition experts have found that vitamin B6 supplements at much lower levels can cause neuropathy (Drug Safety, Sep. 2018). However, the vitamin dose isn’t always linked to the blood levels of the patients. Even a multivitamin may be too much for some people (Journal of Nutrition, Health & Aging, Jul-Aug. 2007).
Moderate Vitamin Intake Resulted in Excess Vitamin B6:
Q. While I was taking 50 mg of vitamin B6 daily, I started having symptoms, including nerve pain in my feet and hands. Then I started walking like Frankenstein. I had lost some of my motor control.
Fortunately, my doctor tested me for B6 toxicity, and my levels were really high. He said to stop taking the supplement immediately. It took over a year to see any real improvement, but a few years later I am now much better. Companies should not be allowed to sell vitamin B6 in large doses.
A. Vitamin B6, also called pyridoxine, is essential for the proper functioning of nerves. But you need the right amount. Both too little and too much have been linked to neuropathy (Nutrients, June 21, 2023). Symptoms of nerve damage may include numbness or tingling, weakness, problems with balance and pain.
As far as we can tell, no studies demonstrate that vitamin B6 supplements at the level of the RDA, which is below 3 mg/day, cause problems. The Food and Nutrition Board has set the tolerable upper limit for American adults at 100 mg, but some readers have reported difficulties after long-term use of 50 mg. We suspect that some people are especially vulnerable to nerve problems even at standard levels.
To get vitamin B6 from food rather than pills, consider including chickpeas, beef liver, turkey, chicken breast, tuna or salmon in your diet.
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 (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.
Judy
I just took a basic multivitamin, and it was too much B6 for me. Blood levels were high, and I had peripheral neuropathy. It eventually went away after not taking any more.
Laurie
Is there a difference between the B6 as pyridoxine and the natural form P5P?
David
I thought all B vitamins were water soluble, and what you don’t need would naturally be excreted from the body by the urine. Wouldn’t that be true with vitamin B6? Or am I missing something?
Terry Graedon
David, the idea that water soluble vitamins are excreted with no harm done may be overly simplistic. You’re not missing anything; that has been the dogma for years. It just might not be the whole story.
Carey
I have also gotten neuropathy from B12 supplements.
John
One supplement with a high level of vitamin B6 is Brewer’s Yeast. A thirty gram serving of the one I purchased contains 16.6 mg., which the label indicates is 980% of the daily value. Due to this fact, I think it would be advisable to only consume a much smaller daily amount of this supplement.
Kim
Have you ever read ALL the labels on B vitamins in a store? It’s impossible to purchase a B complex that has less than 200% RDA of even 1 component. Most are in the 1000% range. Ditto for individual B vitamins. Centrum and other multis tend to stick with 100%, but, contain ingredients I can’t take. It is impossible to get just B vitamins in normal amounts from supplements
Carey
I have had nerve pain in my neck, arms and hands the last several months. Besides a multivitamin, I am taking AZO, which has pumpkin seed extract. It doesn’t provide a vitamin list. Is there any way to tell how much B6 is in it?
I’m switching vitamins and saw that B6 will go down (the old one is only 17mg). I will take fewer of those pills until I get to the new vitamins.
Regarding wearing a splint for carpal tunnel syndrome, I did that for years at night. My current hand doctor does not recommend it because it causes trigger finger – believe me, you don’t want that!
Paulo J
FL
I really need help. I am 31 years old male and I have been suffering from horrible stomach burning, prostate burning, tingling all over body(EVERY DAY FOR A YEAR). My neurologist tested me for b6 and it came out 3 times higher than normal normal levels are 2-21 but . The worst part about it is that I have not taken any vitamins so I do not know how I become toxic. I also suffer from genetic hemochromatosis( my body absorbs to much iron) I am wondering if there is any type of gene test to see if my body absorbs more than the normal person. Or could it be that food created this problem. Please help !!!
How do I lower it down?
Does whey protein , creatine or glutamine cause this?
Cynthia
Florida
I was getting numbness and tingling in my arms and hands. A blood test was done and I tested high for vitamin b6. I was getting only 3 mg in my multiple vitamin. I stopped taking the multiple vitamin about a week ago. So far there seems to be less numbness and tingling. Hopefully it will clear up totally.
Karen
Fort Worth TX
If a person has an MTHFR mutation, pyridoxine is contraindicated. P5P is the correct form of B6 to take. I suspect all of these people saying they got too much have some form of MTHFR mutation which 30-70% of the population can have.
Harold
Kingsville,Ohio
I never knew B 6 could be a problem.How would I know that.The world needs a warning.
When mine was checked it was 200.I walked like a drunk and now need 2 walkers.Indoors and out.
Lori
Could vitamin B6 toxicity be the cause of burning mouth syndrome?
Terry Graedon
Yes, it could. Here is a link to a study: https://www.jomos.org/articles/mbcb/pdf/first/mbcb160045.pdf
Hank
What about B-6 for asthma? I have used 100mg of B-6 for decades to help reduce my asthma symptoms, with no tingling.
Lynn
midwest
I think I am totally confused.
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.
SUZANNE
Virginia
This happened to me as well….prescribed doses of bs for years and now have neuropathy (which took a year to diagnosis) and my dr. denied from b6 because it is water soluble. i went through several misdiagnosis and was described as idiopathic regarding neuropathy.
but i persisted in learning cause, and through help groups, learned about b6 toxicity and asked for a blood test. My levels are 11 times the upper normal range limit, so dr. reluctantly agreed that it is playing a role. I went off b6 3 weeks ago and am hopeful i can see improvement in sensory neuropathy over time. it is particularly painful in my toes and the sensory neuropathy triggered another rare and painful condition called erythromelalgia.
mary
01089
Looking at your article about raisins and gin, what time should it be taken, morning or night or does it make any difference?
EB
USA
100mg causing toxicity is outdated information. Many become toxic on much lower amounts with irreversible damage, even from the daily value in a multivitamin. This should be updated to show that any amount of excess b6 vitamin in one’s diet has the ability to cause nerve damage.
Jane
UK
I took 50mg B6 for 5.5 years and developed nerve damage symptoms after 4 years.
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.
Elle
boone nc
I wonder if Garden of Life multiple vitamin would provide a safer outcome.
Starr M
Oregon
An overlooked cause of Carpal Tunnel Syndrome is being hypothyroid. It is a common symptom of being hypothyroid.
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. :-)
marian
buffalo
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-
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.
Steve
Nevada
Thank you for the information about your experience with B6. I also had a ( now former ) doctor advise me to supplement with B6, supposedly to help my pinched nerves heal. I was told it is water soluble and not possible to take too much and to take a tablet a few times a day. For the past week I’ve been suffering with numbness and tingling in my arms and legs and difficulty swallowing which has also increased my anxiety level. I’m hoping that by discontinuing the B6 my nerves will heal.
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.
Joanna
Colorado
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!
Carey
Chicago
Years ago I got permanent relief from numbness and tingling in my wrists from acupuncture.
Don
Madison
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.
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.
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.
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!
Barry
New Hampshire
Once again, People Pharmacy ignores chiropractic, which can take care of carpal tunnel syndrome without drugs.
BBBob
Buffalo
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
Chicago
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.
Susan
California
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.