Severe sensorimotor neuropathy after intake of highest dosages of vitamin B6

@article{Gdynia2008SevereSN,
  title={Severe sensorimotor neuropathy after intake of highest dosages of vitamin B6},
  author={H. J. Gdynia and Timo M{\"u}ller and Anne Dorte Sperfeld and Peter K{\"u}hnlein and Markus Otto and Jan Kassubek and Albert Christian Ludolph},
  journal={Neuromuscular Disorders},
  year={2008},
  volume={18},
  pages={156-158}
}

Sensory Polyneuropathy Associated with Pyridoxine Overdose

A 74-year-old man presented with paresthesia in both legs that first appeared 2 months previously, and a nerve conduction study revealed axonal sensory polyneuropathy.

Chronic idiopathic axonal polyneuropathy and vitamin B6: a controlled population‐based study

An association between CIAP and vitamin B 6 exposure or elevated vitamin B6 levels appears unlikely, and follow‐up of patients confirming the cessation of supplements showed slow progression of symptoms, stabilization, and regression.

Vitamin B6 in Health Supplements and Neuropathy: Case Series Assessment of Spontaneously Reported Cases

Causality assessment of the case series of 90 reports to Lareb shows it is plausible for the vitamin B6 supplements to have caused complaints such as neuropathies, especially the case with higher dosages and prolonged use, but dosages < 50 mg/day also cannot be excluded.

Revisiting the Evidence for Neuropathy Caused by Pyridoxine Deficiency and Excess

It can be concluded that very low doses of daily pyridoxine are required to prevent peripheral neuropathy and there is inadequate evidence to support routine pyrIDoxine supplementation in patients with disorders of peripheral nervous system.

Nutritional neuropathies

Neuropathies associated with nutritional deficiencies are routinely encountered by the practicing neurologist and when promptly identified, therapeutic nutrient supplementation may result in stabilization or improvement of these neuropathies.

Vitamin B6 levels do not correlate with severity of neuropathy in chronic idiopathic axonal polyneuropathy

Pyridoxine (vitamin B6) toxicity is known to cause a length‐dependent, sensory predominant axonal polyneuropathy. There is debate regarding the threshold at which intake levels can cause neurological

Regressive pyridoxine-induced sensory neuronopathy in a patient with homocystinuria

Pyridoxine-induced sensory ganglionopathy may be reversible, even after prolonged ingestion of high doses of vitamin B6 for more than 20 years, as indicated in a 30-year-old patient with homocystinuria.

Thiamine Deficiency Pathogenesis

Patients receiving total parental nutrition (TPN) are also at risk for vitamin deficiency and TPN formulations should be carefully formulated to include supplemental vitamins and trace minerals.
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References

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Acute sensory neuropathy‐neuronopathy from pyridoxine overdose

Two patients who developed an acute, profound, and permanent sensory deficit after treatment with massive doses of parenteral pyridoxine are reported, who had transient autonomic dysfunction, mild weakness, nystagmus, lethargy, and respiratory depression.

Sensory neuropathy and vitamin B6 treatment in homocystinuria

The results suggest that a safe dose of pyridoxine may be lower than 900mg and higher than 500 mg per day, which may also apply to individuals receiving B6 for other conditions and calculation of doses based on body weight may be necessary to further define the smallest effective dose.

Hoeveel vitamine B6 is toxisch

A report of neurotoxicity in 2 patients who had taken 24 mg and 40 mg of vitamin B6 per day respectively, may be coincidence rather than a true toxic effect of such relatively low doses, however, physicians need to remain alert to high intakes ofitamin B6 as a cause of unexplained neuropathy.

Pyridoxine Megavitaminosis: An Analysis of the Early Changes Induced with Massive Doses of Vitamin B6 in Rat Primary Sensory Neurons

These findings identify the probable target site for pyridoxine toxicity, and establish a simple animal model for studying not only sensory denervation, but also the axonal reaction and secondary degeneration of nerve cell bodies and processes.

Clinical features and pathophysiological basis of sensory neuronopathies (ganglionopathies)

In SSN, early diagnosis by the detection of anti‐Hu antibodies and early treatment of the cancer gives the best chance of stabilizing the disorder and in SS sensory ganglionitis, response to treatment has been disappointing, but immunomodulating treatments are emerging.

Experimental and clinical neurotoxicology

Sensory neuropathy from pyridoxine abuse. A new megavitamin syndrome.

It is indicated that consumption of large doses of pyridoxine can cause sensory neuropathy or neuronopathy syndromes and that safe guidelines should be established for the use of this widely abused vitamin.