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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by iforgotmypassword on February 25, 2007, at 13:19:23
i am very interested in the akathisia studies on pubmed that used 1200mg/day. i am worried however, another pubmed study said that high B6 damaged rat brains (and wasn't actually super high per kg it seemed.) the term "nerve damage" is thrown around a lot in reference to B6 but then so is "reversible". what's the real story?
the official upper limit is "100mg"? multiple different brands at the store sold jars with 250mg pills. the sheet at the store said the neuropathy level is 2000-6000mg... confusing.
Posted by Bob on February 25, 2007, at 13:19:23
In reply to can you really hurt yourself with high vitamin B6?, posted by iforgotmypassword on February 22, 2007, at 13:31:39
I'm not sure about vitamin B, but ever since ECT I've become super exquisitely sensitive to just about everything, and eventually even small amounts of Vitamin D recently, have given me slight akathisia. What has this come to, when 1/4 of a 1000 I.U. pill (approx 100% recommended daily value?) makes me feel uncomfortable.
I originally tried it because of some info suggesting that it was hard to get enough Vitamin D in the winter.
Posted by Bob on February 25, 2007, at 13:19:23
In reply to can you really hurt yourself with high vitamin B6?, posted by iforgotmypassword on February 22, 2007, at 13:31:39
I'm not sure about vitamin B, but ever since ECT I've become super exquisitely sensitive to just about everything, and eventually even small amounts of Vitamin D recently, have given me slight akathisia. What has this come to, when 1/4 of a 1000 I.U. pill (approx 100% recommended daily value?) makes me feel uncomfortable.
I originally tried it because of some info suggesting that it was hard to get enough Vitamin D in the winter.
Posted by Larry Hoover on February 25, 2007, at 13:19:23
In reply to can you really hurt yourself with high vitamin B6?, posted by iforgotmypassword on February 22, 2007, at 13:31:39
> i am very interested in the akathisia studies on pubmed that used 1200mg/day. i am worried however, another pubmed study said that high B6 damaged rat brains (and wasn't actually super high per kg it seemed.) the term "nerve damage" is thrown around a lot in reference to B6 but then so is "reversible". what's the real story?
The neuropathy develops due to two factors, dose and duration. An acute treatment (say, a few weeks) at a high dose will likely have a substantially lesser neuropathy risk than the same dose over a year. Everything I've read suggests that all neuropathy symptoms are reversible upon cessation of the B6, in any case. If you get symptoms, you stop, and the symptoms go away.
> the official upper limit is "100mg"?
Yes, that is correct. It is safety factors within safety factors within safety factors. For a full account, read this chapter on B6:
http://books.nap.edu/openbook.php?record_id=6015&page=150
Toxicity/adverse effects and the derivation of the UL proceed from page 182.> multiple different brands at the store sold jars with 250mg pills. the sheet at the store said the neuropathy level is 2000-6000mg... confusing.
Early medical reports were not so carefully crafted as those published today. As I recall, in an older article, subjects taking 2000-6000 mg/day B6 for periods of 2 to 40 months reported neuropathy symptoms. Those variables cover an incredibly broad range of experience, so it's hard to make conclusions. What I can tell you is that neuropathy at 1,000 mg/day is thought to be uncommon. That's right in about the dose you were considering. And, if your fingers or toes start tingling or go numb, just cut the dose.
Lar
Posted by Phillipa on February 25, 2007, at 13:19:23
In reply to Re: can you really hurt yourself with high vitamin B6? » iforgotmypassword, posted by Larry Hoover on February 22, 2007, at 15:24:32
Lar thought the B vitamins you peed out what your body doesn't use? Love Phillipa ps my OB-GYN used to have me use B6 for bloating.
Posted by yxibow on February 25, 2007, at 13:19:23
In reply to Re: can you really hurt yourself with high vitamin B6? » Larry Hoover, posted by Phillipa on February 22, 2007, at 22:04:46
Yes -- read http://ods.od.nih.gov/factsheets/vitaminb6.asp#h7
"It can cause neuropathic damage to the [body's peripherals] at doses even lower than 500 mg / day"
Stay within the accepted margin.
Posted by Larry Hoover on February 25, 2007, at 13:19:24
In reply to Re: can you really hurt yourself with high vitamin, posted by yxibow on February 23, 2007, at 0:54:28
> Yes -- read http://ods.od.nih.gov/factsheets/vitaminb6.asp#h7
>
> "It can cause neuropathic damage to the [body's peripherals] at doses even lower than 500 mg / day"
>
> Stay within the accepted margin.I'm a toxicologist. Well, I was one, once upon a time. Anyway. I read the literature quite closely. And I'm always struck by the distinct discrepancy between the way we treat therapeutic use of "vitamins" and therapeutic use of "drugs". I use quotation marks because those descriptors are quite arbitrary.
In the case of vitamins, prudent medical thought has it that all side effects must be rigorously excluded, no matter how rare or reversible they may be. Zero side effects is the only accepted outcome.
Compare that to e.g. acetylsalicylic acid, i.e. Aspirin/ASA. Every dose, even enteric coated, causes bleeding in the gut. Every platelet encountering this drug is deactivated permanently, as platelets have no DNA and cannot repair themselves. I could list ten other toxic effects, always present, but I shan't bother. Both B6 and ASA are available OTC.
The AMA rigged studies used to discredit Linus Pauling (one of only two? two-time recipients of the Nobel Prize) when he had the temerity to suggest that vitamin C was not toxic at gram doses. And yet, you will still see the misinformation produced at that time quoted as "proof" of the adverse reactions that no one has ever seen in humans, to this day.
That's why I included the book link to the actual science studied, and arguments used, to create the threshold value called the UL for vitamin B6. That source is the basis for the government's recommendations. The UL is a small fraction of the NOAEL (No Observeable Adverse Effects Level).
Ten years ago, vitamin D was considered to be toxic, but now they're using 100's of 1,000's of IU per dose in medical settings. Old ideas die hard, even when people aren't.
Lar
Posted by Declan on February 25, 2007, at 13:20:51
In reply to Re: can you really hurt yourself with high vitamin » yxibow, posted by Larry Hoover on February 23, 2007, at 8:30:11
My nutritional doctor has from time to time suggested I take reasonably large doses of pyridoxyl-5-phosphate to facilitate neurotransmitter synthesis, I guess...about 500mg/d.
Quite large doses can be used to lower homocysteine levels too.
Is the neurotoxicity thing just with pyridoxine or with p-5-p as well?
Posted by Phillipa on February 25, 2007, at 13:27:16
In reply to can you really hurt yourself with high vitamin B6?, posted by iforgotmypassword on February 22, 2007, at 13:31:39
Staying on the thread. Love Phillipa
Posted by johnnyj on February 25, 2007, at 18:04:17
In reply to Re: can you really hurt yourself with high vitamin » yxibow, posted by Larry Hoover on February 23, 2007, at 8:30:11
Hello Larry, long time no chat. I hope you are doing well and it is nice to have you back.
I do have a question for you. Since I was off meds for about 6 months I have felt better but could not sleep well. Lunesta was disaster. Recently, the lack of sleep is killing me.
I have anxiety,ocd, and this is making me depressed. Anyway, since I have not been on anything and my sleep is messed up I get 4 to 6 hours and then wake up and sometimes get back to REM sleep and sometimes not. Lately, more not. Well I have develope muscle spasms and twitches all over my body. I believe it is because of the lack of sleep. Do you know what causes this from a physiological standpoint? It is a concern because I fear my heart will do the same, thanks ocd/anxiety!
I have started low dose luvox a few days ago because I can't stand the no sleep anymore. It is dicey right now. Any thoughts?
Have a good one Lar
johnj
Posted by Franz on March 9, 2007, at 13:18:46
In reply to Re: can you really hurt yourself with high vitamin B6? » iforgotmypassword, posted by Larry Hoover on February 22, 2007, at 15:24:32
> > i am very interested in the akathisia studies on pubmed that used 1200mg/day. i am worried however, another pubmed study said that high B6 damaged rat brains (and wasn't actually super high per kg it seemed.) the term "nerve damage" is thrown around a lot in reference to B6 but then so is "reversible". what's the real story?
>
> The neuropathy develops due to two factors, dose and duration. An acute treatment (say, a few weeks) at a high dose will likely have a substantially lesser neuropathy risk than the same dose over a year. Everything I've read suggests that all neuropathy symptoms are reversible upon cessation of the B6, in any case.
larry. I think he/she is talking about the B6 cortical toxicity, not peripheral. Sorry I don´t have a link at hand.
Posted by Larry Hoover on March 10, 2007, at 13:56:12
In reply to Re: can you really hurt yourself with high vitamin B6? » Larry Hoover, posted by Franz on March 9, 2007, at 13:18:46
> > > i am very interested in the akathisia studies on pubmed that used 1200mg/day. i am worried however, another pubmed study said that high B6 damaged rat brains (and wasn't actually super high per kg it seemed.) the term "nerve damage" is thrown around a lot in reference to B6 but then so is "reversible". what's the real story?
> >
> > The neuropathy develops due to two factors, dose and duration. An acute treatment (say, a few weeks) at a high dose will likely have a substantially lesser neuropathy risk than the same dose over a year. Everything I've read suggests that all neuropathy symptoms are reversible upon cessation of the B6, in any case.
>
>
> larry. I think he/she is talking about the B6 cortical toxicity, not peripheral. Sorry I don´t have a link at hand.Sorry, I seem to have missed that point. Are you thinking of this: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16201314?
It is correct, that is a rather low exposure, but what exactly is meant by "was injected to"? One doesn't inject B6. It's pretty hard to draw any meaningful conclusions from this paper. Perhaps, one shouldn't inject rats with B6? Injection would bypass the entire first-pass metabolism, and its protective role against overexposure of any sort.
Getting back to the original question, the high-dose B6 treatment of akathisia was short-term. I'd be more concerned with the akathisia than the possible risk of the B6.
Lar
Posted by psychobot5000 on March 27, 2007, at 22:43:11
In reply to Re: can you really hurt yourself with high vitamin B6? » Franz, posted by Larry Hoover on March 10, 2007, at 13:56:12
> It is correct, that is a rather low exposure, but what exactly is meant by "was injected to"? One doesn't inject B6.
>Didn't Margaret Thatcher get B6 injections during times when she needed to go without sleep? If so, I'm sure it's a rare practice...
Anyway...
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