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B12 and B6 toxicity

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Unread 11-24-2012, 11:51 PM   #1
nightnurse30
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Default B12 and B6 toxicity

So i have been feeling wonderful and have been pretty much symptom free from my Post-Concussive Syndrome for about half a year now. I was still taking the same supplements that i was taking since the accident, B12 sublingual, balanced B complex, vit d, fish oil, turmeric, multi vits. Occasionally, I would get a B12 and B6 shot eery 3-4 weeks or so also. They always helped me to feel healthier and more energetic.

In september I had done a few things at once....stopped my nortriptyline after a very very slow wean off since February, stopped my chinese herbs, and also went paddleboarding. That day I also got a B12 and B6 shot the day my symptoms started but didnt realize it till now.

From mid September to November, I was having nerve pain and tingling in my right leg, primarily. Sometimes it felt numb, sometimes it felt like cramps, and others it was just painful and like ants were crawling all over my lower leg. I was convinced it was sciatica as I had previous bulging discs. I re-started acupuncture and chinese herbs after a few month hiatus, i got an MRI of my lumbar spine (negative), saw a podiatrist, got MLS laser treatments by podiatrist, had nerve conduction studies done by a neurologist, and because B12 deficiency can cause neuropathy, I was getting B12 and B6 shots about every 2 weeks. I even went back on vicodin and was thinking about trying neurontin. Nothing was working at all

Finally, I decided since it was starting in the other leg too and nothing made sense, that it had to be metabolic, i asked my doctor to check my thyroid and all my vitamin levels. Sure enough B12 and B6 Toxic levels!! Both were double the highest limit they should be. Side effects of B12 and B6 toxicity....nerve pain, tingling in legs, insomnia, fatigue, and irritability. I had all of that!!

I cant believe that I was trying so hard to be healthy with supplements and make sure I was doing the right thing or my body and I completely went in the opposite direction. So word to the wise....get your levels checked before taking heavy doses of vitamins. Even if they are water soluble like B vitamins. I've been off all B supplements now for a week and a half and the tingling in my legs has improved somewhat. When my labs were drawn I hadnt had a B12 shot or B6 shot in 2 weeks and was on vacation for a week and hadnt been taking my supplements consistently or the day of the lab test. Just goes to show how high my levels really were when i was in the most pain. Good lesson to be learned here.
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Suffered a TBI with PCS on April 25th 2011 from multiple blows to the head from falling, unconscious for 12 hours with no memory of event. Hit the back of my head, and above right eye. MRI and CT negative. Symptoms included constant headaches (migraine, pressure, tension, icepicks), dizziness, tinnitus, visual changes, photophobia, fatigue, "spacing out", word finding difficulties, depression, and emotional lability.
Began Healing in November 2011 after starting acupuncture and Healing Touch (a nurturing energy therapy that promotes relaxation and pain relief). I went back to work in February 2012. Ive been symptom free since July 2012. Very happy, positive, energetic and working out every day, doing yoga, and living a normal life again!
I also began taking Healing Touch classes in November 2011 and completed 5 Levels of Healing Touch Certificate Program that included a 1 year mentorship to become a Healing Touch International Practitioner in June 2013. I am so pleased to offer this wonderful healing therapy to my patients, friends, and clients.
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Unread 11-25-2012, 03:46 AM   #2
Mark in Idaho
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What was your B-12 level?

I did not know there was a test for B-6.

Mine is about 1000 pcg/mL. Has been for a long time. Maybe the shots were putting more into your system than it needed. I take about 400 mcgs of B-12 and 150 mgs of B-6 daily.
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59 years old, retired due to disability, married 34 years, father of three, grandfather of four, Suffered a serious concussion at 10 years old (1965) stopped most driving after concussion at 46 years old (2001), Post Concussion Syndrome/Multiple Concussion/Impact Syndrome with PTSD, immediate/short term visual and auditory memory problems, slowed processing speed, visual/auditory processing difficulties, insomnia, absence seizures, OCD, 14 concussions since first concussion at 8 years old, Taking paroxetine for 14 years and gabapentin for 12 years. Added L-Tryptophan and stopped paroxetine after 3 months of tapering. I currently take 500 mgs of L-Tryptophan AM, 500 mgs noon, and 500 mgs PM.


As of Nov 15th, Due to high stress issues resulting in PTSD, docs put me on 3 meds. Clonazepam but only for 30 days ) .125 mgs twice daily (Doc presc. .25 mgs 2x daily but half a tablet is good) , citalopram (Celexa), an SSRI , and olanzapine (Zyprexa), an atypical anti-psychotic that usually causes weight gain before bed. I lost over 30 pounds since mid July. It just stopped the weight loss. Took me off the gabapentin. I am feeling better than I have in years.

This great feeling only lasted a month. Back to the same old PCS doldrums.

May 2014, I am off the olanzapine due to a 6 fold price increase. Back on 600 mgs of gabapentin before bed.

I am also taking L-Theanine to help with GABA regulation


"Be Still and Know That I am God" Psalm 46:10
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Unread 11-25-2012, 08:11 AM   #3
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B12 does not have a toxic upper limit. This is because there are NO studies of such.

However, B6, can cause a long term toxicity, but usually at
levels over 200 (or more) for a long period of time. But it is still not common.

I too, would like to know the reading for those two nutrients.
Many of us on PN forum here keep our B12 over 1000. Some even higher.

However, I don't understand why you had B6 given by injection.
That is really not necessary. The body activates B6 to pyridoxal (P5P), were the shots in this active form? or the inactive pyridoxine?

There are people with a genetic error in the MTHFR system where they cannot convert B12 from injection to methylcobalamin properly. They also have problems with folic acid which also needs to be methylated. It is thought that 10-30% of people have this hidden polymorphism.
The only way to know is to have testing. 23andMe or other DNA labs do this for a fee.

The amount absorbed from a typical B12 injection is 150mcg.
From 1000mcg oral tablet is about 13 mcg. The RDA for B12 is 2-4mcg.
It is not what you would think, at all.
http://www.ncbi.nlm.nih.gov/pmc/arti...able/T1/#TF1-4
This link is to a study done to see actual absorption from various doses of B12 medically administered.
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Unread 11-25-2012, 02:23 PM   #4
nightnurse30
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At our local Health store there are naturopathic doctors that give B12, B6, B1 and other shots. I was getting them probably once a month for a year or so, and in September when the discomfort started, I thought I was deficient because signs of deficiency of B6 and B12 can be neuropathy, so i just assumed i was low and got the shots every 2 weeks. I was also taking the supplements but thought i was just peeing them out since they are water soluble. I even told my whole story to the Naturopathic doctor and he thought the B12 and B6 would help.

My B6 came back 206. upper limit is 120. My B12 was 1400!! Upper limit is 800. I was having severe neuropathic pain, cramping, couldn't sleep because of the pain, and very irritable for almost 2 months. When my levels were drawn I hadnt had a shot in a week and a half because i was in costa rica, and wasnt really taking my supplements on my trip. I can only imagine what my true levels were when i was having my most severe nerve pain. And right after injections.

The tingling and discomfort in my legs is lessening everyday, I can tell my levels are dropping. Im going to call my doctor tomorrow and find out when she wants me to be re-drawn. My last levels were drawn 2 weeks ago and I stopped all supplements a week and a half ago.
__________________
Suffered a TBI with PCS on April 25th 2011 from multiple blows to the head from falling, unconscious for 12 hours with no memory of event. Hit the back of my head, and above right eye. MRI and CT negative. Symptoms included constant headaches (migraine, pressure, tension, icepicks), dizziness, tinnitus, visual changes, photophobia, fatigue, "spacing out", word finding difficulties, depression, and emotional lability.
Began Healing in November 2011 after starting acupuncture and Healing Touch (a nurturing energy therapy that promotes relaxation and pain relief). I went back to work in February 2012. Ive been symptom free since July 2012. Very happy, positive, energetic and working out every day, doing yoga, and living a normal life again!
I also began taking Healing Touch classes in November 2011 and completed 5 Levels of Healing Touch Certificate Program that included a 1 year mentorship to become a Healing Touch International Practitioner in June 2013. I am so pleased to offer this wonderful healing therapy to my patients, friends, and clients.
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Unread 11-25-2012, 03:01 PM   #5
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I seriously doubt your B12 is the culprit. However if the shots were in cyano form ...and you cannot convert it... it would not be working in the cells at all. But it would be in the blood.

The test to see if you are utilizing your B12 is the MMA blood test.
If the MMA comes back low, that means you are using the B12 normally. It is less expensive than DNA testing for the genetic polymorphism. The range for B12 still goes down to 200, and that is out of date. The new low is now 400 and hence 800 is not high at all.

This link explains:
http://www.aafp.org/afp/2003/0301/p979.html

B6 however, does not need to be given in high doses. High doses of vitamins over time can create a "dependency" situation, where the enzymes change and "need" high doses.
Discontinuing can create therefore deficiency symptoms. This was first discovered with Vit C...massive doses discontinued after a time, created a scurvy reaction, when they were not
deficient.

This is the skinny on B6 toxicity...
http://ods.od.nih.gov/factsheets/Vit...hProfessional/
It started with the PMS old treatments of 500mg or more a day of B6. That is when most of the few accounts were discovered.
Quote:
High intakes of vitamin B6 from food sources have not been reported to cause adverse effects [1]. However, chronic administration of 1–6 g oral pyridoxine per day for 12–40 months can cause severe and progressive sensory neuropathy characterized by ataxia (loss of control of bodily movements) [7,29-32]. Symptom severity appears to be dose dependent, and the symptoms usually stop if the patient discontinues the pyridoxine supplements as soon as the neurologic symptoms appear. Other effects of excessive vitamin B6 intakes include painful, disfiguring dermatological lesions; photosensitivity; and gastrointestinal symptoms, such as nausea and heartburn [1,2,29].
The blood ranges of vitamins really are not that accurate. Your B12 is not alarming IMO at all. The ranges were done many years ago, on people at random. It is important however to make sure you are utilizing B12 properly...because if not...you could be deficient when using cyano type and still testing high.
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Unread 11-25-2012, 04:42 PM   #6
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Having recently had blood level check for B-12, TSH, and D levels, I appreciate the information and discussion shared.

My recent B-12 lab results noted *High* @ "1200" on the lab printout.
It will be interesting to see what my dr. says on Tuesday when I see her.

My primary care physician typically always comments "Your B-12 level is too high. You can stop taking B-12 supplement."

And I reply "Thanks. I've not been taking any B-12 supplement in some years now."

Thanks again,
Theta
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50s Babyboomer; 2008 high-impact rear-ended/totalled-MVC, closed-head injury->pcs ... "Still dealing with it."
1993, Fell on black ice; first closed-head injury; life-altering. // 2014 Now dealing with Peripheral Neuropathy, tremors, shakiness, vestibular disorder, akithesia, anhedonia, yada yada, likely thanks to rx meds // 2014: uprooted to the cold wet gray NW coast, trying to find a way back home ... where it's blue sky and warm!
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Unread 11-25-2012, 05:04 PM   #7
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Yes, this illustrates the addiction doctors have to lab ranges.

If a lab range is flagged it is a warning to them. But for B12, this is not true. Of course they don't understand that 200 which the lab says is "normal" is not, EITHER. The new low normal is 400.
In some other countries it is even higher!

They don't have experience with it, and that is why I post here and give the medical link to American Association of Family Physicians.... which is a CE for DOCTORS to keep up. That link is from 2003, and I can tell you that daily people show up on PN with labs in the 200 range an with significant PN symptoms too.
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Unread 12-06-2012, 07:37 PM   #8
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My levels are on the rise besides stopping all supplementation many weeks ago!! I had my levels redrawn the other day and My B6 is up to 252!!! I have no idea why its rising. My B12 also has gone up to 1280. Very weird to me. I am certain it is the toxic B6 level causing the neuropathy. Although, my tingling in my legs has improved with stopping supplements, I do still feel tingling occasionally and cant understand how my levels continue to rise. I see my doctor on Monday so we can discuss the issue.
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Suffered a TBI with PCS on April 25th 2011 from multiple blows to the head from falling, unconscious for 12 hours with no memory of event. Hit the back of my head, and above right eye. MRI and CT negative. Symptoms included constant headaches (migraine, pressure, tension, icepicks), dizziness, tinnitus, visual changes, photophobia, fatigue, "spacing out", word finding difficulties, depression, and emotional lability.
Began Healing in November 2011 after starting acupuncture and Healing Touch (a nurturing energy therapy that promotes relaxation and pain relief). I went back to work in February 2012. Ive been symptom free since July 2012. Very happy, positive, energetic and working out every day, doing yoga, and living a normal life again!
I also began taking Healing Touch classes in November 2011 and completed 5 Levels of Healing Touch Certificate Program that included a 1 year mentorship to become a Healing Touch International Practitioner in June 2013. I am so pleased to offer this wonderful healing therapy to my patients, friends, and clients.
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Unread 12-07-2012, 07:12 AM   #9
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Some B6 is stored in muscles for a brief time. It is not immediately excreted.

I believe the testing is for all forms of B6. Only pyridoxal form is the active type. The others are not. Pyridoxal kinase enzyme is required to convert pyridoxine to pyridoxal, and it requires B2 (riboflavin).

B6 may be coming out of your muscle tissue or you are eating alot of fortified foods. Take a look at your nutrition labels, to see if that is the case. You may not have the active enzyme action to clear B6 from foods so it is reading "high".

Lab ranges for vitamins are only averages. They were made long ago before fortified foods were available. From what I have read on the net, you have to be over 500 for a long time to develop toxicity and even then it is quite rare.

There was one study done on autistic children that found that they had pretty high B6 levels, when not using vitamin supplements.
http://www.ncbi.nlm.nih.gov/pubmed/16494569
Quote:
J Altern Complement Med. 2006 Jan-Feb;12(1):59-63.
Abnormally high plasma levels of vitamin B6 in children with autism not taking supplements compared to controls not taking supplements.
Adams JB, George F, Audhya T.
Source

Arizona State University, Tempe, AZ 85287-6006, USA. jim.adams@asu.edu
Abstract
BACKGROUND:

There have been many studies of the effect of high-dose supplementation of vitamin B6 on children and adults with autism, with all but one reporting benefits.
OBJECTIVE:

The aim of this study was to investigate the biochemical basis for vitamin B6 therapy by measuring the level of total vitamin B6 in the plasma of unsupplemented children with autism spectrum disorder compared to unsupplemented control subjects.
PARTICIPANTS:

Children with autism spectrum disorders (n = 35, age 3-9 years) and unrelated typical children (n = 11, age 6-9 years), all from Arizona, were studied. (This includes the data from 24 children with autism from our previous study.)
METHODOLOGY:

A microbiologic assay was used to measure the level of total vitamin B6 (including phosphorylated and unphosphorylated forms), in a blinded fashion.
RESULTS:

Children with autism had a 75% higher level of total vitamin B6 than the controls (medians of 56 versus 32 ng/mL, respectively, p = 0.00002). Most of the autistic children (77%) had levels that were more than 2 standard deviations above the median value of the controls. The autistic girls (n = 5) also had elevated levels (mean of 54.6 ng/mL, median of 60 ng/mL).
DISCUSSION:

These results are consistent with previous studies that found that: (1) pyridoxal kinase had a very low activity in children with autism and (2) pyridoxal 5 phosphate (PLP) levels are unusually low in children with autism. Thus, it appears that the low conversion of pyridoxal and pyridoxine to PLP results in low levels of PLP, which is the active cofactor for 113 known enzymatic reactions, including the formation of many key neurotransmitters.
CONCLUSIONS:

Total vitamin B6 is abnormally high in autism, consistent with previous reports of an impaired pyridoxal kinase for the conversion of pyridoxine and pyridoxal to PLP. This may explain the many published studies of benefits of high-dose vitamin B6 supplementation in some children and adults with autism.

PMID:
16494569
[PubMed - indexed for MEDLINE]
Levels vary in children compared to adults. Also there are different lab ranges around the country.

This is not to say you are autistic, but it illustrates that some people may be genetically prone to having higher levels, and that there may be genetic reasons for pyridoxal kinase failure.
There are some studies showing certain drugs impair this enzyme, theophylline for one.
http://www.ncbi.nlm.nih.gov/pubmed/22879864
there may be others that have not been identified yet.

http://www.ncbi.nlm.nih.gov/pubmed/22201923

So you may in fact be one of the people who cannot convert B6 to pyridoxal. Unfortunately, there is less information on this than with the B12 polymorphism MTHFR.
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Unread 12-08-2012, 12:14 PM   #10
Theta Z
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Default Mild-Low B-12 levels: Today on NT Health News Headlines

Research News "Mild B12 Deficiency Linked to Cognitive Decline in Older Adults"

By TRACI PEDERSEN Associate News Editor
Reviewed by NT's John M. Grohol, Psy.D. on December 8, 2012

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http://neurotalk.psychcentral.com/thread180774.html
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