Effect Of Vitamin B6 Supplementation Research Articles

Efficacy of Vitamin B6 Supplementation on Inflammatory Markers, Serum Homocysteine level, Fecal Calprotectin and Clinical Outcomes among Patients with Ulcerative Colitis: A Randomized Double Blind Clinical Trial

Background and study aim: Inflammatory bowel disease (IBD) include a spectrum of immune-mediated chronic disorders. The aim of this study is to evaluate the efficacy of vitamin B6 supplementation on laboratory markers and clinical outcomes in patients with ulcerative colitis. Patients and methods: In this double-blind placebo-controlled randomized clinical trial ulcerative colitis patients were randomly divided into two groups, intervention (usual treatment plus vitamin B6 (40 mg / day)) and placebo group (usual treatment plus placebo). The serum levels of inflammatory markers measured and compared at the beginning and the end of intervention. Results: Overall forty patients were randomly selected to participate in this trial. Age range of participants was between 25-65 years and 3.43% of patients (13 cases) were males. Baseline characteristics of two groups were equal. The mean serum level of homocysteine after intervention in placebo and vitamin B6 groups were 9.05±3.45 and 16.31±20.52 respectively (P= 0.205). There were no significant differences between serum levels of homocysteine, CRP (P=0.328), ESR (P=0.329), calprotectin (P=0.683) and stool frequency after 6 months intervention in univariate analysis. In multivariate analysis stool frequency was significantly greater in vitamin B6 group in comparison with placebo group (P = 0.01). Conclusion: We couldn’t find any significant effect of vitamin B6 supplementation on duration and severity of ulcerative colitis and even stool frequency in vitamin B6 group increased.

Effect of vitamin B6 supplementation, in combination with magnesium, on severe stress and magnesium status: secondary analysis from an RCT

AbstractIntroductionEvidence from a recent randomised controlled trial1 suggests that in severely stressed subjects with low magnesemia, supplementation with magnesium (Mg) in combination with vitamin B6 (B6) provides greater benefits than Mg alone. B6 was reported to facilitate Mg absorption and its cellular uptake and to exert synergistic effect with Mg. The current secondary analysis explored the relationship between Mg-B6 combination and erythrocyte Mg concentration, used as a biomarker of body Mg status.Material and MethodsAn 8-week, Phase IV, controlled, single-blinded, parallel-group trial (EudraCT Number 2015-003749-24) stratified by sex was conducted in adults (n = 264) with a Depression Anxiety Stress Scales - stress subscale score (DASS-42SS) > 18 and serum Mg of 0.5–0.85mmol/L, randomised 1:1 to daily oral Mg-B6 (Magne B6®, Mg 300 mg; B6 30mg) or oral Mg alone (Magnespasmyl®, Mg 300mg). Outcomes were stress score, serum Mg (mmol/L), erythrocytes Mg (mmol/L), and serum B6 (nmol/L) from baseline to Week4 and Week8. Data are given as mean(SD) values.Results & DiscussionBaseline characteristics. Baseline magnesemia was 0.80(0.04) for both groups. Erythrocyte Mg concentration for the lower quintile of the studied population (n = 53) was 0.73–1.62, below the normal range of 1.65–2.65 in general population. The mean stress score in this subgroup was higher [29.5(6.3)], but not significantly different from that in other quintiles [lowest value: 26.1(7.6)]. Baseline B6 serum level for the lower B6 quintile (5–23), below the normal range for general population, was suggestive of possible B6 deficiency.Treatment effects. Both treatments increased slightly but not significantly erythrocyte Mg level from baseline to Week8 [1.84(0.03) to 1.86(0.03), and 1.86(0.03) to 188(0.03), respectively for Mg + B6 and Mg groups]. Significant changes were observed in subjects with low erythrocyte Mg level at baseline (< 1.6), namely an increase of + 0.13(0.04–0.22) for Mg + B6 and + 0.17(0.08–0.25) for Mg groups, but with no difference between treatments. Moreover, Mg + B6 supplementation led to a significant change (p < 0.0001) in serum B6 level between baseline and Wk8 [55.9(4.8) to 370.9(11.3)], as compared to Mg alone [51.9(4.8) to 51.5(11.3)].In conclusion, both treatments significantly increased erythrocyte Mg in subjects with low Mg status. B6 supplementation did not lead to further increase in erythrocyte Mg level. We have previously shown that severely stressed population benefits from B6 supplementation in combination with Mg, however, the mechanism of the interaction between Mg and B6 remains to be elucidated.1Sponsored by Sanofi

The long-term effect of a protein-deficient-diet enriched with vitamin B6 on the blood parameters in unexercised and exercised rats

ABSTRACT Protein undernutrition affects inter alia blood parameters and immune system. These negative effects may be improved by the addition of vitamin B6 to the diet. Here, we evaluated the effect of vitamin B6 supplementation and physical exercise in rats fed a protein-deficient diet. Rats were divided into six groups: exercised or unexercised – control, protein deficient, protein deficient with vitamin B6 supplementation. Sixty days of protein malnutrition caused significant changes in the rat body weight, haematological parameters (mainly red blood cells parameters), immunological parameters (NK and NKT cells) and biochemical parameters (total protein and albumin concentration and activity of AST). The rat exercise did not intensify the negative effects of protein malnutrition. The vitamin B6 supplementation in protein-deficient groups significantly improved body weight and red blood cell parameters. These results indicate that vitamin B6 should be considered as a valuable supplement for individuals suffering from protein malnutrition.

Pyridoxine (vitamin B6) supplementation during pregnancy or labour for maternal and neonatal outcomes.

Vitamin B6 plays vital roles in numerous metabolic processes in the human body, such as nervous system development and functioning. It has been associated with some benefits in non-randomised studies, such as higher Apgar scores, higher birthweights, and reduced incidence of pre-eclampsia and preterm birth. Recent studies also suggest a protection against certain congenital malformations. To evaluate the clinical effects of vitamin B6 supplementation during pregnancy and/or labour. We searched the Cochrane Pregnancy and Childbirth Group Trials Register (31 March 2015) and reference lists of retrieved studies. We included randomised controlled trials comparing vitamin B6 administration in pregnancy and/or labour with: placebos, no supplementations, or supplements not containing vitamin B6. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. For this update, we assessed methodological quality of the included trials using risk of bias and the GRADE approach. Four trials (1646 women) were included. The method of randomisation was unclear in all four trials and allocation concealment was reported in only one trial. Two trials used blinding of participants and outcomes. Vitamin B6 as oral capsules or lozenges resulted in decreased risk of dental decay in pregnant women (capsules: risk ratio (RR) 0.84; 95% confidence interval (CI) 0.71 to 0.98; one trial, n = 371, low quality of evidence; lozenges: RR 0.68; 95% CI 0.56 to 0.83; one trial, n = 342, low quality of evidence). A small trial showed reduced mean birthweights with vitamin B6 supplementation (mean difference -0.23 kg; 95% CI -0.42 to -0.04; n = 33; one trial). We did not find any statistically significant differences in the risk of eclampsia (capsules: n = 1242; three trials; lozenges: n = 944; one trial), pre-eclampsia (capsules n = 1197; two trials, low quality of evidence; lozenges: n = 944; one trial, low-quality evidence) or low Apgar scores at one minute (oral pyridoxine: n = 45; one trial), between supplemented and non-supplemented groups. No differences were found in Apgar scores at five minutes, or breastmilk production between controls and women receiving oral (n = 24; one trial) or intramuscular (n = 24; one trial) loading doses of pyridoxine at labour. Overall, the risk of bias was judged as unclear. The quality of the evidence using GRADE was low for both pre-eclampsia and dental decay. The other primary outcomes, preterm birth before 37 weeks and low birthweight, were not reported in the included trials. There were few trials, reporting few clinical outcomes and mostly with unclear trial methodology and inadequate follow-up. There is not enough evidence to detect clinical benefits of vitamin B6 supplementation in pregnancy and/or labour other than one trial suggesting protection against dental decay. Future trials assessing this and other outcomes such as orofacial clefts, cardiovascular malformations, neurological development, preterm birth, pre-eclampsia and adverse events are required.

Effects of vitamin B6 on one‐carbon metabolism in oral contraceptive users

Oral contraceptive (OC) usage is associated with low plasma pyridoxal phosphate (PLP) indicating low vitamin B6 status. PLP serves as a coenzyme in several steps in 1C metabolism, including the entry of 1C units from serine via the glycine‐cleavage system and serine hydroxymethyltransferase (SHMT), as well as the transsulfuration pathway in which cystathionine β‐synthase (CBS) catalyzes the condensation of homocysteine with serine to form cystathionine, and cystathionine γ‐lyase (CTGL) catalyzes the cleavage of cystathionine to form cysteine. Whether vitamin B6 deficiency in OC users functionally affects 1C metabolism is uncertain. Therefore, we examined PLP‐related 1C metabolism in healthy OC users (20–40y, with plasma PLP < 30 nmol/L) before and after 4 wk of supplementation with pyridoxine (10 mg/d). We used an intravenous primed, constant infusion of stable isotopically‐labeled [13C5]methionine, [3‐13C]serine and [2H3]leucine to determine the effect of vitamin B6 supplementation on homocysteine remethylation from serine, methionine and serine fluxes, and fractional cystathionine synthesis. Preliminary data showed an expected increase in plasma PLP and changes in PLP‐dependent aspects of 1C metabolism due to supplementation. In conclusion, these findings imply a functional effect of vitamin B6 supplementation on 1C metabolism. Supported by NIH Grant DK072398 and NIH CTSA grant 1UL1RR029890.

Interventions with Vitamins B6, B12 and C in Pregnancy

The water-soluble vitamins B6, B12 and C play important roles in maternal health as well as fetal development and physiology during gestation. This systematic review evaluates the risks and benefits of interventions with vitamins B6, B12 and C during pregnancy on maternal, neonatal and child health and nutrition outcomes. Relevant publications were identified by searching PubMed, Popline and Web of Science databases. Meta-analyses were conducted for outcomes where results from at least three controlled trials were available. Potential benefits of vitamin B6 supplementation were reduction in nausea and vomiting, improvement in dental health, and treatment of some cases of anaemia. In meta-analysis based on three small studies, vitamin B6 supplementation had a significant positive effect on birthweight (d = 217 g [95% confidence interval (CI) 130, 304]). Interventions with vitamin C alone or combined with vitamin E did not systematically reduce the incidence of pre-eclampsia, premature rupture of membranes, or other adverse pregnancy outcomes. In meta-analyses, vitamins C and E increased the risk of pregnancy-related hypertension (relative risk 1.10 [95% CI 1.02, 1.19]). Effects of vitamin B6 or C intervention on other neonatal outcomes, including preterm birth, low birthweight, and perinatal morbidity and mortality, were not significant. Data on child health outcomes were lacking. Despite the prevalence of vitamin B12 deficiency amongst populations with limited intake of animal source foods, no intervention trials have evaluated vitamin B12 supplementation before or during pregnancy. In conclusion, existing evidence does not justify vitamin C supplementation during pregnancy. Additional studies are needed to confirm positive effects of vitamin B6 supplementation on infant birthweight and other outcomes. While vitamin B12 supplementation may reduce the incidence of neural tube defects in the offspring based on theoretical considerations, research is needed to support this hypothesis.

Regulation of colon gene expression by vitamin B6 supplementation

Previous studies have shown that vitamin B6 supplementation suppresses the development of colonic aberrant crypt foci (ACF), precursor lesions of colon cancer, and cell proliferation in mice receiving the colonic carcinogen, azoxymethane (AOM). This study investigated the molecular mechanism of these effects of dietary vitamin B6. To date, the mechanism by which ACFs develop is not yet fully understood. In a search for factors that play a critical role during ACF development, we examined colon gene expression during early stage of ACF development in AOM-treated mice using DNA microarray analysis. AOM treatment significantly upregulated mRNA closely related to mast cell and cytotoxic T-cell activity. This study also investigated the effect of vitamin B6 supplementation on colon gene expression in AOM-treated mice. We found that vitamin B6 supplementation downregulates Cd8a and Ccl8 mRNA expression, suggesting these candidate genes may play a protective role against colonic ACF development. Furthermore, we examined genomic affects of dietary vitamin B6, and showed that Reg3γ mRNA expression in colons is downregulated by vitamin B6. This study provides an insight into the genomic activities of dietary vitamin B6 that may be protective against colon tumor development.

The effect of vitamin B6 on cognition.

Micronutrient status can affect cognitive function at all ages. Vitamin deficiencies could influence memory function and might contribute to age-associated cognitive impairment and dementia. Vitamin B6, comprising three chemically distinct compounds pyridoxal, pyridoxamine, and pyridoxine, is involved in the regulation of mental function and mood. Vitamin B6 is also an essential homocysteine re-methylation cofactor, and deficiency is associated with increase in blood homocysteine levels. Homocysteine is a risk factor for cerebrovascular disease and may also have directly toxic effects on neurons of the central nervous system. Neuropsychiatric disorders including seizures, migraine, chronic pain and depression have been linked to vitamin B6 deficiency. Epidemiological studies indicate that poor vitamin B6 status is common among older people. Hyperhomocysteinaemia has been suggested as a cause or mechanism in the development Alzheimer's disease and other forms of dementia. Supplementation with B vitamins including vitamin B6 has been shown to reduce blood homocysteine levels. To assess the efficacy of vitamin B6 supplementation in reducing the risk of developing cognitive impairment by older healthy people, or improving cognitive functioning of people with cognitive decline and dementia, whether or not vitamin B6 deficiency has been diagnosed. The Specialized Register of the Cochrane Dementia and Cognitive Improvement Group was searched on 20 May 2003 using the terms: vitamin B6, pyridoxine, pyridoxamine, pyridoxal. For relevant trials on healthy elderly people MEDLINE, EMBASE and CENTRAL were searched using the previously mentioned terms as well as the term cognit * All unconfounded, double-blind randomized controlled trials in which the intervention with vitamin B6 was compared with placebo for healthy older people or people with cognitive decline or dementia. The primary outcome of interest was the efficacy of vitamin B6 supplementation on cognitive function. The two reviewers independently evaluated all studies identified as possibly meeting the criteria for inclusion. One reviewer independently extracted the data. Studies were rated for their overall quality. The weighted mean differences between treatment and placebo groups, with 95% confidence intervals, were calculated for each outcome. Review Manager version 4.2 was used to analyse the variance. No trials of vitamin B6 involving people with cognitive impairment or dementia were found. The two trials included in the review (Bryan 2002; Deijen 1992) used a double-blind, randomized, placebo-controlled design and involved 109 healthy older people. One trial restricted enrolment to women and the other to men. Vitamin B6 supplementation and healthy older women: Bryan 2002 enrolled 211 healthy women from various age groups into a 5-week study. The trial was of multifactorial design with folic acid, vitamin B12, vitamin B6 and placebo in its four arms. Twelve healthy women aged 65 to 92 years received 75 mg vitamin B6 orally per day and were compared with 21 healthy women who were allocated to placebo. No statistically significant benefits from vitamin B6 on mood or cognition were observed. Vitamin B6 supplementation and healthy older men: Deijen 1992 recruited 76 healthy men aged 70 to 79 years. They were divided into 38 matched pairs, one member of each pair randomly allocated to 20 mg of vitamin B6 (pyridoxine hydrochloride) per day for 12 weeks the other to placebo. No statistically significant differences between treatment and placebo were found in their effects on cognition or mood. Effect of vitamin B6 supplementation on vitamin B6 status: Deijen 1992 reported that 20 mg of pyridoxine hydrochloride per day for 12 weeks increased blood vitamin B6 activity as assessed as by plasma pyridoxal-5'-phosphate (WMD 238, 95%CI 211.58 to 264.42, P<0.00001) and erythrocyte enzyme asparate aminotransferase (WMD 0.43, 95%CI 0.30 to 0.56, P<0.00001). Effect of vitamin B6 supplementation on blood homocysteine concentration: Neither of the included trials measured homocysteine levels. Drop-outs: All participants allocated to vitamin B6 or placebo completed the trial protocol. Adverse Events: No adverse effects were reported. Effect of vitamin B6 on carer burden, care costs and institutionalization rate: We found no trials in which these outcomes were assessed. This review found no evidence for short-term benefit from vitamin B6 in improving mood (depression, fatigue and tension symptoms) or cognitive functions. For the older people included in one of the two trials included in the review, oral vitamin B6 supplements improved biochemical indices of vitamin B6 status, but potential effects on blood homocysteine levels were not assessed in either study. This review found evidence that there is scope for increasing some biochemical indices of vitamin B6 status among older people. More randomized controlled trials are needed to explore possible benefits from vitamin B6 supplementation for healthy older people and those with cognitively impairment or dementia.

Effects of vitamin B6 supplementation in rats during lactation on vitamin B6 concentration and transaminase activities in the offspring

The aim of the present investigation was to study the effect of a varying maternal vitamin B6 supplementation during lactation period on vitamin B6 levels in blood, liver and total body, and on the activity of two transaminase enzymes in the offspring. Therefore, eighty female Sprague‐Dawley rats were fed a semi‐synthetic diet (0.2 mg vitamin B6 per kg) which was supplemented during gravidity with 5 mg vitamin B6 per kg diet. During the following lactation period the rats were assigned to one of 10 vitamin B6 treatment groups (supplementation of 0, 3, 6, 9, 12, 15, 18, 36, 360, 3600 mg vitamin B6 per kg diet). At day 14 of lactation the pubs of all dams were decapitated and blood, liver, and carcass were used for analysis of vitamin B6 concentration, activities of two transaminases, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in plasma, erythrocytes, and liver, and of haematological parameters. While the liver and total body wet weights as well as the haematological parameters (red blood cells, haemoglobin concentration, hematocrit, middle corpuscular cell volume, middle corpuscular haemoglobin, middle corpuscular haemoglobin concentration) did not differ within the experimental groups, the present data clearly show that in blood, liver and total body of the offspring exists a slight dose‐response relationship between the maternal dietary vitamin B6 supplementation and the vitamin B6 concentration. Concerning the activities of the transaminases a dietary supplementation above 3mg vitamin B6 per kg diet had no influence on the AST and ALT activities in offspring plasma. In the erythrocytes no statistical significant influence of the vitamin B6 supplementation during lactation on the activities of AST and ALT was found. The activities of ALT and AST in liver were not consistently altered by the vitamin B6 supplementation of the dams during lactation. In conclusion these results indicate that a minimal maternal dietary vitamin B6 supply of 3.1 mg per kg diet is necessary with regard to health and development of their offspring. But not all of the analysed parameters as the liver and total body weights, the activities of AST and ALT in the erythrocytes, and the haematological parameters were influenced by a deficient maternal dietary vitamin B6 supply.

Plasma total homocysteine response to oral doses of folic acid and pyridoxine hydrochloride (vitamin B6) in healthy individuals. Oral doses of vitamin B6 reduce concentrations of serum folate

Plasma total homocysteine response was compared in four groups of healthy individuals given orally divided doses of vitamin supplementations for a duration of 5 weeks. The vitamin supplements; A, 0.3 mg folic acid; B, 120 mg vitamin B6; C, combination of 0.3 mg folic acid and 120 mg vitamin B6 or D, 0.6 mg folic acid reduced the concentrations of plasma total homocysteine 20, 17, 32 and 24%, respectively. However, the intergroup comparisons did not show a significant difference in the effects of vitamin supplements. Multivariate analysis with correction for differences in pre-supplement values indicated a significant effect of vitamin B6 supplementation on plasma total homocysteine and serum folate. Our data show that plasma total homocysteine concentrations are reduced with low to medium divided doses of folic acid alone or in combination with vitamin B6.

Effect of vitamin B6 supplementation in McArdle's disease: a strategic case study

A patient-blind study into the effect of a 10-week cessation of long-term vitamin B6 supplementation on B6 status and performance in McArdle's disease is reported. Muscle performance was assessed both subjectively and objectively by an ischaemic fatiguing protocol of the adductor pollicis muscle. Nine weeks after withdrawal of supplementation, vitamin B6 status had changed from adequacy to inadequacy and the force loss during the ischaemic fatiguing protocol had increased at all frequencies studied. The patient reported decreased exercise tolerance after 7 weeks and by the tenth week was experiencing an increase in muscle cramps. Vitamin B6 status and muscle performance may be linked in McArdle's disease and there is potential for enhancement of performance by B6 supplementation.