In recent weeks, reports have been circulating about severe reactions in people who’ve taken over-the-counter vitamin B6 supplements.

Vitamin B6 poisoning can injure nerves and lead to symptoms including numbness, tingling and even trouble walking and moving.

In some cases, those affected didn’t know the product contained any vitamin B6.

So what is vitamin B6, where is it found and how much is too much? Here’s what you need to know about this essential nutrient.

What is vitamin B6?

Vitamin B6 (also known as pyridoxine) is a group of six compounds that share a similar chemical structure.

It is an essential nutrient, meaning we need it for normal body functions, but we can’t produce it ourselves.

Adults aged 19–50 need 1.3mg of vitamin B6 per day. The recommended dose is lower for teens and children, and higher for those aged 51 and over (1.7mg for men and 1.5mg for women) and people who are breastfeeding or pregnant (1.9mg).

Most of us get this in our diet – largely from animal products, including meat, dairy and eggs.

The vitamin is also available in a range of different plant foods, including spinach, kale, bananas and potatoes, so deficiency is rare, even for vegetarians and vegans.

The vitamin B6 we consume in the diet is inactive, meaning the body can’t use it. To activate B6, the liver transforms it into a compound called pyridoxal-5’-phosphate (PLP).

In this form, vitamin B6 helps the body with more than 140 cellular functions, including building and breaking down proteins, producing red blood cells, regulating blood sugar and supporting brain function.

Vitamin B6 is important for overall health and has also been associated with reduced cancer risk and inflammation.

Despite being readily available in the diet, vitamin B6 is also widely included in various supplements, multivitamins and other products, such as Berocca and energy drinks.

Should we be worried about toxicity?

Vitamin B6 toxicity is extremely rare. It almost never occurs from dietary intake alone, unless there is a genetic disorders or disease that stops nutrient absorption (such as coeliac disease).

This is because all eight vitamins in the B group are water-soluble. If you consume more of the vitamin than your body needs, it can be excreted readily and harmlessly in your urine.

However, in some rare cases, excessive vitamin B6 accumulates in the blood, resulting in a condition called peripheral neuropathy. We’re still not sure why this occurs in some people but not others.

Peripheral neuropathy occurs when the sensory nerves – those outside our brain and spinal cord that send information to the central nervous system – are damaged and unable to function. This can be caused by a wide range of diseases (and is most well known in type 2 diabetes).

The most common symptoms are numbness and tingling, though in some cases patients may experience difficulty with balance or walking.

We don’t know exactly how excess vitamin B6 causes peripheral neuropathy, but it is thought to interfere with how the neurotransmitter GABA sends signals to the sensory nerves.

Vitamin B6 can cause permanent damage to nerves. Studies have shown symptoms improved when the person stopped taking the supplement, although they didn’t completely resolve.

What is considered excessive? And has this changed?

Toxicity usually occurs only when people take supplements with high doses of B6.

Until 2022, only products with more than 50mg of vitamin B6 were required to display a warning about peripheral neuropathy. But the Therapeutic Goods Administration lowered this and now requires any product containing more than 10mg of vitamin B6 to carry a warning.

The Therapeutic Goods Administration has also halved the daily upper limit of vitamin B6 a product can provide – from 200mg to 100mg.

These changes followed a review by the administration, after receiving 32 reports of peripheral neuropathy in people taking supplements. Two thirds of these people were taking less than 50mg of vitamin B6.

The Therapeutic Goods Administration acknowledges the risk varies between individuals and a lot is unknown. Its review could not identify a minimum dose, duration of use or patient risk factors.

But I thought B vitamins were good for me?

Too much of anything can cause problems.

The updated guidelines are likely to significantly lower the risk of toxicity. They also make consumers more aware of which products contain B6, and the risks.

The Therapeutic Goods Administration will continue to monitor evidence and revise guidelines if necessary.

While vitamin B6 toxicity remains very rare, there are still many questions about why some people get peripheral neuropathy with lower dose supplements.

It could be that some specific vitamin B compounds have a stronger effect, or some people may have genetic vulnerabilities or diseases which put them at higher risk.

So what should I do?

Most people don’t need to actively seek vitamin B6 in supplements.

However, many reports to the Therapeutic Goods Administration were of vitamin B6 being added to supplements labelled as magnesium or zinc – and some weren’t aware they were consuming it.

It is important to always check the label if you are taking a new medicine or supplement, especially if it hasn’t been explicitly prescribed by a health-care professional.

Be particularly cautious if you are taking multiple supplements. While one multivitamin is unlikely to cause an issue, adding a magnesium supplement for cramping, or a zinc supplement for cold and flu symptoms, may cause an excessive vitamin B6 dose over time, and increase your risk.

Importantly, pay attention to symptoms that may indicate peripheral neuropathy, such as pins and needles, numbness, or pain in the feet or hands, if you do change or add a supplement.

Most importantly, if you need advice, you should talk to your doctor, dietitian or pharmacist.

Vasso Apostolopoulos, Distinguished Professor, Professor of Immunology, RMIT University and Jack Feehan, Vice Chancellors Senior Research Fellow in Immunology, RMIT University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The war in Ukraine has had impacts around the world. Supply chains have been disrupted, the cost of living has soared and we’ve seen the fastest-growing refugee crisis since World War II. All of these are in addition to the devastating humanitarian and economic impacts within Ukraine.

Our international team was conducting a global study on wellbeing in the lead up to and after the Russian invasion. This provided a unique opportunity to examine the psychological impact of the outbreak of war.

As we explain in a new study published in Nature Communications, we learned the toll on people’s wellbeing was evident across nations, not just in Ukraine. These effects appear to have been temporary – at least for the average person.

But people with certain psychological vulnerabilities struggled to recover from the shock of the war.

Tracking wellbeing during the outbreak of war

People who took part in our study completed a rigorous “experience-sampling” protocol. Specifically, we asked them to report their momentary wellbeing four times per day for a whole month.

Data collection began in October 2021 and continued throughout 2022. So we had been tracking wellbeing around the world during the weeks surrounding the outbreak of war in February 2022.

We also collected measures of personality, along with various sociodemographic variables (including age, gender, political views). This enabled us to assess whether different people responded differently to the crisis. We could also compare these effects across countries.

Our analyses focused primarily on 1,341 participants living in 17 European countries, excluding Ukraine itself (44,894 experience-sampling reports in total). We also expanded these analyses to capture the experiences of 1,735 people living in 43 countries around the world (54,851 experience-sampling reports) – including in Australia.

A global dip in wellbeing

On February 24 2022, the day Russia invaded Ukraine, there was a sharp decline in wellbeing around the world. There was no decline in the month leading up to the outbreak of war, suggesting the change in wellbeing was not already occurring for some other reason.

However, there was a gradual increase in wellbeing during the month after the Russian invasion, suggestive of a “return to baseline” effect. Such effects are commonly reported in psychological research: situations and events that impact our wellbeing often (though not always) do so temporarily.

Unsurprisingly, people in Europe experienced a sharper dip in wellbeing compared to people living elsewhere around the world. Presumably the war was much more salient for those closest to the conflict, compared to those living on an entirely different continent.

Interestingly, day-to-day fluctuations in wellbeing mirrored the salience of the war on social media as events unfolded. Specifically, wellbeing was lower on days when there were more tweets mentioning Ukraine on Twitter/X.

Our results indicate that, on average, it took around two months for people to return to their baseline levels of wellbeing after the invasion.

Different people, different recoveries

There are strong links between our wellbeing and our individual personalities.

However, the dip in wellbeing following the Russian invasion was fairly uniform across individuals. None of the individual factors assessed in our study, including personality and sociodemographic factors, predicted people’s response to the outbreak of war.

On the other hand, personality did play a role in how quickly people recovered. Individual differences in people’s recovery were linked to a personality trait called “stability”. Stability is a broad dimension of personality that combines low neuroticism with high agreeableness and conscientiousness (three traits from the Big Five personality framework).

Stability is so named because it reflects the stability of one’s overall psychological functioning. This can be illustrated by breaking stability down into its three components:

1. low neuroticism describes emotional stability. People low in this trait experience less intense negative emotions such as anxiety, fear or anger, in response to negative events
2. high agreeableness describes social stability. People high in this trait are generally more cooperative, kind, and motivated to maintain social harmony
3. high conscientiousness describes motivational stability. People high in this trait show more effective patterns of goal-directed self-regulation.

So, our data show that people with less stable personalities fared worse in terms of recovering from the impact the war in Ukraine had on wellbeing.

In a supplementary analysis, we found the effect of stability was driven specifically by neuroticism and agreeableness. The fact that people higher in neuroticism recovered more slowly accords with a wealth of research linking this trait with coping difficulties and poor mental health.

These effects of personality on recovery were stronger than those of sociodemographic factors, such as age, gender or political views, which were not statistically significant.

Overall, our findings suggest that people with certain psychological vulnerabilities will often struggle to recover from the shock of global events such as the outbreak of war in Ukraine.

Luke Smillie, Professor in Personality Psychology, The University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.