Signs and Symptoms of Vitamin B6 Deficiency

Most people get enough B6 in their diet, but if you are deficient in other B complex vitamins, such as folate and B12, you’re more likely to be deficient in vitamin B6 as well (1).

Vitamin B6 deficiency is more common in people with liver, kidney, digestive or autoimmune diseases, as well as smokers, obese people, alcoholics and pregnant women (2, 3, 4).

In your body, B6 is involved in more than 150 enzyme reactions. These help your body process the protein, carbs and fat you eat. B6 is also closely linked with the functions of your nervous and immune systems (3, 5, 6).

More recently, it’s been found that B6 has antioxidant and anti-inflammatory properties. This means that it may play a role in helping prevent chronic conditions like heart disease and cancer (5, 7, 8).

Here are 9 signs and symptoms of vitamin B6 deficiency.

1. Skin Rashes

Vitamin B6 deficiency is one cause of a red, itchy rash called seborrheic dermatitis.

The rash can appear on your scalp, face, neck and upper chest. It’s known for its oily, flaky appearance and may cause swelling or white patches (9).

One reason B6 deficiency may result in skin rashes is that the vitamin helps synthesize collagen, which is needed for healthy skin. In these cases, consuming B6 may clear up the rash quickly (10, 11).

Some people affected with seborrheic dermatitis may have higher requirements for B6. A B6 face cream has helped some people improve symptoms from seborrheic dermatitis (12).

2. Cracked and Sore Lips

Cheilosis, which is characterized by sore, red and swollen lips with cracked mouth corners, can result from B6 deficiency. Cracked areas may bleed and become infected.

In addition to being very painful, having cracked and sore lips can make activities like eating and talking difficult.

Correcting B6 deficiency with foods rich in the vitamin or a supplement may clear up these symptoms.

Notably, deficiencies of riboflavin, folate, iron and other nutrients can also cause this condition, as can sunny, dry or windy weather and other external factors (13, 14).

3. Sore, Glossy Tongue

If you have a B6 deficiency, your tongue may become swollen, sore, smooth, inflamed or reddened. This is called glossitis.

The glossy, smooth surface of the tongue is due to the loss of papillae. Those are the bumps on your tongue. Glossitis can cause problems chewing, swallowing and talking.

Replenishing B6 treats glossitis, provided that a deficiency is the only cause.

Deficiencies of other nutrients, including folate and B12, can also result in this condition. Consuming enough of all these vitamins may then be needed to clear up glossitis (15).

4. Mood Changes

Shortfalls of B6 may affect your mood, sometimes contributing to depression, anxiety, irritability and increased feelings of pain (16).

That’s because B6 is involved in the making of several neurotransmitters, such as serotonin and gamma-aminobutyric acid (GABA). Both serotonin and GABA help control anxiety, depression and feelings of pain.

The role of B6 in combating such mood issues is being tested in a variety of conditions.

For example, in about half of individuals with autism, supplementing with B6 helps decrease behavioral problems, possibly because it helps produce neurotransmitters (17).

Research also suggests that taking 50–80 mg of B6 supplements daily may help with symptoms of premenstrual syndrome (PMS), such as moodiness, irritability, anxiety and depression (18, 19).

One possible reason B6 may help with PMS is because it helps make serotonin, which lifts your mood. Scientists are doing more research to figure out if women who experience PMS may actually have vitamin and mineral deficiencies (19, 20, 21).

5. Weakened Immune Function

A well-working immune system is key to preventing infections, inflammation and various cancers. Nutrient deficiencies, including B6, can disrupt the immune system.

More specifically, a deficiency in B6 can result in the decreased production of antibodies needed to fight infections (22).

A B6 deficiency may also reduce your body’s production of white blood cells, including T cells. These cells regulate immune function, helping it respond appropriately.

Additionally, B6 helps your body make a protein called interleukin-2, which helps direct the actions of white blood cells (23).

People with autoimmune disorders (in which the immune system turns against itself), can have increased destruction of B6, which increases the need for the vitamin (2).

6. Tiredness and Low Energy

A vitamin B6 deficiency can leave you feeling unusually tired and sluggish.

A big reason is vitamin B6’s role in helping make hemoglobin. That’s the protein in your red blood cells that helps carry oxygen throughout your body.

If your cells don’t get enough oxygen as a result of too little hemoglobin, it’s called anemia. That can make you feel tired and weak.

7. Tingling and Pain in Hands and Feet

Deficiency of B6 can cause nerve damage called peripheral neuropathy.

The nerve damage may also result in clumsiness, balance problems and difficulty walking (26).

8. Seizures

Seizures happen for different reasons, including B6 deficiency.

Correcting B6 deficiency has proven very successful in treating related seizures.

Foods High in Vitamin B6

The reference daily intake (RDI) for vitamin B6 for non-pregnant adults is 1.7 mg (34).

Here are some of the top foods that naturally supply B6, as well as common serving sizes (35):

If you eat only plant foods, you may need more B6 to make up for this difference (36).

The Bottom Line

Vitamin B6 doesn’t receive a lot of fanfare, but it’s a very hard-working nutrient.

In some cases, a vitamin B6 supplement may be advised as well.

There have been select cases of B6-related anemia in which taking the inactive pyridoxine hydrochloride (HCl) form of the vitamin didn’t help. However, supplementing with the body’s most active form of B6, called pyridoxal 5’- phosphate (PLP), resolved the anemia (16).

You can buy either form of B6 as a supplement, but pyridoxine HCl is more common and generally costs less than PLP.

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Besides feeling tired from anemia, B6 deficiency could also potentially contribute to tiredness due to its role in making the sleep-promoting hormone melatonin (24, 25).

7. Tingling and Pain in Hands and Feet

Deficiency of B6 can cause nerve damage called peripheral neuropathy.

Symptoms may include burning, shooting and tingling pain in your arms, legs, hands and feet. Some describe it as a “pins and needles” feeling.

The nerve damage may also result in clumsiness, balance problems and difficulty walking (26).

Additionally, continually taking too much of the inactive form of B6 (pyridoxine HCl) from supplements can also cause neuropathy. This may happen because large amounts of inactive B6 can compete with and block the active PLP form of B6 in your body (27).

Nerve problems from B6 deficiency are reversible with adequate B6 intake. On the other hand, nerve problems from B6 toxicity may be more difficult to treat.

8. Seizures

Seizures happen for different reasons, including B6 deficiency.

Without enough B6, you don’t make adequate amounts of the calming neurotransmitter GABA, so your brain may become overstimulated.

Seizures can cause symptoms such as muscle spasms, rolling eyes and jerky arms or legs. Sometimes people have rapid, uncontrollable shaking (convulsions) or lose consciousness.

A deficiency of B6 is well-known to cause seizures in newborns. The first cases were noted in the 1950s when babies were fed infant formula with insufficient B6 (26).

More recently, seizures due to B6 deficiency have been reported in adults. These cases were most commonly found in pregnancy, alcoholism, medication interactions or liver disease (6, 28).

Correcting B6 deficiency has proven very successful in treating related seizures.

9. High Homocysteine

Homocysteine is a byproduct created during protein digestion.

A B6 deficiency, as well as folate and B12, can result in an abnormally high blood level of homocysteine, as these B vitamins are needed to help process homocysteine (29).

Increased homocysteine levels have been linked with several health issues, most notably heart disease and stroke, as well as Alzheimer’s disease. When homocysteine is elevated, it can damage blood vessels and nerves (30, 31, 32, 33).

Fortunately, your homocysteine level can be checked with a simple blood test. Generally, elevated homocysteine can be lowered by taking B6, B12 and folate supplements.

Just keep in mind that other factors, such as your eating habits and physical activity, are also typically involved in diseases linked with high homocysteine and must be addressed.

Foods High in Vitamin B6

Your body isn’t able to store very much B6. To avoid deficiency, you need to consume it on a regular basis.

This is generally not hard to do, as B6 is widely found in many animal and plant foods. In addition, it’s often added to fortified foods like breakfast cereals and nutrition bars.

The reference daily intake (RDI) for vitamin B6 for non-pregnant adults is 1.7 mg (34).

Here are some of the top foods that naturally supply B6, as well as common serving sizes (35):

Notably, the forms of B6 in animal sources and fortified foods and supplements are generally better absorbed than the form found in plant foods.

If you eat only plant foods, you may need more B6 to make up for this difference (36).

The Bottom Line

Vitamin B6 doesn’t receive a lot of fanfare, but it’s a very hard-working nutrient.

Possible signs and symptoms of B6 deficiency include skin rashes, cracked lip corners, a glossy tongue, mood changes, impaired immune function, tiredness, nerve pain, seizures and elevated homocysteine levels.

If you’re concerned you may not be getting enough B6 or may have a deficiency, talk to your doctor to determine the best course of action.

Fortunately, B6 deficiency is generally easy to avoid as long as you have healthy eating habits that include a variety of fruits, vegetables, nuts, meats and fish.

In some cases, a vitamin B6 supplement may be advised as well.

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