Vitamin B6 IV Therapy (Pyridoxine)

This page covers Vitamin B6 IV Therapy (Pyridoxine) including its benefits. IV League provides mobile IV therapy services for Vitamin B6.

What is Vitamin B6 IV?

Water-soluble vitamin B6, also known as pyridoxine, is a nutrient that can be added to foods and supplements as well as occurring naturally in many foods. The active form of the coenzyme, pyridoxal 5′ phosphate (PLP), is the most often used indicator of the body’s B6 blood levels.

PLP is a coenzyme that helps more than 100 enzymes carry out a variety of tasks, such as breaking down proteins, carbs, and lipids; preserving appropriate homocysteine levels (because elevated levels can lead to cardiac problems); and promoting immune system and brain health. It’s important for red blood cell and neurotransmitter production as well as protein, lipid, and carbohydrate metabolism.

Vitamin B6 must be obtained from food or supplements because your body is unable to create it on its own. Although the majority of people consume adequate vitamin B6 through their diets, some groups may be at risk for insufficiency.

Getting enough vitamin B6 is crucial for good health and may even help to prevent and treat chronic disorders. As a coenzyme, vitamin B6 functions as a cofactor in more than 100 enzymatic processes, including the metabolism of amino acids, carbohydrates, and lipids.

It aids in the synthesis of neurotransmitters, immune system function, haemoglobin creation, and cognitive development. Seizures, altered mental status, normocytic anaemia, a non-specific pruritic rash, cheilitis, glossitis, and sadness may be symptoms of vitamin B6 insufficiency.

It is the collective term for six substances (vitamers) with vitamin B6 activity, including the 5′-phosphate esters of pyridoxine, an alcohol; pyridoxal, an aldehyde; and pyridoxamine, an amino molecule.

The active coenzyme forms of vitamin B6 are pyridoxal 5′ phosphate (PLP) and pyridoxamine 5′ phosphate (PMP). Significant amounts of the naturally occurring pyridoxine found in grains, fruits, and vegetables are found in glycosylated forms with lower bioavailability.

With involvement in more than 100 enzyme activities, largely related to protein metabolism, vitamin B6 in coenzyme form serves a variety of vital bodily functions. PLP and PMP both participate in the metabolism of amino acids, and PLP also participates in the metabolism of one-carbon compounds, carbohydrates, and lipids.

Through the manufacture of neurotransmitters and the maintenance of normal blood levels of the amino acid homocysteine, vitamin B6 also contributes to cognitive development.

Vitamin B6 is essential for the creation of gluconeogenesis and glycogenolysis, immune system activity (such as lymphocyte and interleukin-2 production), and haemoglobin.

The jejunum is where the body receives vitamin B6. Vitamins that have been phosphorylated are dephosphorylated, and the pool of free vitamin B6 is then taken up through passive diffusion.

PLP, other vitamers, or total vitamin B6 concentrations in plasma, erythrocytes, or urine can all be used to directly test vitamin B6 levels. Additionally, tryptophan metabolites or erythrocyte aminotransferase saturation by PLP can be used to test vitamin B6 concentrations indirectly.

The most widely used indicator of vitamin B6 status is plasma PLP.

Benefits of Vitamin B6 IV Pyridoxine

1. The effect of vitamin B6 in preventing disease has received extensive research. The vitamin in supplement form has the most potential for treating pregnancy-related nausea, but such use should only be done under a doctor’s supervision. Compared to low blood levels of B6, adequate blood levels may be linked to a lower risk of cancer.
2. The modulation of mood is significantly aided by vitamin B6. This is partially due to the fact that this vitamin is required for the production of neurotransmitters like serotonin, dopamine, and gamma-aminobutyric acid, which control emotions (GABA).
3. High blood levels of the amino acid homocysteine, which have been connected to depression and other psychiatric conditions, may be reduced by vitamin B6.
4. Studies have indicated that low blood levels and intakes of vitamin B6 are linked to depressive symptoms, particularly in older persons who are at a higher risk for B vitamin insufficiency. In one study of 250 senior citizens, it was discovered that low blood levels of vitamin B6 more than doubled the risk of depression. The effectiveness of vitamin B6 in treating or preventing depression, however, has not been established. In a controlled two-year trial involving about 300 older men who were initially free of depression, it was discovered that supplement users of vitamins B6, folate (B9), and B12 were no less likely than those taking a placebo to experience depressive symptoms.
5. Although there is conflicting evidence, vitamin B6 may help with brain health and Alzheimer’s disease prevention. On the one hand, B6 can lower high blood levels of homocysteine, which may raise the risk of Alzheimer’s. One study demonstrated that taking high doses of B6, B12, and folate (B9) decreased homocysteine and reduced wasting in specific parts of the brain that are prone to Alzheimer’s disease in 156 persons with high homocysteine levels and mild cognitive impairment. But it’s not obvious if a drop in homocysteine corresponds to better brain health or a slower pace of cognitive decline.
6. High dosages of vitamins B6, B12, and folate were shown to lower homocysteine levels but had no effect on the rate of decline in brain function when compared to a placebo in a randomized controlled trial including more than 400 persons with mild to moderate Alzheimer’s disease. Additionally, a review of 19 research found no evidence that taking supplements of B6, B12, and folate separately or together reduced the chance of developing Alzheimer’s disease or improved cognitive function. To fully comprehend the role that vitamin B6 plays in enhancing brain health, additional study on the impact of this vitamin alone on homocysteine levels and cognitive function is required.
7. Vitamin B6 may be useful in preventing and treating anaemia brought on by a deficiency because of its part in the synthesis of haemoglobin. A molecule called haemoglobin transports oxygen to your cells. Your cells don’t receive enough oxygen when your haemoglobin level is low. As a result, you can become anaemic and experience fatigue or weakness.
8. Low vitamin B6 levels have been associated to anaemia in studies, particularly in pregnant and childbearing women. There has been little study on utilizing vitamin B6 to treat anaemia because vitamin B6 deficiency is regarded to be uncommon in the majority of healthy persons. Anemia caused by low B6 levels in a 72-year-old woman’s case study was treated with the most potent form of vitamin B6, which reduced symptoms.
9. Taking 75 mg of vitamin B6 daily during pregnancy reduced anaemia symptoms in 56 pregnant women who did not respond to iron treatment, according to another study.
10. Premenstrual syndrome, or PMS, symptoms like anxiety, despair, and irritability have been treated with vitamin B6. Because it plays a part in the production of neurotransmitters that control mood, researchers believe that vitamin B6 helps with emotional symptoms associated with PMS. In a three-month trial involving more than 60 premenopausal women, it was discovered that 50 mg of vitamin B6 daily reduced PMS symptoms of fatigue, irritability, and depression by 69%. However, women who got a placebo also reported improved PMS symptoms, indicating that there may have been some placebo effect in play when it came to the efficiency of the vitamin B6 supplement. Another small study discovered that 200 mg of magnesium and 50 mg of vitamin B6 daily significantly reduced PMS symptoms, including irritability, anxiety, and mood swings.
11. For many years, pregnant women have utilized vitamin B6 to relieve morning sickness and vomiting. In reality, it is a component of Diclegis, a drug frequently prescribed to alleviate morning sickness. Morning sickness may be helped by vitamin B6, which plays multiple important roles in supporting a healthy pregnancy, although researchers are unsure of why. After five days of treatment, a daily dosage of 30 mg of vitamin B6 significantly decreased nausea symptoms compared to a placebo in research including 342 pregnant women in the first 17 weeks of their pregnancies. Another study evaluated the effects of ginger and vitamin B6 on 126 pregnant women’s episodes of nausea and vomiting. The findings demonstrated that, after four days, consuming 75 mg of B6 daily reduced symptoms of nausea and vomiting by 31%. According to these researches, morning sickness can be treated with vitamin B6 even for shorter periods of time than a week.
12. Vitamin B6 may lessen the risk of heart disease and clear blocked arteries. According to research, those with low blood levels of vitamin B6 are nearly twice as likely to develop heart disease as those with high amounts of the vitamin. This is probably as a result of B6’s ability to lower excessive homocysteine levels linked to a number of disease processes, including heart disease. According to one study, rats lacking in vitamin B6 developed lesions that could obstruct arteries after being exposed to homocysteine and had higher blood levels of cholesterol than rats with adequate B6 levels.
13. B6 is effective in avoiding heart disease, according to human research. In a randomized controlled experiment, individuals were split into two groups and given either a placebo or 250 mg of vitamin B6 and 5 mg of folic acid daily for two years in 158 healthy adults who had relatives who had heart disease. In comparison to the placebo group, the B6 and folic acid group experienced fewer abnormal cardiac tests during exercise and had lower homocysteine levels, putting them at a decreased overall risk of developing heart disease.
14. Getting enough vitamin B6 may help reduce your risk of getting some cancers. It is unclear why B6 may help prevent cancer, but experts believe it has something to do with the antioxidant’s capacity to combat inflammation, which has been linked to both cancer and other chronic diseases. Both adequate food consumption and blood levels of B6 were linked to lower chances of colorectal cancer, according to a study of 12 research. The chance of acquiring this type of cancer was almost 50% reduced in people with the highest blood levels of B6. According to studies on vitamin B6, having enough blood levels of the vitamin is linked to a lower chance of developing breast cancer, particularly in postmenopausal women. There is no correlation between vitamin B6 levels and cancer risk, according to other studies. To determine the precise function of vitamin B6 in cancer prevention, additional research that uses randomized trials as opposed to simple observational studies is required.
15. Vitamin B6 may help prevent eye conditions, including age-related macular degeneration, a condition that causes visual loss in older people (AMD). High blood levels of circulating homocysteine have been related in studies to a higher risk of AMD. Getting adequate vitamin B6 may minimize your risk of developing this condition since it lowers high homocysteine levels in the blood. In comparison to a placebo, taking a daily combination of vitamins B6, B12, and folic acid (B9) significantly reduced AMD risk by 35–40% throughout the course of a seven-year research involving more than 5,400 female health professionals. While these findings imply that B6 might help prevent AMD, it’s unclear if B6 by itself would have the same positive effects. Low blood levels of vitamin B6 have also been related in studies to eye problems that obstruct veins that lead to the retina. The lowest blood levels of B6 were found to be strongly related with retinal diseases in a controlled investigation involving more than 500 individuals.
16. Rheumatoid arthritis symptoms might be lessened by vitamin B6. Low amounts of vitamin B6 may be caused by the high levels of inflammation brought on by rheumatoid arthritis. 36 adults with rheumatoid arthritis participated in a 30-day research that demonstrated that 50 mg of vitamin B6 daily rectified low blood levels of B6 but did not reduce the body’s production of inflammatory chemicals. In contrast, research in 43 rheumatoid arthritis-suffering people found that those who received 100 mg of vitamin B6 daily together with 5 mg of folic acid had considerably reduced levels of pro-inflammatory molecules after 12 weeks. The disparity in vitamin B6 dosage and research duration may be the cause of these studies’ inconsistent findings. More research is required; however, it appears that long-term use of high dosages of vitamin B6 supplements may assist rheumatoid arthritis sufferers by reducing inflammation.

History of Vitamin B6 Pyridoxine IV

Rudolf Peters demonstrated in the 1930s that juvenile rats fed a semi-synthetic diet with additional thiamin and riboflavin but no other supplement developed “rat acrodynia,” a disorder marked by severe skin sores. Paul György demonstrated in 1934 that vitamin B6 was the component that treated “rat acrodynia.” Other investigations soon revealed that a lack of vitamin B6 led to microcytic anaemia in some species and convulsions in rats, pigs, and dogs.

In 1938, Samuel Lepkovsky successfully extracted and crystallized vitamin B6. Leslie Harris, Karl Folkers, Richard Kuhn, and their collaborators independently demonstrated the pyridine derivative 3-hydroxy-4,5-dihydroxy-methyl-2-methyl-pyridine as vitamin B6 the next year.

György suggested calling this derivative pyridoxine. In 1942, Esmond Snell created a microbiological growth experiment that helped characterize the main product of pyridoxine, pyridoxamine, and the formyl derivative of pyridoxine, pyridoxal.

Additional research revealed that pyridoxal, pyridoxamine, and pyridoxine are largely equally active in animals and derive their vitamin action from the body’s capacity to transform them into the enzymatically active form, pyridoxal-5-phosphate.

Many different enzyme systems utilize pyridoxal-5-phosphate, but it is particularly important for the metabolic use and modification of amino acids.

Mechanisms of Action for Vitamin B6 Pyridoxine IV

Either free form or enzyme-bound Due to PLP’s ability to pull electrons, which unstabilizes the bonds around the alpha-carbon atom through the system created by amino acids, these processes are greatly expedited and facilitated.

Metabolism of Vitamin B6 IV

The mucosal cells of the small intestine quickly absorb pyridoxine, pyridoxamine, and pyridoxal from food and oral medications, but their phosphorylated analogues first go through dephosphorylation before being absorbed.

Analogs of vitamin B6 are passively diffused into the colon, where they are readily absorbed in large amounts without saturating cells.

Pyridoxal kinase reacts with PM and PN after their absorption to produce PMP and PNP, respectively. Pyridoxine (pyridoxamine) phosphate (PNP) oxidase subsequently transforms these molecules into the coenzyme PLP. Due to the absence of PNP oxidase in most tissues, this process only takes place in hepatocytes and, to a lesser extent, in tiny intestinal mucosal cells. Since PLP cannot pass through cell membranes, it must either be directly coupled to albumin and released into the bloodstream by hepatocytes as a PLP-albumin complex or it must first be dephosphorylated by the phosphohydrolase enzyme. PLP is also taken up by erythrocytes and transported to other tissues by haemoglobin.

The dephosphorylation of protein-bound PLP is the last step before the coenzyme PLP, which is the active form of vitamin B6, is produced inside target tissues by the action of the pyridoxal kinase enzyme. This coenzyme is subsequently transported outside of the target tissues. In order to guard against phosphatase enzymes, PLP is linked to numerous proteins inside tissues.

How is IV B6 Pyridoxine Used to Treat Diseases?

1. Pyridoxine has been used to prevent or cure peripheral neuropathy; a specific nerve condition brought on by a number of drugs (such as isoniazid).
2. It has been applied to the treatment of some inherited conditions (such as xanthurenic aciduria, hyperoxaluria, homocystinuria).
3. There is some evidence that vitamin B6 can reduce lactation and the negative effects of oral contraceptives, like depression and nausea.
4. Research on the effectiveness of vitamin B6 supplements for treating and preventing essential hypertension, premenstrual syndrome, carpal tunnel syndrome, morning sickness, and gestational diabetes has produced mixed results.
5. Although there is little proof that pyridoxine is effective for these uses, some conditions like atopic dermatitis, dental caries, acute alcohol intoxication, autism, diabetic complications, Down syndrome, schizophrenia, Huntington chorea, and steroid-dependent asthma have been empirically treated with it.
6. Increased B6 intake in humans is associated with a lower risk of colorectal cancer, according to research. According to certain studies, high B6 levels can prevent rats’ in-vitro hepatic tumor cell proliferation.
7. INH and ethylene glycol overdoses are the two toxicological crises for which vitamin B6 is most frequently used. If the amount of INH is unknown, the dose is 5 grammes for adults and 1 gramme for children in cases of INH overdose-related seizures. When seizures stop or the maximum dose has been administered, pyridoxine can be administered at a rate of 0.5 to 1 grams/minute. After potentially dangerous ingestion of isoniazid within two hours, patients who are asymptomatic and have not experienced seizures should be given the prescribed amount of pyridoxine. To help shift the metabolism of ethylene glycol to nontoxic routes leading to glycine (nontoxic) instead of toxic pathways leading to toxic metabolites such as formate, vitamin B6 at 50 to 100 mg IV every six hours is advised in cases of ethylene glycol overdose.

Intravenous IV B6 Pyridoxine vs Oral Supplementation

Both oral and intravenous methods can be used to administer vitamin B6. The most common form of vitamin B6 is oral, however intravenous vitamin B6 can be helpful in select rare circumstances, including anorexia, malabsorption syndromes, and patients receiving parenteral nutrition. It can also be found in subcutaneous and intramuscular versions.

For the efficient management of active seizures in neonates with B6 deficient seizures, 10 to 100 mg intravenous (IV) may be necessary. Depending on the symptom complex, dosages ranging from 25 mg to 600 mg might be added to less severe or less acute presentations.

Importantly, treatment with vitamin B6 can prevent death in cases of refractory INH overdose-induced seizures. A dose of 1 to 4 grammes IV is administered as the initial dose, followed by 1 g IM or IV every 30 minutes, up to a maximum of 5 grammes of INH. To help shift the metabolism of ethylene glycol to nontoxic routes leading to glycine (nontoxic) instead of toxic pathways leading to toxic metabolites such as formate, vitamin B6 at 50 to 100 mg IV every six hours is advised in cases of ethylene glycol overdose.

In cases of hydralazine overdose, vitamin B6 may also be used; the suggested dosage is 25 mg/kg, with the first third injected intramuscularly and the remaining portion as a 3-hour IV infusion. Gyromitra (mushroom) toxicity is treated with an IV infusion of 25 mg/kg over 30 minutes. Vitamin B6 at a dosage of 25 mg orally every 8 hours may help with hyperemesis gravidarum.

One 25mg pyridoxine tablet should be crushed into a fine powder using a tablet crusher.

Allow this powder to dissolve in 5 mL of water while occasionally shaking. In 2-3 minutes, the powder should dissolve.

Concentration is 25mg/5mL = 5mg/mL.

Initial Diagnostic Test dose IV or IM: 50 -100mg

• Maintenance dose

Oral:

•             50 – 100mg daily.
• IV Injection: Give slowly over 5 minutes IM Injection: as per NCCU guideline
• Oral: May be given at any time with regard to feeds.

Molecular Structure of Vitamin B6 Pyridoxine

The molecular formula of IV B6 Pyridoxine is C8H12ClNO3 and its molecular weight is 205.64. The IUPAC name for IV B6 Pyridoxine is 4,5-bis(hydroxymethyl)-2-methylpyridin-3-ol; hydrochloride. The cofactor for the production of amino acids, neurotransmitters (serotonin, norepinephrine), sphingolipids, and aminolaevulinic acid is vitamin B6 in its 4-methanol form, which is transformed to pyridoxal phosphate.

The molecular structure is given below: