Index of Sources

Below is a compiled list of educational resources and articles retrieved during the research we conducted on vitamin B6 toxicity.

Achari, M., Haider, M., & Mohammed, Z. (2021, April 13). Vitamin B6 (pyridoxine) toxicity and OTC supplements (5222). Neurology. Retrieved March 21, 2022, from 

Adeyemo, M., & Garg, D. (2022). A Case of Vitamin B6 Neurotoxicity.

B Arkaravichien, T., Sattayasai, N., Daduang, S., & Sattayasai, J. (2003). Dose-dependent effects of glutamate in pyridoxine-induced neuropathy. Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association41(10), 1375–1380.

Ashina, K., Tsubosaka, Y., Nakamura, T., Omori, K., Kobayashi, K., Hori, M., Ozaki, H., & Murata, T. (2015). Histamine Induces Vascular Hyperpermeability by Increasing Blood Flow and Endothelial Barrier Disruption In Vivo. PloS one10(7), e0132367.

Bacharach, R., Lowden, M., & Ahmed, A. (2017). Pyridoxine toxicity small fiber neuropathy with dysautonomia: A case report. Journal of Clinical Neuromuscular Disease19(1), 43–46. 

Barrett-O’Keefe, Z., Kaplon, R. E., & Halliwill, J. R. (2013). Sustained postexercise vasodilatation and histamine receptor activation following small muscle-mass exercise in humans. Experimental physiology98(1), 268–277.

Beckett, A. (1998, July 4). Debate continues on vitamin B6. The Lancet. Retrieved January 24, 2022, from 

Berger, A. R., Schaumburg, H. H., Schroeder, C., Apfel, S., & Reynolds, R. (1992). Dose response, coasting, and differential fiber vulnerability in human toxic neuropathy: a prospective study of pyridoxine neurotoxicity. Neurology42(7), 1367–1370.

B Beynon, R. J., Leyland, D. M., Evershed, R. P., Edwards, R. H., & Coburn, S. P. (1996, July 15). Measurement of the turnover of glycogen phosphorylase by GC/MS using stable isotope derivatives of pyridoxine (vitamin B6). The Biochemical journal. Retrieved March 21, 2022, from 

Bhatla, R., Gogna, M., Aggarwal, R., & Bhat, V. (2022). Possible Interaction of Water-Soluble Vitamins with Nitric Oxide and Its Significance – Evidence from Reversed Phase-High Pressure Liquid Chromatography (RP-HPLC). IJIRT, 9(3), 547–557. PDF:

B Bigazzi, M., Ferraro, S., Ronga, R. et al. Effect of vitamin B6 on the serum concentration of pituitary hormones in normal humans and under pathologic conditions. J Endocrinol Invest 2, 117–124 (1979).

B Black, A. L., Guirard, B. M., & Snell, E. E. (1978). The behavior of muscle phosphorylase as a reservoir for vitamin B6 in the rat. The Journal of Nutrition108(4), 670–677. 

Blackburn, K., & Warren, K. (2017, April 18). A case of peripheral neuropathy due to pyridoxine toxicity in association with NOS Energy Drink Consumption (p4.043). Neurology. Retrieved March 15, 2022, from

Blood volume test. Cleveland Clinic. (n.d.). Retrieved March 22, 2022, from  

B Borst, A. J., & Tchapyjnikov, D. (2018, April). B6 and bleeding: A case report of a novel vitamin … ResearchGate. Retrieved March 22, 2022, from 

Brasky, T. M., White, E., & Chen, C. L. (2017). Long-Term, Supplemental, One-Carbon Metabolism-Related Vitamin B Use in Relation to Lung Cancer Risk in the Vitamins and Lifestyle (VITAL) Cohort. Journal of clinical oncology : official journal of the American Society of Clinical Oncology35(30), 3440–3448.

Bryson, G. (1973). Role of vitamin B6 in neurobiology. M. S. Ebadi and E. Costa, eds. Raven Press, hewlett, Long Island, N. Y. 11557, 1972, X + 238 pp. $15.95. Clinical Chemistry19(1), 142–143. 

Burt, L. A., Billington, E. O., Rose, M. S., Raymond, D. A., Hanley, D. A., & Boyd, S. K. (2019). Effect of high-dose vitamin D supplementation on volumetric bone density and bone strength. JAMA322(8), 736. 

B Callizot, N., Warter, J. M., & Poindron, P. (2001). Pyridoxine-induced neuropathy in rats: a sensory neuropathy that responds to 4-methylcatechol. Neurobiology of disease8(4), 626–635.

B Castagnet, S., Blasco, H., Vourc’h, P., Andres, C. R., & Praline, J. (2010). Polyneuropathie chronique démyélinisante et hypervitaminose B6 [Chronic demyelinating polyneuropathy and B6 hypervitaminosis]. La Revue de medecine interne31(12), e1–e3.

Center for Food Safety and Applied Nutrition (CFSAN). (n.d.). CFSAN Adverse Event Reporting System Voluntary and Mandatory Reports on 5-Hour Energy, Monster Energy, and Rockstar Energy Drink. U.S. Food and Drug Administration. Retrieved March 28, 2022, from 

Chang, H. Y., Tzen, J. T., Lin, S. J., Wu, Y. T., & Chiang, E. P. (2011). Long-term prednisolone treatments increase bioactive vitamin B6 synthesis in vivo. The Journal of pharmacology and experimental therapeutics337(1), 102–109. B6-and-Steroids (PDF)

Changes in blood volume following administration of Oral Rehydration Solutions. Otsuka Pharmaceutical Co., Ltd. (n.d.). Retrieved April 6, 2023, from

Cheng, C.-H., Chang, S.-J., Lee, B.-J., Lin, K.-L., & Huang, Y.-C. (2006, May 3). Vitamin B6 supplementation increases immune responses in critically ill patients. Nature News. Retrieved March 21, 2022, from 

B Chung, J. Y., Choi, J. H., Hwang, C. Y., & Youn, H. Y. (2008). Pyridoxine induced neuropathy by subcutaneous administration in dogs. Journal of veterinary science9(2), 127–131.

Clark, D. J. (2018, December 14). Adverse response to vitamin B6 in a 43 year old woman. Frontiers. Retrieved March 21, 2022, from 

Clarkson, P., Institute of Medicine (US) Committee on Military Nutrition Research; Marriott BM, editor. Nutritional Needs in Hot Environments: Applications for Military Personnel in Field Operations. Washington (DC): National Academies Press (US); 1993. 8, The Effect of Exercise and Heat on Vitamin Requirements. Available from:

B Coburn, S. P. (1990). Location and Turnover of Vitamin B6 Pools and Vitamin B6 Requirements of Humans. Annals of the New York Academy of Sciences585(1 Vitamin B6), 76–85. 

Coburn S. P. (2015). Vitamin B-6 Metabolism and Interactions with TNAP. Sub-cellular biochemistry76, 207–238.

B Coburn, S. P., Lewis, D. L., Fink, W. J., Mahuren, J. D., Schaltenbrand, W. E., & Costill, D. L. (1988). Human vitamin B-6 pools estimated through muscle biopsies. The American Journal of Clinical Nutrition48(2), 291–294. 

Coburn, S. P., Mahuren, J. D., Schaltenbrand, W. E., Wostmann, B. S., & Madsen, D. (1981). Effects of vitamin B-6 deficiency and 4′- deoxypyridoxine on pyridoxal phosphate concentrations, pyridoxine kinase and other aspects of metabolism in the rat. The Journal of nutrition111(2), 391–398.

B Coburn, S. P., Thampy, K. G., Lane, H. W., Conn, P. S., Ziegler, P. J., Costill, D. L., Mahuren, J. D., Fink, W. J., Pearson, D. R., & Schaltenbrand, W. E. (1995). Pyridoxic acid excretion during low vitamin B-6 intake, total fasting, and bed rest. The American Journal of Clinical Nutrition, 62(5), 979–983.

Coburn, S. P., Ziegler, P. J., Costill, D. L., Mahuren, J. D., Fink, W. J., Schaltenbrand, W. E., Pauly, T. A., Pearson, D. R., Conn, P. S., & Guilarte, T. R. (1991). Response of vitamin B-6 content of muscle to changes in vitamin B-6 intake in men. The American Journal of Clinical Nutrition53(6), 1436–1442. 

B Cooper, M. A., Kluding, P. M., & Wright, D. E. (2016). Emerging Relationships between Exercise, Sensory Nerves, and Neuropathic Pain. Frontiers in neuroscience10, 372.

Critcher, M. S., & Sobczynska-Malefora, A. (2015, September). Vitamin B6: low and very high concentrations in hospital patients. The Biomedical Scientist. Retrieved January 24, 2022, from

B Cruz, A. A., Togias, A. G., Lichtenstein, L. M., Kagey-Sobotka, A., Proud, D., & Naclerio, R. M. (1991). Steroid-induced reduction of histamine release does not alter the clinical nasal response to cold, dry air. The American review of respiratory disease143(4 Pt 1), 761–765.

Cupa, N., Schulte, D., Ahrens, M. et al. Vitamin B6 intoxication after inappropriate supplementation with micronutrients following bariatric surgery. Eur J Clin Nutr 69, 862–863 (2015).

Dalton, K. (1985). Pyridoxine overdose in premenstrual syndrome. The Lancet325(8438), 1168–1169.  Dalton-1985-the-Lancet

Dalton, K., & Dalton, M. J. (1987). Characteristics of pyridoxine overdose neuropathy syndrome. Acta Neurologica Scandinavica76(1), 8–11. 

Dalton, K., & Dalton, M. J. T. (1998, July 4). Debate continues on vitamin B6. The Lancet. Retrieved January 24, 2022, from 

B Dakshinamurti, K., Paulose, C. S., & Vriend, J. (1986). Hypothyroidism of hypothalamic origin in pyridoxine-deficient rats. The Journal of endocrinology109(3), 345–349.

B Dakshinamurti, K., Paulose, C. S., Thliveris, J. A., & Vriend, J. (1985). Thyroid function in pyridoxine-deficient young rats. The Journal of endocrinology104(3), 339–344.

de Kruijk, J. R., & Notermans, N. C. (2005). Gevoelsstoornissen veroorzaakt door multivitaminepreparaten [Sensory disturbances caused by multivitamin preparations]. Nederlands tijdschrift voor geneeskunde149(46), 2541–2544.

B Demir, R., Acar, G., Tanriover, G., Seval, Y., Kayisli, U. A., & Agar, A. (2005). Effects of excess vitamin B6 intake on cerebral cortex neurons in rat: an ultrastructural study. Folia histochemica et cytobiologica43(3), 143–150.

Ebadi, M. (1981). Regulation and function of pyridoxal phosphate in CNS. Neurochemistry International3(3-4), 181–205. 

Ebadi M., Costa, E. (1972) Role of Vitamin B6 in Neurobiology. Clinical Chemistry19(1), 142–143. 

B EFSA Journal. (2016, April 21). Dietary reference values for vitamin B6. EFSA. Retrieved March 22, 2022, from 

B Enomoto, T., Nagasako-Akazome, Y., Kanda, T., Ikeda, M., & Dake, Y. (2006). Clinical effects of apple polyphenols on persistent allergic rhinitis: A randomized double-blind placebo-controlled parallel arm study. Journal of investigational allergology & clinical immunology16(5), 283–289.

European Food Safety Authority. (2000, October). Opinion of the Scientific Committee on Food on the Tolerable Upper Intake Level of Vitamin B6 (expressed on 19 October 2000). Bruxelles/Wetstraat; EUROPEAN COMMISSION HEALTH & CONSUMER PROTECTION DIRECTORATE-GENERAL. 

B European Food Safety Authority. (2016). Scientific opinion on dietary reference values for vitamin B6. Retrieved March 22, 2022, from 

European Food Safety Authority. (2006, February). Tolerable upper intake levels for vitamins and minerals. EFSA. Retrieved December 1, 2021, from

Evans, G. W., & Johnson, E. C. (1981). Effect of iron, vitamin B-6 and picolinic acid on zinc absorption in the rat. The Journal of nutrition111(1), 68–75.

B Farzam K, Sabir S, O’Rourke MC. Antihistamines. [Updated 2022 Jul 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:

B Ferro, Y., Carè, I., Mazza, E., Provenzano, F., Colica, C., Torti, C., Romeo, S., Pujia, A., & Montalcini, T. (2017). Protein and vitamin B6 intake are associated with liver steatosis assessed by transient elastography, especially in obese individuals. Clinical and molecular hepatology23(3), 249–259.

Field, T. , Hernandez-Reif, M., Diego, M., Schanberg, S., & Kuhn, C. (2005). Cortisol decreases and serotonin and dopamine increase following massage therapy. International Journal of Neuroscience115(10), 1397–1413. 

B Fletcher, J. (2020, January 3). Vasodilation: What it is, causes, and more. Medical News Today. Retrieved March 21, 2022, from 

Folkers, K., Morita, M., & Mcree, J. (1993). The activities of coenzyme Q10 and vitamin B6 for immune responses. Biochemical and Biophysical Research Communications193(1), 88–92.  The-Activities-of-coenzyme-Q10-and-Vitamin-B6-for-Immune-Responses-1 (PDF)

Food sources of potassium. Food Sources of Potassium | Dietary Guidelines for Americans. (n.d.). Retrieved March 21, 2022, from 

B Fukuwatari, T., Sugimoto, E., Tsuji, T., Hirose, J., Fukui, T., & Shibata, K. (2009). Urinary excretion of vitamin B12 depends on urine volume in Japanese female university students and elderly. Nutrition research (New York, N.Y.)29(12), 839–845.

Furth-Walker, D., Leibman, D., & Smolen, A. (1990). Relationship between blood, liver and brain pyridoxal phosphate and pyridoxamine phosphate concentrations in mice. The Journal of Nutrition120(11), 1338–1343. 

Generali J. A. (2013). Energy drinks: food, dietary supplement, or drug?. Hospital pharmacy48(1), 5–9.

Ghavanini, A. A., & Kimpinski, K. (2014). Revisiting the evidence for neuropathy caused by pyridoxine deficiency and excess. Journal of clinical neuromuscular disease16(1), 25–31.

B Grundy, L., Caldwell, A., Garcia Caraballo, S., Erickson, A., Schober, G., Castro, J., Harrington, A. M., & Brierley, S. M. (2020). Histamine induces peripheral and central hypersensitivity to bladder distension via the histamine H1 receptor and TRPV1. American Journal of Physiology-Renal Physiology, 318(2).

B Guala, A., Folgori, G., Silvestri, M., Barbaglia, M., & Danesino, C. (2022). Vitamin B6 neonatal toxicity. Case Reports in Pediatrics, 2022, 1–4.

Hadtstein, F., & Vrolijk, M. (2021). Vitamin B-6-Induced Neuropathy: Exploring the Mechanisms of Pyridoxine Toxicity. Advances in nutrition (Bethesda, Md.)12(5), 1911–1929.

Halliwill, J. R., Buck, T. M., Lacewell, A. N., & Romero, S. A. (2013). Postexercise hypotension and sustained postexercise vasodilatation: what happens after we exercise?. Experimental physiology98(1), 7–18.

Hammond, D., Reid, J. L., & Zukowski, S. (2018). Adverse effects of caffeinated energy drinks among youth and young adults in Canada: a Web-based survey. CMAJ open6(1), E19–E25.

B Haugen, M., Lillegaard, I. T. L., Frøyland, L., Henjum, S., Holvik, K., Løvik, M., Skålhegg, B. S., Stea, T. H., Strand, T. A., & Iversen, P. O. (2017, October 17). Assessment of vitamin B6 intake in relation to tolerable upper intake levels. opinion of the panel on nutrition, Dietetic Products, novel food and allergy of the Norwegian Scientific Committee for Food Safety. VKM report 2017:3. Norwegian Institute of Public Health Open Repository. Retrieved March 22, 2022, from 

B Hauser, Ross M. D. (2022, February 18). Joint instability as the cause of nerve pain – treatment of neuralgia. Caring Medical Florida. Retrieved August 2, 2022, from 

B Heiskanen, K., Salmenperä, L., Perheentupa, J., & Siimes, M. A. (1994). Infant vitamin B-6 status changes with age and with formula feeding. The American Journal of Clinical Nutrition, 60(6), 907–910.

Higgins, C. (2008, July). Orange juice overdose – a quirky case history of potentially fatal hyperkalemia. Retrieved March 21, 2022, from 

B Hong, B. N., Yi, T. H., Kim, S. Y., & Kang, T. H. (2009). High-dosage pyridoxine-induced auditory neuropathy and protection with coffee in mice. Biological & pharmaceutical bulletin32(4), 597–603.

B Hong, W. Y., Kabach, M., Feldman, G., & Jovin, I. S. (2020). Intravenous fluids for the prevention of contrast-induced nephropathy in patients undergoing coronary angiography and cardiac catheterization. Expert Review of Cardiovascular Therapy, 18(1), 33–39.

Hoover, D. M., Carlton, W. W., & Henrikson, C. K. (1981). Ultrastructural lesions of pyridoxine toxicity in beagle dogs. Veterinary pathology18(6), 769–777.

B-V House, A. A., Eliasziw, M., Cattran, D. C., Churchill, D. N., Oliver, M. J., Fine, A., Dresser, G. K., & Spence, J. D. (2010). Effect of B-vitamin therapy on progression of diabetic nephropathy. JAMA303(16), 1603. 

Hovaguimian, A., & Gibbons, C. H. (2011). Diagnosis and treatment of pain in small-fiber neuropathy. Current pain and headache reports15(3), 193–200.

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B Hoy, M. K., & Goldman, J. D. (2012, September). Potassium intake of the U.S. population – USDA ARS. Agricultural Research Service. Retrieved May 2, 2022, from 

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Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Vitamins, O. B., & Choline, and. (1998, January 1). Vitamin B12. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Retrieved March 22, 2022, from 

Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Vitamins, O. B., & Choline, and. (1998, January 1). Vitamin B6- Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. NCBI. Retrieved April 4, 2022, from 

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B Iyengar, S., Ossipov, M. H., & Johnson, K. W. (2017). The role of calcitonin gene-related peptide in peripheral and central pain mechanisms including migraine. Pain158(4), 543–559.

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B Jansen, T., Romiti, R., Kreuter, A., & Altmeyer, P. (2001). Rosacea fulminans triggered by high-dose vitamins B6 and B12. Journal of the European Academy of Dermatology and Venereology : JEADV15(5), 484–485.

Johnson, C. (2021, May 7). Damaged small nerve fibers may be causing energy problems in chronic fatigue syndrome (ME/CFS). Health Rising. Retrieved March 31, 2022, from 

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B Jones, B. M., & Tykocki, N. R. (2020). New direct evidence that histamine augments bladder sensory outflow during filling is nothing to sneeze at. American Journal of Physiology-Renal Physiology, 318(2).

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B Jwa, S.-J., Ko, K. H., Park, S. J., & Kang, S.-Y. (2016). Sensory polyneuropathy associated with pyridoxine overdose. Journal of the Korean Neurological Association34(4), 350–352. 

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B Kendall, B. F. (n.d.). An investigation of selected toxic effects of pyridoxal and pyridoxine in the sprague-dawley rat. eLibrary.RU. Retrieved April 4, 2022, from 

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B Krinke, G., Naylor, D. C., & Skorpil, V. (1985, March 1). Pyridoxine megavitaminosis: An analysis of the early changes induced with massive doses of vitamin B6 in rat primary sensory neurons. OUP Academic. Retrieved March 22, 2022, from 

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B Muhamad, R., Akrivaki, A., Papagiannopoulou, G., Zavridis, P., & Zis, P. (2023). The role of vitamin B6 in peripheral neuropathy: A systematic review. Nutrients, 15(13), 2823.

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B Park, C., Lim, H., Moon, S. K., & Park, R. (2019). Pyridoxine preferentially induces auditory neuropathy through mitochondrial dysfunction and endoplasmic reticulum stress-mediated apoptosis. Annals of Otology, Rhinology & Laryngology, 128(6_suppl).

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