Vitamin B6 toxicity explained

There have been recent news reports raising concerns about vitamin B6 toxicity and I wanted to offer some further information and clinical context based on current evidence.

The Therapeutic Goods Administration (TGA) requires warning labels on all products containing more than 10mg of vitamin B6 per day, following reports of peripheral neuropathy. This was reduced from 50mg last year following 32 adverse event reports; these were mostly involving self-prescribed doses ranging from 50mg to over 200mg per day, often taken for long periods and in combination with other supplements containing B6.

• Peripheral neuropathy is damage or dysfunction of the peripheral nerves (not your brain or spinal column).  
• Symptoms include tingling, numbness, burning, or weakness—typically starting in the hands or feet. 
• It can be caused by a variety of factors including diabetes, nutrient deficiencies or excesses (such as vitamin B6), infections, or exposure to toxins.

 Tingling and other symptoms could be peripheral neuropathy (or something else) and it could be due to vitamin B6 (or something else).  There is increasing evidence that suggests that:

• Vitamin B6 toxicity is pretty rare, typically associated with high doses (>500mg/day) and prolonged use (>6 months), and symptoms are usually reversible upon stopping.
• There is no consistent evidence of toxicity at doses under 200mg/day when robust neurological assessments have been carried out.
• Some reported low-dose cases lack clear data on actual intake, product composition, or clinical confirmation.
• Notably, peripheral neuropathy can also result from deficiency in B6, highlighting the importance of accurate diagnosis.

Interestingly, the Nutrient Reference Values for Australia and New Zealand have set the upper limit of vitamin B6 for adults and pregnant women over 19 years of age at 50mg per day, with a NOAEL (no observed adverse effect level) at 200mg daily. 

If you have any numbness, tingling, pain, and weakness, (typically in your fingers and toes) - then stop your supplements and see your healthcare professional.

What You Can Do
To reduce the risk of either deficiency or excess:

• Check your labels: Vitamin B6 is often added to fortified foods like some cereals, protein powders, and energy drinks (do you need energy drinks?) - sometimes in surprising amounts.
• Avoid self-prescribing supplements, especially multiple products at once. If you have a bit of B6 in your protein powder and some in your bread, some in you multivitamin you picked up because you were tired and stress and then there's some in your PMS formula, and then you grab something for that flu going around and it has more B6 in it …. you get the picture; it's easy to add up to a fair bit of B6.
• Tell your practitioner about all supplements and fortified foods you’re taking, even if they seem minor.
• Be aware of symptoms like tingling, numbness, or burning in the hands or feet—especially if using high doses or multiple products.
• Don’t rely solely on blood tests; B6 status testing is affected by many factors (e.g., inflammation, protein levels, alcohol intake) so as always, a thorough clinical history is is important to include in any assessment.