To the Editor: Paradoxically, both vitamin B6 deficiency and excess are associated with peripheral neuropathy. Increasingly, patients are presenting with peripheral neuropathy associated with elevated vitamin B6 whole blood levels, as previously presented by our laboratory.1
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- 1. Browning S, Teis B, Henman M, et al. Retrospective review of increasing vitamin B6 whole blood levels in Australia [abstract]. In: Proceedings of the Australasian Association of Clinical Biochemists’ 52nd Annual Scientific Conference; 2021 Oct. Clin Biochem Rev 2021; 42 (Suppl 1): S9.
- 2. Abraham GE, Schwartz UD, Lubran MM. Effect of vitamin B‐6 on plasma and red blood cell magnesium levels in premenopausal women. Ann Clin Lab Sci 1981; 11: 333‐336.
- 3. Nutrient Reference Values for Australia and New Zealand. Vitamin B6. https://www.eatforhealth.gov.au/nutrient‐reference‐values/nutrients/vitamin‐b6 (viewed Mar 2023).
- 4. Berger AR, Schaumburg HH, Schroeder C, et al. Dose response, coasting and differential fiber vulnerability in human toxic neuropathy: a prospective study of pyridoxine neurotoxicity. Neurology 1992; 42: 1367‐1370.
- 5. Therapeutic Goods Administration. Safety update: Peripheral neuropathy with supplementary vitamin B6 (pyridoxine). 4 Oct 2022. https://www.tga.gov.au/news/safety‐updates/peripheral‐neuropathy‐supplementary‐vitamin‐b6‐pyridoxine (viewed Oct 2022).
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