• Welcome to Phoenix Rising!

    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To become a member, simply click the Register button at the top right.

Is there a reliable way to assess B6 status?

pspa123

Senior Member
Messages
105
This question is triggered by my recent interest in pyroluria. The theory there of course is that one becomes B6 deficient because it is bound by pyrolles and excreted -- or along those lines. So my question is whether there is a direct way to confirm that this is really happening by evaluating B6 status, the same way one can directly measure zinc. I find it interesting that the lab testing based on the Walsh protocol measures zinc but not B6. I think it is important because the protocol recommends very large doses of B6, but I have read that too much B6 can actually CAUSE anxiety.
 

pspa123

Senior Member
Messages
105
PS the doses recommended for pyroluria, at least by people I have talked to, are multiples of the supposed "upper safe limit" of 100 mg. per day. Which makes me wonder why only zinc (and copper) levels typically seem to be monitored?
 
Messages
151
There is no evidence that disease exists but blood zinc, b6, and urinary porphyrins could be checked. There are genetic diseases of b6 called pyridoxine dependent epilepsy, and they give up to 600mg a day pyridoxine or P5P long term for them.
 

pspa123

Senior Member
Messages
105
I hear you, recently I participated in a thread where people were advocating rather forcefully that it is very real and there seems no end to the debate or consensus. I tested positive for it myself, and even though my zinc seemed pretty in range from what I could tell (B6 is not routinely tested apparently by pyroluria practitioners, not sure why, they just seem to assume you are deficient), it was recommended that I take what seems a large dose of zinc (75 mg) and a very large dose (multiples of the 100 mg upper limit of safety) B6. It's hard to know what to believe.

FYI my plasma zinc was 90 ug/dl which is very much in the middle of the Labcorp range but at the low end of the "Walsh/Pfeiffer functional range."

Also my homocysteine was towards the higher end of normal but I'm not sure that in and of itself is a marker for B6 deficiency.

I'm tempted to get my B6 status tested before taking 100s of mg a day, as it apparently is not completely safe and you don't just urinate out any excess. At the same time, the pyroluria folks will tell you that you have to take the high doses, that modest ones won't help.
 
Last edited:
Messages
151
b6 is needed for zinc absorption which may be the relationship between deficiency of b6 and zinc. zinc supplements alone deplete copper. eat oysters for zinc which have all the other minerals too. b6 is in rice bran, paprika, chilli, pistachio, brazil nuts.

there is no evidence of pyroluria genetic disease so the folks promoting it should be asked to provide evidence for it.
 
Messages
151
there is no proof for it in the literature. even if it was real it is treatable with oysters, and rice bran.
 
Last edited by a moderator:

pspa123

Senior Member
Messages
105
I am not advocating for it, I am skeptical myself, especially after the recommendations I received. There are just so many of these niche theories out there it can be overwhelming.
 
Last edited by a moderator:

pamojja

Senior Member
Messages
2,384
Location
Austria
So my question is whether there is a direct way to confirm that this is really happening by evaluating B6 status, the same way one can directly measure zinc.

Many report high levels of B6 in serum, with or without supplementing. So probably it only is good to test for deficiency. Just as high B9, B12 in serum is good at detecting sure deficiency, but once above normal doesn't necessarily means sufficiency, but rather through some mechanism it is being building up in blood and not metabolizing properly. Or a particular person just needs much more of them due to bio-chemical individuality to function properly.

All 3 of them are needed for the metabolism of homocysteine, therefore that can be a good substitution blood marker. In my case having taken in average about 2 mg of B9 + B12 along with 170 mg per day of B6 for many years - with all these in serum and blood high above normal - my homocysteine still borderline high. However, by titrating them all slowly higher I've now reached above 200 mg/d of B6 (at the same time receiving for the first time Mg-sulfate IV, for making real improvements with my severe Mg-deficiency), and for the first time in my life I consistently remember dreams. Which some take as a sign of B6 sufficiency (or also in Mg).

Beside that am at about 70 mg/d of supplemented zinc, but that hasn't made a tend yet in my consistently at the bottom low of normal serum zinc within 10 years (supplemented about 46 mg/d in average).
 

pspa123

Senior Member
Messages
105
It seems some claim organic acid tests can give a reliable measure of functional B6 status. As a side note, when I spoke to two practitioners about pyroluria, I pointed out that I don't have any of the classic physical signs of B6 or zinc deficiency, and that I have very vivid dream recall at least upon waking, but predictably they didn't change their view on whether I needed the megadoses. What do I know, but it seems to me inconsistent that on the one hand they describe pyroluria as a zinc and B6 deficiency because pyrolles bind them, but on the other hand it doesn't seem to affect the diagnosis or recommended treatment if you don't show signs of deficiency or your actual zinc level is within range. I mean there is nobody on earth who doesn't exhibit some of the more amorphous symptoms on those lists. The whole thing remains confusing to me.
 

Learner1

Senior Member
Messages
6,305
Location
Pacific Northwest
A reliable test for B6 and the other nutrients mentioned above is a Genova Diagnostics NutrEval test, which covers all B vitamins, antioxidants, aminos, lipids, trace minerals, gut health and toxins.

It is best not to guess. Though B6 toxicity has been found in some patients at 200mg a day, my B6 was low, low, low til I got up to my current 350mg a day, with significant amounts of all the cofactors. B6 is used in over 100 reactions in the body, including methylation, glutathione production, sphingolipid production, and heme production.
 

pspa123

Senior Member
Messages
105
My concern about Genova is that years ago, I had repeat organic acid tests done within just a month or two (one was standalone, one was part of NutrEval or perhaps its predecessor that was offered only as a package) and the results were quite inconsistent. I went from low to high on some markers and vice versa. And had not made any changes in anything. The lab would not talk to me about this and, conveniently, my doctor refused to as well. It really made me wonder about the legitimacy of the lab and/or the test,
 

Learner1

Senior Member
Messages
6,305
Location
Pacific Northwest
I have been using the NutrEval for 10 years, through its changes, for me, for family members, and for others, with the guidance of excellent doctors. I've seen dozens if them, snd corroborated them with LabCorp, OAT, and other tests, and have found them to be quite valuable and accurate.

You can PM me and show me your tests with discrepancies and I'll try to see if I can figure out what the problem was.
 

pspa123

Senior Member
Messages
105
I very much appreciate that offer. Unfortunately I can't now find them, I must have neglected to copy them when I changed computers. I may be able to retrieve them from someone I shared them with and if so I will PM you.
 

Learner1

Senior Member
Messages
6,305
Location
Pacific Northwest
Or maybe just go do the test. Like I said, it's valid, and i have been to several medical conferences where doctors have shown results from it as they share case studies. They say it picks up nutrient status goung back about 3 months.
 

pspa123

Senior Member
Messages
105
So I decided to start with the basic Labcorp blood test, which incidentally DHA Labs which is the preferred lab of the Walsh practitioners. My result is 35.7 ug/L with the lab range being 5.3-46.7. What do I know, but that sure doesn't sound to me like a profound deficiency of B6 as supposedly pyroluria causes. At this point I am very loath to supplement at high dose as I was advised -- 300 mg./day (3 times the official upper limit of safety)-- or at all for that matter.