Editing Vitamin B6 (section)

==Dietary recommendations==
From regulatory agency to regulatory agency there is a wide range between what is considered [[Tolerable upper intake level]]s (ULs). The [[European Food Safety Authority]] (EFSA) adult UL for vitamin B<sub>6</sub> is set at 12&nbsp;mg/day<ref name="EFSA2023"/> versus 100&nbsp;mg/day for the United States.<ref name="DRItext"/> 

The US [[National Academy of Medicine]] updated [[Dietary Reference Intake]]s for many vitamins in 1998. Recommended Dietary Allowances (RDAs), expressed as milligrams per day, increase with age from 1.2 to 1.5&nbsp;mg/day for women and from 1.3 to 1.7&nbsp;mg/day for men. The RDA for pregnancy is 1.9&nbsp;mg/day, for [[lactation]], 2.0&nbsp;mg/day. For children ages 1–13 years the RDA increases with age from 0.5 to 1.0&nbsp;mg/day. As for safety, ULs for vitamins and minerals are identified when evidence is sufficient. In the case of vitamin B<sub>6</sub> the US-established adult UL was set at 100&nbsp;mg/day.<ref name="DRItext">{{cite book|chapter-url=https://www.nap.edu/read/6015/chapter/9#150|title=Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline|last1=Institute of Medicine|author-link=Institute of Medicine|publisher=The National Academies Press|year=1998|isbn=978-0-309-06554-2|location=Washington, DC|pages=150–195|chapter=Vitamin B<sub>6</sub>|doi=10.17226/6015|pmid=23193625|lccn=00028380|oclc=475527045|access-date=April 20, 2018|archive-date=March 6, 2022|archive-url=https://web.archive.org/web/20220306133707/https://www.nap.edu/read/6015/chapter/9#150|url-status=live}}</ref>

The EFSA refers to the collective set of information as Dietary Reference Values, with Population Reference Intake (PRI) instead of RDA. For women and men ages 15 and older the PRI is set at 1.6 and 1.7&nbsp;mg/day, respectively; for pregnancy 1.8&nbsp;mg/day, for lactation 1.7&nbsp;mg/day. For children ages 1–14 years the PRIs increase with age from 0.6 to 1.4&nbsp;mg/day.<ref>{{cite web|url=https://www.efsa.europa.eu/sites/default/files/assets/DRV_Summary_tables_jan_17.pdf |title=Overview on Dietary Reference Values for the EU population as derived by the EFSA Panel on Dietetic Products, Nutrition and Allergies | year=2017|archive-url=https://web.archive.org/web/20170828082247/https://www.efsa.europa.eu/sites/default/files/assets/DRV_Summary_tables_jan_17.pdf|archive-date=August 28, 2017|url-status=live}}</ref> The EFSA also reviewed the safety question and in 2023 set an upper limit for vitamin B<sub>6</sub> of 12&nbsp;mg/day for adults, with lower amounts ranging from 2.2 to 10.7 mg/day for infants and children, depending on age.<ref name="EFSA2023">{{cite journal |vauthors=Turck D, Bohn T, Castenmiller J, de Henauw S, Hirsch-Ernst KI, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Pelaez C, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Fairweather-Tait S, Vrolijk M, Fabiani L, Titz A, Naska A |display-authors=5 |title=Scientific opinion on the tolerable upper intake level for vitamin B6 |journal=EFSA J |volume=21 |issue=5 |pages=e08006 |date=May 2023 |pmid=37207271 |pmc=10189633 |doi=10.2903/j.efsa.2023.8006 |url=}}</ref> This replaced the adult UL set in 2008 at 25&nbsp;mg/day.<ref name="EFSA2008">{{cite journal |publisher=Scientific Panel on Food Additives, Flavorings, Processing Aids and Materials in Contact with Food |date=2008 |title=Opinion on Pyridoxal 5′-phosphate as a source for vitamin B<sub>6</sub> added for nutritional purposes in food supplements |url=https://www.efsa.europa.eu/en/efsajournal/pub/760 |journal=The EFSA Journal |volume=760 |issue=7 |page=760 |doi=10.2903/j.efsa.2008.760 |pmid=37213840 |doi-access=free |pmc=10193624 |author1=European Food Safety Authority (EFSA) |access-date=September 22, 2019 |archive-date=October 24, 2020 |archive-url=https://web.archive.org/web/20201024062140/https://www.efsa.europa.eu/en/efsajournal/pub/760 |url-status=live }}</ref>

The Japanese [[Ministry of Health, Labour and Welfare]] updated its vitamin and mineral recommendations in 2015. The adult RDAs are at 1.2&nbsp;mg/day for women 1.4&nbsp;mg/day for men. The RDA for pregnancy is 1.4&nbsp;mg/day, for lactation is 1.5&nbsp;mg/day. For children ages 1–17 years the RDA increases with age from 0.5 to 1.5&nbsp;mg/day. The adult UL was set at 40–45&nbsp;mg/day for women and 50–60&nbsp;mg/day for men, with the lower values in those ranges for adults over 70 years of age.<ref name="JapanDRI2015">{{cite web |url=https://www.mhlw.go.jp/file/06-Seisakujouhou-10900000-Kenkoukyoku/Overview.pdf |title=Overview of Dietary Reference Intakes for Japanese |website=Ministry of Health, Labour and Welfare (Japan) |date=2015 |access-date=August 19, 2021 |archive-date=October 21, 2022 |archive-url=https://web.archive.org/web/20221021004240/https://www.mhlw.go.jp/file/06-Seisakujouhou-10900000-Kenkoukyoku/Overview.pdf |url-status=live }}</ref>

===Safety===
{{Main|Megavitamin-B6 syndrome}}
Adverse effects have been documented from vitamin B<sub>6</sub> dietary supplements, but never from food sources. Even though it is a water-soluble vitamin and is excreted in the urine, doses of pyridoxine in excess of the dietary upper limit (UL) over long periods cause painful and ultimately irreversible neurological problems.<ref name="DRItext" /> The primary symptoms are pain and numbness of the extremities. In severe cases, motor neuropathy may occur with "slowing of motor conduction velocities, prolonged [[F wave]] latencies, and prolonged sensory latencies in both lower extremities", causing difficulty in walking. Sensory [[neuropathy]] typically develops at doses of pyridoxine in excess of 1,000&nbsp;mg per day, but adverse effects can occur with much less, so intakes over 200&nbsp;mg/day are not considered safe.<ref name="DRItext" /> Trials with amounts equal to or less than 200&nbsp;mg/day established that as a "[[No-observed-adverse-effect level]]", meaning the highest amount at which no adverse effects were observed. This was divided by two to allow for people who might be extra sensitive to the vitamin, referred to as an "uncertainty factor", resulting in the aforementioned adult UL of 100&nbsp;mg/day set for the United States.<ref name="DRItext" /> As noted above, in 2023 the European Food Safety Commission set an adult UL at 12&nbsp;mg/day.<ref name="EFSA2023"/> While Australia has set an upper limit of 50&nbsp;mg/day, the [[Therapeutic Goods Administration]] requires a label warning about peripheral neuropathy if the daily dose is predicted to exceed 10&nbsp;mg/day.<ref name="NHMRC2019">{{cite web |title=Vitamin B<sub>6</sub> |website=Nutrient Reference Values for Australia and New Zealand |publisher=National Health and Medication Research Council (NHMRC) |url=https://www.nrv.gov.au/nutrients/vitamin-b6 |access-date=2019-12-02 |archive-date=2019-03-04 |archive-url=https://web.archive.org/web/20190304153020/https://www.nrv.gov.au/nutrients/vitamin-b6|date=2014-03-17 }}</ref><ref>{{cite web |title=Peripheral neuropathy with supplementary vitamin B6 (pyridoxine) |url=https://www.tga.gov.au/news/safety-updates/peripheral-neuropathy-supplementary-vitamin-b6-pyridoxine |website=[[Therapeutic Goods Administration]] |publisher=[[Australian Government]] |access-date=5 January 2025}}</ref>

===Labeling===
For US food and dietary supplement labeling purposes the amount in a serving is expressed as a percent of Daily Value. For vitamin B<sub>6</sub> labeling purposes 100% of the Daily Value was 2.0&nbsp;mg, but as of May 27, 2016, it was revised to 1.7&nbsp;mg to bring it into agreement with the adult RDA.<ref name="FedReg">{{cite web|url=https://www.gpo.gov/fdsys/pkg/FR-2016-05-27/pdf/2016-11867.pdf|title=Federal Register May 27, 2016 Food Labeling: Revision of the Nutrition and Supplement Facts Labels |archive-url=https://web.archive.org/web/20170922104400/https://www.gpo.gov/fdsys/pkg/FR-2016-05-27/pdf/2016-11867.pdf|archive-date=September 22, 2017|url-status=live}}</ref><ref>{{cite web | title=Daily Value Reference of the Dietary Supplement Label Database (DSLD) | website=Dietary Supplement Label Database (DSLD) | url=https://www.dsld.nlm.nih.gov/dsld/dailyvalue.jsp | access-date=May 16, 2020 | archive-date=April 7, 2020 | archive-url=https://web.archive.org/web/20200407073956/https://dsld.nlm.nih.gov/dsld/dailyvalue.jsp | url-status=dead }}</ref> A table of the old and new adult daily values is provided at [[Reference Daily Intake]].