Vitamin B6 and Arthritis

High doses of vitamin B6, also called pyridoxine, may reduce inflammatory markers associated with rheumatoid arthritis, researchers report in the European Journal of Clinical Nutrition.

Rheumatoid arthritis is an autoimmune disorder that occurs when the body's immune system, which normally fights against disease and infection, attacks itself. Unlike osteoarthritis, which only affects the bones and cartilage, rheumatoid arthritis may also cause swelling in other areas of the body.

In the 12-week study, 35 adults with rheumatoid arthritis were randomly assigned to take either 100 milligrams of vitamin B6 plus 5 milligrams of folic acid or 5 milligrams of folic acid alone daily. The Recommended Dietary Allowance (RDA) for vitamin B6 is 1.3 milligrams for adults who are 19-50 years old.

At the beginning and end of the study, the researchers measured the patients’ blood levels of pro-inflammatory markers, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), C-reactive protein and erythrocyte sedimentation rate (ESR). The researchers also measured immune responses by recording the number of immune cells present in the blood.

IL-6 and TNF-alpha levels significantly decreased in the vitamin B6 group after supplementation, while no significant changes were noted in the folic acid group. However, the number of immune cells was generally similar between the two groups.

Additional research is needed to determine if vitamin B6 is beneficial for patients with rheumatoid arthritis.

Many other integrative therapies have been studied as potential treatment options for rheumatoid arthritis. For instance, borage seed oil may be beneficial in treating rheumatoid arthritis because it is high in gamma linolenic acid (GLA), which has known anti-inflammatory effects. Several human studies suggest that fish oil supplements may improve morning stiffness and joint tenderness. Group therapy has also been reported to improve joint pain.

For more information about integrative therapy options for rheumatoid arthritis, please visit Natural Standard's Comparative Effectiveness database.

Comments

[Caitie]

The results of this study are promising for those who have RA and have limited treatment options. I’m very interested to see future studies further explore this area. I am concerned by the use of 100mg supplements of B6 alone, as toxicity occurs at high doses and has been reported with as little as 100mg a day. If B6 turns out to be an effective therapy, measures should be put in place to reduce toxicity possibilities.

[RxCAM]

There seem to be multiple conditions that high-dose B6 is being studied for, including carpal tunnel syndrome, ADHD, autism and now arthritis. The only thing I worry about with this is what if people start to assume that more is better since they hear 'high-dose therapy.'

The National Academies Institute of Medicine declared a tolerable upper intake level for B6 right at 100mg. Anything above that and you get a higher possibility of adverse effects, which for B6 includes mainly peripheral neuropathy at high doses, so people losing sensation in their extremities that may or may not come back completely after discontinuing the supplementation.

Also, I wonder if there have been any studies done on longer term high-dose B6 supplementation, and if there is any kind of accumulation in the body that may lead to these adverse effects.

[husky86]

Significantly decreasing inflammatory biomarkers, such as IL-6 and TNF-alpha, doesn’t really put the benefit of pyridoxine for rheumatoid arthritis into perspective. I would be more interested to see patient pain and activity surveys that could actually demonstrate noticeable symptomatic improvement in these patients. It is strange that adverse effects weren’t mentioned, particularly peripheral neuropathy, so I’d also like to see what side effects were reported in this study.

[KM]

I was also reading up on possible toxicities of high-dose B6 therapy and found sources that recommended taking the B6 in combination with other B vitamins to reduce the toxicity. Has anyone heard anything about whether that is accurate? I also found that while The National Academies Institute of Medicine set the upper limit to 100mg, there is a large discrepancy to the acceptable limit in other countries. For example, in Britain the upper limit is 10mg, based on possible toxicities. I feel additional research is needed into not only the effectiveness of supplementation but also the safety, both short and long term.

[Julia]

It's great that something like RA can be approached from a CAM perspective. The medications typically used to treat RA are so hard on patients and have such serious side effects, like increased infections, that finding something that works but isn't as toxic will truly change the way RA is treated (hopefully). Even if traditional medications are used, maybe they can be used at lower doses if B6 pans out as a viable option.

[e82248]

What is the rationale behind the fact that rheumatoid patients take folic acid? Both vitamin B6 and placebo groups took folic acid, and it seems like a standard thing to take in rheumatoid patients. It is surprising that vitamin B6 can help rheumatoid patients. It is great news to hear that a relatively safe vitamin can help this autoimmune disease, while most of other drugs are pretty hard on our bodies.

[Bryan]

I see in the article that the recommended dietary allowance of vitamin B6 is 1.3 milligrams, and the study subjects received 100 milligrams of vitamin B6 for rheumatoid arthritis. I agree with RxCAM and worry about the possible side effects of vitamin B6 therapy. I would love to see a similar study conducted with vitamin B6 that used a dose that wasn't so close to the upper tolerable level of 100mg.

[VB]

I agree. It would be wonderful if vitamin B6 can be beneficial for patients with rheumatoid arthritis, but additional side effects or overdose would just be adding to the problem. And, consuming over that upper-tolerable limit could be easier than we think, without even purposely overdosing. For example, vitamin B6 is also found in cereal grains, carrots, spinach, peas, potatoes, milk, eggs, fish, meat, liver, flour and more! It's also found in multivitamins at the full daily requirement. People eating diets high in these products, taking 100 mg vitamin B6 for rheumatoid arthritis and a multivitamin, could be easily at risk for adverse effects. Like Bryan says, perhaps we could evaluate the effects of vitamin B6 on rheumatoid arthritis at a lower dose.

[PJ]

I noticed that they measured the levels of many pro-inflammatory markers. However, I'd like to know how the subjects with rheumatoid arthritis felt with regard to to the therapies received in this study. Did they notice a difference or feel better? I always like to hear some anecdotal effects of therapies.

[naturalpharmmm]

The most effective prescription treatments for RA come with the chances of severe side effects. Because RA is an autoimmune disease, immunosuppressants are given in some more severe cases to stop the body from attacking itself. Unfortunately, turning off the immune system can have many consequences. I hope more studies are done on natural products for RA so patients have more options and hopefully find treatment less intimidating.

[drdr123]

While I agree with naturalpharmmm, I think it's always important to note that both conventional and natural medicines are important and that each situation is different. Immunosuppressants can work wonders for those with severe RA. It is important for the patient to be aware of the possible side effects and to stay in contact with their healthcare provider. Side effects can be managed, but communication is key.

[Herculese]

I just found out that if you have rheumatoid arthritis, you should not take anything with bisophophonates because it may contribute to serious side affects like lupus! These bisphosphonates are supposed to help with bone restoration in osteoporosis and Paget’s disease, but they are lethal to our body’s natural bone regeneration!

So I just started going the homeopathic route about 4 and 1/2 months ago and it has helped me without the side effects. It is almost impossible to find a place to buy the right nutrients without paying ridiculous prices, but I did find one that sells for way below wholesale and has given me free shipping. The site is NuvaLife. They have all the top brand names at NuvaLife, so you can check it out for yourself if you want. I can’t say the arthritis is cured, but I don’t have the daily pain and swelling anymore, just like twice a month, and plain old aspirin works for that. Good Luck =o) I will try to post if I find anyone else that offers as good of prices or deals for vitamins!