Vitamin B6 Deficiency: Signs and Symptoms - Health.com

Vitamin B6, or pyridoxine, plays an important role in many of your body's most essential functions, such as producing antibodies to fight off infection, regulating blood sugar, and helping your brain and nervous system work effectively. 

If your vitamin B6 levels get dangerously low, you may experience symptoms of vitamin B6 deficiency. Signs of vitamin B6 deficiency may include mood changes, sores on the mouth and tongue, skin lesions, peripheral neuropathy, anemia, and loss of muscle control.

Vitamin B6 deficiency is common, affecting an estimated 10% of Americans. However, some people with minimal deficiency will not experience symptoms. People who have a greater deficiency due to malnutrition or a condition causing malabsorption are more likely to experience symptoms.

Low vitamin B6 levels are associated with several mood changes and mental health symptoms. Examples include confusion, brain fog, irritability, anxiety, and depression. 

Research suggests that people who take vitamin B6 supplements may have lower levels of anxiety and depression. This may be because of the effects of vitamin B6 on the nervous system, which helps the body regulate stress and tension.

Vitamin B6 deficiency often leads to problems with the mouth and tongue. People with extremely low levels of vitamin B6 may have mouth sores, cheilitis (cracked lips), and dryness around the mouth. Some people may experience glossitis (inflammation of the tongue) and a painful, sore tongue.

Low vitamin B6 levels can cause a skin condition known as seborrheic dermatitis. Symptoms include red, scaly, flaky, or greasy skin rashes that often affect the back, face, or scalp. The skin may also slough off (shed) or appear irritated. Researchers believe this is due to inflammation, which is often caused by B vitamin deficiencies.

Vitamin B6 plays a significant role in the production of hemoglobin—a protein that helps provide oxygen to the body's tissues through the blood. A serious vitamin B6 deficiency can lead to a type of anemia known as microcytic anemia, which involves unusually small red blood cells.

Potential symptoms of anemia include fatigue, shortness of breath, difficulty concentrating, weakness, headache, appetite loss, dizziness, and rapid heart rate, among others.

Because of the role of vitamin B6 in protecting nerve function, a vitamin B6 deficiency may cause nerve damage if left untreated. One possible outcome is peripheral neuropathy, a condition related to damaged nerves in the arms, hands, and feet.

People with peripheral neuropathy may experience pins and needles sensations—such as tingling and prickling—in the extremities, as well as lowered reflexes, numbness, muscle weakness, and pain.

In severe cases, vitamin B6 deficiency can cause ataxia—a loss of muscle control. Signs of ataxia include problems with balance and coordination, clumsiness, difficulty walking, and slurred speech. This is often related to peripheral neuropathy that affects the extremities.

The signs of vitamin B6 deficiency may be somewhat different in babies and young children. Infants who have vitamin B6 deficiency may exhibit the following symptoms:

• Irritability and excessive crying
• Seizures
• Particularly sensitive, acute hearing

You should contact a healthcare provider if you experience any of the above symptoms on a persistent basis. They can perform a physical examination, review your medical history, and test your B6 levels through a serum (blood) test. 

Vitamin B6 is naturally found in foods like legumes (especially chickpeas), beef liver, poultry, and fish. Your provider might recommend that you get more B6 through dietary changes or in supplements—whether as a pyridoxine supplement on its own, in a B-complex supplement, or in a multivitamin. 

You may be particularly at risk of vitamin B6 deficiency if you have:

• Kidney disease
• Liver disease
• An autoimmune disorder, such as rheumatoid arthritis
• A digestive disorder that affects your capacity to absorb nutrients from food, such as Crohn's disease 
• Alcohol use disorder (AUD)
• Obesity
• Other vitamin B deficiencies

If your vitamin B6 deficiency is related to any of the above conditions, your provider may recommend treating the underlying disorder to resolve your symptoms.

A deficiency in vitamin B6 can lead to mental health symptoms like depression, irritability, and brain fog. It can also cause sores, cracks, and swelling on the mouth or tongue, as well as skin rashes and lesions. Other potential symptoms of vitamin B6 deficiency include anemia, peripheral neuropathy (nerve damage), and ataxia (loss of muscle control). In infants, it can also cause seizures and hearing changes. 

If you think you may have a vitamin B6 deficiency, contact your healthcare provider. They can test your vitamin B6 levels and prescribe supplements if needed.