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Pyridoxine Deficiency Follow-up

  • Author: Richard E Frye, MD, PhD; Chief Editor: George T Griffing, MD  more...
Updated: Jan 15, 2014


Prophylactic administration of pyridoxine should be provided when a patient is using certain medications, such as isoniazid (30-450 mg/d, which may be based gram for gram) and penicillamine (100 mg/d).

Estrogen-induced reduction in tryptophan metabolism may require supplementation of 20-25 mg/d.



Care should be taken when supplementing pyridoxine, because high pyridoxine states can cause a neuropathy characterized by ataxia and burning pain in the feet, beginning approximately 1 month to 3 years following supplementation. Although this usually occurs at very high supplementation doses, complications have been reported with doses as low as 50 mg/d.

Care should be taken when prescribing pyridoxine supplementation to postpartum women who are breastfeeding, because high doses of pyridoxine can cause hypolacticemia.

Injecting pyridoxine into an infant or neonate can cause a precipitous decrease in blood pressure.

Pyridoxine has the highest adverse outcome per toxic exposure for any vitamin, although no deaths have been reported.

Contributor Information and Disclosures

Richard E Frye, MD, PhD Associate Professor of Pediatrics, University of Arkansas for Medical Sciences College of Medicine; Director of Autism Research, Child and Behavioral Neurologist, Arkansas Children's Hospital Research Institute

Richard E Frye, MD, PhD is a member of the following medical societies: American Academy of Neurology, American Academy of Pediatrics, Child Neurology Society, International Neuropsychological Society

Disclosure: Nothing to disclose.


Serge A Jabbour, MD, FACP, FACE Professor of Medicine, Division of Endocrinology, Diabetes and Metabolic Diseases, Jefferson Medical College of Thomas Jefferson University

Serge A Jabbour, MD, FACP, FACE is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Physicians-American Society of Internal Medicine, American Diabetes Association, American Medical Association, American Thyroid Association, Endocrine Society, Pennsylvania Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

George T Griffing, MD Professor Emeritus of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, International Society for Clinical Densitometry, Southern Society for Clinical Investigation, American College of Medical Practice Executives, American Association for Physician Leadership, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society

Disclosure: Nothing to disclose.

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