Update on Safety Profiles of Vitamins B1, B6, and B12: A Narrative Review

Calderón-Ospina, Carlos-Alberto; Nava-Mesa, Mauricio O.; Paez-Hurtado, Ana María

doi:10.2147/tcrm.s274122

Cited by 25 publications

(24 citation statements)

References 86 publications

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“…Due to the inconsistent curative effect and considering the adverse effect of high-dose vitamin B6, few studies were conducted to evaluate the potential efficacy. However, vitamin B6 is supposed that it works by promoting dopamine production and then activates dopamine receptors to reduce the secretion of pituitary prolactin [ 51 ], and the side-effects of high-dose vitamin B6 are fewer than expected [ 52 ], re-attempts of it are conducted recently and the results indicated that it could improve the AP-induced HPRL with few side-effects [ 30 , 53 ]. In our study, the results of NMA showed that this option might be a very effective method for the patients with AP-induced HPRL and provide a moderate certainly evidence.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological treatment strategies for antipsychotic-induced hyperprolactinemia: a systematic review and network meta-analysis

Sun

Zhang

et al. 2022

Transl Psychiatry

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Antipsychotic-induced hyperprolactinemia (AP-induced HPRL) occurs overall in up to 70% of patients with schizophrenia, which is associated with hypogonadism and sexual dysfunction. We summarized the latest evidence for the benefits of prolactin-lowering drugs. We performed network meta-analyses to summarize the evidence and applied Grading of Recommendations Assessment, Development, and Evaluation frameworks (GRADE) to rate the certainty of evidence, categorize interventions, and present the findings. The search identified 3,022 citations, 31 studies of which with 1999 participants were included in network meta-analysis. All options were not significantly better than placebo among patients with prolactin (PRL) less than 50 ng/ml. However, adjunctive aripiprazole (ARI) (5 mg: MD = −64.26, 95% CI = −87.00 to −41.37; 10 mg: MD = −59.81, 95% CI = −90.10 to −29.76; more than 10 mg: MD = −68.01, 95% CI = −97.12 to −39.72), switching to ARI in titration (MD = −74.80, 95% CI = −134.22 to −15.99) and adjunctive vitamin B6 (MD = −91.84, 95% CI = −165.31 to −17.74) were associated with significant decrease in AP-induced PRL among patients with PRL more than 50 ng/ml with moderated (adjunctive vitamin B6) to high (adjunctive ARI) certainty of evidence. Pharmacological treatment strategies for AP-induced HPRL depends on initial PRL level. No effective strategy was found for patients with AP-induced HPRL less than 50 ng/ml, while adjunctive ARI, switching to ARI in titration and adjunctive high-dose vitamin B6 showed better PRL decrease effect on AP-induced HPRL more than 50 ng/ml.

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Section: Discussionmentioning

confidence: 99%

Pharmacological treatment strategies for antipsychotic-induced hyperprolactinemia: a systematic review and network meta-analysis

Sun

Zhang

et al. 2022

Transl Psychiatry

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“…study design (prospective cohort study) and self-reporting by participants. Combined with the other studies reviewed, this led the authors to advise against changing intake recommendations for vitamin B6 (Calderon-Ospina et al, 2020). No newer studies have been identified to further clarify the association between a high intake of vitamin B6 and the risk of hip fracture.…”

Section: Risk Of Hip Fracturementioning

confidence: 99%

Preparatory work for the update of the tolerable upper intake levels for vitamin B6

Tetens

Petersen

Christensen

et al. 2023

EFSA Supporting Publications

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To support EFSA in the preparatory work for the assessment of Tolerable Upper Intake Levels (UL) for vitamin B6, a tailored ‘high level’ protocol was developed, based on a template protocol and taking into account the specificities of vitamin B6. This protocol outlined the methods, the relevant endpoints and priority adverse health effects in relation to high intakes of vitamin B6. Systematic reviews (SR) were conducted following a tailored literature search, data extraction, evidence appraisal (i.e. risk of bias (RoB) assessment) and evidence synthesis. Narrative reviews (NR) were conducted to gather contextual evidence relevant to the interpretation of the main body of evidence. In the SR on the dose‐response relationship between vitamin B6 and peripheral neuropathy, 3793 records were identified and reduced to 32 individual records after screening for eligibility. The evidence appraisal revealed an overall moderate to high RoB of the individual studies and an overall rating of the total body of evidence as very low due mainly due to the type of data from case studies/case reports and limited number of other data. The available evidence confirmed a high degree of inter‐individual variability to sensitivity to a high exposure of vitamin B6 in relation to development of peripheral neuropathic outcomes but did not allow to determine a No Observed Adverse Effect Level or Lowest Observed Adverse Effect Level. In the SR on developmental toxicity, 4941 records were identified and reduced to 23 individual records including human and animal studies after screening for eligibility. The available data demonstrated a high degree of heterogeneity with respect to exposure and adverse health outcomes and overall, showed no positive or causal relationship between vitamin B6 intake and adverse developmental effects, including congenital defects. The NRs showed a paucity of data on high intake of vitamin B6 vitamers and their metabolism.

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“…Given the frequency of deficiency, vitamin B supplementation is likely to be beneficial. As vitamin B is water soluble, long-term supplementation, even at high doses, is considered safe [ 134 ].…”

Section: Nutritional Therapy For Aldmentioning

confidence: 99%

Nutritional Support for Alcoholic Liver Disease

et al. 2023

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Malnutrition is a common finding in alcohol use disorders and is associated with the prognosis of patients with alcoholic liver disease (ALD). These patients also frequently show deficiencies in vitamins and trace elements, increasing the likelihood of anemia and altered cognitive status. The etiology of malnutrition in ALD patients is multifactorial and complex and includes inadequate dietary intake, abnormal absorption and digestion, increased skeletal and visceral protein catabolism, and abnormal interactions between ethanol and lipid metabolism. Most nutritional measures derive from general chronic liver disease recommendations. Recently, many patients with ALD have been diagnosed with metabolic syndrome, which requires individualized treatment via nutritional therapy to avoid overnutrition. As ALD progresses to cirrhosis, it is frequently complicated by protein–energy malnutrition and sarcopenia. Nutritional therapy is also important in the management of ascites and hepatic encephalopathy as liver failure progresses. The purpose of the review is to summarize important nutritional therapies for the treatment of ALD.

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Update on Safety Profiles of Vitamins B1, B6, and B12: A Narrative Review

Cited by 25 publications

References 86 publications

Pharmacological treatment strategies for antipsychotic-induced hyperprolactinemia: a systematic review and network meta-analysis

Pharmacological treatment strategies for antipsychotic-induced hyperprolactinemia: a systematic review and network meta-analysis

Preparatory work for the update of the tolerable upper intake levels for vitamin B6

Nutritional Support for Alcoholic Liver Disease

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