Vitamin B6 (pyridoxine) is involved in over 100 enzyme reactions in your body. It’s essential for protein metabolism, neurotransmitter production, immune function, and hemoglobin synthesis.1
Most people get enough B6 from food. But certain groups are at higher risk for deficiency:
- People with kidney disease or on dialysis
- Those with autoimmune conditions (rheumatoid arthritis, inflammatory bowel disease)
- Alcoholics
- Pregnant women (especially with hyperemesis gravidarum)
- People taking certain medications (isoniazid, penicillamine, some anti-epileptics)
- Those with vitamin B12 or folate deficiency
Low B6 status has been linked to increased risk of cardiovascular disease, cognitive decline, and certain cancers.2 Here are the warning signs to watch for.
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Available on the App Store1. Skin rashes
Seborrheic dermatitis — a red, itchy, oily rash — is a classic sign of B6 deficiency. It typically appears on the scalp, face (especially around the nose and eyebrows), neck, and upper chest.
The rash has a characteristic flaky appearance and can cause swelling or white patches. B6 is needed for healthy skin metabolism, and in deficiency cases, the rash often clears quickly once B6 levels are restored.
Some people with seborrheic dermatitis may have higher B6 requirements even without frank deficiency.
2. Cracked and sore lips
Cheilosis, which is characterized by sore, red, and swollen lips with cracked mouth corners, can result from vitamin B6 deficiency. Cracked areas may bleed and become infected.
In addition to being very painful, having cracked and sore lips can make activities like eating and talking difficult.
Clear up symptoms of vitamin B6 deficiency by consuming foods rich in the vitamin or taking a supplement.
Notably, deficiencies of riboflavin, folate, iron, and other nutrients can also cause this condition, as can sunny, dry, or windy weather and other external factors.
Summary: Sore lips with cracks in the corners of your mouth can be a sign of vitamin B6 deficiency. If that’s the case, getting enough vitamin B6 through food or a supplement could heal your lips.
3. Sore, Glossy Tongue
If you have a vitamin B6 deficiency, your tongue may become swollen, sore, smooth, inflamed, or reddened. This is called glossitis.
The glossy, smooth surface of the tongue is due to the loss of papillae. Those are the bumps on your tongue. Glossitis can cause problems chewing, swallowing, and talking.
Replenishing vitamin B6 treats glossitis provided that a deficiency is the only cause.
Deficiencies of other nutrients, including folate and B12, can also result in this condition. Consuming enough of all these vitamins may then be needed to clear up glossitis.
Summary: A swollen, inflamed, glossy-looking tongue is a sign of vitamin B6 deficiency. Shortfalls of other nutrients, particularly folate, and B12, may also contribute to the condition.
4. Mood changes
Shortfalls of vitamin B6 may affect your mood, sometimes contributing to depression, anxiety, irritability, and increased feelings of pain.
That’s because vitamin B6 is involved in making several neurotransmitters, such as serotonin and gamma-aminobutyric acid (GABA). Both serotonin and GABA help control anxiety, depression, and feelings of pain.
The role of vitamin B6 in combating such mood issues is being tested in various conditions.
For example, in about half of individuals with autism, supplementing with vitamin B6 helps decrease behavioral problems, possibly because it helps produce neurotransmitters.
Research also suggests that taking 50–80 mg of vitamin B6 supplements daily may help with premenstrual syndrome (PMS) symptoms, such as moodiness, irritability, anxiety, and depression.
Suggested read: Thiamine (Vitamin B1): Deficiency Symptoms and Treatment
Vitamin B6 may help with PMS because it helps make serotonin, which lifts your mood. Scientists are researching more to determine if women who experience PMS may actually have vitamin and mineral deficiencies.
Summary: Mood changes like irritability, anxiety, and depression can happen when you’re low in vitamin B6. That’s because vitamin B6 is needed to make nerve messengers that help control your mood.
5. Weakened immune function
A well-working immune system is critical to preventing infections, inflammation, and various cancers. Nutrient deficiencies, including vitamin B6, can disrupt the immune system.
More specifically, a deficiency in vitamin B6 can decrease the production of antibodies needed to fight infections.
A vitamin B6 deficiency may also reduce your body’s production of white blood cells, including T cells. These cells regulate immune function, helping it respond appropriately.
Additionally, vitamin B6 helps your body make a protein called interleukin-2, which helps direct the actions of white blood cells.
People with autoimmune disorders (in which the immune system turns against itself), can have increased destruction of vitamin B6, which increases the need for the vitamin.
Summary: If you don’t get enough vitamin B6, your body can’t make the antibodies, white blood cells, and other immune factors it needs to fight germs and ward off diseases.
6. Tiredness and low energy
A vitamin B6 deficiency can leave you feeling unusually tired and sluggish.
A big reason is vitamin B6’s role in helping make hemoglobin. The protein in your red blood cells helps carry oxygen throughout your body.
If your cells don’t get enough oxygen due to too little hemoglobin, it’s called anemia. That can make you feel tired and weak.
Suggested read: Iron Deficiency: Symptoms, Signs, and Causes
There have been select cases of vitamin B6-related anemia in which taking the inactive pyridoxine hydrochloride (HCl) form of the vitamin didn’t help. However, supplementing with the body’s most active form of vitamin B6, called pyridoxal 5’-phosphate (PLP), resolved the anemia.
You can buy either form of vitamin B6 as a supplement, but pyridoxine HCl is more common and generally costs less than PLP.
Besides feeling tired from anemia, vitamin B6 deficiency could also potentially contribute to tiredness due to its role in making the sleep-promoting hormone melatonin.
Summary: Vitamin B6 is needed to help make the red blood cells that transport oxygen throughout your body and help you feel energized.
7. Tingling and pain in hands and feet
A deficiency of vitamin B6 can cause nerve damage called peripheral neuropathy.
Symptoms may include burning, shooting, and tingling pain in your arms, legs, hands, and feet. Some describe it as a “pins and needles” feeling.
The nerve damage may also result in clumsiness, balance problems, and difficulty walking.
Additionally, continually taking too much of the inactive form of vitamin B6 (pyridoxine HCl) from supplements can also cause neuropathy. This may happen because large amounts of inactive vitamin B6 can compete with and block the active PLP form of B6 in your body.
Nerve problems from vitamin B6 deficiency are reversible with adequate vitamin B6 intake. On the other hand, nerve problems from vitamin B6 toxicity may be more challenging to treat.
Summary: Burning, shooting pains in your limbs, hands, and feet can be caused by nerve damage from vitamin B6 deficiency or overdose.
8. Seizures
Seizures happen for different reasons, including vitamin B6 deficiency.
Without enough vitamin B6, you don’t make adequate amounts of the calming neurotransmitter GABA, so your brain may become overstimulated.
Seizures can cause symptoms such as muscle spasms, rolling eyes, and jerky arms or legs. Sometimes people have rapid, uncontrollable shaking (convulsions) or lose consciousness.
A deficiency of vitamin B6 is well-known to cause seizures in newborns. The first cases were noted in the 1950s when babies were fed infant formula with insufficient vitamin B6.
More recently, seizures due to vitamin B6 deficiency have been reported in adults. These cases were most commonly found in pregnancy, alcoholism, medication interactions, or liver disease.
Suggested read: 8 Signs and Symptoms You’re Deficient in Vitamins
Correcting vitamin B6 deficiency has proven very successful in treating related seizures.
Summary: Seizures are an uncommon but possible result of vitamin B6 deficiency. This is more frequently seen in infants but has also happened in adults.
9. High homocysteine
Homocysteine is a byproduct created during protein digestion.
A vitamin B6 deficiency, as well as folate and B12, can result in an abnormally high blood level of homocysteine, as these B vitamins are needed to help process homocysteine.
Increased homocysteine levels have been linked with several health issues, most notably heart disease, stroke, and Alzheimer’s disease. When homocysteine is elevated, it can damage blood vessels and nerves.
Fortunately, your homocysteine level can be checked with a simple blood test. Generally, elevated homocysteine can be lowered by taking vitamin B6, B12, and folate supplements.
Remember that other factors, such as your eating habits and physical activity, are also typically involved in diseases linked with high homocysteine and must be addressed.
Summary: A deficiency of vitamin B6, as well as folate and B12, may cause a high homocysteine level, which can damage blood vessels and nerves and increase the risk of disease.
Foods high in vitamin B6
Your body can’t store large amounts of B6, so you need regular intake. The good news: it’s widely available in both animal and plant foods.
The recommended daily amount is 1.3–1.7 mg for adults (higher during pregnancy and breastfeeding).
Best food sources:
| Food | Serving | % Daily Value |
|---|---|---|
| Turkey breast, roasted | 3 oz (85 g) | 40% |
| Pork loin, roasted | 3 oz (85 g) | 33% |
| Salmon, cooked | 3 oz (85 g) | 24% |
| Chicken breast, cooked | 3 oz (85 g) | 26% |
| Banana | 1 medium | 22% |
| Baked potato with skin | 1 small | 21% |
| Pistachios | 1 oz (28 g) | 19% |
| Sunflower seeds | 1 oz (28 g) | 11% |
| Avocado | 1/2 fruit | 11% |
| Lentils, cooked | 1/2 cup | 10% |
Animal sources and fortified foods provide B6 in forms that are more bioavailable than plant sources. If you eat only plant foods, you may need to consume more to meet your needs.
Suggested read: B-complex Vitamins: Benefits, Side Effects & Dosage Guide
The bottom line
Vitamin B6 deficiency is relatively uncommon in people eating a varied diet, but certain groups are at higher risk.
Watch for these warning signs: skin rashes (especially seborrheic dermatitis), cracked lips, glossy tongue, mood changes, weakened immunity, fatigue, nerve tingling, and — in severe cases — seizures.
If you suspect deficiency, a blood test can check your B6 levels (pyridoxal 5’-phosphate is the most accurate marker). Treatment typically involves dietary changes or supplementation, depending on the underlying cause.
For most people, eating a balanced diet rich in poultry, fish, potatoes, bananas, and fortified cereals provides adequate B6.
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