B6 and Nausea

Written by: Bianca Fontaine, McGill Faculty of Medicine

B6 also known as pyridoxine is a water soluble vitamin and essential coenzyme for the metabolism of macromolecules (amino acids, lipids and carbohydrates). B6 is known for its antiemetic property[1]. Vitamin B6 is the first line medication recommended by the American College of Obstetricians and Gynecologists for the treatment of nausea and vomiting in pregnancy.

It is commonly prescribed for nausea and vomiting in pregnancy on its own or in combination with doxylamine (an antihistamine). Many studies have shown that the anti-nausea effect of B6 is independent to that of doxylamine and may be used on its own to get the benefits without the side effects of antihistamines [9]. Dosages of 10-40 mg/day of B6 supplementations have been shown to reduce the severity of nausea and vomiting in pregnancy (doses up to 500 mg/day can be used without any increased chances of maternal or fetal adverse effects)[2]. Vitamin B6 deficiency during pregnancy may contribute to complications such as pre-eclampsia, aggravation of gingivitis, dental decay and some types of anaemia[3]. Supplementation may help reduce these risks. In addition, a meta-analysis demonstrated that B6 supplementation during pregnancy was associated with significant positive effects on birthweight [4].

In addition, B6 has been shown to be effective in combating chemo-induced nausea and vomiting (CINV) by reducing the severity of nausea and the frequency of vomiting in both pediatric and adult population [5]. B6 may be used in chemotherapy patients to get the anti-vomit benefits while eliminating the common side effects of pharmaceutical drugs [6]. B6 has thus been shown to be a non-invasive, safe, inexpensive and less complicated alternative to the conventional antiemetic medications [7].

Additionally, Vitamin B6 is often prescribed by general practitioners to alleviate premenstrual syndrome (PMS) symptoms [8]. It has been shown to alleviate both physical and psychological symptoms of PMS[9].Studies have found it to be specifically effective in reducing premenstrual depression [10].

Written by: Bianca Fontaine, McGill Faculty of Medicine 

[1] Ebrahimi N, Maltepe C, Einarson A. Optimal management of nausea and vomiting of pregnancy. Int J Womens Health. 2010;2:241-248. Published 2010 Aug 4. doi:10.2147/ijwh.s6794

[2] Matok I, Clark S, Caritis S, et al. Studying the antiemetic effect of vitamin B6 for morning sickness: pyridoxine and pyridoxal are prodrugs. J Clin Pharmacol. 2014;54(12):1429-1433. doi:10.1002/jcph.369

[3] Ebrahimi N, Maltepe C, Einarson A. Optimal management of nausea and vomiting of pregnancy. Int J Womens Health. 2010;2:241-248. Published 2010 Aug 4. doi:10.2147/ijwh.s6794

[4] Dror DK, Allen LH. Interventions with vitamins B6, B12 and C in pregnancy. Paediatr Perinat Epidemiol. 2012;26 Suppl 1:55-74. doi:10.1111/j.1365-3016.2012.01277.x

[5] Dror DK, Allen LH. Interventions with vitamins B6, B12 and C in pregnancy. Paediatr Perinat Epidemiol. 2012;26 Suppl 1:55-74. doi:10.1111/j.1365-3016.2012.01277.x

[6] Mousavi_hasanzadeh M, Adelnia A, Farokhmehr G, Mehrabi S, Zahedi S, Eghbali A et al . The effect of Vitamin B6 on chemotherapy induced nausea and vomiting in pediatric cancer. Iran J Ped Hematol Oncol. 2020; 10 (1) :1-9
URL: http://ijpho.ssu.ac.ir/article-1-476-en.html

[7] Mousavi_hasanzadeh M, Adelnia A, Farokhmehr G, Mehrabi S, Zahedi S, Eghbali A et al . The effect of Vitamin B6 on chemotherapy induced nausea and vomiting in pediatric cancer. Iran J Ped Hematol Oncol. 2020; 10 (1) :1-9
URL: http://ijpho.ssu.ac.ir/article-1-476-en.html

[8] Mousavi_hasanzadeh M, Adelnia A, Farokhmehr G, Mehrabi S, Zahedi S, Eghbali A et al . The effect of Vitamin B6 on chemotherapy induced nausea and vomiting in pediatric cancer. Iran J Ped Hematol Oncol. 2020; 10 (1) :1-9
URL: http://ijpho.ssu.ac.ir/article-1-476-en.html

[9] Soheila, S. & Faezeh, K. & Sayehmiri, Kourosh & Fatemeh, S. & Nasrollah, Nazanin & Mahin, G. & Asadi-Samani, M. & Bahmani, Mahmoud. (2016). Effects of vitamin B6 on premenstrual syndrome: A systematic review and meta-Analysis. 9. 1346-1353.

[10] Soheila, S. & Faezeh, K. & Sayehmiri, Kourosh & Fatemeh, S. & Nasrollah, Nazanin & Mahin, G. & Asadi-Samani, M. & Bahmani, Mahmoud. (2016). Effects of vitamin B6 on premenstrual syndrome: A systematic review and meta-Analysis. 9. 1346-1353.

[11] Wyatt KM, Dimmock PW, Jones PW, Shaughn O'Brien PM. Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: systematic review. BMJ. 1999;318(7195):1375-1381. doi:10.1136/bmj.318.7195.1375