The Influence of Pyridoxine in Diabetic Peripheral Neuropathy

Abstract

To determine the role of pyridoxine in the treatment of diabetic peripheral neuropathy, 18 symptomatic diabetic patients were treated with vitamin B6 or placebo in a double-blind controlled study. Only one patient had a low plasma pyridoxal phosphate level at the start of the study. After 4 mo of treatment with pyridoxine hydrochloride (50 mg three times daily) 6 of 9 pyridoxine-treated and 4 of 9 placebo-treated patients noted significant relief from their neuropathic symptoms. There was no difference between the two groups with regard to fasting plasma glucose, motor nerve conduction velocity, or ophthalmologic examination at the beginning or at the conclusion of the study. Our results suggest that vitamin B6 deficiency is not a factor in the etiology of diabetic peripheral neuropathy. Furthermore, treating diabetic peripheral neuropathy with high dose vitamin B6 or placebo results in a similar frequency of symptomatic improvement.

Advanced glycation endproducts: what is their relevance to diabetic complications?

“…Pyridoxine supplementation (120 mg/day) to normal control and diabetic subjects deficient in PLP decreased total cholesterol and LDL concentrations [104]. In a study comparing thiamine (20 mg/day) and pyridoxine (50 mg/day) in diabetic patients with polyneuropathy, thiamine supplementation was fivefold more effective than pyridoxine [105]; other reports claimed pyridoxine was not effective against diabetic neuropathy [106–108]. The effects of PM in diabetes are probably multiple and linked to prevention of AGE formation, mitochondrial damage [100] and dyslipidaemia by carbonyl scavenging and PLP supplementation [104].…”

Non-nutritional uses of vitamin B6

“…Supplements of vitamin B 6 ranging from 25 to 500 mg/d have been recommended for treatment of a variety of conditions, discussed later, in which there is an underlying physiological or biochemical mechanism to justify the use of supplements, although in most cases there is little evidence of efficacy. It has also been used empirically, with little or no evidence of efficacy, in the treatment of a variety of conditions, including: acute alcohol intoxication (Mardel et al 1994), atopic dermatitis (Mabin et al 1995), autism (Rimland et al 1978;Rimland, 1988;Lelord et al 1982;Pfeiffer et al 1995;Findling et al 1997), dental caries (Hillman, 1964), diabetic peripheral neuropathy (Levin et al 1981;Cohen et al 1984), Down's syndrome (Pueschel et al 1980;Coleman et al 1985), Huntington's chorea (Barr et al 1978), schizophrenia (Bucci, 1973), and steroiddependent asthma (Sur et al 1993).…”

Natural products for the management of type 2 diabetes mellitus and comorbid conditions

“…Efficacy: Pyridoxine may have a role in the treatment of diabetic neuropathy. 38,[78][79][80] In combination with thiamine 25 mg daily, pyridoxine 50 mg may reduce the severity of symptoms in patients with diabetic neuropathy. 38,78 Abbas et al 80 assessed the effect of pyridoxine 50 mg and thiamine 25 mg daily in patients with diabetes.…”