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Vitamin B6, Pyridoxine


Pyridoxine

Metabolism
Pyridoxine is absorbed in the upper small intestine by simple diffusion. Greater absorption occurs with more acidic environments.

Biochemistry

The active form is pyridoxine phosphate, PyrP, which is cofactor for:
L-DOPA -> Dopamine (note: Dopamine -> NE -> EPI)
tryptophan -> niacin (several steps)
linoleic acid -> gamma linoleic acid (note: GLA -> DHGLA -> PGE-1)
homocysteine -> Cystathione-> Cysteine (both steps)
histidine -> histamine
Succinyl CoA -> 2 Amino 3 Keto Adipate (forms Heme)
5-HTP -> Serotonin

Functions
transamination - transfer NH2 to amino acids
deamination, desulfuration, decarboxylation
promotes release of glycogen from liver and muscle as glucose-1P
vital for the formation of sphyngolipids involved in myelin sheaths
involved in the synthesis of intrinsic factor

Requirements
RDA - 2-2.2 mg, pregnancy - 6 mg, lactation - .5 mg
Optimal - men - 35 mg, women - 50 mg
Requirement increased in pregnancy and with estrogen use.
Estrogens may inhibit pyridoxal phosphate in tryptophan metabolism.

Labs
tryptophan load test
Erythrocyte Glutamate Oxaloacetic Transaminase Test

Sources
bran

Toxicity
controversial
contraindicated with L-Dopa treatment for Parkinson's
but not with Cinemet (L-Dopa with carbo-Dopa)
Inhibitors
hydrazines (Nardil), Isoniazid, theophylin, BCPs, hydralazine
tartrazine (yellow dye #5), tobacco smoke, some pesticides

Test
bend the fingers at the PIP joint while keeping the DIP joints straight

Genetics
people with homocysteinuria develop significant atherosclerosis
and severe osteoporosis by age 20


Deficiency
Gastroenterology
nausea and vomiting
Dermatology
mucus membrane lesions, seborrheic dermatitis
Neurology
peripheral neuritis, grand mal seizures
Psychology
depression


Therapeutics
Respiratory
asthma - phosphodiesterase inhibitor (similar to theophylin)
Liver
MSG sensitivity - cofactor for glutamate -> 2-Keto glutarate
Urology
kidney stones - cofactor for oxaloacetate -> aspartate
Hematology
anemia - cofactor for Succinyl CoA-> Heme
Neurology
tardive dyskinesia
pyridoxine dependant epilepsy - siezures up to 18 months of age
depression, dementia, schizophrenia, ADD - 5-HTP -> Serotonin
Musculoskeletal
carpal tunnel syndrome, rheumatism
Endocrinology
diabetic neuropathy - prevents tissue glycosylation
Dermatology
acne - phosphodiesterase inhibitor
seborrheic dermatitis - topically, usually gets worse short-term
Immunology
lupus - drugs that induce lupus also inhibit B6, 500 mg qd
Gynecology
PMS
Obstetrics
nausea of pregnancy, toxemia of pregnancy
gestational diabetes - high estrogen impairs tryptophan pathways
which promotes xanthurenic acid production which binds to insulin
Psychology
autism - large doses reduce difficult behavior patterns

 

 

 

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