The Low B6 Diet Is Not Effective for B6 Toxicity
Hello all,
Dr. Malek here. Because I’m aware that this article has the potential to be highly inflammatory, I have to caveat as follows:
I have directly treated more B6 toxic patients than nearly any other doctor/provider in the world.
I am an allopathic MD, i.e. a “normal” doctor. I’m not a chiropractor (though I respect what they do!) nor an ND, NP, healthfluencer, or anything else.
Though I’m a “normal” doctor, I don’t work through the (truly bankrupt) insurance-pharmaceutical paradigm, nor did I get the COVID vaccine (i.e. I’m not that “normal”).
I do love and respect the low/RDA B6 diet approach, and I think it has helped a lot of people. But it’s not the right thing for most.
I’m writing this article after about one year of a tremendous increase in the number of patients I’ve treated with B6 toxicity and seeing with my own eyes exactly what works and what doesn’t.
If you want to get an idea of my approach to B6 toxicity, join Roadmaps to Health and then join my private Facebook group where I’ll be interacting directly with you all on this stuff.
The following is not coming from a vacuum. Nor is it theoretical. Nor is it a lazy concoction of ChatGPT made in pursuit of “likes” and engagement.
I’m making the following conclusions based on my direct clinical experience with patients I know and now love. And my goal is to see every one of them get better as quickly and as thoroughly as possible.
By far the most common question I have gotten from my B6 toxic patients is whether they need to stay on a low B6 diet (and usually it’s asked with an air of anxiety, i.e. “Do I really have to do that?”).
And, to their general shock, I usually tell them no, because the low B6 diet is simply not the right approach for 99% of people with B6 toxicity.
The reasoning behind the low B6 diet is of course simple and admittedly reasonable:
You have accumulated too much B6 due to excess supplementation (or even excess dietary B6), and consequently the only solution is for you to stop the influx of B6 into your system to below a sufficient threshold such that it can slowly be “flushed out of your system.” And the threshold set here is usually the RDA of B6; i.e. don’t consume more than ~1.5 mg of B5 per day,
But this approach only works if excess B6 is itself the fundamental cause of the issue.
And this is where my approach diverges sharply from both the “normal doctor” approach and the mainstream internet approach.
The “normal doctor” approach to B6 toxicity
Firstly, the “normal doctor” approach is generally either:
Total lack of awareness that B6 toxicity is a thing, or
To see B6 toxicity as a diagnosis of exclusion and simply prescribe cessation of B6 supplementation.
In other words: You don’t have anything else that could be causing these symptoms; therefore it could be that you’re taking too much B6, so simply stop B6 supplementation.
This works sub-optimally and generally takes a very long time.
The mainstream internet approach to B6 toxicity
On the other hand, the “mainstream internet approach” exemplified by several popular Facebook groups and YouTube videos is essentially:
Stop all B6 supplementation
Hydrate thoroughly and religiously avoid all dehydrating events
Exercise etc. to facilitate removal
Maximize electrolyte consumption
Avoid vasodilators
and pursue a low B6 diet.
I recognize that this approach has worked for some people as well—but again, generally only when maintained over a very long period of time.
The low B6 diet does not work better than simply stopping B6 supplementation.
Even further (and quite controversially, truthfully) I do not believe that we have sufficient evidence to suggest that this approach works faster than simply stopping B6 supplementation, as implemented by the “normal” doctors, above.
My clinical experience with B6 toxicity in my own real, live patients has shown me that the low B6 diet does not work better than simply stopping B6 supplementation. Both approaches are faulty.
And that is because they both view excess B6 as the fundamental cause of B6 toxicity, which is generally not the case.
Note: Importantly, I am not doing the classical “alternative medicine doc” move here, which is to claim that the B6 is not getting into your cells, and therefore you need to take active B6 in the form of P5P, case closed. That doesn’t work, generally.
On the contrary, the fundamental cause of B6 is generally an adjacent biochemical process.
That should be read twice.
In other words, B6 toxicity is usually caused by something else working in parallel to B6-dependent pathways. And that “something else” is itself susceptible to toxic inhibition and deficiency, whether nutritional or genetic!!
Do you see the glaring issue here?
The issue, very simply, is that the Low B6 Diet (even at RDA) has the very strong potential to worsen those adjacent pathways—those adjacent pathways that are fundamentally causative of B6.
That is to say:
The Low B6 Diet runs directly counter to the mechanisms for healing from B6 toxicity.
And because of that, it actually has the potential to be even less effective than simply stopping B6 supplementation as advised by the “normal” docs!
We’re therefore stuck between the very, very slow approach of simple B6 cessation and the potentially counterproductive approach of RDA or Low B6 dieting.
This is an enormous pitfall and a stark demonstration of just how lacking our modern medical paradigm is—because B6 toxicity is incredibly common: I estimate that it afflicts hundreds of thousands! And those hundreds of thousands are being advised with that which is either counterproductive or severely underpowered.
I DO NOT advise Low (or RDA) B6 dieting to my patients (and, of course, this is not advice to you, reader, because you’re not legally my patient). And I strongly advise those patients to pursue more personalized measures than the aforementioned broad-brush approach.
I am working on two new things in the area of B6 toxicity right now:
A B6 Toxicity-dedicated section of my Roadmaps to Health platform. This is an online platform + (new) private Facebook group where I can interact with a bunch of you directly and (educationally) help steer you in the right direction. JOIN ROADMAPS TO HEALTH HERE
A B6 Toxicity Group session within the next 1-2 weeks for about 15-20 people. This will go for a couple hours over live video and be built directly on your questions, interactions, and data. This will be around $299/person as opposed to my usual one-on-one consults. If you’re interested, email me soon.
This is my life’s work and my living. I appreciate your support.
Again, you can also send me an email at admin@malekmd.com.
EVERYTHING in this article is purely educational and informational in nature. None of this is medical advice. Make no health changes based on this article. I am not your doctor. Discuss any and all implementations with your own doctor.
