Signs and Symptoms of Vitamin B6 Deficiency

Medically reviewed by Suzanne Fisher, RD

Vitamin B6, or pyridoxine, plays an important role in many of your body’s most essential functions, such as producing antibodies to fight off infection, regulating blood sugar, and helping your brain and nervous system work effectively.

If your vitamin B6 levels get dangerously low, you may experience symptoms of vitamin B6 deficiency. Signs of vitamin B6 deficiency may include mood changes, sores on the mouth and tongue, skin lesions, peripheral neuropathy, anemia, and loss of muscle control.

Vitamin B6 deficiency is common, affecting an estimated 10% of Americans. However, some people with minimal deficiency will not experience symptoms. People who have a greater deficiency due to malnutrition or a condition causing malabsorption are more likely to experience symptoms.

Mood Changes

Low vitamin B6 levels are associated with several mood changes and mental health symptoms. Examples include confusion, brain fog, irritability, anxiety, and depression.

Research suggests that people who take vitamin B6 supplements may have lower levels of anxiety and depression. This may be because of the effects of vitamin B6 on the nervous system, which helps the body regulate stress and tension.

Mouth and Tongue Changes

Vitamin B6 deficiency often leads to problems with the mouth and tongue. People with extremely low levels of vitamin B6 may have mouth sores, cheilitis (cracked lips), and dryness around the mouth. Some people may experience glossitis (inflammation of the tongue) and a painful, sore tongue.

Skin Rashes

Low vitamin B6 levels can cause a skin condition known as seborrheic dermatitis. Symptoms include red, scaly, flaky, or greasy skin rashes that often affect the back, face, or scalp. The skin may also slough off (shed) or appear irritated. Researchers believe this is due to inflammation, which is often caused by B vitamin deficiencies.

Anemia

Vitamin B6 plays a significant role in the production of hemoglobin—a protein that helps provide oxygen to the body’s tissues through the blood. A serious vitamin B6 deficiency can lead to a type of anemia known as microcytic anemia, which involves unusually small red blood cells.

Potential symptoms of anemia include fatigue, shortness of breath, difficulty concentrating, weakness, headache, appetite loss, dizziness, and rapid heart rate, among others.

Peripheral Neuropathy

Because of the role of vitamin B6 in protecting nerve function, a vitamin B6 deficiency may cause nerve damage if left untreated. One possible outcome is peripheral neuropathy, a condition related to damaged nerves in the arms, hands, and feet.

People with peripheral neuropathy may experience pins and needles sensations—such as tingling and prickling—in the extremities, as well as lowered reflexes, numbness, muscle weakness, and pain.

Ataxia

In severe cases, vitamin B6 deficiency can cause ataxia—a loss of muscle control. Signs of ataxia include problems with balance and coordination, clumsiness, difficulty walking, and slurred speech. This is often related to peripheral neuropathy that affects the extremities.

Symptoms in Children

The signs of vitamin B6 deficiency may be somewhat different in babies and young children. Infants who have vitamin B6 deficiency may exhibit the following symptoms:

• Irritability and excessive crying

• Seizures

• Particularly sensitive, acute hearing

When to Contact a Healthcare Provider

You should contact a healthcare provider if you experience any of the above symptoms on a persistent basis. They can perform a physical examination, review your medical history, and test your B6 levels through a serum (blood) test.

Vitamin B6 is naturally found in foods like legumes (especially chickpeas), beef liver, poultry, and fish. Your provider might recommend that you get more B6 through dietary changes or in supplements—whether as a pyridoxine supplement on its own, in a B-complex supplement, or in a multivitamin.

You may be particularly at risk of vitamin B6 deficiency if you have:

• Kidney disease

• Liver disease

• An autoimmune disorder, such as rheumatoid arthritis

• A digestive disorder that affects your capacity to absorb nutrients from food, such as Crohn’s disease

• Alcohol use disorder (AUD)

• Obesity

• Other vitamin B deficiencies

If your vitamin B6 deficiency is related to any of the above conditions, your provider may recommend treating the underlying disorder to resolve your symptoms.

Questions to Ask Your Provider

If you think you may have a vitamin B6 deficiency, consider asking your healthcare provider the following questions:

• What are the possible complications of a vitamin B deficiency?

• What could put me at a higher risk of developing a vitamin B deficiency?

• How can I get more vitamin B6 from my diet?

• Are there other possible reasons for my symptoms?

• What are the potential side effects of vitamin B6 supplements?

• Can other medications interact with vitamin B6 supplements?

• How often should I follow up with you?

A Quick Review

A deficiency in vitamin B6 can lead to mental health symptoms like depression, irritability, and brain fog. It can also cause sores, cracks, and swelling on the mouth or tongue, as well as skin rashes and lesions. Other potential symptoms of vitamin B6 deficiency include anemia, peripheral neuropathy (nerve damage), and ataxia (loss of muscle control). In infants, it can also cause seizures and hearing changes.

If you think you may have a vitamin B6 deficiency, contact your healthcare provider. They can test your vitamin B6 levels and prescribe supplements if needed.

Frequently Asked Questions

How can I raise my B6 levels fast?

Foods like chickpeas, beef liver, tuna, salmon, chicken, turkey, potatoes, bananas, and fortified grains (such as breakfast cereal) are especially rich in vitamin B6. If you need to raise your B6 levels more quickly, your provider might prescribe supplements. In very rare cases, you may need to receive vitamin B6 intravenously.

What part of the body does vitamin B6 affect?

Vitamin B6 affects the entire body in some capacity. It plays a pivotal role in creating antibodies to fight off infections and other illnesses, as well as regulating blood sugar, aiding in digestion, and allowing the blood to carry oxygen throughout the body. It’s especially important in promoting the healthy function of the central and peripheral nervous systems, which include the brain and spinal cord in addition to nerves and ganglia.

Is it better to take vitamin B6 supplements in the morning or at night?

Some evidence suggests that it’s best to take vitamin B6 supplements at night. B vitamins can increase energy levels, making it more difficult to fall and stay asleep. One study found that people who took B-complex and vitamin B6 supplements before bedtime experienced more vivid dreams and lower sleep quality.

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