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B6 toxicity

Ryan Barnes2/3/22 1:03 PM (CST)
Does anyone have guidance on the relationship of vitamin B6 toxicity and laboratory reference range of this vitamin?  Our lab measures B6 in mcg/L with a normal range of 2-32.8mcg/L.  In our workup of axonal polyneuropathy, we frequently receive results slightly outside of the range (40mcg/L) and infrequently much higher (156mcg/L is the highest we've seen).  My understanding is that B6 neurotoxicity is very rare and generally occurs with supplementation above 1000mg daily.  As we see these abnormal results in patients frequently and in those who do not take high dose supplement, I question the lab cutoff as a marker for neurotoxicity.  

I'd appreciate any insight others have in addressing this issue. 
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