Vitamin B6: pyridoxine hydrochloride vs. pyridoxal 5’-phosphate?

Ray - All I can say is Wow. I have gotten used to accepting there is “good” cholesterol (HDL) and “bad” cholesterol (LDL), but now trying to understand good B6 from bad B6 seems a bit unreasonably complicated for the average Joe trying to stay on top of their health labs. I’m in no position to question your doctor, but we should campaign for new names for the two B6’s to help distinguish them or for a major educational campaign from the FDA or NIH to help consumers. My B6 registered a little high when I was advised to add B supplements in 2016. Then a startled doctor said “Woah! Stop! Add B12 not B6!” They knew it was only high because I had it in the supplements I started taking, but we never discussed whether it was from hydrochloride or from phosphate. This Medical University just said whatever I’m adding, stop it. But that was 2016 - maybe they’ve learned more, or perhaps your doctor is more thoroughly reviewing your case. Either way, I think simplification is in order to help patients understand.

Hello again, Debbie. I'm guessing, as it's been since last night since I posed my question (pyridoxine vs. pyridoxal) and five hours since you posted the only response that the question of the possibility of two effectively distinct forms of B6 (as you summed up so perfectly: one "good" form and one "bad" form) is a question many people have not heard before. If that's true, it just deepens my perplexity. –Ray (@ray666)

Hi Ray, Did you see these? Not that I understand what they mean 🙃

--- What is the Difference Between Pyridoxal 5 Phosphate and Pyridoxine Hydrochloride: https://www.differencebetween.com/what-is-the-difference-between-pyridoxal-5-phosphate-and-pyridoxine-hydrochloride/
--- The vitamin B6 paradox: Supplementation with high concentrations of pyridoxine leads to decreased vitamin B6 function: https://pubmed.ncbi.nlm.nih.gov/28716455/

WOW! Thanks, John! Not that I'll do a better job of deciphering the medicalese.🙃 If nothing else, however, it'll keep me busy for the next few hours. Again, John, thank you so much for this! –Ray

Maybe also see:

On the issue of B-6 - I did some research and found that a good number of the foods I eat on a consistent basis contain vitamin B-6. So, I thought why continue taking a B-6 supplement. About 3 weeks ago, with approval, I decided to stop taking B-6 supplements. I was on a low dosage. To my surprise, I feel that I have gained a little more feeling in both feet. I have sensory motor PN. Balance has not improved but it appears I can feel my feet a little better both sides and bottom. It took about 2 weeks before I felt a difference. Again, it is only a small improvement, perhaps about 5% to 10% but more important, the question is, will this slow down progression. Like most things, time will tell. Prior to going off B-6, I ran this past my nurse practitioner. Ed

Just to confirm there is a difference in (B6) toxic effects between Pyridoxal 5 Phosphate (P5P) and Pyridoxine Hydrochloride. I became concerned that my integrative health doctor prescribed a product "Prostate Flo",
that contained 10mg B6, even though he knew I have severe peripheral neuropathy. After further review, and reading some of the links provided in this venue, I found that the product contained pyridoxal 5' phosphate rather than the Pyridoxine form.
As stated in this article: https://pubmed.ncbi.nlm.nih.gov/36608063/
"PLP-based supplements are preferred over pyridoxine supplements because of minimal neurotoxicity observed in neuronal cell viability tests. Since B6 metabolites have a long half-life, weekly administration is preferred over daily use to prevent toxicity."

I hope this helps or at least provides clarity on B6 concerns.