Written by Jessica Patella, ND. 35 participants with arthritis were given 5 mg folic acid and 100 mg vitamin B6 had a significant decrease in one marker of inflammation, but not significant in two others.
Rheumatoid arthritis is an autoimmune disease resulting in inflammation throughout the body. It usually affects the small joints of the hands and feet, and eventually can lead to joint destruction (1). Recent research showed the potential benefit of vitamin B6 in reducing inflammation related to rheumatoid arthritis (2).
Past research has shown that patients with rheumatoid arthritis tend to have low vitamin B6 levels, compared to healthy individuals (3). It is thought that low levels of pyridoxal 5’-phosphate (the active form of vitamin B6) result in high levels of pro-inflammatory cytokines (tumor necrosis factor-alpha, interlukin-6), which then result in increased inflammation throughout the body (2). Rheumatoid joint destruction is characterized by the inflammation of synovial cells in the joints (2). The pro-inflammatory cytokines, interlukin-6 and tumor necrosis factor-alpha, are specifically related to inflammation in the synovial cells of the joints. This explains the potential benefit of vitamin B6 in rheumatoid arthritis (2).
Recent research looked at giving high dose pyridoxine (100mg vitamin B6) for 12 weeks to determine if it could lower inflammation markers in individuals with rheumatoid arthritis (2). Thirty-five participants that met the American College of Rheumatology criteria for rheumatoid arthritis were randomly assigned to one of two groups. The control group (n=15) received 5mg of folic acid per day and the vitamin B6 group (n=20) received 5 mg of folic acid and 100mg of vitamin B6 per day for 12 weeks. The supplements were taken before breakfast and no other vitamins were taken during the duration of the study (2). All participants took 5mg folic acid because methotrexate, the standard treatment drug for rheumatoid arthritis, is a folate antagonist. Therefore, folate is routinely prescribed for all patients on methotrexate (1) . Seventy four percent of the study participants were taking the drug methotrexate (1).
After 12 weeks, the plasma concentrations of pyridoxal 5’-phosphate (the active form of vitamin B6) increased in the vitamin B6 group (from 62.9 +/- 52.8 to 457.9 +/- 173.6 nmol/l; P<0.05). There was also a significant decrease in interlukin-6 (-2.9 +/- 2.0 pg/ml; P<0.05) and tumor necrosis factor-alpha (-4.2 +/- 5.1pg/ml; P<0.05) in the vitamin B6 group. No significant changes were seen in the control group. Levels of C-reactive protein and erythrocyte sedimentation rate (markers of inflammation) were not significantly changed in either group (2). It is not completely understood why levels of C-reactive protein and erythrocyte sedimentation rate did not decrease (2).
In conclusion, vitamin-B6 did suppress pro-inflammatory cytokines over the 12-week period, showing the benefit of vitamin-B6 in decreasing inflammation related to rheumatoid arthritis. Further research should be done with more study participants.
Source: Huang, S. C., et al. “Vitamin B6 supplementation improves pro-inflammatory responses in patients with rheumatoid arthritis.” European journal of clinical nutrition 64.9 (2010): 1007-1013.
© 2010 Macmillan Publishers Limited
Posted September 10, 2010.
References:
- Rheumatoid Arthritis. See the Mayo Clinic website.
- Huang S-C et al. Vitamin B6 supplementation improves pro-inflammatory responses in patients with rheumatoid arthritis. Doi:10.1038/ejcn.2010.107.
- Roubenoff et al. Abnormal vitamin B6 status in rheumatoid cachexia. Arthritis Rhem 1995;38, 105-109.
