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Pyridoxine Vit B6

  1. Biological activity is displayed by pyridoxine, pyridoxal and pyridoxamine and their 5-phosphate esters.
  2. The co-enzyme form is pyridoxal- 5- phosphate.   


  1. Pyrophosphate act as a cofactor for many enzyme involved in amino acid metabolism mainly tryptophan, glycine sevine, glutamate and sulpur containing AA.
  2. Role in synthesis of hame precursor S-amino levulinic acid.
  3. Adequate functioning of nervous system.  


  1. ↑ in pregnancy and administration of estrogens
  2. ↑ by high protein intake
  3. Pyridoxine def. may be seen after pnelonged INH, penicillamine and Hydralazine therapy.
  4. Infants whose mothers have received large doses of pyridoxine during pregnancy are at increased risk of seizures due to pyridoxine dependence.
Clinical manifestation in deficiency state more common in adult than children. 

Four clinical disturbances caused by Vit B6 def.

  1. Convulsion in infants                    
  2. Peripheral neuritis
  3. Dermatitis                            
  4. Anemia - Microcytic Hypochromic  

Pyridoxine dependent condo


There are several types of Vit B6 dependence syndrome presumably a result of errors in enzyme structure or function in which patient respond to very large amount of pyridoxine. These include

  1. B6 dependent convulsion                      
  2. B6 responsive anemia
  3. Xanthurenic acidemia                    
  4. Cystathioninuria
  5. Homocystinuria                            
  6. Oxaluria

Points to remember

  1. Vitamin use in Hyperemesis gravidum → B6
  2. Maple syrup urine disease ~ B I responsive
  3. Vitamin used in chediak Higashi syndrome  Vit C
  4. Burning foot syndrome due to def. of  pantothenic acid
  5. Pseudotumor cerelrri due to  Vit A excess
  6. Circum corneal vasculararization  riboflavin (B2) def.
  7. Associated vitamin· def. in carcinoid syndrome  Niacin (B3)
  8. Tryptophan loading test used to detect  B6 def
  9. Methyl malonic acid urea  Vit B12 def
  10. Oxaluria occur in  Vit C excess
  11. Subperiosteal hemorrhage  Vit C def
  12. Cerebellar ataxia  Vit E def.
  13. Tender nerve  Thiamine def
  14. Vitamin used in treatment of Hypercholesterolemia  B3
  15. Earliest manifestation of Rickets in Infants is  Cramotabes
  16. Hartnup disease responds to high doses of  Niacin

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