While folic acid is recommended as a supplement for all pregnant women, for some, doctors advise taking vitamin B6 along with it. Although a deficiency of vitamin B6 is not easy to identify, a history of early miscarriage or difficulty in conception could indicate vitamin B6 deficiency, say experts. Vitamin B6 also known as pyridoxine is given as a supplement during pregnancy along with vitamin B12 and folic acid for regulating the central nervous system of the woman and foetus.
Vitamin B6 supplements, prescribed to some pregnant women, are often a combination medicine along with folic acid, says Dr Vidya V Bhat, medical director and gynaecologist, Radhakrishna Multispeciality Hospital, Bengaluru. She adds that it is especially needed for women who have:
- A history of early miscarriage
- Opted for fertility treatments such as in-vitro fertilisation (IVF) due to fertility issues
- Megaloblastic anemia (A type of vitamin deficiency anemia caused by deficiency of vitamin B12 and/or folate)
However, Dr Bhat warns against the self-medication of any supplement during pregnancy.
In 2017, Divya Nayak (31), a farm producer and entrepreneur from Kundapura, Karnataka, opted for IUI (intrauterine insemination) after failing to conceive naturally. She recalls, “During the pre-pregnancy counselling, my doctor said I was anemic as my hemoglobin level was 9.0 g/dL.”
Divya went through three trials of IUI and conceived in 2019. Through this period, she was advised folic acid and vitamin B6. “My combined folic acid and vitamin B6 supplement that started three months before my IUI trials went on till three months after delivery. I was also given iron supplements from the second trimester of my pregnancy. This resolved my vitamin B6 deficiency.” Dr Nirmala Chandrashekar, gynecologist and gynec oncologist, BGS Gleneagles Global Hospital, Bengaluru, explains, “Vitamin B6 helps cure anemia by converting iron into hemoglobin. So, anemia in pregnant women is most often treated with vitamin B6 and iron supplements.”
Who needs vitamin B6 supplements?
Vitamin B6 supplement during pregnancy is not a requirement for all women, say experts. Consumption of wholesome meals including vegetables, specific forms of meat and cereals can fulfill the nutritional requirement, say experts. But, when women have difficulty in conception or are deficient in vitamin B12 and/or folate, it could indicate vitamin B6 deficiency too.
Women who want to conceive, but have other risk factors like certain autoimmune disorders should also take the supplement, point out experts. Shah lists that women who need vitamin B6 supplements are those who:
- Consume tobacco or alcohol
- Have autoimmune conditions (celiac disease, Crohn’s disease, rheumatoid arthritis, thyroid disorders)
- Have kidney diseases
- Are exposed to toxins or chemicals
- Have a history of crash diet or fad diet
- Restrict certain food types for health reasons.
How much vitamin B6 is required during pregnancy?
While non-pregnant women in the age group of 15-30 years need at least one microgram of vitamin B6 per day, pregnant and lactating women need up to two micrograms in a day, explains Shah.
Natural sources of vitamin B6
Karishma Shah, an integrative health nutritionist from Mumbai, explains that including foods naturally rich in vitamin B6 in everyday meals can fulfill the nutritional need of any woman. Some of the natural sources of vitamin B6 include:
- Banana
- Papaya
- Musk melon
- Oranges
- Dark leafy vegetables
- Spinach
- Avocados
- Fish including tuna and salmon
- Chickpeas
- Cereals
- Dried white peas.
Early symptoms of vitamin B6 deficiency
Vitamin B6 plays a crucial role in the production of red blood cells, say experts. Hence, the earliest sign of vitamin B6 deficiency is anemia, explains Dr Chandrashekar.
Another crucial role of vitamin B6 lies in regulating the homocysteine levels in the body (an amino acid that acts as a building block of protein); a deficiency increases its level. “This increases the risk of early miscarriages and pregnancy-induced hypertension (PIH),” warns Dr Bhat.
From Shah’s perspective, vitamin B6 plays a role in detoxification of the body. The deficiency of this water-soluble vitamin leads to water retention. Swelling or bloating of the face, joints, fingers, flare in the legs and a tingling sensation or numbness of the hands and feet are some of the early signs of deficiency.
An acute deficiency of vitamin B6 could lead to depression, mood swings and other neurological issues, adds Dr Chandrashekar.
Does vitamin B6 supplement reduce nausea?
There is a debate about whether nausea during pregnancy is relieved through vitamin B6 supplements. Experts confirm this is not true.
Pune-based entrepreneur Shweta Anirudh Kamath (40), suffered from anemia (hemoglobin level=8.0 g/dL) when she was pregnant in 2013. Anemia was the core reason she was advised a combination of folic acid and vitamin B6 for the first trimester of the pregnancy and iron supplements after the second trimester. She tells Happiest Health, “I was unable to eat much due to nausea and lack of appetite. Vitamin B6 and iron supplements helped me resolve my deficiency. But it did not help me reduce my nausea.”
Nausea or morning sickness is the result of hormonal changes in the body during pregnancy, says Dr Suman Lal, director, head of the department, obstetrics and gynaecology, Max Hospitals, Gurgaon. “The proximity of the vomiting centre of the brain to the hormonal centre could induce nausea in few pregnant women.”
“Hormonal upheaval reduces gastric motility due to which food remains in the stomach for a longer period. Having vitamin B6 supplements can increase gastric motility and reduce nausea for some women. However, this is not the case always,” explains Dr Chandrashekhar.
How to know if you have vitamin B6 deficiency
Experts recommend pre-pregnancy counselling to understand any vitamin deficiencies. Healthcare professionals will suggest the following tests to understand vitamin B6 deficiency in women who are at risk:
- Serum homocysteine levels test
- Hemoglobin (Hgb) blood test
Those who are deficient will be advised to take vitamin B6 in combination with folic acid. Dr Bhat explains, “These supplements are given three months before and after conception. Also, cases with vitamin B6 deficiency caused by anemia, are accompanied by iron supplements.”
Takeaways
- Pyridoxine or vitamin B6 often works along with B12 and folate in regulating the central nervous system.
- Vitamin B6 is present in fruits and vegetables (banana, papaya, musk melon, oranges, dark leafy vegetables, spinach, avocados), most fishes (tuna, salmon) and cereals.
- Those at risk of B6 deficiency are women with a history of early miscarriages, megaloblastic anemia and those undergoing fertility treatments such as in-vitro fertilisation (IVF).
- Consuming vitamin B6 supplements as a combination medicine along with folic acid helps.
