How Do You Know If You Are Low in B6? Signs, Causes, and Solutions

January 2, 2026 •

3 min read

According to the National Institutes of Health, while severe vitamin B6 deficiency is uncommon in the United States, certain groups like older adults and those with alcohol dependence are at higher risk. Recognizing the subtle signs of low B6 is key to managing your overall health and preventing more serious complications.

Quick Summary

This article details the signs and symptoms of low vitamin B6, including skin rashes, fatigue, and nerve issues like tingling. It also covers the common causes of pyridoxine deficiency, such as medications and certain health conditions, and outlines dietary and supplemental strategies for correction. Additionally, it highlights key risk factors and diagnostic methods.

Key Points

Skin and Mouth Symptoms: A scaly facial rash (seborrheic dermatitis), cracked lips (cheilosis), and an inflamed, sore tongue (glossitis) are classic signs of low B6.
Nerve Issues: Persistent numbness, tingling, or a 'pins-and-needles' sensation in the hands and feet (peripheral neuropathy) can indicate a deficiency.
Mood and Mental Health: Low B6 can impact neurotransmitter production, leading to mood swings, irritability, anxiety, depression, and confusion.
Fatigue and Weakness: Unexplained and persistent fatigue can be caused by microcytic anemia, which is linked to a lack of vitamin B6 for hemoglobin production.
Weakened Immunity: Reduced B6 levels can impair the immune system, making you more susceptible to infections and illnesses.
Diagnosis by a Professional: Because symptoms overlap with other conditions, a healthcare provider should confirm a B6 deficiency through a physical exam and blood tests.

Recognizing the Signs of a B6 Deficiency

Vitamin B6, or pyridoxine, is a crucial nutrient that supports a wide range of bodily functions. A deficiency can manifest in various ways, often overlapping with other B vitamin deficiencies.

Skin and Oral Manifestations

Low B6 can lead to inflammatory skin conditions and issues in the mouth. These include:

Seborrheic Dermatitis: A red, itchy, scaly rash, commonly on the face, scalp, and upper chest.
Cheilosis: Scaling and painful cracks at the corners of the mouth.
Glossitis: An inflamed, red, swollen, and potentially sore tongue.

Neurological and Psychological Symptoms

The nervous system relies on B6 for proper function. Deficiency can cause:

Peripheral Neuropathy: Numbness, tingling, or a "pins-and-needles" sensation in the hands and feet due to nerve damage.
Mood Changes: Irritability, anxiety, and depression can occur as B6 is vital for neurotransmitter synthesis.
Confusion and Fatigue: Persistent fatigue and mental fog are common. Severe cases can cause confusion and cognitive impairments.
Seizures: Rare in severe deficiencies, particularly in infants or those with specific conditions.

Other Systemic Issues

Beyond visible symptoms, low B6 can impact other body systems.

Anemia: B6 is needed for hemoglobin production, and a deficiency can lead to microcytic anemia, causing fatigue.
Weakened Immune System: Low levels can compromise immune function, increasing infection susceptibility.

Factors Contributing to B6 Deficiency

While rare from diet alone in developed countries, certain factors increase risk.

Risk Factors and Causes

Alcohol Use Disorder: Impairs B6 absorption and increases excretion.
Kidney Disease: Higher risk, especially for those on dialysis.
Malabsorption Syndromes: Conditions like celiac disease or Crohn's reduce nutrient absorption.
Certain Medications: Drugs such as isoniazid, penicillamine, and oral contraceptives can deplete B6.
Older Age: May have lower absorption efficiency and reduced dietary intake.

How to Diagnose and Treat Low B6

Consult a healthcare professional if you suspect a B6 deficiency.

The Diagnostic Process

Physical Examination: To look for signs like rashes or neuropathy.
Medical History: Review of health, diet, medications, and lifestyle.
Blood Tests: Plasma pyridoxal 5'-phosphate (PLP) level test can confirm deficiency.

Comparison of B6 Deficiency vs. Other Conditions

Symptoms can overlap with other conditions, requiring professional diagnosis.


Symptom	B6 Deficiency	B12 Deficiency	Folic Acid Deficiency
Anemia Type	Microcytic	Megaloblastic	Megaloblastic
Skin Rash	Seborrheic dermatitis common.	Skin paleness/pigmentation changes possible.	Skin color changes possible.
Tongue Issues	Glossitis characteristic.	Mouth ulcers common.	Open mouth sores may appear.
Neurological Symptoms	Peripheral neuropathy, confusion common.	Peripheral neuropathy, memory issues, balance problems common.	Irritability, headache possible; severe nerve issues less common.

Treatment and Prevention

Treatment involves diet and supplements, potentially higher doses in severe cases under medical supervision.

Key steps for treatment and prevention:

Dietary Adjustments: Increase B6-rich foods like chickpeas, tuna, salmon, and bananas.
Supplementation: Often recommended for moderate to severe deficiencies, dosage determined by doctor.
Address Underlying Causes: Manage chronic conditions or adjust medications with a doctor.

Conclusion

Knowing how to recognize signs of low B6, including skin, neurological, and systemic symptoms, is vital for health management. Risk factors like alcoholism and kidney disease increase susceptibility. Professional diagnosis through examination and blood tests is crucial for effective treatment. Treatment typically involves dietary adjustments and supplements, often requiring medical supervision for proper dosage. Early intervention is key to managing symptoms and preventing complications.

Learn more about vitamin B6 from the National Institutes of Health.

Frequently Asked Questions

The first signs of low B6 often involve skin and mood changes. You might notice a scaly rash, cracked lips, or a sore tongue. Irritability, mood swings, and feelings of confusion are also common early indicators.

Causes include poor dietary intake, chronic alcohol consumption, malabsorption disorders like celiac disease, and the use of certain medications such as isoniazid and oral contraceptives. Older age and kidney disease can also increase risk.

Good sources of vitamin B6 include chickpeas, tuna, salmon, chicken breast, bananas, potatoes, and fortified breakfast cereals. Incorporating these foods into your diet can help maintain healthy levels.

Yes, a deficiency can cause peripheral neuropathy, leading to numbness, tingling, and a "pins-and-needles" sensation in the hands and feet. This is due to damage to the peripheral nerves over time.

Diagnosis is typically made by a healthcare professional based on your symptoms, medical history, and a physical exam. Blood tests, specifically measuring plasma pyridoxal 5'-phosphate (PLP), can confirm the diagnosis.

Yes, vitamin B6 supplements are an effective way to correct a deficiency, especially in moderate to severe cases. The dosage should be determined by a healthcare provider, and it's often used alongside dietary improvements.

Long-term deficiency can weaken the immune system, increase the risk of certain cancers, and contribute to cognitive impairment. Prompt diagnosis and treatment are important to prevent these complications.