We describe seven adults who had ataxia and severe sensory-nervous-system dysfunction after daily high-level pyridoxine (vitamin B6) consumption. Four were severely disabled; all improved after withdrawal. Weakness was not a feature of this condition, and the central nervous system was clinically spared. Although consumption of large doses of pyridoxine has gained wide public acceptance, this report indicates that it can cause sensory neuropathy or neuronopathy syndromes and that safe guidelines should be established for the use of this widely abused vitamin.
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(1998). Vitamin Supplementation Reduces Blood Homocysteine Levels : A Controlled Trial in Patients With Venous Thrombosis and Healthy Volunteers. Arterioscler. Thromb. Vasc. Bio.
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(1988). Nutrition Fraud: Vitamins and Obesity--Pharmacists' Responsibilities. Journal of Pharmacy Practice
1: 131-149
Bender, A. E.
(1985). Nutritional requirements. The Journal of the Royal Society for the Promotion of Health
105: 1-4
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