Heads up on Vitamin B6 & Neuropathy

Reviewed 10/16/26 by the NatMed Clinical Team

Top Takeaways

Australia is restricting vitamin B6 products above 50 mg after reports of neuropathy at lower doses than expected. 
Recommend the lowest effective dose and have patients add up B6 from all their products.

Starting June 2027, the Therapeutic Goods Administration (TGA) in Australia will reclassify products providing above 50 mg vitamin B6 to be pharmacist-only. This change may spark questions in the US, where there are no dose limits on vitamin B6 supplements. Here’s what you should know.

What are the risks of using higher doses of vitamin B6?

Vitamin B6 can cause neuropathy. Doses exceeding 1000 mg daily or total doses of 1000 grams or more pose the most risk, but neuropathy can occur with lower daily or total doses as well. Doses that don’t exceed the tolerable upper intake level (UL) of 100 mg daily in the form of pyridoxine are likely safe and unlikely to cause neuropathy in most adults.

Why is the TGA taking action to restrict vitamin B6 use?

Primarily due to a rise in neuropathy reports related to vitamin B6 use – the TGA adverse events database reported 174 reports of neuropathy as of June 2025. A review of the data led the TGA to determine that neuropathy may occur in some individuals taking doses of 50 mg daily or less, thus leading to this new classification. Many reports involved patients stacking several vitamin B6-containing products. Starting June 2027 in Australia, products providing more than 50 mg up to 200 mg will be pharmacist-only – and products providing over 200 mg will remain prescription-only.

What should you tell patients in the US?

While the UL in the US remains 100 mg daily, given these reports, it’s reasonable to recommend the lowest effective dose depending on the reason for vitamin B6 use. For example, the American College of Obstetrics and Gynecology (ACOG) says B6 10-25 mg 3-4 times daily is reasonable for pregnancy induced nausea and vomiting – consider starting with just 10 mg three times daily initially. The recommended dietary allowance (RDA) for vitamin B6 is only 1.3-1.7 mg daily for adults. If any symptoms of neuropathy arise, such as numbness or tingling, patients should stop taking vitamin B6 and contact their healthcare provider. Additionally, remind patients that vitamin B6 is in many combination products, such as multivitamins, B-complex supplements, and nootropic blends. So patients need to review all products they are taking to ensure they aren’t exceeding their intended total daily dose.

Check out our recently updated vitamin B6 monograph to learn more.