Big cut in upper-level B6 limits proposed

A new recommended daily upper level of 14 mg will be put in place for B6 if a new National Health and Medical Research Council (NHMRC) proposal goes ahead.
 
The suggested change to the vitamin’s Nutrient Reference Values (NRV) is ‘based on recently updated international guidance’, according to the NHMRC.  
 
It is a dramatic reduction from the current daily upper level of 50 mg/day and would bring Australia closer to guidelines in the European Union, where a 12 mg/day upper tolerable limit was introduced in 2023.
 
The NHMRC says its proposal, which is open for consultation until 30 September, is ‘in response to concerns about nerve damage from high supplemental vitamin B6 intakes’.
 
It is the main change put forward in the first revision of the vitamin’s NRVs in two decades.

While the NHMRC change is not regulatory, it is likely to shape changes put in place by the Therapeutic Goods Administration (TGA).
 
NHMRC noted recent TGA rule changes around warning labels for supplements with higher levels of vitamin B6, and impending changes restricting the sales of higher-dose supplements.
 
Last November, the TGA announced a series of measures designed to address concerns about the vitamin’s potential to cause nerve damage, following a sharp rise in neuropathy related adverse events linked to products containing vitamin B6.
 
It said products with a recommended daily dose of 50–200 mg would be limited to pharmacist-only from June 2027 – a proposal backed by the RACGP, which called it ‘a positive step towards reducing the risk of harm from excessive vitamin B6 intake and improving safety and awareness’.
 
It also noted the work looking at evidence of the upper levels.
 
‘Should there be a change following the NHMRC review, the appropriateness of the new limits in this final decision will be re-evaluated,’ the TGA report states.
 
Following consultation, the NHMRC is likely to confirm any changes in early 2027.
 
Dr Terri-Lynne South, a GP and dietitian, welcomed the proposed move.
 
‘I do think it’s a good idea, because what I’m hearing from the coalface, particularly from my dietitian colleagues, is that they still are finding that B6 is a problem,’ she told newsGP.
 
‘We’ve had a number of iterations to try and contain this problem, but my colleagues are saying to me that they’re not seeing that it’s making a big difference.’
 
According to the NHMRC, the limits for B6 were last reviewed in 2006.
 
‘Since that time, concerns have been raised over people developing a nerve condition (peripheral neuropathy) from taking too much vitamin B6 through supplements,’ its consultation states.
 
It noted that ‘not getting enough vitamin B6 is rare’, with recommended daily intakes unchanged in its proposed update.
 
‘The recommended daily intake is slightly different depending on your age and male versus female, but we’re really only talking about 1.6 mg,’ said Dr South.
 
‘It seems like a big drop from 50 mg down to 14 mg, but 14 is still ten times the recommended daily intake to avoid deficiency.’
 
The NHMRC says the upper levels classification ‘represents the highest intake of a nutrient that is likely to pose no adverse health effects for almost all people within the population’.
 
A University of Sydney study published in July found that more than three million products with a daily dose higher than 50 mg had been sold from 1 August 2022 – 31 July 2025 according to pharmacy sales data.
 
It concluded that warnings and public health alerts had not prompted much impact on sales of supplements containing vitamin B6, leading to ‘an ongoing risk’ of harm.
 
Following the release of the study, the pace of regulatory change was criticised by former GP Dr Mary Buchanan, who was personally affected by vitamin B6 toxicity.
 
Last month, she lamented ‘the very slow implementation’ of measures to cut the availability of products with high-dose vitamin B6.
 
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