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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by proudfoot on August 27, 2010, at 20:59:51
How common/real is the development of pyridoxine (vitamin B6) deficiency when taking an MAOI? My doc who just started me on Nardil didn't recommend vitamin supplementation to me, but I've read about people who ingest a vitamin B complex supplement as prophylaxis against developing pellagra while on the MAOI.
Seems like good common sense to me nutritionally to do this since the MAOIs are pyridoxine agonists in the body, but I was just curious how widespread or common it is for folks to supplement their diets like this. If you do take a B vitamin, how much do you take, how often do you take it, and when in the day do you take it with regards to the timing of your MAOI dose(s)?
Last thing I need in my life right now is to develop pellagra, so I eagerly await your viewpoints on this. Muchos gracias!
Doug
Posted by angels78 on August 27, 2010, at 23:28:31
In reply to Vitamin B supplementation and MAOIs?, posted by proudfoot on August 27, 2010, at 20:59:51
I would like to know this answer aswell.
Posted by ambidexter on August 28, 2010, at 13:43:42
In reply to Vitamin B supplementation and MAOIs?, posted by proudfoot on August 27, 2010, at 20:59:51
Hi Doug,
I take Nardil in the morning, and a sublingual B supplement (2mg B6, 800 mcg folic acid, and 1000 mcg B12) in the evening.
I have no idea how good this is as a B6 supplement. It's just what they had at Trader Joe's :)
Mostly I'm taking it because I have read that B6 deficiency can contribute to fluid retention, which is a side effect of Nardil that I would like to minimize.
I haven't been on a therapeutic dose of Nardil long enough to know how much of a problem this might be.
Posted by proudfoot on August 28, 2010, at 16:21:20
In reply to Re: Vitamin B supplementation and MAOIs?, posted by ambidexter on August 28, 2010, at 13:43:42
> Hi Doug,
>
> I take Nardil in the morning, and a sublingual B supplement (2mg B6, 800 mcg folic acid, and 1000 mcg B12) in the evening.
>
> I have no idea how good this is as a B6 supplement. It's just what they had at Trader Joe's :)
>
> Mostly I'm taking it because I have read that B6 deficiency can contribute to fluid retention, which is a side effect of Nardil that I would like to minimize.
>
> I haven't been on a therapeutic dose of Nardil long enough to know how much of a problem this might be.Given that the RDA of B6 is 2 mg, this seems like an appropriate amount to supplement if you're going to, as you'll still be getting a fair amount of B6 from your regular diet. There's always the question of excess B6 interacting with and neutralizing the Nardil as well, which kinda defeats the purpose of what we're trying to do here with the brain candy, eh?
As you're taking them at different times of the day, the likelihood of this interaction is minimized, though, so probably no biggie. How much Nardil are you taking, and do you take all at one time during the day?
I'm currently on no vitamin supplementation, but taking my Nardil 15 mg in the morning, 15 mg in the mid-afternoon, and 30 mg at bedtime. Guess I could switch it to 60 mg all at once at bedtime and then take the vitamin supplement during the day. I sent my doc a message asking for his thoughts about the B6 but no answer yet.
Thanks for the feedback!
Doug
Posted by ambidexter on August 29, 2010, at 18:53:40
In reply to Re: Vitamin B supplementation and MAOIs? » ambidexter, posted by proudfoot on August 28, 2010, at 16:21:20
> Given that the RDA of B6 is 2 mg, this seems like an appropriate amount to supplement if you're going to, as you'll still be getting a fair amount of B6 from your regular diet. There's always the question of excess B6 interacting with and neutralizing the Nardil as well, which kinda defeats the purpose of what we're trying to do here with the brain candy, eh?
>
> As you're taking them at different times of the day, the likelihood of this interaction is minimized, though, so probably no biggie. How much Nardil are you taking, and do you take all at one time during the day?
>
> I'm currently on no vitamin supplementation, but taking my Nardil 15 mg in the morning, 15 mg in the mid-afternoon, and 30 mg at bedtime. Guess I could switch it to 60 mg all at once at bedtime and then take the vitamin supplement during the day. I sent my doc a message asking for his thoughts about the B6 but no answer yet.
>
> Thanks for the feedback!
>
> DougI am taking 45 mg all in the morning. Will probably go up to 60 after my next appt.
Posted by pedr on August 31, 2010, at 13:29:14
In reply to Vitamin B supplementation and MAOIs?, posted by proudfoot on August 27, 2010, at 20:59:51
Hi Doug,
I take 90mg Nardil
10am: 30mg
5pm: 30mg
midnight: 30mgand a large B6 pill (can't recall mg) at 8am. I've no idea what it is or is not doing to me. I too just read that it's potentially a good idea. There have been a few threads about Nardil+B6 recently, I will try find them.
Pete
Posted by pedr on August 31, 2010, at 13:41:20
In reply to Re: Vitamin B supplementation and MAOIs? » proudfoot, posted by pedr on August 31, 2010, at 13:29:14
Previous threads:
http://www.dr-bob.org/babble/20100811/msgs/958862.html
http://www.dr-bob.org/babble/20070622/msgs/766615.html- lots to get through!
Pete
Posted by proudfoot on August 31, 2010, at 19:49:27
In reply to Re: Vitamin B supplementation and MAOIs?, posted by pedr on August 31, 2010, at 13:41:20
> Previous threads:
> http://www.dr-bob.org/babble/20100811/msgs/958862.html
> http://www.dr-bob.org/babble/20070622/msgs/766615.html
>
> - lots to get through!
> PeteHi Pete - thanks for the helpful links. Just tried to do a more refined search on Google and came up with a Google books citation (see book here: http://www.amazon.com/gp/search?index=books&linkCode=qs&keywords=0323029647) that basically states on page 330 that studies haven't been done yet to determine an effective dose, but that:
"Many providers trained and experienced in nutritional therapeutics routinely advise patients treated with these medications to supplement with vitamin B6, usually at moderate levels, such as 25 to 50 mg per day."
My pdoc can't give me a straight answer (not enough experience with Nardil), so I'm gonna have to wing this one using the resources on here, which thanks to persons like you, get better all the time. I've settled on a B-complex I found on Amazon that contains 10 mg of pyridoxine (B6) and 10 mg of pyridoxal 5' phosphate (activated B6).
Interestingly, a more accurate approach could be argued for by monitoring serum pyridoxine levels, but this would increase both the cost for yours truly, as well as the discomfort and inconvenience of repeated blood draws. Next time I need labwork, though, it might be interesting to see where the levels are. Has your doc ever checked your levels of pyridoxine while taking an MAOI?
Thanks again for your thoughtfulness in finding those older posts for me.
Doug
This is the end of the thread.
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