Vitamin B6 and magnesium on neurobehavioral status of autism spectrum disorder with hyperactivity and irritability (research)

Today I’m sharing new research that supports some of the original findings about vitamin B6 and magnesium published by autism biomedical pioneer Bernie Rimland.

Despite the small population size, this study demonstrated neurobehavioural improvement among children with ASD [autism spectrum disorder] with hyperactivity and irritability. Consequently, it can be expected that future studies conducted on a larger scale might help to establish the beneficial role of Vitamin B6 and Magnesium as a complementary treatment for autism with hyperactivity and irritability.

The above comes from the conclusion of  this 2021 paper, Vitamin B6 and Magnesium on Neurobehavioral Status of Autism Spectrum Disorder: A Randomized, Double-Blind, Placebo Controlled Study.

There were 50 children in the study, with a random assignment of 27 to the study group (vitamin B6 and magnesium) and 23 to the control group (placebo). All the children were autism patients from a pediatric autism and neurodevelopmental disorder outpatient clinic in India.

One of the primary aims over the 3 month study period was to investigate “any improvement among the six domains of ASD: general observation, cognition, emotion, social behavior, communication, and sensory deficits.”

Read on for learning more about the study outcomes, and dosing and forms of magnesium and vitamin B6 (and how this compares to P5P). I also share more about autism biomedical pioneer Bernie Rimland’s earlier research and the autism/B6/pyroluria connections. And end with some of the many possible mechanisms, GABA and vitamin B6, and other applications for vitamin B6.

More about the study outcomes

• The improvement observed in the study/intervention group was 81% compared to only 47% in the placebo group.
• Both the study group and control group had a mixture of patients rated as having mild, low moderate, high moderate and severe symptoms of ASD. At the conclusion of the study, there were fewer patients in high moderate and severe categories.
• There was “an overall improvement in the symptoms of autism along with improvements in specific domains e.g. Emotion and Cognition.” The Emotion domain includes hyperactivity, aggressiveness, emotional lability (or instability) and stress.

Dosing varied by age and forms of magnesium and vitamin B6

The dosage of magnesium and vitamin B6 for the 27 children in the intervention/study group was pre-determined by the age of the subjects: “Patients aged 2-3 years received 50 mg Magnesium and 25mg Vitamin B6 daily, aged 4-8 years received 100 mg Magnesium and 50mg Vitamin B6 daily, and patients aged 9-12 years were given 200 mg Magnesium and 100mg Vitamin B6 daily.”

Patients in both groups received Risperidone for hyperactivity and irritability.

The form of magnesium used in the study was glycinate and the form of vitamin B6 was pyridoxine.

Vitamin B6 and magnesium research by autism biomedical pioneer Bernie Rimland

The authors share that of the many autism studies with nutrients, studies using vitamin B6 and magnesium “given by parents to ASD children have been observed to produce improvement for about 30 years.”

As I mentioned above, this new research builds on some of the original findings about vitamin B6 and magnesium published by autism biomedical pioneer Bernie Rimland. The study authors share this: “Rimland found significant improvement with the use of high doses of pyridoxine, however high doses of pyridoxine showed side effects which could be negated by co-administering magnesium.”

This 1988 paper by B. Rimland is referenced: Controversies in the treatment of autistic children: vitamin and drug therapy, and states that “Among the biomedical treatments, the use of high-dosage vitamin B6 and magnesium received the highest ratings”

Also referenced is this vitamin B6 paper, co-authored by B. Rimland and published 46 years ago: The effect of high doses of vitamin B6 on autistic children: a double-blind crossover study. It states that “Behavior was rated as deteriorating significantly during the B6 withdrawal.”

Vitamin B6, autism and pyroluria

My experience when it comes to vitamin B6 and P5P is primarily with the many individuals in my community who have pyroluria or suspect they do based on their symptoms (here is the pyroluria symptoms questionnaire). This is about 80% of the anxious folks in my community.

I share this because pyroluria is common in autism spectrum disorder:

• children with learning disorders and behavioral disorders: 25% (Abram Hoffer)
• autism spectrum disorders: 46% (Woody McGinnis)

(more on prevalence and associated conditions here)

And this study found emotional instability – a key aspect of pyroluria and autism – improved with vitamin B6 and magnesium.

For adults with pyroluria, vitamin B6 is used in the range of 100 mg  to 500 mg, starting low and increasing as needed. We use dream recall and increased ability to socialize without feeling anxious as a clue that the correct dose is being used.

Keep in mind that 25 mg P5P (pyridoxal-5-phosphate) or the active form of vitamin B6 is approximately equivalent to 100 mg pyridoxine.

I have found that some folks do better on one form of vitamin B6 than the other i.e. not everyone needs P5P and some folks do better with a combination of P5P and pyridoxine. As with all supplements there is no one–size fits all and so the protocol and form of vitamin B6 used in this study group really only serves as a guideline.

The possible mechanisms

The authors mention this as one possible mechanism under these circumstances:  “Magnesium inhibits the excitatory channel glutamate N-methyl-D-aspartate (NMDA) and reduces hyperactivity – a part of the emotional domain.” They also mention the fact that “magnesium increases presynaptic releases” enhancing “both short term and long term synaptic facilitation and long-term potentiation, improving learning and other memory functions.”

I’m adding these as possible mechanisms to consider too:

• Vitamin B6 is a potent anti inflammatory compound
• Vitamin B6 and magnesium are co-factors needed to make serotonin (which is calming and helps with emotional stability) and dopamine (which helps with focus and motivation)
• “GABA is formed from glutamate via the addition of glutamate decarboxylase and vitamin B6”
• Vitamin B6 offers neuroprotection in situations of excess glutamate release (together with vitamin B12 and B2)
• Vitamin B6 is key (together with zinc, evening primrose oil and others) for addressing social anxiety/pyroluria which is common in autism (as mentioned above)
• Vitamin B6 and magnesium improve hormonal health
• Oxalate issues are common in autism, leading to depleted levels of vitamin B6 and magnesium. Supplementation can help counter some of the adverse effects.

Also vitamin B6 (and other B vitamins) and magnesium are depleted by sugar, stress, dysbiosis, food allergies, certain medications and caffeine. And it’s common to find deficiencies of both.

A comprehensive dietary and functional medicine / biomedical approach, targeted individual amino acids such as GABA and tryptophan, in addition to vitamin B6 and magnesium is imperative in ASD.

Many other applications for vitamin B6

It’s wonderful to be able to share yet another application for vitamin B6, which, in some circles, is receiving an unfavorable reputation about causing toxicity.

Here are a few other related vitamin B6 blog posts that may be of interest:

• The role of low serotonin, low vitamin B6 and low iron in anxiety and panic attacks
• Oral contraceptives cause low vitamin B6 and zinc, reduce serotonin levels and increase anxiety
• Am I an anxious introvert because of low zinc and vitamin B6? My response to Huffington Post blog
• Side stitch when running or exercising: the anxiety/stress connection (and the pyroluria protocol of zinc and vitamin B6 as a solution?)

Because of the role of vitamin B6 when it comes to calming GABA, it’s worth sharing this blog too  – Half a crushed GABA Calm for my autistic child: sleep, anxiety and sensorimotor skills (writing, horse riding and swimming) improve. Both vitamin B6 and GABA are commonly beneficial.

And sometimes, vitamin B6 on it’s own provides results – Anxiety and vomit phobia in an 8-year-old: within a week of starting vitamin B6 she made a complete turnaround.

Additional resources when you are new to using amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low GABA or other neurotransmitter imbalances may be an issue.

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control (this is covered in an entire chapter too), sugar cravings, anxiety and mood issues.

There is also an entire chapter on pyroluria and in-depth sections on vitamin B6 and zinc.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Wrapping up and your feedback

I’d love to hear from you – have you had success with vitamin B6 and magnesium – personally or with your child? How much has helped and which products? (feel free to share the diagnosis and what symptoms have improved)

Have dietary changes and/or addressing pyroluria helped too?

If you’re a practitioner have you seen these nutrients to help in situations like this?

I’m also curious to hear if you’re familiar with the vitamin B6 and magnesium research and work done by Bernie Rimland?

Feel free to share and ask your questions below.