In short:
The National Health and Medical Research Council (NHMRC) has recommended reducing the upper limit of daily human consumption of vitamin B6 to 14 milligrams, down from the current 50mg.
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Council → recommend → mg
Synthetic vitamin B6 is added to thousands of products sold in Australia, including supplements like multivitamins, protein powders and energy drinks,
What's next?
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What → add → multivitamins
The Therapeutic Goods Administration says it is waiting for the NHMRC recommendation process to be completed before it commits to taking "further regulatory action" on products containing vitamin B6.
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it → say → B6
Months after taking vitamin supplements, Dominic Noonan-O'Keefe says he feared he was dying.
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he → take → supplements
His body was overwhelmed by pain and numbness, his mind overcome with dread.
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mind → overwhelm → dread
"Every millimetre of my body was exploding with misfiring, misdirected signals to my brain," he told 7.30.
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he → explode → 7.30
It was the most awful thing I've ever lived through."
Today
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I → live → ?
, more than two years after he stopped taking the supplements, he said the pain had "turned down", but he still lived with balance and vision problems, among a long list of symptoms he attributes to unknowingly consuming too much vitamin B6.
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he → stop → B6
Amid a public health crackdown, Australia's peak health research body is moving to cut the amount of vitamin B6 considered safe to consume.
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body → move → B6
The medicines regulator has also confirmed it will act within weeks to bring in stronger warnings and labelling, as consumers are urged to check what is in their cabinets.
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what → confirm → cabinets
Proposed change to 'upper limit'
Vitamin B6 is an essential nutrient found naturally in foods like meat, fish and vegetables.
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B6 → propose → meat
But the synthetic form, also known as pyridoxine, is added to thousands of products sold in Australia — from supplements like multivitamins, B-complex tablets, magnesium and zinc tablets, to fortified foods and drinks including protein powders, energy drinks and weight-loss shakes.
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form → know → powders
Since 2006, regulators, doctors and manufacturers have all worked from the same figure: the intake of up to 50 milligrams of vitamin B6 a day was safe.
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intake → work → B6
That threshold is known as the "upper limit".
But after an extensive review of global evidence, Australia's peak health research body, the National Health and Medical Research Council (NHMRC), has now recommended reducing it by 72 per cent to 14mg.
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body → know → mg
"There's really no good reason to be taking 50mg of vitamin B6, unless of course you're suffering from severe malnutrition," said Tim Green, who co-chaired the working group behind the proposed change.
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who → be → change
The amount of B6 people are advised to consume for good health — around 1.3mg a day — is not changing.
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people → advise → health
Professor Green said a deficiency would be rare.
"It wouldn't happen with a normal Australian diet," he said.
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he → say → diet
Matt Silsby, a neurologist and neurophysiologist, said B6 toxicity typically caused "primarily sensory symptoms, pins and needles or prickling or painful symptoms", and sometimes cramps or muscle twitches.
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toxicity → say → symptoms
In more serious cases, he said it could "get quite severe and lead to nerve damage", and in a subset of those patients that damage can be permanent.
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damage → say → patients
He was quick to stress that symptoms "could potentially have very many causes", and it's "not appropriate to just attribute everything to the vitamin B6 level".
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it → stress → level
Regulators, manufacturers face potential shake-up
The review followed years of mounting concern and, recently, a dramatic intervention by the medicines regulator.
In November last year the Therapeutic Goods Administration (TGA) — which had conceded it had been too slow to act — moved to pull high-dose B6 products from general sale, while also asking the NHMRC to review the science behind the limit.
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it → face → limit
According to the recommendation, the new limit would apply to all adults, including during pregnancy and breastfeeding, with lower limits for children scaled down by body weight, to as little as 4mg a day for under-4s.
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limit → accord → under-4s
Alexandra Jones, a food policy expert at the George Institute for Global Health, told 7.30 the proposed reduction was "encouraging" and brought Australia "closer to the approach adopted by the European Food Safety Authority", which enforces some of the most conservative safety limits in the world.
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which → tell → world
The upper limit is also a key reference that medicine and food regulators draw on when deciding what can be sold, how it is labelled, and what sits behind the pharmacy counter.
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what → draw → counter
"The outcomes of the NHMRC's work are not regulatory, but they do provide an important scientific foundation for updating guidance to consumers and potentially updating policy and regulation down the track," Dr Jones said.
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Jones → provide → track
The working group acknowledged the change could carry "cost implications for manufacturers", but said its decision was "made on the basis of population health".
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decision → work → health
"There's nobody who's going to be harmed by lowering it," Professor Green said, "but there will be people who may be harmed by keeping it at 50 milligrams.
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who → be → milligrams
"
'Hidden' in supplements and energy drinks
Just how many Australians have been affected is impossible to say.
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affected → affect → supplements
Pathology clinics across the country sounded the alarm more than a year ago, noting a spike in concerning results.
But the TGA's surveillance of cases has been cumbersome.
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surveillance → sound → cases
The TGA publicly lists reports of potential issues related to medicines as "adverse events".
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TGA → list → events
As of August 13, the current number of potential peripheral neuropathy cases linked to pyridoxine (B6) since 2020 was 279.
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number → link → 2020
But even by the TGA's own admissions, that number should not be considered an accurate reflection of prevalence in the community.
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number → consider → community
The Australian lobby group for complementary medicines, CMA, which represents major manufacturers, maintains that adverse events are "extremely rare".
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events → represent → manufacturers
A CMA spokesperson told 7.30 "high doses of vitamin B6 are often recommended by healthcare practitioners for specific therapeutic benefits or preventing deficiency".
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doses → tell → deficiency
Professor Green believes toxicity cases are under-reported and what has been recorded officially was "likely the tip of the iceberg", probably skewed towards the most "severely affected people".
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recorded → believe → people
Another issue in trying to understand prevalence is that toxicity symptoms exist on a spectrum and can often mimic other conditions.
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symptoms → try → conditions
Dr Silsby, who is researching the effect of B6 on nerves, said patients rarely realise how much they are taking and were often "absolutely shocked" when they figured out how many of their products contain B6.
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many → research → B6
"It can be hidden or unexpected in supplements … and we always ask them to go home and check through their cabinets and to stop anything that contains it,"he said.
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that → hide → anything
Professor Green himself admitted he unknowingly took B6 in a magnesium supplement for a while.
"If I can't figure it out, having been in this area for 20 years, how is the general public meant to?" he said.
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he → admit → years
For many people, though, the biggest source of hidden B6 is not vitamin supplements.
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source → hide → B6
…and 26 more, not listed.