Vitamin B6 is a water-soluble vitamin that is an important cofactor in various metabolic processes. Although rare, its consumption can sometimes result in toxicity, which typically presents with peripheral neuropathy in the early stage. While vitamin B6 toxicity is most often associated with supplemental mega-doses of more than 50 mg/day, more recent studies have shown that toxicity can occur in cases of much smaller doses as well. We present a case of a 73-year-old male with a three-year history of progressive peripheral neuropathy who was found to have a serum vitamin B6 level of 259.9 nmol/L (reference range: 20-125 nmol/L) but only reported taking a daily multivitamin containing 6 mg of vitamin B6. This case of toxicity in the setting of a daily intake lower than the European Food Safety Administration's (EFSA) newly established Tolerable Upper Intake Level (UL) of 12 mg/day highlights the need for further research into the effects of relatively low-dose vitamin B6 supplementation.
