P5P – Vitamin B6 (pyridoxine)

From Migraine and Headache Revolution By Dr. Alex Vasuez, OD, ND, DC 

The safety and efficacy of supplemental pyridoxine (vitamin B6) in reducing glutamate levels—and thus reducing excessive stimulation of the NMDAr by glutamate—necessitates its inclusion in the treatment of any and all chronic pain disorders, especially migraine and fibromyalgia. Pyridoxine does more than simply lower glutamate levels, as pyridoxine also helps to lower homocysteine (HYC) levels. Glutamate and HYC are both amino acids that activate the NMDAr and mGluR [31]—the metabotropic glutamate receptor (detailed shortly)

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I will state plainly here what everyone needs to know about this section: Because glutaminergic neurotransmission promotes pain/anxiety/depression/neurodegeneration, our therapeutic goals are to

  1. reduce glutamate levels with vitamin B6 and by avoiding/treating microglial activation (ie, “brain inflammation”),
  2. reduce glutamate-triggered influx of calcium with zinc and magnesium, also vitamin D, alkalinization (increased consumption of base-forming foods, such as fruits and vegetables which contain citrate which is converted to bicarbonate to promote alkalinization, one effect of which is to promote magnesium retention, thereby alleviating pain [33]), omega-3 fatty acids such as from fish oil,
  3. reduce the effects of glutamate/NMDA receptor activation by counterbalancing with benzodiazepine/GABA receptor activation by promoting conversion of glutamate to GABA and perhaps also by using niacinamide and botanicals that act as ligands for the GABA receptor.

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