Support/Supplement - Vitamin B6

Vitamin B6, mood, and hormones — a simple tool that’s often overlooked

Vitamin B6 (pyridoxine) is one of those supplements that doesn’t get a lot of attention but in women’s health, it can be incredibly helpful, particularly when it comes to mood and hormonal changes.

I most often use it for PMS , PMDD, and alongside that, nausea in pregnancy.

1. PMS, PMDD, and mood support

If you work in this space or live in it you’ll know how significant hormone-related mood changes can be.

Irritability. Anxiety. Low mood. That sense of not quite feeling like yourself.

Vitamin B6 can help here.

Why?

B6 is a key cofactor in the production of neurotransmitte rs:

• Serotonin → mood regulation
• GABA → calming, reduces anxiety
• Dopamine → motivation and focus

During the luteal phase, when progesterone and estrogen are fluctuating, some women are more sensitive to these shifts. That sensitivity often shows up as mood symptoms.

Supporting these neurotransmitter pathways can help smooth some of that fluctuation.  There’s also some evidence that B6 plays a role in hormone metabolism, which may further contribute to its benefit in PMS and PMDD.

Typical dosing:

50–100 mg/day

(often used in the luteal phase rather than continuously, but often I use 50mg continually as it's easier to remember, and therefore safer than the high dose)

I’m careful to check for other sources of B6 in supplements so we’re not unintentionally overdosing.

2. Nausea in pregnancy and hyperemesis

Vitamin B6 is also widely used as a first-line treatment for nausea and vomiting in pregnancy, including hyperemesis gravidarum.

It’s safe, well tolerated, and recommended in multiple guidelines (including ACOG), often with or without other anti-emetics/antisickness tablets

Why does it work?

Again, it comes back to neurotransmitters, particularly serotonin and dopamine pathways involved in nausea signalling in the brain.

Typical dosing:

• 10–25 mg, 2–3 times daily (up to ~75–100 mg/day)

There’s also some suggestion that starting B6 pre-conception may reduce nausea severity, although the evidence here is still limited.

Safety considerations

As always - dose matters.

• Long-term use above 100 mg/day increases the risk of peripheral neuropathy.   So I tend to stick to 50mg/day
• Best used with some clinical guidance if taking higher doses
• Check total intake  across all supplements
• A small intervention that can make a real difference

Vitamin B6 isn’t a magic fix, but it’s a simple, accessible, evidence-based tool that can be really helpful when used in the right contex t.

Particularly for women navigating hormonal mood changes or contemplating pregnancy (especially if previous hyperemesis, it’s often worth considering.

References

https://www.pms.org.uk/app/uploads/2018/06/guidelinesfinal60210.pdf

American College of Obstetricians and Gynecologists (ACOG). Practice Bulletin No. 189: Nausea and Vomiting of Pregnancy. Obstet Gynecol. 2018.

Sahakian V, Rouse D, Sipes S, Rose N, Niebyl J. Vitamin B6 is effective therapy for nausea and vomiting of pregnancy. Obstet Gynecol. 1991.

Wyatt KM et al. Efficacy of vitamin B6 in the treatment of premenstrual syndrome: systematic review. BMJ. 1999.

Chocano-Bedoya PO et al. Dietary B vitamin intake and incident PMS. Am J Clin Nutr. 2011.

Hellhammer J et al. Magnesium + B6 and stress/mood. Nutrients. 2018.

Institute of Medicine. Dietary Reference Intakes for Vitamin B6.