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NSAID Painkillers Found To Deplete Vitamin B-6 Levels


November 11, 2013

By: Case Adams, Naturopath


New research has determined that COX-inhibitors, which include numerous NSAIDs - Nonsteroidal anti-inflammatory drugs – reduce Vitamin B-6 levels within the body.

The study, published in the American Journal of Clinical Nutrition, tested 150 patients with rheumatoid arthritis. Some of the patients were treated with cyclooxygenase (COX) -inhibitor treatments while some were not.

After six months of treatment, the researchers compared the two groups for their blood levels of pyridoxal-phosphate – the active form of vitamin B-6. The researchers found that the patients taking NSAIDs had significantly reduced levels of circulating vitamin B-6.

Both types of COX-inhibitors reduce B6

Both selective and non-selective COX-inhibitors were found to lower vitamin B6 levels. Laboratory research found this effected both kidney and liver levels of the important B-vitamin as well.

Vitamin B6 is critical for nerve function, fat metabolism, glucose metabolism, and many other functions in the body.

Non-selective COX-inhibitors include aspirin and ibuprofen, while selective COX-inhibitors include celecoxib (Celebrex).

Non-selective COX-inhibitors halt both the cyclooxygenase-1 enzyme and the cyclooxygenase-2 enzyme. While the cyclooxygenase-2 inhibition blocks prostaglandins involved in the pain and inflammatory response, cyclooxygenase-1 inhibition stops the prostaglandins related to producing healthy mucosal membranes, particularly among the stomach and lower esophagus.

This is why aspirin , naproxen (Naprosyn, Naprelan) and ibuprofen can produce ulcerative and bleeding stomach symptoms.

Arthritis, which now affects one in five adult Americans, is a leading reason people take COX-inhibitors.

Research that came to light about a decade ago revealed that selective COX-2 inhibitors can produce cardiovascular issues. This resulted in the removal of Vioxx and Bextra from the market. Celebrex (celecoxib ) still remains in the U.S. market, but has been removed from other markets, such as the European and Australian markets.

So besides the risk of ulcers, gastric bleeding and cardiovascular disease, we can now add blocking vitamin B6 uptake to the list of serious risks of these medications.

Learn natural solutions for arthritis.

Natural COX-inhibitors come without side effects

It should be noted that natural COX-inhibitors such as willow bark and meadowsweet herb block pain-related prostaglandins but they do not cause the negative side effects relating to bleeding ulcers and cardiovascular effects. While this study did not test these with respect to vitamin B6, it is logical to assume that these herbs also do not block B6 as these do as well.

In fact both willow and meadowsweat stimulate the healing of ulcers and gastric bleeding, and are frequently used to help heal ulcers by herbalists.

Why do natural COX-inhibiting herbs not have the same negative effects? Because nature's herbs contain tens and sometimes hundreds of different medicinal compounds, which help balance and buffer the effects of the COX inhibition.

That's because nature is smart.


Chang HY, Tang FY, Chen DY, Chih HM, Huang ST, Cheng HD, Lan JL, Chiang EP. Clinical use of cyclooxygenase inhibitors impair vitamin B-6 metabolism. Am J Clin Nutr. 2013 Oct 23.

Adams C. Arthritis: The Botanical Solution. Logical Books, 2011.