Evidence supporting the use of: Vitamin B6 (pridoxal 5-phosphate)
For the health condition: PMS (general)

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Vitamin B6 (pyridoxal 5'-phosphate, the active form) is used to support or treat premenstrual syndrome (PMS) symptoms, and this use is primarily based on some scientific evidence, although the overall quality of the evidence is moderate to low. Several randomized controlled trials (RCTs) and systematic reviews have investigated the efficacy of vitamin B6 in reducing PMS symptoms such as mood changes, irritability, breast tenderness, and bloating. A 1999 meta-analysis (Obstetrics & Gynecology) found that vitamin B6 at doses up to 100 mg/day was more effective than placebo in alleviating overall PMS symptoms and specifically emotional symptoms. However, most studies included in the analysis were small and of varying methodological quality.

A 2015 Cochrane review concluded that there is limited evidence for vitamin B6's efficacy, citing methodological flaws and the risk of bias in many studies, but acknowledged small benefits, particularly for mood-related symptoms. The mechanism by which vitamin B6 might help involves its role as a cofactor in neurotransmitter synthesis, including serotonin and dopamine, which are implicated in mood regulation.

Despite some positive findings, larger and more rigorously designed studies are needed. The evidence base does not firmly support routine use, but vitamin B6 continues to be recommended by some clinicians, as it is generally well-tolerated at recommended dosages. Thus, its use is justified by a mix of tradition and scientific evidence, with scientific support rated as modest (2/5).

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