Evidence supporting the use of: Vitamin B6 (pyridoxal 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) is used to support or treat symptoms of premenstrual syndrome (PMS) primarily on the basis of scientific investigation, although the degree of evidence is modest. Several clinical trials and reviews have evaluated the efficacy of vitamin B6 in reducing PMS symptoms such as mood swings, irritability, bloating, and breast tenderness. A 1999 meta-analysis (Wyatt et al., BMJ) found that vitamin B6 may be more effective than placebo for overall PMS symptoms, particularly mood-related complaints, but emphasized that most studies were small and methodologically limited. Doses in studies typically ranged from 50-100 mg per day, and concerns about potential neurotoxicity at higher dosages have been noted. Subsequent reviews (e.g., Kashanian et al., 2013; Dickerson et al., 2003) have supported a possible small benefit, especially for psychological symptoms, but have also highlighted the low quality and heterogeneity of the evidence. Vitamin B6 is thought to act by influencing neurotransmitter synthesis, particularly serotonin and dopamine, which may be relevant to PMS mood symptoms. Overall, while vitamin B6 is widely used and there is some scientific support for its use in PMS, the effect size appears modest and evidence quality is low to moderate. Guidelines suggest it can be considered as an option but should be used cautiously and at recommended doses to avoid toxicity.

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