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Vitamin B6 & H. pylori

iStock-1332110200Results of a randomized and controlled trial that enrolled 280 patients and tested the effect of adding vitamin B6 to a standard drug regimen for the treatment of H. pylori were recently published in BMC Infectious Diseases. The primary treatment for H. pylori is often quadruple therapy (in this Shanghai-based study it included rabeprazole, metronidazole, minocycline, and bismuth potassium citrate), yet this approach often has a very high rate of adverse and sometimes severe effects, likely driven by metronidazole and minocycline. This study assessed whether adding B6 to quadruple therapy would mitigate these symptoms, such as vomiting, dizziness, headaches, and other central nervous system pathology.

Over a 2-week study period, half of the participants received only quadruple therapy while the other half also received 20mg of vitamin B6, given twice per day. Eradication was assessed by C-urea breath testing. There was no significant difference between groups in terms of eradication rates; 61.5% and 56.2% in the control and B6 groups, respectively, both fairly low rates attributed to drug resistance in the area. However, a significantly lower rate of adverse effects was observed in the group receiving B6, 57% vs. 74.6%. In addition to an overall lower rate, there was also a lower rate of moderate to severe adverse effects. For example, only 14.6% of those receiving B6 experienced moderate to severe neurological symptoms, compared to 58.7% in the standard group. No patients receiving B6 had moderate to severe gastrointestinal symptoms, versus 1/3 of those in the standard group. The authors speculate that the benefit may be due to B6’s ability to drive GABA production in the brain, and offers a safe addition to standard therapy without reducing drug efficacy.

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