Vitamin B6 & H. pylori

Results 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.