Bioidentical Hormones 101 
The Book, by Jeffrey Dach MD

Chapter 44. Vitamin B6, Pyridoxine for Trigger Finger and Carpal Tunnel

Chapter 44. Vitamin B6, Pyridoxine for Trigger Finger and Carpal Tunnel

Jim is a 46 year old retired New York policeman who uses power tools to repair his house. His problem is chronic pain at the base of the thumb and wrist. The pain worsens with use of the hand, making it difficult to use the power tools.  Certain repetitive hand movements cause pain such as turning a key in a lock, unscrewing the lid of a jar, and opening the car door. Jim also has "trigger finger" involving the thumb joint.  He reports tingling and numbness in the hands most noticeable at night just before sleep.  Jim's hand pain worsened lately, so he went to a hand surgeon who gave him a steroid injection at the base of the thumb and applied a hand/wrist splint.  These measures were ineffective, and his pain continued.  The surgeon suggested operation.  Jim came into the office to ask if anything else could be done to avoid surgery.

Vitamin B6, Pyridoxine for Trigger Finger

As it turns out, there is a simple and effective vitamin therapy for Jim's Trigger Finger hand condition.(1-9)  This vitamin is Pyridoxine, vitamin B6.  Jim was given a bottle of B6, pyridoxine phosphate (the activated form) and 3 weeks later, an amazed Jim returned to report that his pain and swelling is gone, and his trigger finger had also resolved.  He no longer needs the operation.

John Ellis MD, The Doctor Who Looked At Hands

I first learned of Vitamin B6 for carpal tunnel from Dr Jonathan Wright’s newsletter mentioning Dr. John Ellis, a Texas physician in the 1960's who discovered that vitamin B6 eliminates carpal tunnel syndrome, trigger finger, and other hand conditions.  Examine the backs of your hands. Have you ever noticed the backs of your hands are puffy and swollen, making the tendons obscured?   Are your hands so swollen that you can’t touch your palms with the tips of your fingers?  That’s the positive “Ellis sign,” indicating extra B6 could be helpful.  Usual dosage is 20 milligrams three times daily of the activated P-5-P form of Vitamin B6.  Old copies of Dr. Ellis’ book "The Doctor Who Looked at Hands" originally written in 1966, are still available.(10)

Vitamin B6 Toxicity

Unlike other water soluble B vitamin which are safe at high doses, vitamin B6 (pyridoxine) can be toxic, causing sensory neuropathy at dosages above 300 mg per day.(11-15)  The biologically active form of pyridoxine P-5-P (pyridoxal-5-phosphate) has no reported toxicity.  Therefore, P-5-P is the preferred form of vitamin B6.   Make sure your B Vitamin Complex uses the P-5-P version rather than plain old pyridoxine.

Warning – B6 Pyridoxine Toxicity

At high doses above 300 mg per day, Vitamin B6 (pyridoxine) can be toxic, causing sensory neuropathy.


For references and links, see my web site:

References for Chapter 44. Vitamin B6, Pyridoxine for Trigger Finger and Carpal Tunnel Syndrome

Response of vitamin B-6 deficiency and the carpal tunnel syndrome to pyridoxine . Proc. NatL Acad. Sci. USA Vol. 79, pp. 7494-7498, December 1982 Medical Sciences, (neuropathy/nutrition/vitamin supplementation/diet)  by  John Ellis et al.

Klin Wochenschr. 1989 Jan 4;67(1):38-41. Carpal tunnel syndrome and vitamin B6. Laso Guzmán  et al.

Res Commun Chem Pathol Pharmacol. 1977 Jun;17(2):283-93. Deficiency of vitamin B6 in women taking contraceptive formulations. Kishi H, Kishi T, Williams RH, Watanabe T, Folkers K, Stahl ML.

J Nutr Sci Vitaminol (Tokyo). 1981;27(3):193-7. Distribution of vitamin B6 deficiency in university students. Shizukuishi S, Nishii S, Folkers K.

Plast Reconstr Surg. 1987 Mar;79(3):456-62. Carpal tunnel syndrome and vitamin B6.
Kasdan ML, Janes C.

Ann Plast Surg. 2001 Aug;47(2):153-60. Experimental model of pyridoxine (B6) deficiency-induced neuropathy. Dellon AL et al.

Pyridoxine & Pyridoxal 5'Phosphate. Alternative Medicine Review Thorne. Volume 6, Number 1 x 2001.

J Am Coll Nutr. 2008 June; 27(3): 421–427.  Vitamin B6 Is Associated with Depressive Symptomatology in Massachusetts Elders Cristina Merete, MS, Luis M. Falcon, PhD, and Katherine L. Tucker, PhD

Vitamin B6 Therapy  The Case of Tunis Johnson, Gary Null B5 Arthritis, The Case of Ellen Cardwell, The Case of Joseph DeChamp, The Cases of Sarah and Gerald Black, The Research of John Marion Ellis, M.D.

(10) The Doctor Who Looked At Hands,  by John M Ellis, ARC Books (1971)

Ann Rheum Dis. 2006 December; 65(12): 1666–1667.  Pyridoxine toxicity courtesy of your local health food store by C D Silva and D P D'Cruz

Med J Aust. 1987 Jun 15;146(12):640-2. Pyridoxine neuropathy.  Waterston JA, Gilligan BS. 

Neurology. 1985 Oct;35(10):1466-8. Sensory neuropathy with low-dose pyridoxine.Parry GJ et al.

N Engl J Med. 1983 Aug 25;309(8):445-8.  Sensory neuropathy from pyridoxine abuse. A new megavitamin syndrome. Schaumburg H et al.

Indices of Pyridoxine Levels on Symptoms Associated with Toxicity: A Retrospective Study
Aliya N. Chaudary et al.

Author Jeffrey Dach MD

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