In order for vitamins to be utilized by the body, they must first be converted into their active coenzyme forms. The active form of Vitamin B-6 is Pyridoxal-5-phosphate, or P5P. This active form allows for the best absorption, because it is ready to go to work immediately. It is primarily in the liver that P5P is synthesized from pyridoxine with the help of enzymes. This process requires Vitamin B2, zinc, and magnesium. P5P is associated with numerous enzymes, many of which are involved in amino acid metabolism, which produces the neurotransmitters dopamine, nor-adrenalin, and GABA as well as the hemoglobin in red blood cells. Many B6 supplements are the inactive pyridoxine HCL form. In some cases supplementation with this form alone caused a reversible numbness & tingling of the extremities, in doses as low as 200 mg daily, over a 3-year period. This problem is thought to be secondary to the liver’s inability to convert this form into the useable P5P form. Using P5P avoids this problem. It’s the P5P our bodies really need to break down and use fats, proteins, and carbohydrates, to make red blood cells and antibodies, to help the digestive and nervous systems function, and to maintain healthy skin. But some folks have trouble converting pyridoxine into P5P. Those susceptible to a deficiency include some breast-fed infants, elderly persons on a poor diet, and women on estrogen-containing oral contraceptive pills. B6 has recently been found to benefit the autistic and is thought the P5P form may even provide more benefit. Also, people such as: pregnant and nursing mothers, the elderly, the autistic, and babies at risk of SIDS (Sudden Infant Death Syndrome). P5P is the only form of B6 that the fetus and newborn baby can use. In premature babies, who are more susceptible than full-term babies to SIDS, the use of the pyridoxine form of B6 can result in irreversible central nervous system damage. And lack of P5P can predispose a surviving premature infant to atherosclerosis in later life. In addition, the fact that B6 benefits some persons with Carpal Tunnel Syndrome, and not others, we think may well be traced to the person’s ability or inability to make P5P from pyridoxine. P5P and CARPAL TUNNEL SYNDROME In many cases, carpal tunnel syndrome (CTS) is thought to result from long-term repetitive motions of the hands and wrists, such as typing. Although repetitive motion is often the culprit, it does not explain the frequent occurrence of CTS with non-motion-related conditions, such as pregnancy. Conventional treatment includes splinting, rest, anti-inflammatory drugs, and frequently, surgery, which relieves pressure and eliminates the symptoms. Nutritional supplements may be helpful. Vitamin B6 is the most frequently-used and well-known nutritional treatment for CTS. It appears that many people with CTS have vitamin B6 deficiencies, and some studies show that such people are helped when given 100 mg of vitamin B6 three times per day. Although some researchers have found benefits with lesser amounts, the results have not been consistent. Often, CTS will improve in two to three months with vitamin B6 supplementation. In order to be effective, vitamin B6 must be transformed in the body to pyridoxal-5-phosphate. Some doctors of natural medicine suggest that people who do not respond well to the vitamin B6 supplements try 50 mg of pyridoxal-5-phosphate three times per day. Are there any side effects or interactions? Although side effects from vitamin B6 supplements are rare, at very high levels this vitamin can damage sensory nerves, leading to numbness in the extremities as well as difficulty walking. Should these symptoms develop, immediately stop supplementing with Vitamin B6. Note: Pregnant and lactating women should not take more than 100 mg of vitamin B6 per day, or 75 mg of P5P. Consult your health care professional before using this product. Pyridoxal-5-Phosphate is somewhat humidity-sensitive. It should be kept out of the sun, in a cool, dry place, with the lid of the container tightly closed. Do not refrigerate! Keep out of the reach of children. Recommended Dosage as per Health Canada Label Claims–Adults: Take 1 capsule per day on an empty stomach.