Activated Vitamin B6 in pregnancy and labour

Vitamin B6(Pyridoxine) is a water soluble vitamin substantially found in fruit, vegetables, grains, chickpeas and meat. It is readily absorbed in the upper small intestine where it is used as a co factor in over a 100 known enzyme reactions in the body.

In the liver, VitaminB6(pyridoxine) is activated by a process of phosphorylation to become activated Vitamin B6.(P5P). This activated coenzyme form goes on to catalyze  a myriad of biochemical reactions.

Pyridoxine 5 phosphate(P5P) is the predominant form of vitB6 in the plasma.

P5P is needed for the proper absorption of  vitamin B12, Magnesium and gastric HCl.

P5P  is an important coenzyme in the metabolism of carbohydrates, fats, and proteins, and the elongation of essential fatty acids. It is a vital ingredient to stop the build up of homocysteine (thus protecting the cardio-vascular system) and is also required for the production of antibodies and red blood cells (in pregnancy you will be making new blood cells).

It participates in the Phase 1 and Phase 2 liver detox pathways. Therefore in morning sickness during pregnancy it is the go to co-factor in helping to ease the extra load on the maternal liver.

In labour, activated VitaminB6 helps release stored glycogen(stored glucose) in the form of glucose within the uterine muscle, making this glucose available to be used in the Krebs cycle for energy consumption. This takes place in the mitochondria of uterine muscle tissue.

Also in labour, skeletal muscle is being used to keep you physically active and help with the labour so P5P is very important in participating in the release of stored glucose to be used as energy in skeletal muscle.

P5P also participates in the formation of noradrenalin.

Noradrenaline is a very important hormone of labour as it stimulates the release of glucose from the liver and increases the maternal heart rate to pump blood around the body (with all that extra glucose/O2/fats/nutrients).

Noradrenaline is essentially getting Mother's brain and body ready for action - the action of labour, so you want this to be at its optimal level.

Noradrenaline mobilizes the break down of brown fat for energy.

In the kidneys, noradrenaline release glucagon which in turn release more glucose from the liver.

In adipose tissue(fat tissue) it breaks down fats to be used as energy within the uterus and skeletal muscle.

In the gut it slows down digestion, blood flow and release of digestive enzymes (you don’t want to be digesting food when going through labour).

You can see from the above simplified list how important this co factor-P5P is, and any reduction in levels could have a significant affect on your well being.

In clinical practice a number of questions arise. If Vitamin B6 is so abundant in so many food groups why do patients need the activated form P5P?

Simply put, they are not converting an abundance of B6 in the diet/body to P5P.
So why is this not happening in some people, especially those that belong to the RED body type (mesomorph)?

The reason we feel is a genetic glitch we call a single nucleotide polymorphism (SNIP for short). In other words, somewhere in their genetic code these individuals have a hiccup that doesn’t allow them to make enough enzymes to convert VitB6 to it's activated form - P5P. This explains why I see so many people that require a supplement of P5P to maintain optimal well being (mainly but not exclusively Red body type/mesomorph).

So lets keep this simple, the Red body types have a genetic glitch (SNIP) that prevents them from fully converting all of the abundant VitB6 in the diet/plasma to P5P, which the body then goes on to use in a myriad of biological reactions.

Therefore, a shortage of P5P may lead to excessive morning sickness as the maternal liver struggles with the extra endogenous toxins.

A shortage of P5P may also lead to a prolonged and uncomfortable labour due to the reduction of available glucose and fats for energy needed by the uterus.

There is not enough P5P to go around to give you a full compliment of noradrenaline, thus your fat stores/glucose stores and O2 levels are not being fully utilized.

All in all this one supplement, P5P in capsule, covers many bases and is very beneficial during all stages of pregnancy and labour.

The other nutrients for labour are Zinc, magnesium and H4 biopterin.