Sydney Pead
Every day millions of Australians take vitamin supplements hoping for a health boost. But there’s been a sharp rise in people suffering numbness, nerve damage, even paralysis after unknowingly overdosing on vitamin B6. Today, reporter for the ABC’s 7.30 program, Tom Hartley, unpacks his year-long investigation into the surge in cases and the regulators’ long overdue crackdown. I’m Sydney Pead, filling in for Sam Hawley. On Gadigal land, Sydney, this is ABC News Daily. Tom, at the very start of the year, you began looking into vitamin supplements for the ABC’s 7.30 program. And since, there’s been a shocking series of stories about the vitamin B6, which is seriously harming people. So just tell me about Mary Buchanan.

Tom Hartley
At the start of the year, in our team, in a production meeting, we got onto the topic of supplements, as you say. And there was this one story that had popped up online saying that pathologists were alarmed by the number of B6 poisoning cases. So we started hunting, and eventually we tracked down Dr. Mary Buchanan, who was 76 years old at the time. And before she retired, she was an emergency physician and a GP, 40 years in the field. But in 2021, she couldn’t figure out why she was getting unbearable leg cramps. And she was having these sleepless nights, she was restless. It was a genetic condition, but her pharmacist recommended a magnesium supplement saying, hey, give this a crack, this might help. And so that worked for Mary for a few weeks, but she became extremely weak. And then she stopped being able to use her legs properly, which for anyone you can imagine, that’s a terrifying thing.

Mary Buchanan
The weakness continued so much so that I was having trouble going up and down stairs. And I could hardly walk, you know, 100 metres really.

Tom Hartley
It got so bad that Mary actually feared she had multiple sclerosis or motor neurone disease.

Mary Buchanan
And so I thought, I probably have got something quite nasty neurologically. I’d need more help and more care early than I thought I might ever need assistance. And I don’t like the thought of that.

Sydney Pead
Yeah, very, very scary. And her doctors eventually, they pinpointed those symptoms to the supplements she was taking.

Tom Hartley
Yeah, but I mean, almost two years too late, it was March 2023. She’d been taking magnesium routinely for a couple of years. A neurologist diagnosed her with peripheral neuropathy. And that was the result of vitamin B6 toxicity, which was essentially this vitamin poisoning, her frying her nerve endings in her legs. Test results revealed that she had seven times the normal level of the vitamin in her system. In these magnesium formulas that are in these common over-the-counter supplements, B6 is a really common additive.

Mary Buchanan
My mother lived till she was 98. Now, that’s not the sort of future I really want for myself, that I might be dependent on people before I may have needed to be.

Sydney Pead
Okay, Tom, well, you better just explain what B6 is exactly, because as you say, it’s in all kinds of things, isn’t it?

Tom Hartley
Yeah, it’s surprising where it pops up. It is vital to cognitive function and it assists with more than 140 processes in the body. But most people get all the B6 they need from a balanced diet. This is designed by scientists. It’s manufactured in a lab. It starts as a bunch of chemical compounds. It’s eventually produced en masse in a factory before it’s mixed into supplement pills or products that you buy on your shelves. It can be known as pyridoxine, pyridoxamine, or pyridoxical. It’s registered in more than 1,500 over-the-counter supplements from magnesium to multivitamins. But then you’ll also see it in places like, I mean, walk down the aisles of your supermarket, you’ll see it in cereals, breakfast cereals. You’ll see it in protein shakes. You’ll see it in food and dietary supplements.

Sydney Pead
I want to get an idea of just how people have been overdosing, so to speak, on B6, because many of us assume that if you take too much of a vitamin, it just gets flushed out of your system naturally. But that’s clearly not the case here.

Tom Hartley
Yeah. I mean, some supplements do absolutely nothing, right? Like one doctor told me that they do pass through your body to become—this is other supplements, not B6—to become what is really just very expensive urine. Yeah. But one key issue with manufactured vitamin B6 is that it has this cumulative effect. Traces of the vitamin can survive in the body for up to 30 days. And so when you take too much of it, it can cause nerve damage.

Sydney Pead
And so how are people managing to take so much of it? It’s not just through one product, is it?

Tom Hartley
Eighty percent of the over-the-counter supplements with registered B6 products contain levels well over the recommended daily amount of 1.7 milligrams. Now, in my reporting, I spoke to GP dietician Terri Lins-South, and she says the over-consumption is not necessarily because someone’s taking too much of one product, but multiple products containing B6 without realising.

Dr Terri-Lynne South, dietician
People don’t understand that it’s in our food naturally. It’s supplemented in some of our foods. It’s in foods that you might not even think that have additional minerals, such as the energy drinks. It’s in our multivitamins and minerals where you might expect to find it. And then again, it can be in some complementary medicines as well. That’s a lot.

Sydney Pead
Tom, and what is really scary is that after you shared Mary’s story, you then heard from dozens of other people just like her. Just tell me about that.

Tom Hartley
The number of people that we heard from was pretty overwhelming. Initially, we heard from more GPs who had no idea, like retired GPs who had no idea this was a thing. Chief executives, an award-winning musician, more retirees, even pregnant women who’d been taking B6 because it is something that’s recommended in the course for treating nausea and vomiting in pregnancy. Just this growing list of people who emailed in. I mean, people saying that I was taking it for seven years religiously, and I’d completely lost all the feeling in my legs, and I thought I was going crazy. Like, these are people who just had no idea what was happening. And all these symptoms from all these people from all walks of life were pretty similar, though. The numbness in the legs, pins and needles, mobility issues, even paralysis.

B6 toxicity patients
I had to give up work. I couldn’t use a keyboard. I could not type. It just seemed to affect every bit of my body. I literally thought I was dying.

Sydney Pead
Yeah, Tom, in your investigation, you really did unpack just how underreported these cases of B6 toxicity really are. So just tell me about what you did uncover. You looked at some blood test data, didn’t you?

Tom Hartley
We went effectively to the coalface, which is the pathology labs where they test the blood. This one in particular, Sullivan Nicolades in Brisbane, they’d actually set up a specialist B6 testing area because of the sudden spike in cases. So their midyear data at that point when we’d visited them had showed us that more than 2,700 people probably had probable cases of peripheral neuropathy or other health issues attributed to B6 blood toxicity. And they were able to say that because they could see that the numbers were so high, like these saturated levels of B6 in the blood was so high that there was a very, very high chance that they would be having some sort of potentially life-altering implications. The man in charge of this Sullivan Nicolades clinical testing is pathologist Dr David Kanowski, who noted a massive increase in the number of people who’d been coming forward for B6 blood tests since January, since our reports really started taking off.

Dr David Kanowski, Sullivan Nicolaides Pathology
It is still surprising and shocking. It’s big, really. And sometimes we’ll talk to doctors who don’t believe that it’s a clerical error that the result is that high. And we have to say, no, no, it’s real, you need to sort it out.

Sydney Pead
Tom, if B6 toxicity is so potentially dangerous, what kind of rules are there about how much of the vitamin products can contain? Are there warnings on the labels?

Tom Hartley
Yeah, there are. So the warnings have been there and I guess the Therapeutic Goods Administration, the regulators, they have tried to lessen the public health risk over previous years. So in 2022, they strengthened labelling requirements, requiring a warning about peripheral neuropathy on products containing daily doses of more than 10 milligrams. It also reduced the maximum permitted daily dose of B6 enlisted medicines down from 200 milligrams down to 100. Now, all the while, amidst our reporting in the background, there’s this committee which refers to the TGA. It’s called the Advisory Committee on Medicines Scheduling. Basically, they give advice and recommendations to the regulator. The TGA responded to advice from the committee and found that the benefits of B6 were negligible. And this was quite big for them to come out and say this. The delegate, the TGA’s delegate, said the labelling was inconsistent and confusing. And that managing doses of B6 was, and I quote, well beyond the health literacy capability of typical consumers.

Sydney Pead
Okay. And well, since that report, we’ve really seen the medicine regulator try and ramp up its efforts to crack down on B6. But it has really taken them a long time to respond to this issue, hasn’t it, Tom?

Tom Hartley
It really was a big moment in this whole saga when the TGA admitted to us, to 730, that it had underestimated how big the problem of B6 toxicity is. The chief medical adviser from the administration, Dr. Robyn Langham, told me that those 2022 changes were not enough to slow the growing number of potential toxicity in the community.

Prof Robyn Langham, TGA chief medical adviser
And the changes from a few years ago we’ve seen were not sufficient to reduce the rate of the level of toxicity from B6. And that’s probably because of a number of factors. And so we’re adjusting again. And we may need to look at it again in the future. I don’t know.

Tom Hartley
Now, there’s been another extensive review since the middle of the year, including 248 public submissions. That’s now led to the TGA ultimately saying, yes, we are going to crack down on the sale of B6 supplements. And so this means from June 2027, so a year and a half away still, customers will require a pharmacist supervision to purchase products containing more than 50 milligrams of B6. And anything with more than 200 milligrams will need a prescription.

Sydney Pead
Okay, Tom. And the report also pushed back against the supplement industry too, right, which, by the way, is worth more than $6.2 billion. And the industry had claimed that B6 was only toxic in very high doses, right?

Tom Hartley
Yeah. I mean, it’s been their argument all along. The report from the TGA directly challenged those claims. It said it had convincing evidence that harm had happened at much, much lower intakes. And it also highlighted that the studies industry submissions relied on for their evidence were actually funded by major vitamin B6 manufacturers, which raises serious questions about conflicts of interest. Now, they put a lot of the onus back on the consumer and say that it is important that consumers understand the product they’re taking and that they do so in accordance with what the labels say in terms of directions for use.

Sydney Pead
Okay, Tom. So from June 2027, products with more than 50 milligrams of vitamin B6 will be behind the counter and you’ll need a prescription for doses higher than 200 milligrams. So they’re the new rules. But 2027, that’s quite a while away, especially because in other countries like the UK, it’s been regulated for a long time.

Tom Hartley
The TGA said when they made this announcement that the time is necessary for changes to take place. The sector’s now looking at a one and a half year transition period, as you said, to update labels. They’ve got to manage their stock, comply with new scheduling rules. Some will probably reformulate some of their supplements and they’ll have to re-register, et cetera.

Sydney Pead
And Tom, after all your reporting on this, what is your advice to people who might be taking supplements right now and are probably pretty concerned about what you’ve been uncovering this past year?

Tom Hartley
Look, I’ll just repeat what other people have told me, right? So from B6 toxicity survivors, they say, they’re telling me and everyone else, if you’re taking supplements, look at the packaging, look at the warnings. And importantly, as the medical advice says, if you’re experiencing tingling, burning or numbness in your hands or your feet, stop taking what you’re taking and seek medical advice as soon as possible.

Sydney Pead
Tom Hartley is a reporter for the ABC’s 7.30 program in Brisbane. Audio production on this episode was by Sam Dunn. Our supervising producer is David Coady. I’m Sydney Pead. ABC News Daily will be back again tomorrow. Thanks for listening.