{"id":"d6a3f2d7-ebdb-5c99-b37f-f5b9d3694787","stable_key":"1310afbd-6010-586e-805d-551d846da421:b6-toxicity-coasting","predicate":"toxicity_progressed_after_withdrawal","statement":"Symptoms progressed for two to three weeks after pyridoxine withdrawal despite normalized serum PLP.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"context_dependent","is_public":true,"mechanism_event_id":"40dd8e6a-729e-59f6-9614-84e69afbe371","mechanism_event_label":"A blood vitamin level returned to normal before the nerve symptoms stopped worsening.","subject":{"id":"aa6648f2-8962-5567-9939-ef4145e40ed1","slug":"pyridoxine","display_name":"Pyridoxine","entity_type_key":"small_molecule"},"object":{"id":"77b81275-d0fb-5f84-a963-1c93614b204f","slug":"sensory-neuropathy","display_name":"Sensory neuropathy","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"40dd8e6a-729e-59f6-9614-84e69afbe371","stable_key":"1310afbd-6010-586e-805d-551d846da421:b6-toxicity-coasting-event","event_type":"observed_intervention","label":"A blood vitamin level returned to normal before the nerve symptoms stopped worsening.","description":"Symptoms progressed for two to three weeks after pyridoxine withdrawal despite normalized serum PLP.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"6b656ff5-9532-5da4-8eea-8ca163a48649","slug":"pyridoxal-phosphate","display_name":"PLP","entity_type_key":"small_molecule"},"role":"serum_marker","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"aa6648f2-8962-5567-9939-ef4145e40ed1","slug":"pyridoxine","display_name":"Pyridoxine","entity_type_key":"small_molecule"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"77b81275-d0fb-5f84-a963-1c93614b204f","slug":"sensory-neuropathy","display_name":"Sensory neuropathy","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""}]},"contexts":[{"dimension":"experimental_model","value_text":"Five healthy volunteers prospectively followed during experimental pyridoxine excess.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"Pyridoxine 1 or 3 g/day, stopped with clinical/laboratory abnormality; very high historical exposures.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Demonstrates clinical timing; does not identify the molecular injury mechanism or prove irreversible damage.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Vitamin B6 research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"vitamin-b6","display_name":"Vitamin B6","entity_type_key":"chemical_species"}},{"dimension":"organism","value_text":"Homo sapiens","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"A blood vitamin level returned to normal before the nerve symptoms stopped worsening.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[b6-berger1992] Dose response, coasting, and differential fiber vulnerability in human toxic neuropathy: a prospective study of pyridoxine neurotoxicity (1992). https://pubmed.ncbi.nlm.nih.gov/1620347/ DOI: 10.1212/wnl.42.7.1367","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Peripheral sensory function after exposure withdrawal","comparator":null,"unit":null,"notes":"","entity":null}],"evidence":[{"id":"c94ffb5b-1d87-536c-896f-2f68abcea201","evidence_kind":"source_excerpt","locator":"Lines 1584-1594","start_line":1584,"end_line":1594,"excerpt":"### b6-toxicity-coasting\nSymptoms progressed for two to three weeks after pyridoxine withdrawal despite normalized serum PLP.\nCondition category: normal\nnutrient_topic: Vitamin B6 research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: A blood vitamin level returned to normal before the nerve symptoms stopped worsening.\norganism: Homo sapiens\ntissue_or_cell_type: Peripheral sensory function after exposure withdrawal\nexperimental_model: Five healthy volunteers prospectively followed during experimental pyridoxine excess.\nlimitations: Demonstrates clinical timing; does not identify the molecular injury mechanism or prove irreversible damage.\nexposure: Pyridoxine 1 or 3 g/day, stopped with clinical/laboratory abnormality; very high historical exposures.\n[b6-berger1992] Dose response, coasting, and differential fiber vulnerability in human toxic neuropathy: a prospective study of pyridoxine neurotoxicity (1992). https://pubmed.ncbi.nlm.nih.gov/1620347/ DOI: 10.1212/wnl.42.7.1367","model_system":"Five healthy volunteers prospectively followed during experimental pyridoxine excess.","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [b6-berger1992] Dose response, coasting, and differential fiber vulnerability in human toxic neuropathy: a prospective study of pyridoxine neurotoxicity (1992). https://pubmed.ncbi.nlm.nih.gov/1620347/ DOI: 10.1212/wnl.42.7.1367","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"251773bb-16f5-5903-b135-db4a61d9dec4","stable_key":"import-1310afbd-6010-586e-805d-551d846da421","title":"Vitamin B6: mechanisms, deficiency and nutrient interactions (2026-09-17)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"ef0019b344b2219220f801a84d0d138ff6880c1be1a59540d9034bfa4334f61e","revision_id":"cac3555f-48af-5c52-a84e-add4482c87fb","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}