P5P: Uses and Health Benefits of Bioavailable Vitamin B-6

on Jul 20, 2021| Modified on Jul 26, 2021
P5P B6

P5P (Pyridoxal-Phosphate), the most bioavailable form of Vitamin B6, is frequently recommended to people suffering from many different ailments, such as carpal tunnel syndrome, nerve pain, burning feet, edema (water retention), anxiety, fatigue, and insomnia. P5P is also commonly used to ease breast pain due to PMS.

Earth Clinic readers recommend P5P for depression, trigger finger, cystic acne, lichen planus, and cradle cap, as you will discover in our reader feedback section below.

Because cooked, canned, frozen, and processed foods lose 30-40% on average of their B6 content during the manufacturing process, you might not be getting as much of this nutrient as you thought from your daily diet. People thus turn to P5P, the most active form of Vitamin B6, to make up for any deficiency.

Why B6 Is So Important

Vitamin B6 (pyridoxine) was discovered in 1934 and is connected with over 140 coenzymatic functions. [1]

A coenzyme is a substance that enhances the action of an enzyme.

Vitamin B6 has many functions in various systems of the body. These include the following:

  • immune system 
  • nervous system
  • gluconeogenesis 
  • lipid metabolism
  • erythrocyte function 
  • hormone modulation 
  • gene expression
  • niacin formation [2]

Interestingly, Vitamin B6 is widespread in nature. Higher-developed plants and microbes synthesize it. [3]

What is P5P?

P5P, or pyridoxal-5-phosphate, is the most active component of vitamin B6. Because it is manufactured as pyridoxine hydrochloride, the body cannot synthesize B6 in its natural state. Your liver must first convert vitamin B6 to a coenzyme form (P5P) to act as a vital enzyme catalyst in your body's processes.

P5P is made from three organic compounds -- pyridoxal, pyridoxine, and pyridoxamine.

P5P serves as a coenzyme to support essential enzymes in the body that play a crucial role in biosynthesis. It makes optimum use of vitamin B6 by facilitating body metabolism and other critical biological processes.

By taking a P5P supplement, you eliminate the need for your liver to convert pyridoxine, thus allowing better absorption and utilization of this critical nutrient.

Common B6 Deficiency Symptoms

If you want to know if you might need this supplement, take a look at the common symptoms of B6 Deficiency:

  • Brain Fog
  • Depression
  • Dizziness
  • Fatigue
  • Headaches
  • High Homocysteine
  • Low Energy
  • Morning Sickness
  • Seborrheic Dermatitis on the Face
  • Rashes
  • Cracked Lips
  • Sore Tongue
  • Numb Hands and Feet (Nerve Issues)
  • Weak Immune System
  • Panic Attacks
  • Trigger Finger
  • Carpal Tunnel Syndrome

Conditions That Can Cause a B6 Deficiency

Low blood levels of B6 are present in many chronic diseases, including:

  • Diabetes Type I and II
  • Depression
  • IBD
  • Inflammatory Diseases such as Crohn's 
  • Osteoporosis
  • Heart Disease
  • Dementia
  • Chronic Fatigue
  • Lung Cancer
  • Colorectal Cancer
  • Severe Diarrhea 
  • Malabsorption
  • Hyperthyroidism
  • Renal and Hepatic Disease
  • Congestive Heart Failure
  • Alcoholism
  • Drug-Induced Conditions
  • Pregnancy
  • Lactation


P5P for Trigger Finger

P5P is the top-recommended natural treatment for trigger finger, a condition that occurs when the tendon in one of your fingers becomes inflamed. The treatment for trigger finger was discovered by Dr. John Ellis back in the early 1970s. He reported the cure in his books, The Doctor Who Looked at Hands and Vitamin B6: The Doctor’s Report.

Progress is slow, and patience is needed for successfully treating Trigger Finger. It can take up to 6 months of P5P to see results depending on when the symptoms of trigger finger first appear.


50 mg of P5P taken 3 times a day will slowly heal a trigger finger.

Note: Online reviewers suggest it is best to take P5P with Magnesium.

P5P for Depression

People with depression usually have low B6 levels. Some clinical trials showed that supplementing with vitamin B6 reduced anxiety in people with depression. [4]

P5P for Sleep

P5P is needed for the production of melatonin. While research hasn't yet found a link between low P5P levels and sleep issues, one study involving 120 children showed that taking vitamin B6 at bedtime increased melatonin release from the pineal gland. [5]

P5P for Brain Health

B6 has been well researched for its essential function in synthesizing neurotransmitters like dopamine, serotonin, and GABA. Over 100 enzymes in your body are driven by P5P activity, making it a vital nutrient for your brain health.

Enzymes create neurotransmitters, which need P5P to work effectively. [5] These crucial neurotransmitters for the brain include the following:

  • GABA
  • Serotonin
  • Dopamine
  • Norepinephrine
  • Acetylcholine

While researchers still don't know whether supplemental P5P can affect neurotransmitters, reviews on various supplement sites suggest it can help with anxiety and depression, as well as a profoundly relaxing effect.

P5P Reviews

Below are a few interesting reviews we found for P5P. These reviews are from iHerb and Amazon.

Increases Brain Neurotransmitters

"My functional medicine doc recommended I take (before bedtime) together P5P, L-Tryptophan, and 5-HTP to generate serotonin in my "well," which had gone dry. It really made a huge difference and helped me get through a high-stress couple of months."

"Vitamin B6 is an all-around effective supplement for increasing dopamine, GABA, and serotonin. It can lower estrogen and enhance dream recall. A good way to see if you're sufficient or deficient in vitamin B6 is your ability to recall dreams. I like this B6 because it's in the form of P5P, it's cheap, and the dosage is just right so that I can take it away from food and not get nauseous."

"They really work for me! Calmer and better mood."

Increases Energy

"I started taking this supplement along with zinc gluconate as I suspect I may have pyroluria. Whether that is the case or not, I can confirm I had a noticeable boost in energy level and reduced 'brain fog' from the first day of supplementation. I have taken a similar dose of regular B6 in the past and did not get the benefits."

"I found this product great for nervous tension and energy levels. A great improvement, after using many other products with minimum results."

"Noticeable effects on energy but taken close to bed can make it hard to sleep."

Helps Trigger Finger and Peripheral Neuropathy

"Very helpful for trigger finger or tingling nerve on fingers."

Natural Aphrodisiac

"Helps lower prolactin. Helpful for the ability to reach orgasm in males and females."


"Helps to remove built-up fluid."

Joint Pain

"I used this for joint pain, and I believe it relieved the pain and increased joint mobility."

Gut Motility

"It is good to increase gut motility."

Where to Buy

You can find P5P in most health food stores (check the vitamin b section) and online at Amazon, iHerb, and many others.

Here are some popular examples from Amazon:

NOW Supplements, P-5-P 50 mg with Coenzyme B-6 + Mg Bisglycinate, 90 Veg Capsules

Life Extension Pyridoxal 5-Phosphate Caps 100 mg P5P, 90 Veg Capsules - Advanced Vitamin B6 Supplement

P5P Side Effects

Side effects of P5P Supplementation may include:

  • Headache
  • Nausea
  • Drowsiness (common)
  • Slight Numbness
  • Slight Tingling (pins and needles sensation)
  • Vomiting
  • Diarrhea
  • Stomach Cramps

Drug Interactions

Increased intakes from B6 supplements may interact with the action of certain drugs, including the following:

  • Levodopa (Dopar, Larodopa, Sinemet, Atamet)
  • Phenobarbital (Luminal, Solfoton)
  • Phenytoin (Dilantin)

Please continue reading below to learn how Earth Clinic readers use P5P to treat their conditions!

Do you take P5P?  Please send us your feedback on how this supplement has helped you.


1 User Review
5 star (1) 

Posted by Penelope (Boston, Ma) on 10/24/2009

The most incredible supplements I have ever tried for acne are L-Glutathione (500 milligrams up to 3 times a day) and vitamin B6 (ONLY get the P5P form. The other form can cause neuropathy). Split a 50 milligram pill of vitamin B6 (P5P) up and take a few times a day. I would ask your doctor about going up to as high as 100 milligrams of P5P if you really need that much to keep your skin clear. My skin is completely clear as long as I take the B6 or the L-Glutathione. I do not need to take both of these supplements together to have clear skin, - both have worked separately equally as well to clear my skin in record time (about a week to see results) but test it out and see what works for you - both have amazing health benefits. I have noticed that L-Glutathione has the added benefit of also making my hair really shiny and healthy looking.

Both vitamin B6 and L-Glutathione are potent detoxifiers of the liver so go up to the dose you need VERY slowly! If you break out initially, bear with it - this is just a detox/cleansing reaction.

Try opening a capsule of vitamin B6 (P5P) and take a third of it - or half of it - and see how you do Same goes with the L-Glutathione pills or powder . You can take the same dosage up to 3 times a day. Definitely take the B6 with food because it can make you nauseous. Also, the B6 (P5P) could keep you up by giving you energy if you take it late at night.

Topically, Jojoba oil is great for acne. It moisturizes without clogging pores. I wear it all over my face and neck at night. It is the only moisturizer that does not break me out!

I have suffered with severe cystic acne and was on 3 courses of Accutane so I know what it's like to suffer with acne. With either of these supplements, thankfully I don't have to suffer anymore. I hope this info helps anyone out there who is struggling with acne.

Cradle Cap

1 User Review
5 star (1) 

Posted by Dee (Australia) on 07/18/2015

B6 for Cradle cap:

Most cradle's cap is due to a deficiency of Vitamin B6 and magnesium (B6 needs magnesium to be absorbed).

*Take B6. A nursing mother should take 30mg of P5P (P5P is the best form of B6, it is active B6) supplement each day for at least a month, plus 250 milligrams of magnesium.

Topical B6 for Cradle cap.

This works very very well.

*Apply a vit-b6 salve or cream to head 2x daily for 2 to 3 days.

Topical B6 recipe:

Things You'll Need

  • Vitamin P5P (B6) capsules (or tablets)
  • 1/4 cup olive oil
  • Mortar and pestle (*if using tablets.)
  • Measuring cup


1. Using P5P capsules is best because there is less fillers in the capsules than the tablets. If using tablets, Mortar and pestle. Crush two or three Vitamin B6 tablets with a mortar and pestle until very fine.

2. Measure 1/4 cup vegetable oil and pour into a clean bowl. Add crushed B6 tablets and mix well.

3. Apply mixture to baby's scalp two times daily. The cradle cap should clear up in two days.

Deep Sleep, Trigger Thumb

1 User Review
5 star (1) 

Posted by Deirdre (CT) on 07/20/2021

I started using P5P a couple of weeks ago for a trigger thumb that got aggravated again 8 months after a cortisone shot from frequently lifting and carrying one of my elderly dogs. P5P supposedly takes up to 6 months to work so slow going, but I definitely have more flexibility and less clicking in the thumb joint within 30 minutes of taking it, which lasts a few hours. Also appears to somewhat improve my cold hands and feet.

The main thing I noticed is that when 2 PHP capsules are taken with magnesium l threonate after dinner, it really zonks me out for the night. It has a deeply calming effect, which has been reported by other people too. Anyone with sleeping issues should try this P5P with Magnesium and see if it helps.

Replied by Tamara

What strength of P5P do you take? The 25mg or 50mg or something else? Thank you


Hi! I have the 50 mg capsules from NOW.


1 User Review
5 star (1) 

Posted by Tim (Perth, Western Australia) on 03/13/2009

I am a 46 year old male who has suffered from regular bouts of depression for most of my adult life. These depressed episodes were not usually linked to any situational cause and indeed could be very difficult to understand for my family because there was no obvious trigger or reason why I was depressed. The symptoms presented as physical as well as mental and I would suffer from joint pain, lethargy and extreme nausea and in severe bouts even cold sweats and shivering that would last for days and sometimes a week. I have tried prescription anti-depressants but the side effects were almost as bad as the ailment so I resolved to put up with the ups and downs (I only probably had episodes bad enough to take off work maybe twice a year).

About 2 years ago someone put me on to 5 Hydroxy Tryptophan or 5-HTP as a precursor to serotonin production and I decided to give it a try (the potential for weight loss was an added incentive) and I found the results somewhat hit and miss until after some research and experimentation I hit on the combination of 5-HTP (100mg) combined with Pyridoxal 5 Phosphate (15mg) (the active enzyme version of vitamin B6 and assists in the conversion of the 5-HTP to serotonin) taken first thing in the morning on an empty stomach (I avoid eating for at least half an hour). The theory from my research into taking it on an empty stomach is that this avoids the 5-htp metabolising into serotonin in the stomach before it can be absorbed into the bloodstream. Further, I have found that the active version of B6 is more effective than the common variety version (pyridoxine) because I think I struggle to metabolise the pyridoxine variety into the active enzyme and therefore have a natural B6 deficiency (probably why I don't produce enough serotonin).

I haven't had a bout of depression for over 12 months now despite the fact that I have experienced (as many others have over the past 4 months) the most stressful and extreme anxiety creating environment of my professional life.

Apart from sharing my discovery on this excellent website I have a question about Apple Cider Vinegar and my 5-HTP regimen. I have in the past week begun to experiment with the ACV and Baking Soda remedy for Acid Reflux and I have a dilemma in that the majority of posts suggest that the ACV/BS solution should be taken on an empty stomach. If I take it first thing in the morning at the same time as the 5-HTP and B6 combo will that cause the 5-HTP to metabolise into serotonin in my stomach before it gets a chance to be absorbed (My research indicates that serotonin itself can't be absorbed). Because I don't want to jeopardise the efficacy of the depression remedy, I am waiting half an hour to drink the ACV concoction which is inconvenient to say the least as it makes me nauseas and I can't eat breakfast before having to leave for work (maybe that is the weight loss trick).

Any suggestions? By the way the ACV/BS Combo seems to be working with some interesting side effects (nausea diarrhoea and gas) but it's still too early to tell.

Lichen Planus

1 User Review
5 star (1) 

Posted by Mspatpat (Dayton, Ohio) on 06/28/2011

I have had skin Lichen Planus for about 1-1yrs. I tried all the Dr's suggestion. But it always returned just as bad. Finally and herbalist for a health food store in Atlanta Georgia call (i think) the Garden of Eden, told me to take 2000-3000mg of L-Lysine & 50mg P5P (B6) 3x per day.

And from the first 1000 mg that evening my itching & breakouts decrease about 99%!! I like the L-Lysine by Solaray that also contains vitamin C, Zinc and Vitamin B6. Hope this helps.

Trigger Finger

2 User Reviews
5 star (2) 

Posted by Niecie (Covina, CA) on 05/21/2020

Trigger finger seems to be a vitamin B6 deficiency. My mom had a severe case for years. She could not bend her finger and had pain. I began giving her vitamin B6 in P-5-P (pyridoxal-5-phosphate) form. 50 mg 3x/day. Within a few weeks all pain was gone and she had full movement. I then reduced her dose to 50mg twice a day and still no symptoms. Truly a miracle! This remedy is also good for carpal tunnel syndrome.

Trigger Finger
Posted by Mimi (San Diego ) on 06/10/2019

Hello. I had trigger finger really bad a year ago. Tried everything on this site. Did not work. I did more research and Pyridoxal 5 Phosphate (P5P) WORKS....gone gone! I took 3 a day for 7 months and GONE. I still take 1 a day and I have absolutely no stiffness. Get it at a health food store. May help arthritus.