Why is vitamin B6 supplementation often recommended during INH therapy?

During isoniazid (INH) therapy, vitamin B6 supplementation is primarily recommended to prevent peripheral neuropathy. Isoniazid can interfere with the metabolism of vitamin B6 (pyridoxine), which is crucial for the synthesis of neurotransmitters and the maintenance of nerve health. When vitamin B6 levels drop due to the medication's effects, patients may experience symptoms of peripheral neuropathy, such as tingling and numbness in the extremities.

Supplementing with vitamin B6 helps to mitigate this risk by restoring adequate levels of this vitamin, thus supporting proper nerve function and preventing the potential neurological side effects associated with INH treatment. This consideration is particularly important for individuals at higher risk for neuropathy, such as those with pre-existing conditions like diabetes or those who are malnourished.

While enhancing absorption, preventing gastrointestinal side effects, and boosting immune function are important in the context of therapy, they are not the primary reasons for recommending vitamin B6 alongside INH. The focus here is predominantly on preserving neurological health, making the prevention of peripheral neuropathy the central rationale for B6 supplementation during INH therapy.