Question: Is it harmful to take vitamin B6 to help with water retention when I have been on prednisone for 16 years?

Dr. Hibberd's Answer:

Taking Prednisone for 16 years is associated with many problems, including fluid retention. I assume you are taking it under professional guidance, and the benefits exceed the significant risks of long-term use.

There are conditions that do occasionally require long-term steroid use, but we are finding many newer treatment regimens for autoimmune and other diseases that once had prednisone as the only option. Now, long-term prednisone treatment often can be avoided given newer immune suppressants such as TNF (tumor necrosis factor) inhibitors.

Long-term prednisone has large risks for osteoporotic and spontaneous compression fractures as well as adverse metabolic and endocrine risks. Since prednisone will cause fluid retention and electrolyte disorders, periodic lab monitoring is essential.

Adding vitamin B6 (pyridoxine) to prednisone shouldn't cause any problems as long as the dose of vitamin B6 is not excessive, but it may be best to supplement B vitamins as part of a complex multivitamin.

Vitamin B6 is lost in the freezing and canning of many food products, and cooking may force a loss of over 50 percent. Dried milk loses as much as 60 to 70 percent of its vitamin B6 when compared with its liquid version. Good sources of vitamin B6 are brown rice and red meat.

Here are some other tips to reduce swelling in addition to your vitamin B6 supplementation:

• Drink plenty of water and reduce the amount of salt in your diet. It sounds contradictory, but a well-hydrated body is less likely to retain fluid.
• Cut back on dehydrating drinks such as tea, coffee, cranberry juice, and alcohol.
• Avoid herbal diuretics such as dandelion leaf, corn silk, and horsetail.
• Exercise regularly, and wear support stockings if necessary.
• Vitamin B5 (pantothenic acid), along with with calcium and vitamin D, helps the body excrete excess fluid.
• Be sure to include fresh fruits and low-fat dairy foods in your daily diet.
• Always see your doctor when you have fluid retention.

As a general caution, edema (fluid retention) can be a sign of a serious medical condition such as heart, kidney, or liver disease, and should always be evaluated by your physician.