Low serum concentrations of vitamin B6 and iron are related to panic attack and hyperventilation attack

Acta Med Okayama. 2013;67(2):99-104. doi: 10.18926/AMO/49668.


Patients undergoing a panic attack (PA) or a hyperventilation attack (HVA) are sometimes admitted to emergency departments (EDs). Reduced serotonin level is known as one of the causes of PA and HVA. Serotonin is synthesized from tryptophan. For the synthesis of serotonin, vitamin B6 (Vit B6) and iron play important roles as cofactors. To clarify the pathophysiology of PA and HVA, we investigated the serum levels of vitamins B2, B6, and B12 and iron in patients with PA or HVA attending an ED. We measured each parameter in 21 PA or HVA patients and compared the values with those from 20 volunteers. We found that both Vit B6 and iron levels were significantly lower in the PA/HVA group than in the volunteer group. There was no significant difference in the serum levels of vitamins B2 or B12. These results suggest that low serum concentrations of Vit B6 and iron are involved in PA and HVA. Further studies are needed to clarify the mechanisms involved in such differences.

MeSH terms

  • Adult
  • Anemia, Iron-Deficiency / blood
  • Anemia, Iron-Deficiency / complications*
  • Female
  • Hemoglobins / metabolism
  • Humans
  • Hyperventilation / blood
  • Hyperventilation / etiology*
  • Iron / blood*
  • Multivariate Analysis
  • Panic Disorder / blood
  • Panic Disorder / etiology*
  • Riboflavin / blood
  • Serotonin / metabolism
  • Vitamin B 12 / blood
  • Vitamin B 6 / blood*
  • Vitamin B 6 Deficiency / blood
  • Vitamin B 6 Deficiency / complications*
  • Young Adult


  • Hemoglobins
  • Serotonin
  • Vitamin B 6
  • Iron
  • Vitamin B 12
  • Riboflavin