Overview
SCIENTIFIC SCORE
Possibly Effective
Based on 12 Researches
7.3
USERS' SCORE
Good
Based on 5 Reviews
8.1
Supplement Facts
Serving Size: 1 Capsule
Amount Per Serving
%DV
Vitamin B6 (as pyridoxine HCl and pyridoxal-5-phosphate)
50 mg
2,941%
Top Medical Research Studies
8
We explored how vitamin B6, along with other B vitamins like folate and B12, might help in preventing migraines. Through a thorough review of existing research, we discovered that while vitamin B6 showed some promise in reducing migraines with aura in adults, the results aren’t as clear-cut for individuals suffering from other forms of headaches. In fact, in the context of treating acute migraine attacks, the benefits of these vitamins have not been supported by strong evidence from studies.
We found several trials that looked specifically at vitamin B6 for migraine prevention. The results were generally positive, especially for those experiencing migraines with aura, where vitamin B6 exhibited significant benefits against placebo in multiple studies. However, when it comes to folate, using it alone didn’t show improved outcomes compared to placebo. Limited data on children and those suffering from migraines without aura prevented us from making definitive conclusions about vitamin B6’s effectiveness across different demographics.
Overall, there’s a potential positive effect of vitamin B6 in managing migraines, particularly in adults with aura. While the safety profile appears favorable, we advocate for more high-quality research to clarify its role in treating various types of migraines.
We found several trials that looked specifically at vitamin B6 for migraine prevention. The results were generally positive, especially for those experiencing migraines with aura, where vitamin B6 exhibited significant benefits against placebo in multiple studies. However, when it comes to folate, using it alone didn’t show improved outcomes compared to placebo. Limited data on children and those suffering from migraines without aura prevented us from making definitive conclusions about vitamin B6’s effectiveness across different demographics.
Overall, there’s a potential positive effect of vitamin B6 in managing migraines, particularly in adults with aura. While the safety profile appears favorable, we advocate for more high-quality research to clarify its role in treating various types of migraines.
Read More
7
Vitamin B6 for headache relief
We explored the role of vitamin B6 in treating headaches associated with histamine intolerance. The research indicated that headaches in these patients might be linked to low levels of diamine oxidase, the enzyme responsible for breaking down histamine in the body. Given that vitamin B6 plays a vital role in the activity of this enzyme, its supplementation was considered as a potential supportive treatment.
While the study highlighted that a histamine-free diet is the primary solution for managing these headaches, vitamin B6 supplementation appeared to be beneficial as well. It is thought that by increasing the activity of diamine oxidase, vitamin B6 could help reduce headache frequency and intensity in individuals suffering from histamine intolerance. However, it's important to underscore that the study did not focus exclusively on vitamin B6 effects; thus, we remain cautious in drawing strong conclusions about its isolated efficacy.
Overall, the findings suggest that while vitamin B6 might be a useful addition to a treatment plan for chronic headaches linked to histamine intolerance, it should be complemented with dietary adjustments and consideration of other factors.
While the study highlighted that a histamine-free diet is the primary solution for managing these headaches, vitamin B6 supplementation appeared to be beneficial as well. It is thought that by increasing the activity of diamine oxidase, vitamin B6 could help reduce headache frequency and intensity in individuals suffering from histamine intolerance. However, it's important to underscore that the study did not focus exclusively on vitamin B6 effects; thus, we remain cautious in drawing strong conclusions about its isolated efficacy.
Overall, the findings suggest that while vitamin B6 might be a useful addition to a treatment plan for chronic headaches linked to histamine intolerance, it should be complemented with dietary adjustments and consideration of other factors.
Read More
8
Vitamin B6 shows potential for migraines
We conducted a study to evaluate how vitamin B6, when combined with folic acid, affects migraine attacks in adults suffering from aura. Our research followed a double-blind, randomized, placebo-controlled design, which involved 95 migraine patients from Isfahan, Iran. These individuals received either folic acid and vitamin B6, folic acid alone, or a placebo for three months.
The results showed that the combination of folic acid and vitamin B6 led to significant improvements in migraine characteristics. We observed a decrease in headache severity, attack frequency, and the overall impact of headaches on daily life. Specifically, the combined treatment exhibited more robust effects compared to the placebo and even outperformed folic acid taken alone, particularly in reducing headache severity and frequency.
However, it's important to note that the positive impact on attack duration was not statistically significant when taking other influencing factors into account. Meanwhile, taking folic acid by itself did not yield any noteworthy benefits compared to the placebo.
Overall, our findings suggest that vitamin B6, especially in conjunction with folic acid, may play a beneficial role in managing migraine attacks for those who experience aura. Still, further research is essential to deepen our understanding of these effects and confirm our results.
The results showed that the combination of folic acid and vitamin B6 led to significant improvements in migraine characteristics. We observed a decrease in headache severity, attack frequency, and the overall impact of headaches on daily life. Specifically, the combined treatment exhibited more robust effects compared to the placebo and even outperformed folic acid taken alone, particularly in reducing headache severity and frequency.
However, it's important to note that the positive impact on attack duration was not statistically significant when taking other influencing factors into account. Meanwhile, taking folic acid by itself did not yield any noteworthy benefits compared to the placebo.
Overall, our findings suggest that vitamin B6, especially in conjunction with folic acid, may play a beneficial role in managing migraine attacks for those who experience aura. Still, further research is essential to deepen our understanding of these effects and confirm our results.
Read More
Most Useful Reviews
7.5
Enhances magnesium effect
I take it to boost the effectiveness of magnesium when I have a headache.
Read More
7.5
Eases sleep issues
1 people found this helpful
I take B6 together with magnesium. It became easier to fall asleep in the evening, and my headaches have disappeared.
Read More
7.5
Reduces PMS symptoms
It alleviates symptoms of PMS, reduces swelling, nervousness, and headaches.
Read More
Medical Researches
SCIENTIFIC SCORE
Possibly Effective
Based on 12 Researches
7.3
- All Researches
9
We explored the effects of vitamin B6 treatment in a unique case involving a 25-year-old man who experienced headaches and memory issues due to a specific genetic condition. This condition caused a build-up of branched-chain amino acids (BCAAs) like valine and leucine in the bloodstream, leading to neurological symptoms.
The patient had notable brain MRI findings, and metabolic tests revealed significantly high plasma levels of BCAAs. Interestingly, standard tests for a related disorder, maple syrup urine disease, came back normal, helping guide the investigation. Upon discovering mutations in the BCAT2 gene, which heavily influences BCAA metabolism, we were curious about the role of vitamin B6 in this scenario.
After the patient began taking vitamin B6, we observed impressive reductions in his BCAA levels, especially valine, and improvements in the brain MRI lesions. Although the initial focus was on his headaches, it's important to note that the study didn’t isolate the specific effects of vitamin B6 on headaches alone. Instead, the broader context of metabolic improvement is significant.
Ultimately, our findings highlight a new and rare amino acid metabolism disorder linked to genetic mutations. They also suggest that vitamin B6 supplementation may lead to beneficial outcomes in managing BCAA-related conditions, even if direct links to headache relief weren’t the sole focus of this particular case.
The patient had notable brain MRI findings, and metabolic tests revealed significantly high plasma levels of BCAAs. Interestingly, standard tests for a related disorder, maple syrup urine disease, came back normal, helping guide the investigation. Upon discovering mutations in the BCAT2 gene, which heavily influences BCAA metabolism, we were curious about the role of vitamin B6 in this scenario.
After the patient began taking vitamin B6, we observed impressive reductions in his BCAA levels, especially valine, and improvements in the brain MRI lesions. Although the initial focus was on his headaches, it's important to note that the study didn’t isolate the specific effects of vitamin B6 on headaches alone. Instead, the broader context of metabolic improvement is significant.
Ultimately, our findings highlight a new and rare amino acid metabolism disorder linked to genetic mutations. They also suggest that vitamin B6 supplementation may lead to beneficial outcomes in managing BCAA-related conditions, even if direct links to headache relief weren’t the sole focus of this particular case.
Read More
We evaluated the effectiveness of vitamin B6 in alleviating headaches associated with premenstrual syndrome (PMS). In a real-world study, participants were assigned to different treatment groups, with one group receiving a combination of Ezedayz tablets containing vitamin B6, along with other ingredients, while others received traditional therapies.
Throughout the three-month study, participants rated their headache severity, among other PMS symptoms. Though all groups reported some improvements, the data indicated that those taking Ezedayz tablets, either alone or with standard treatments, enjoyed a more significant reduction in headaches and other PMS symptoms.
Notably, while the combined therapy appeared promising in enhancing overall quality of life, the specific impact of vitamin B6 on headaches couldn't be isolated due to the formulation's combination with other active ingredients. Overall, while we observed benefits, the direct effect of vitamin B6 alone remains unclear, emphasizing the need for further focused research.
Throughout the three-month study, participants rated their headache severity, among other PMS symptoms. Though all groups reported some improvements, the data indicated that those taking Ezedayz tablets, either alone or with standard treatments, enjoyed a more significant reduction in headaches and other PMS symptoms.
Notably, while the combined therapy appeared promising in enhancing overall quality of life, the specific impact of vitamin B6 on headaches couldn't be isolated due to the formulation's combination with other active ingredients. Overall, while we observed benefits, the direct effect of vitamin B6 alone remains unclear, emphasizing the need for further focused research.
Read More
8
We explored how vitamin B6, along with other B vitamins like folate and B12, might help in preventing migraines. Through a thorough review of existing research, we discovered that while vitamin B6 showed some promise in reducing migraines with aura in adults, the results aren’t as clear-cut for individuals suffering from other forms of headaches. In fact, in the context of treating acute migraine attacks, the benefits of these vitamins have not been supported by strong evidence from studies.
We found several trials that looked specifically at vitamin B6 for migraine prevention. The results were generally positive, especially for those experiencing migraines with aura, where vitamin B6 exhibited significant benefits against placebo in multiple studies. However, when it comes to folate, using it alone didn’t show improved outcomes compared to placebo. Limited data on children and those suffering from migraines without aura prevented us from making definitive conclusions about vitamin B6’s effectiveness across different demographics.
Overall, there’s a potential positive effect of vitamin B6 in managing migraines, particularly in adults with aura. While the safety profile appears favorable, we advocate for more high-quality research to clarify its role in treating various types of migraines.
We found several trials that looked specifically at vitamin B6 for migraine prevention. The results were generally positive, especially for those experiencing migraines with aura, where vitamin B6 exhibited significant benefits against placebo in multiple studies. However, when it comes to folate, using it alone didn’t show improved outcomes compared to placebo. Limited data on children and those suffering from migraines without aura prevented us from making definitive conclusions about vitamin B6’s effectiveness across different demographics.
Overall, there’s a potential positive effect of vitamin B6 in managing migraines, particularly in adults with aura. While the safety profile appears favorable, we advocate for more high-quality research to clarify its role in treating various types of migraines.
Read More
8
Vitamin B6 shows potential for migraines
We conducted a study to evaluate how vitamin B6, when combined with folic acid, affects migraine attacks in adults suffering from aura. Our research followed a double-blind, randomized, placebo-controlled design, which involved 95 migraine patients from Isfahan, Iran. These individuals received either folic acid and vitamin B6, folic acid alone, or a placebo for three months.
The results showed that the combination of folic acid and vitamin B6 led to significant improvements in migraine characteristics. We observed a decrease in headache severity, attack frequency, and the overall impact of headaches on daily life. Specifically, the combined treatment exhibited more robust effects compared to the placebo and even outperformed folic acid taken alone, particularly in reducing headache severity and frequency.
However, it's important to note that the positive impact on attack duration was not statistically significant when taking other influencing factors into account. Meanwhile, taking folic acid by itself did not yield any noteworthy benefits compared to the placebo.
Overall, our findings suggest that vitamin B6, especially in conjunction with folic acid, may play a beneficial role in managing migraine attacks for those who experience aura. Still, further research is essential to deepen our understanding of these effects and confirm our results.
The results showed that the combination of folic acid and vitamin B6 led to significant improvements in migraine characteristics. We observed a decrease in headache severity, attack frequency, and the overall impact of headaches on daily life. Specifically, the combined treatment exhibited more robust effects compared to the placebo and even outperformed folic acid taken alone, particularly in reducing headache severity and frequency.
However, it's important to note that the positive impact on attack duration was not statistically significant when taking other influencing factors into account. Meanwhile, taking folic acid by itself did not yield any noteworthy benefits compared to the placebo.
Overall, our findings suggest that vitamin B6, especially in conjunction with folic acid, may play a beneficial role in managing migraine attacks for those who experience aura. Still, further research is essential to deepen our understanding of these effects and confirm our results.
Read More
8
We explored the impact of vitamin B6, alongside betaine, on headaches in a unique case study involving a 30-year-old woman. Initially, she faced several health challenges, including severe headaches and neurological issues, which ultimately led to a diagnosis of homocystinuria, a rare metabolic condition.
The treatment regimen combined vitamin B6 with betaine, aimed at normalizing her elevated homocysteine levels, which were over 350 μmol/L compared to normal levels of under 15 μmol/L. While this treatment approach was successful in managing her condition, it's difficult to ascertain the specific contribution of vitamin B6 on her headaches alone, as it was part of a combined therapy.
Therefore, while we can assert that vitamin B6 played a role in her overall treatment, we cannot definitively claim that it is effective for headaches on its own. The complexity of her case highlights the importance of a multifaceted treatment plan when tackling such intricate health issues.
The treatment regimen combined vitamin B6 with betaine, aimed at normalizing her elevated homocysteine levels, which were over 350 μmol/L compared to normal levels of under 15 μmol/L. While this treatment approach was successful in managing her condition, it's difficult to ascertain the specific contribution of vitamin B6 on her headaches alone, as it was part of a combined therapy.
Therefore, while we can assert that vitamin B6 played a role in her overall treatment, we cannot definitively claim that it is effective for headaches on its own. The complexity of her case highlights the importance of a multifaceted treatment plan when tackling such intricate health issues.
Read More
User Reviews
USERS' SCORE
Good
Based on 5 Reviews
8.1
- All Reviews
- Positive Reviews
- Negative Reviews
7.5
Enhances magnesium effect
I take it to boost the effectiveness of magnesium when I have a headache.
Read More
7.5
Eases sleep issues
1 people found this helpful
I take B6 together with magnesium. It became easier to fall asleep in the evening, and my headaches have disappeared.
Read More
7.5
Reduces PMS symptoms
It alleviates symptoms of PMS, reduces swelling, nervousness, and headaches.
Read More
7.5
Supports headache therapy
Vitamin B6 is beneficial for various body systems, including the nervous and digestive systems. I took it as part of a treatment for headaches and sensitivity to weather changes, combined with magnesium. I experienced a noticeable effect.
Read More
6
Fights migraines
I’ve taken B6 for migraines twice. A large dose of three capsules suppresses the headache for 2-3 hours but doesn't completely relieve it. I discovered its effectiveness while using a homeopathic remedy containing a substantial amount of B6.
Read More
Frequently Asked Questions
6
Fights migraines
I’ve taken B6 for migraines twice. A large dose of three capsules suppresses the headache for 2-3 hours but doesn't completely relieve it. I discovered its effectiveness while using a homeopathic remedy containing a substantial amount of B6.
7.5
Eases sleep issues
1 people found this helpful
I take B6 together with magnesium. It became easier to fall asleep in the evening, and my headaches have disappeared.
7.5
Supports headache therapy
Vitamin B6 is beneficial for various body systems, including the nervous and digestive systems. I took it as part of a treatment for headaches and sensitivity to weather changes, combined with magnesium. I experienced a noticeable effect.
7.5
Reduces PMS symptoms
It alleviates symptoms of PMS, reduces swelling, nervousness, and headaches.
7.5
Enhances magnesium effect
I take it to boost the effectiveness of magnesium when I have a headache.
8
We explored how vitamin B6, along with other B vitamins like folate and B12, might help in preventing migraines. Through a thorough review of existing research, we discovered that while vitamin B6 showed some promise in reducing migraines with aura in adults, the results aren’t as clear-cut for individuals suffering from other forms of headaches. In fact, in the context of treating acute migraine attacks, the benefits of these vitamins have not been supported by strong evidence from studies.
We found several trials that looked specifically at vitamin B6 for migraine prevention. The results were generally positive, especially for those experiencing migraines with aura, where vitamin B6 exhibited significant benefits against placebo in multiple studies. However, when it comes to folate, using it alone didn’t show improved outcomes compared to placebo. Limited data on children and those suffering from migraines without aura prevented us from making definitive conclusions about vitamin B6’s effectiveness across different demographics.
Overall, there’s a potential positive effect of vitamin B6 in managing migraines, particularly in adults with aura. While the safety profile appears favorable, we advocate for more high-quality research to clarify its role in treating various types of migraines.
We found several trials that looked specifically at vitamin B6 for migraine prevention. The results were generally positive, especially for those experiencing migraines with aura, where vitamin B6 exhibited significant benefits against placebo in multiple studies. However, when it comes to folate, using it alone didn’t show improved outcomes compared to placebo. Limited data on children and those suffering from migraines without aura prevented us from making definitive conclusions about vitamin B6’s effectiveness across different demographics.
Overall, there’s a potential positive effect of vitamin B6 in managing migraines, particularly in adults with aura. While the safety profile appears favorable, we advocate for more high-quality research to clarify its role in treating various types of migraines.
7
Vitamin B6's mixed effects on headaches
We explored the effects of a nutritional supplement, including vitamin B6, on children suffering from chronic headaches, some of whom also experienced sleep disorders. In our study, 34 children were closely monitored for one month without any treatment. After this initial period, we divided them into two groups. One group received melatonin alone, while the other group received a combination of melatonin, tryptophan, and vitamin B6 for an additional two months.
While we observed positive changes in headache frequency for both groups, the results didn't clearly identify a strong benefit solely attributable to vitamin B6. In fact, while 91.7% of children in the melatonin-only group reported fewer headaches, only 66.7% in the group that received both vitamin B6 and tryptophan saw similar improvements.
When we looked at the number of night awakenings, both groups showed a decrease over time. However, those receiving the combination treatment with tryptophan and vitamin B6 experienced a significant decrease, while those on melatonin alone did not show marked improvements. This suggests that while vitamin B6 is part of an effective treatment combination, the overall effect on headache management was less distinct.
While we observed positive changes in headache frequency for both groups, the results didn't clearly identify a strong benefit solely attributable to vitamin B6. In fact, while 91.7% of children in the melatonin-only group reported fewer headaches, only 66.7% in the group that received both vitamin B6 and tryptophan saw similar improvements.
When we looked at the number of night awakenings, both groups showed a decrease over time. However, those receiving the combination treatment with tryptophan and vitamin B6 experienced a significant decrease, while those on melatonin alone did not show marked improvements. This suggests that while vitamin B6 is part of an effective treatment combination, the overall effect on headache management was less distinct.
8
We conducted a randomized, double-blind trial to explore how vitamin supplementation, specifically including vitamin B6, affects headaches in individuals suffering from migraines. Our study involved 52 patients with migraine and aura over a period of six months. Participants received daily doses of a combination of vitamins, including 25 mg of vitamin B6, along with folic acid and vitamin B12.
The results were promising as we observed a significant reduction in homocysteine levels by approximately 39%. This is important because elevated homocysteine is associated with migraine headaches. Moreover, vitamin supplementation led to a notable decrease in migraine disability, dropping from 60% at the start to 30% after six months.
Additionally, we found that headache frequency and intensity also improved for those receiving vitamin therapy. Interestingly, carriers of certain genetic types showed an even greater response to the treatment, highlighting how individual genetics may play a role in treatment effectiveness.
While our findings suggest that vitamin B6, among other vitamins, can play a role in reducing migraine-related issues, further larger-scale studies are needed to solidify our understanding and explore vitamin therapy as a safe and effective option for migraine prevention.
The results were promising as we observed a significant reduction in homocysteine levels by approximately 39%. This is important because elevated homocysteine is associated with migraine headaches. Moreover, vitamin supplementation led to a notable decrease in migraine disability, dropping from 60% at the start to 30% after six months.
Additionally, we found that headache frequency and intensity also improved for those receiving vitamin therapy. Interestingly, carriers of certain genetic types showed an even greater response to the treatment, highlighting how individual genetics may play a role in treatment effectiveness.
While our findings suggest that vitamin B6, among other vitamins, can play a role in reducing migraine-related issues, further larger-scale studies are needed to solidify our understanding and explore vitamin therapy as a safe and effective option for migraine prevention.
7
Vitamin B6 shows headache relief promise
We looked into how vitamin B6 affects headache treatment, particularly in comparison to the widely used medication amitriptyline. While studies have shown mixed results regarding its effectiveness, vitamin B6 has emerged as a potential option worth considering alongside existing treatments.
Interestingly, we found that both vitamin B6 and amitriptyline seem to offer similar benefits for headache relief, yet it’s important to note that vitamin B6 may come with fewer side effects. This is a significant advantage, especially for those who are cautious about long-term medication use.
By increasing serotonin levels, which often play a role in headache triggers, vitamin B6 might help address underlying causes of headaches for some patients. However, further research is still needed to fully understand its benefits and safety profile, particularly for those taking it over long periods.
In summary, while vitamin B6 shows promise as a complementary treatment for headaches, we must carefully weigh its effectiveness and safety against existing options.
Interestingly, we found that both vitamin B6 and amitriptyline seem to offer similar benefits for headache relief, yet it’s important to note that vitamin B6 may come with fewer side effects. This is a significant advantage, especially for those who are cautious about long-term medication use.
By increasing serotonin levels, which often play a role in headache triggers, vitamin B6 might help address underlying causes of headaches for some patients. However, further research is still needed to fully understand its benefits and safety profile, particularly for those taking it over long periods.
In summary, while vitamin B6 shows promise as a complementary treatment for headaches, we must carefully weigh its effectiveness and safety against existing options.
References
- Sureja VP, Kheni DB, Dubey VP, Kansagra J, Soni ZK, et al. Efficacy and Tolerability Evaluation of a Nutraceutical Composition Containing Vitex agnus-castus Extract (EVX40™), Pyridoxine, and Magnesium in Premenstrual Syndrome: A Real-World, Interventional, Comparative Study. Cureus. 2023;15:e42832. doi:10.7759/cureus.42832
- Liampas IN, Siokas V, Aloizou AM, Tsouris Z, Dastamani M, et al. Pyridoxine, folate and cobalamin for migraine: A systematic review. Acta Neurol Scand. 2020;142:108. doi:10.1111/ane.13251
- Bravaccio C, Terrone G, Rizzo R, Gulisano M, Tosi M, et al. Use of nutritional supplements based on melatonin, tryptophan and vitamin B6 (Melamil Tripto®) in children with primary chronic headache, with or without sleep disorders: a pilot study. Minerva Pediatr. 2020;72:30. doi:10.23736/S0026-4946.19.05533-6
- Askari G, Nasiri M, Mozaffari-Khosravi H, Rezaie M, Bagheri-Bidakhavidi M, et al. The effects of folic acid and pyridoxine supplementation on characteristics of migraine attacks in migraine patients with aura: A double-blind, randomized placebo-controlled, clinical trial. Nutrition. 2017;38:74. doi:10.1016/j.nut.2017.01.007
- Woods E, Dawson C, Senthil L, Geberhiwot T. Cerebral venous thrombosis as the first presentation of classical homocystinuria in an adult patient. BMJ Case Rep. 2017;2017. doi:10.1136/bcr-2016-217477
- Menon S, Nasir B, Avgan N, Ghassabian S, Oliver C, et al. The effect of 1 mg folic acid supplementation on clinical outcomes in female migraine with aura patients. J Headache Pain. 2016;17:60. doi:10.1186/s10194-016-0652-7
- Wang XL, Li CJ, Xing Y, Yang YH, Jia JP. Hypervalinemia and hyperleucine-isoleucinemia caused by mutations in the branched-chain-amino-acid aminotransferase gene. J Inherit Metab Dis. 2015;38:855. doi:10.1007/s10545-015-9814-z
- Menon S, Lea RA, Roy B, Hanna M, Wee S, et al. Genotypes of the MTHFR C677T and MTRR A66G genes act independently to reduce migraine disability in response to vitamin supplementation. Pharmacogenet Genomics. 2012;22:741. doi:10.1097/FPC.0b013e3283576b6b
- Lea R, Colson N, Quinlan S, Macmillan J, Griffiths L. The effects of vitamin supplementation and MTHFR (C677T) genotype on homocysteine-lowering and migraine disability. Pharmacogenet Genomics. 2009;19:422. doi:10.1097/FPC.0b013e32832af5a3
- Villegas-Salas E, Ponce de León R, Juárez-Perez MA, Grubb GS. Effect of vitamin B6 on the side effects of a low-dose combined oral contraceptive. Contraception. 1997;55:245.
- Jarisch R, Wantke F. Wine and headache. Int Arch Allergy Immunol. 1996;110:7.
- Bernstein AL. Vitamin B6 in clinical neurology. Ann N Y Acad Sci. 1990;585:250.
