Mikawa · Acta medica Okayama 2013 · case-control study · n=41

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

Cited 9 times in the scientific literature.

Level 4 - case-series / case-control

Case-control study comparing emergency department patients to healthy controls

PubMed 23603926 · doi:10.18926/AMO/49668 · record verified 2026-08-28

What was done

A case-control study compared serum concentrations of vitamins B2, B6, and B12, along with iron, between 21 patients presenting to an emergency department with panic attacks (PA) or hyperventilation attacks (HVA) and 20 volunteer controls.

What was found

Serum levels of both vitamin B6 and iron were significantly lower in the PA/HVA group compared to the control group. There were no significant differences between groups in serum levels of vitamin B2 or vitamin B12. The abstract reported no exact numerical values, effect sizes, or p-values.

Why it matters

Vitamin B6 and iron act as cofactors in serotonin synthesis from tryptophan. These findings suggest a possible nutritional or biochemical association with panic and hyperventilation attacks, warranting further mechanistic study.

Limits

The sample size is very small (n=41 total). The observational case-control design cannot determine causality, and the abstract provides no numerical data, demographic information, or adjustments for dietary intake and other potential confounders.

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