In most individuals, the average dosage for vitamin B6 deficiency is 2.5–25 mg daily for three weeks, then 1.5–2.5 mg per day after that. Higher doses may be required in severe cases. The recommended dose of pyridoxine for prevention of neurological defects in infants born to vitamin B6-deficient mothers is 20 mg daily during pregnancy and 10 mg daily after birth. The use of higher doses has not been reported to be beneficial. No evidence supports the use of a high dose regimen (i.e., greater than 25 mg daily) for treatment of established pyridoxine deficiency states. A large dose of pyridoxine may lead to adverse effects such as nausea, vomiting, diarrhea, abdominal pain, skin rash, or confusion. Pyridoxine toxicity results in peripheral neuropathy that begins in the feet and progresses up the legs. Symptoms include numbness, tingling, burning, cold feelings, muscle weakness, and paralysis. Toxic levels also can cause memory problems, mood changes, seizures, and heart failure. The risk of toxicity increases with higher doses over longer periods of time.