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The P5P form is what is used in cellular reactions, and 70-90% of the vitamin B6 circulating in plasma is this active form.[ref] The first step of the B6 conversion process in the liver involves pyridoxal kinase ( PDKX gene)

PMID 29733881

Pickart, L., Vasquez-Soltero, J., Pickart, F., & Majnarich, J

There are reports of rare cases of toxicity following dosing within the therapeutic range, although there is debate about whether this latter category truly exists

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In a study published in 2017, the long-term use of metformin (Glucophage), an anti-diabetic medication, was correlated with a lower risk of gallstones in diabetic subjects (Liao 2017)