The serum pyridoxal phosphate test measures the level of the active and stable form of vitamin B6 (pyridoxine) in the blood. This vitamin acts as an essential cofactor in more than 100 enzymatic reactions, including amino acid metabolism, neurotransmitter synthesis (such as serotonin and dopamine), and hemoglobin formation. It is used to assess deficiencies that may affect nerve function, blood, and skin.