Paper
Imbalance of Vitamin B Factors
Published Mar 31, 1945 · M. B. Richards
British Medical Journal
23
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Abstract
In the clinical literature during recent years there have been numerous indications of a certain interrelationship or antagonism between various factors of the vitamin B complex. Pellagrins, after treatment with nicotinic acid, often show signs of beriberi or of ariboflavinosis (Spies, Vilter, and Ashe, 1939; Sebrell and Butler, 1938, 1939; Sydenstricker et al., 1940). There are recorded instances also of converse antagonisms. Thus Bichel and Meulengracht (1941) report a case of pellagra arising after treatment of the Plummer-Vinson syndrome with riboflavin (i.e., vitamin B2); and Salvesen (1940), Briendstrup (1940), and Lehmann and Nielsen (1939) all found signs of pellagra in patients who had been given large injections of vitamin B. There is little doubt that in many of these cases the deficiencies in the diet were multiple, and it is assumed that successful treatmenit of the predominant deficiency with a single factor of the B complex showed up other deficiencies which had previously been masked. At the same time there is the possibility, in some cases at least, that secondary deficiencies were induced by the excessive dosing -with one particular factor of the B complex, and that the unbalanced proportions of the different factors gave rise to a deficiency which was not present under the original conditions. Spies, Vilter, and Ashe i1939) made the significant remark, without apparently realizing its possible implications, that in pellagrins treated with nicotinic acid and continuing on their usual diets, the associated deficiencies (i.e., of B, and riboflavin) often became worse. One or two attempts have been made, but without much success, to indurce symptoms of deficiency of one B factor by excessive dosing with another. Klopp, Abels, and Rhoads (1943) found a transitory increase in urinary excretion of riboflavin in some patients after administration of thiamine (i.e., B,), but could not induce either clinical or chemical evidence of riboflavin deficiency in these individuals even when large amounts of thiamine were given daily for 73 days. Unna and Clark (1942) could find no evidence of adverse effects on the growth of rats following administration of excess of individual vitamins in the presence of deficiencies of other vitamins of the B complex. Effect of Overloading with B2
Imbalance of vitamin B factors can cause secondary deficiencies, potentially causing symptoms in patients with multiple deficiencies.
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