Biosynthesis of folic acid

Summary The influence of various vitamins on the biogenesis of folic acid has been studied in microorganisms requiring these as growth factors. In L. arabinosus, the folic acid synthesised was directly proportional to the availability of both riboflavin and pantothenic acid. The influence of cyanocobalamin on folic synthesis varied radically in different organisms. In case of the B₁₂/methionine auxotroph of E. coli there was an inverse relationship of vitamin B₁₂ to folic acid synthesis, while in Euglena the folic acid elaborated was in proportion to cyanocobalamin supplied. Synthesis of both folic acid and vitamin B₁₂ was depressed when thymine supply was adequate in the nutrition of E. coli 15 T ^-, a thymine auxotroph.     

Dietary vitamin B12, sulfur amino acids,and odd-chain fatty acids affect the response of rats to nickel deprivation

An experiment was performed to ascertain whether changing the dietary intake of two substances, cystine and margaric acid (heptadecanoic acid), that affect the flux through pathways involving the two vitamin B₁₂-depednent enzymes, methionine synthase and methylmalonyl-CoA mutase, would affect the interaction between nickel and vitamin B₁₂. Rats were assigned to treatment groups of six in a fully crossed, four-factorial arrangement. The independent variables, or factors, were: per kg of fresh diet, nickel analyzed at 25 and 850 μg; vitamin B₁₂ supplements of 0 and 50 μg; margaric acid supplements of 0 and 5 g; andl-cystine supplements of 0 and 12 g. The diet without cystine was marginally deficient in sulfur amino acids. Nickel affected growth, liver wt/body wt ratio (LB/BW), and a number of variables associated with iron, calcium, zinc, copper, and magnesium metabolism. Most of the effects of nickel were modified by the vitamin B₁₂ status of the rat. In numerous cases, the interaction between nickel and vitamin B₁₂ was dependent on, or altered by, the cystine or margaric acid content of the diet. Thus, the findings showed that the extent and the direction of changes in numerous variables in response to nickel deprivation varied greatly with changes in diet composition. These variables include those previously reported to be affected by nickel deprivation, including growth and the distribution or functioning of iron, calcium, zinc, copper, and magnesium. The findings also support the hypothesis that nickel has a biological function in a metabolic pathway in which vitamin B₁₂ is important.     

Effect of casein and soy protein isolate on vitamin B6 nutritional status in rats

Two experiments were conducted to test the effect of casein and soy protein isolate (SPI) on the nutritional status of vitamin B₆ in rats. Adult Long-Evans rats were fed with a casein or SPI diet at a 40% protein level with (control) or without (B₆-deficient) 7 mg of pyridoxine/kg diet. Vitamin-B₆-deficient rats were depleted of B₆ with (experiment 1) or without (experiment 2) deoxypyridoxine. In experiment 1, each rat was loaded with 150 mg ofDL-tryptophan after 5 weeks of pair feeding. The rats on the vitamin-B₆-deficient SPI diet (SPI-B₆) excreted twice the amount of urine xanthurenic acid in 24 h than did the rats on the vitamin-B₆-deficient casein (casein-B₆) diet (p<0.05). In experiment 2,L-tryptophan was loaded in a 20-mg dose at the end of each week. The excretion of xanthurenic acid was higher in the SPI-B₆ group than in the casein-B₆ group over the 5-week period of the experiment (p<0.05). Erythrocyte transaminase (EGOT and EGPT) activities were lower, while EGOT and EGPT indexes were higher in the SPI-B₆ group than in the casein-B₆ group (p<0.05). The results suggest that the source of dietary protein significantly influenced the status of B₆ nutrition in these rats.     

Effect of restricted feed intake and addition of vitamins B2 and B6 and folic acid on the liver concentration of zinc and copper in rats

The aim of the present study was to investigate the influence of nutritional deficiency and dietary addition of vitamins (B₂, B₆, and folate) on hepatic concentration of zinc and copper in rats. The experiment was performed on 260 growing male Wistar rats divided into 13 groups. Animals of 11 groups were fed isocaloric diets (14.7 MJ/kg) in which the 20% of energy was derived from protein. Another two groups of rats were offered diets with 9% or 4.5% of energy originating from protein. Animals of both mentioned groups and of the control group (20% of energy from protein) were offered diets ad libitum. The other 10 groups were offered 50% and 30% of the amount consumed in the control group. Eight groups, from those 10 restricted ones, were differentiated by dietary addition of vitamins B₂ and B₆ and folate (300% addition). Restricted feed intake did not affect the liver zinc concentration but significantly increased the copper concentration. The addition of vitamin B₆ decreased the liver Zn concentration. The highest liver Cu concentration was noted in rats offered restricted diets to only 30% of intake in the control group and high in vitamin B₂ and in rats supplemented with all of studied vitamins together. It suggests that vitamin B₂ had the strongest impact on liver Cu concentration in rats fed restricted diets.     

ASSESSMENT OF INTAKE AND NUTRITIONAL STATUS OF VITAMIN B1, B2, AND B6 IN MEN AND WOMEN WITH DIFFERENT PHYSICAL ACTIVITY LEVELS

The purpose of the present study was to examine the nutritional status of vitamin B₁, B₂, and B₆ in respect to dietary intake of these vitamins and activity coefficients of the erythrocyte enzymes transketolase, glutathione reductase, and aspartic aminotransferase in young men and women with different physical activity levels. The participants of this study were 20 women and 20 men with high physical activity (groups HAW and HAM, respectively), and 20 women and 20 men with low physical activity (groups LAW and LAM, respectively). The intake of vitamins B₁, B₂, B₆, proteins, and calorie content of the diet was based on the average of the 4-day dietary recalls. To assess nutritional status of vitamin B₁, B₂, and B₆, the activity coefficients (α) of erythrocyte transketolase (ETK), erythrocyte glutathione reductase (EGR), and erythrocyte aspartic aminotransferase (EAST) were estimated in blood hemolysates. The intake of the studied vitamins in the diet was statistically significantly lower in the female groups compared with the respective male groups. Deficiency of vitamin B₆ in the diet was present more often in women than in men (in terms of the recommended dietary allowances [RDA]). Values of the activity coefficient α_ETK indicated that none of the groups in this study suffered the risk of vitamin B₁ deficiency. The value of the activity coefficient α_EGR indicated that the groups of women and men with low physical activity were more prone to vitamin B₂ deficiency compared with the high physical activity groups. The risk of vitamin B₆ deficiency (α_EAST) in both male groups was higher than in both female groups. The obtained results do not allow for unequivocal determination of the impact of sex and the level of physical activity on intake and nutritional status of vitamin B₁, B₂, and B₆. Independently of sex and the level of physical activity, the women and men consumed insufficient quantities of vitamins B₁ and B₆, although this was not always related to increased values of corresponding activity coefficients.     

Vitamin losses during frozen storage of Liza aurata (Risso, 1810), Cyprinus carpio L. 1758, Clupeonella cultriventris caspia (Nordmann, 1840), Rutilus frisii kutum (Kamenskii, 1901) and Sander lucioperca (L., 1758)

The objective of this study was to determine the fat and water‐soluble vitamins contents (A, E, D, K, B₁, B₂, B₆, B₁₂, niacin, biotin, ascorbic, folic and pantethonic acids; in mg kg^?1 fresh weight) lost during frozen storage (?24°C) in time intervals of 0, 1, 2, 3 and 4 months. Studied species included: Liza aurata (golden grey mullet), Cyprinus carpio (common carp), Clupeonella cultriventris caspia (common kilka or sprat), Rutilus frisii kutum (Caspian kutum) and Sander lucioperca (pike perch). Results showed that A, D and K vitamin losses occurred in all samples during storage, but no statistically significant differences were observed. Vitamin E losses under frozen conditions were significant in common kilka, Caspian kutum and pike perch, however, not in golden grey mullet or common carp. A decrease in vitamin C was significant in all fish species, but there were no significant decreases in other water‐soluble vitamins (B₁, B₂, B₆, B₁₂, niacin, folic acid, pantothenic acid, biotin).     

A Combined Supplementation of Omega-3 Fatty Acids and Micronutrients (Folic Acid,Vitamin B12) Reduces Oxidative Stress Markers in a Rat Model of Pregnancy Induced Hypertension

Objectives

Our earlier studies have highlighted that an altered one carbon metabolism (vitamin B₁₂, folic acid, and docosahexaenoic acid) is associated with preeclampsia. Preeclampsia is also known to be associated with oxidative stress and inflammation. The current study examines whether maternal folic acid, vitamin B₁₂ and omega-3 fatty acid supplementation given either individually or in combination can ameliorate the oxidative stress markers in a rat model of pregnancy induced hypertension (PIH).

Materials and Methods

Pregnant Wistar rats were assigned to control and five treatment groups: PIH; PIH + vitamin B₁₂; PIH + folic acid; PIH + Omega-3 fatty acids and PIH + combined micronutrient supplementation (vitamin B₁₂ + folic acid + omega-3 fatty acids). L-Nitroarginine methylester (L-NAME; 50 mg/kg body weight/day) was used to induce hypertension during pregnancy. Blood Pressure (BP) was recorded during pregnancy and dams were dissected at d20 of gestation.

Results

Animals from the PIH group demonstrated higher (p<0.01 for both) systolic and diastolic BP; lower (p<0.01) pup weight; higher dam plasma homocysteine (p<0.05) and dam and offspring malondialdehyde (MDA) (p<0.01), lower (p<0.05) placental and offspring liver DHA and higher (p<0.01) tumor necrosis factor–alpha (TNF–ά) levels as compared to control. Individual micronutrient supplementation did not offer much benefit. In contrast, combined supplementation lowered systolic BP, homocysteine, MDA and placental TNF-ά levels in dams and liver MDA and protein carbonyl in the offspring as compared to PIH group.

Conclusion

Key constituents of one carbon cycle (folic acid, vitamin B₁₂ and DHA) may play a role in reducing oxidative stress and inflammation in preeclampsia.     

Short-Term Evaluation of the Impact of a Fortified Food Aid Program on the Micronutrient Nutritional Status of Argentinian Pregnant Women

We studied the impact of a food supplementation program (Plan Más Vida (PMV)) on the micronutrient nutritional condition of pregnant women from low-income families 1 year after its implementation. The food program provided supplementary diet (wheat and maize—fortified flour, rice or sugar, and fortified soup). We performed a prospective, nonexperimental, cross-sectional study in the province of Buenos Aires, Argentina, evaluating pregnant women at baseline (n?=?164) and 1 year after PMV implementation (n?=?108). Biochemical tests (hemogram, ferritin, vitamin A, zinc, and folic acid), anthropometric assessments (weight and height), and dietary surveys (24 h recall) were performed at the two study points. One year after PMV implementation, no significant changes in anthropometric values were observed. Folic acid deficiency and the risk of vitamin A deficiency (retinol, 20–30 μg/dl) decreased significantly (35.8 to 6.1 % and 64 to 41 %, respectively; p?<?0.000). Anemia and prevalence of iron and zinc deficiency values did not change. Diet survey results showed that although nutrient intake increased significantly, it was still below recommendations. Implementation of the PMV and of the government nutritional strategies had a high impact on the prevalence of folic acid deficiency. We also observed a decrease in the risk of vitamin A deficiency, and no impact on iron and zinc nutritional status. Adherence to the specific fortified food (soup) was not good and intra-family dilution and distribution of food was high.     

Influence of vitamin B12 and light on the formation of chlorosomes in green- and brown-colored Chlorobium species

The specific Bchl a and c content of the vitamin B₁₂-dependent Chlorobium limicola strain 1230 decreased strongly under vitamin B₁₂ limitation. In comparison to a regularly grown culture (20 g vitamin B₁₂/l) the specific Bchl c content of a B₁₂-limited culture was reduced to 20% and the specific Bchl a content to 42%. By ultrathin sections it could be clearly demonstrated that B₁₂-deficient cells contained no chlorosomes. After the addition of vitamin B₁₂ to a deficient culture, chlorosomes were formed and the Bchl a and c content increased again to the level of regularly grown cells. The brown-colored Chlorobium phaeobacteroides strain 2430 (type strain) and the extremely low-light-adapted strain MN1 were compared with respect to the influence of light on the formation of chlorosomes and the Bchl e and carotenoid content. By ultrathin sections it could be demonstrated that strain MN1 produced two-fold larger chlorosomes. Chlorosome dimensions of strain MN1 decreased with increasing light intensities. The number of chlorosomes per cell in both strains did not change with different light intensities. Strain MN1 formed twice as much Bchl e as the type strain when grown at 30 or below 1 mol · m^-2 · s^-1. Under comparable light conditions strain MN1 formed 14–57% more carotenoids than the type strain. Low light intensities aaused the carotenoid content to increase by 25% in strain 2430 in comparison to high light intensity.     

N5-methyltetrahydrofolate: Homocysteine methyltransferase activity in extracts from normal,malignant and embryonic tissue culture cells

Malignant cells (J111, L1210, W-256) and human embryonic cells (FL) are unable to survive and grow when homocystine replaces methionine in tissue culture media containing excess vitamin B₁₂ and folic acid. Extracts of these same cells when grown in media containing methionine and more than adequate vitamin B₁₂ and folic acid have diminished N⁵-methyltetrahydrofolate: homocysteine methyltransferase activities in the absence of added cyanocobalamin when compared with extracts of normal cells (adult rat thymus and liver fibroblasts). Extracts of human monocytic leukemia (J111) and human amnion cells (FL) have normal enzymatic activity in the presence of added cyanocobalamin whereas the rodent malignant cells (W-256 and L1210) have abnormally low activity in the absence or presence of added vitamin B₁₂.     

The effect of toxic doses of cholecalciferol (Vitamin D3) on the serum zinc levels in rats

Zinc is a trace element important to bone mineralization as well as, in general, nutrition. It is known that cholecalciferol (vitamin D₃) affects bone metabolism. In this study toxic doses of vitamin D₃ were injected subcutaneously (25 μg/d) to rats for 5 wk. It caused a significant increase in serum zinc levels (p<0.02). On the other hand, no significant increase was detected in the other groups. Excessive amounts of vitamin D₃ caused bone breakdown and increased the levels of zinc in blood.     

Maternal micronutrients and omega 3 fatty acids affect placental fatty acid desaturases and transport proteins in Wistar rats

Adequate supply of LCPUFA from maternal plasma is crucial for fetal normal growth and development. The present study examines the effect of maternal micronutrients (folic acid and vitamin B₁₂) and omega 3 fatty acids on placental mRNA levels of fatty acid desaturases (Δ5 and Δ6) and transport proteins. Pregnant female rats were divided into 6 groups at 2 levels of folic acid both in the presence and absence of vitamin B₁₂. Both the vitamin B₁₂ deficient groups were supplemented with omega 3 fatty acid. Maternal vitamin B₁₂ deficiency reduced placental mRNA and protein levels of Δ5 desaturase, mRNA levels of FATP1 and FATP4 (p<0.05 for all) as compared to control while omega 3 fatty acid supplementation normalized the levels. Our data for the first time indicates that altered maternal micronutrients and omega 3 fatty acids play a key role in regulating fatty acid desaturase and transport protein expression in placenta.     

Methionine,folic acid and vitamin B12 in growing-finishing pigs: Impact on growth performance and meat quality

Growth performance, metabolic variables, and meat quality were measured in 78 growing-finishing pigs using supplements of 0 (C), or 0.2% of DL-methionine (M), and three combinations of folic acid [mg/kg] and cyanocobalamin [μg/kg], respectively 0 and 0 (V0), 10 and 25 (V1), and 10 and 150 (V2) in a 2 × 3 factorial arrangement. Feed conversion was lower (p = 0.05) in M than in C pigs during the growing period (0–4 weeks). Both V1 and V2 treatments increased plasma vitamin B₁₂ (p < 0.01) and decreased plasma homocysteine (p < 0.01). Plasma 5-methyl-tetrahydrofolates were the lowest, highest and intermediate in V0, V1 and V2 pigs (p < 0.04), respectively. In V2 meat, folates were 32% higher, vitamin B₁₂, 55% higher and homocysteine, 28% lower than in V0 (p < 0.01). Oxidative stability of the fresh meat was similar among treatments during a storage period of 42 days. Therefore, methionine supplements improved growth performance during the growing period. Vitamin supplements interacted with the methionine cycle pathway, increased vitamin content of pork meat but did not improve oxidative stability of the fresh meat during storage.     

Intra-Individual Double Burden of Overweight and Micronutrient Deficiencies among Vietnamese Women

Background

Vietnamese Living Standard Surveys showed that the rate of overweight and obese in Vietnamese adults doubled between 1992 and 2002, from 2% to 5.5%, respectively with no significant difference in the proportions of overweight/obesity between men and women.

Objectives

Considering the increasing public health concern over the double burden of malnutrition in Vietnam, we investigated micronutrient deficiencies among women of reproductive age according to their Body Mass Index.

Methods

A transversal study was conducted in 2010 among 1530 women of reproductive age from 19 provinces. Participating women were asked to give a non-fasting blood sample for plasma iron, vitamin A, folate, vitamin B₁₂ and zinc assessment.

Results

Although % body fat was associated with haemoglobin, ferritin, retinol and zinc concentrations, BMI category was only associated with marginal vitamin A status (19% among underweight vs 7% among overweight/obese; p<0.0001) and not with iron deficiency anemia, zinc deficiency, vitamin B₁₂ deficiency or folate status. The prevalence of iron, and vitamin B₁₂ deficiencies was respectively 11.4% and 15% among the 20% overweight/obese women; prevalence of zinc deficiency and marginal/deficient folate status was much higher, affecting respectively 61.1% and 25.8%. Intra-individual double burden of malnutrition (overweight/obesity (OW) and micronutrient deficiency) was observed among 2.0% for OW-anemia, 2.3% OW-iron deficient, 3.0% for OW-Vitamin B₁₂ deficiency, 12.2% for OW-Zinc deficiency and 5.2% for OW-marginal/deficient folate status.

Conclusions

This large, cross-sectional survey demonstrated that micronutrient deficiencies are an issue across the weight spectrum among women in Vietnam, with only vitamin A status being better among overweight than underweight women. It is therefore essential for Vietnam to actively prevent women of reproductive age from overweight/obesity and at same time to control micronutrient deficiencies in this population to limit their economic and health consequences.     

Studies on the vitamin B12 auxotrophy of Rhodocyclus purpureus and two other vitamin B12-requiring purple nonsulfur bacteria

The vitamin B₁₂ requirement of Rhodocyclus purpureus 6770, Rhodospirillum tenue 1/67, and Rhodopseudomonas palustris G 53/2 was determined. A wide variety of biogenetic precursors of the vitamin including cobinamide, cobyric acid, cobinic acid and several partially amidated cobyrinic acids showed growth-promoting activity in all three strains. In R. purpureus vitamin B₁₂ could even be substituted by cobyrinic acid which is the first cobalt-containing precursor of vitamin B₁₂ so far established. Neither methionine, deoxynucleosides, dimethylbenzimidazole nor increased amounts of cobalt could replace vitamin B₁₂ as growth factor.Cupribalamin, which is a strong antimetabolite of vitamin B₁₂ in Escherichia coli 113-3 and Lactobacillus leichmannii ATCC 7830, exhibited only a weak antagonistic effect on growth of R. purpureus and R. tenue. Growth of R. palustris was not inhibited by cupribalamin. The cells of all three strains were shown to contain metal-free corrinoids in addition to cobalt-containing corrinoids. The principal products were identified as 5-deoxyadenosylcobalamin and hydrogenobalamin, the metal free analogue of vitamin B₁₂. The latter does not originate from the vitamin by removal of cobalt but is de novo biosynthesized as could be demonstrated in the case of R. purpureus by a labelling experiment with [¹³C] methyl-l-methionine.     

Serum zinc, selenium, copper, and lead levels in women with second-trimester induced abortion resulting from neural tube defects

Neural tube defects are important causes of infant mortality and childhood morbidity. We investigated the relationship between zinc, selenium, copper, and lead concentrations and neural-tube-defect occurrence in women with a second-trimester termination due to fetal-neural-tube defects (NTDs) in this case-control study. Fourteen pregnant women whose pregnancies were terminated as a result of second-trimester ultrasonographic diagnosis of neural tube defects were recruited as cases. The control group (n=14) consisted of women who were selected among age-, gravidity-, and socio-economic-state (SES)-matched women who had a normal triple-screen and targeted ultrasound during the second trimester with documented normal fetal outcome. Zinc and copper determinations were made using flame atomic absorption spectrophotometer (AAS). Graphite furnace AAS was used for Pb, and Se levels were measured with hydride generation AAS. Cases had significantly low serum zinc and selenium levels (62.48±15.9 vs 102.6±23.7 and 55.16±11.3 vs 77.4±5.5, respectively, p<0.001). Serum Cu and whole-blood Pb levels were significantly high when compared to controls. There was a negative correlation between serum zinc and selenium levels, and serum copper levels (r=−425 and −0.443, p<0.05). Our results are consistent with some previous reports. The etiology of NTDs cannot be explained with one strict etiologic mechanism. On the contrary, an interaction among environmental, genetic, and nutritional factors such as trace elements and vitamins would explain these anomalies. If folic acid supplementation is given, additional Zn supplementation should be considered for the further decrease in the recurrence and occurrence of NTDs.     

Nutritional Anemia and Megaloblastosis in Pregnancy

Macrogranulocytic and/or erythroid megaloblastic bone marrow changes which could not be accurately predicted from the hematologic findings in the blood were present in 25% of 305 mildly to moderately anemic pregnant women attending a public antepartum clinic in Montreal. Iron deficiency was the primary cause of anemia in most instances. Serum folate activity of less than 4.1 ng./ml. and/or serum vitamin B₁₂ levels of less than 100 pg./ml. were present in 90% of the 77 patients having these bone marrow changes, whereas approximately one-third of 228 patients with normoblastic marrow had these low values. Red cell folate did not correlate as well as serum folate activity with bone marrow changes. After treatment with oral folic acid in the range of 0.2 mg. to 0.8 mg., daily, for seven to 14 days, the megaloblastic and macrogranulocytic changes in patients with low serum folate activity and normal serum vitamin B₁₂ values disappeared in 15 of 21 patients. Of five women having both low folate and vitamin B₁₂ values, three failed to respond and two showed only partial improvement after 0.4 mg. of folic acid daily, per os, for 10 days. The average diet of these anemic women was suboptimal in folate and in iron.     

Separation and quantification of the B6 vitamers in plasma and 4-pyridoxic acid in urine of adolescent girls by reversed-phase high-performance liquid chromatography

The vitamin B₆ status of seemingly healthy adolescent girls was determined using several accepted and proposed parameters in an effort to establish guidelines for status evaluation. High-performance liquid chromatography-derived plasma B₆ vitamers (pyridoxal phosphate, PLP; pyridoxine phosphate, PNP; pyridoxamine phosphate, PMP; pyridoxal, PL; pyridoxine, PN; and pyridoxamine, PM) and 4-pyridoxic acid (4-PA) concentrations and urinary 4-PA levels of 28 white adolescent females, 12–15 years, having radiomonitored plasma PLP concentrations and coenzyme stimulation of erythrocyte alanine aminotransferase activities indicative of adequate status were determined. Mean vitamin B₆ and protein intakes were 1.48 mg and 78.3 g. Ranges for plasma B₆ vitamer and 4-PA concentrations (nmol/1) were: PLP, 40.9–122.2; PNP, non-detectable (ND)—16.1; PMP, ND—8.1; PL, ND—15; PN, ND—21.9; PM, ND—17.8; and 4-PA, ND—55.7. PLP was the only vitamer found in plasma of all subjects. Urinary 4-PA concentrations ranged from 0.11 to 2.50 μmol/mmol of creatinine. B₆ vitamer values of these girls should be of use in the establishment of normal ranges for vitamin B₆ status parameters.     

Effects of maternal vitamin B12 deficiency from end of gestation to weaning on the growth and haematological and immunological parameters in mouse dams and offspring

Vitamin B₁₂-deficiency may induce specific symptoms as neurological alterations and unspecific symptoms such as anaemia and growth retardation. In this study, maternal vitamin B₁₂ deficiency from end of gestation to weaning was evaluated in mouse dams, which was provoked by feeding a vitamin B₁₂-deficient diet. The animals were divided into two groups (control and deficient). The control group received the vitamin B₁₂-deficient diet supplemented with commercial vitamin B₁₂. Compared to the control, the vitamin B₁₂-deficient dams and their offspring showed a significant decrease of body weight (by 20 and 39%, respectively), serum vitamin B₁₂ concentration (by 61 and 67%, respectively), haematological values as haematocrit (25 and 26%, respectively), and IgA producer cells (by 36 and 54%, respectively). In both, vitamin B₁₂-deficient mouse dams and their offspring, histological alterations of small intestine were observed, whereas growth retardation occurred in the offspring only. This experimental murine model allows assessing the incidence of maternal cobalamin deficiency in offspring and would be useful for evaluating novel adjuncts such as functional foods to prevent vitamin B₁₂ deficiency.     

THE NEWER HEMATINICS,THEIR USE AND ABUSE

The newer hematinics are merely refinements of preexisting forms of treatment, but they have aided particularly in a better understanding of the deficiency states. The intrinsic factor of Castle has not been isolated from the gastric juice, and the interrelationships of this substance with the extrinsic factor (vitamin B₁₂) and folic acid have not been defined at this time. Vitamin B₁₂ appears to be the active principle of refined liver extract and alone is probably adequate treatment for pernicious anemia. The other varieties of megaloblastic anemia may result from deficiency of vitamin B₁₂ or folic acid, although generally treatment with the latter brings about complete and lasting remission.The use of multihematinics and multivitamin preparations containing folic acid is to be condemned, particularly because of the possibility of their obscuring anemia and thwarting diagnosis of pernicious anemia until neurologic complications have taken place.Saccharated oxide of iron is a relatively safe preparation for intravenous administration, but the indications for its use are few. Because the body has no mechanism for iron excretion, only the amount of iron necessary to make up a deficiency should be given, although there is no definite evidence that hemochromatosis results from overdosage.