vitamin-b-12 and Alcoholism

Vitamin B12, or cobalamin, belongs to the group of water-soluble vitamins and is ingested through food of animal origin such as eggs, milk, red meat and poultry, fish, and shellfish. Its clinical indication is the treatment of hypovitaminosis B12 administered orally or intramuscularly in the form of hydroxocobalamin. Hypovitaminosis B12 is mainly caused by deficient dietary intake (individuals with malnutrition, vegetarians or vegans, older adults, pregnant people, individuals with alcohol use disorder); when intestinal absorption is reduced (atrophic gastritis, malabsorption syndrome, gastrointestinal surgery); and for causes associated with the intake of drugs (antacids, metformin). Hypervitaminosis B12 has been associated with renal failure; liver diseases such as cirrhosis and acute-phase hepatitis; alcohol use disorder with or without liver involvement; solid tumors of the lung, liver, esophagus, pancreas, and colorectum; and in hematological malignancies such as leukemia and bone marrow dysplasia.

Topics: Alcoholism; Anemia, Megaloblastic; Animals; Female; Pregnancy; Vitamin B 12; Vitamin B 12 Deficiency; Vitamins

Homocysteine (Hcy) is methylated by methionine synthase to form methionine with methyl-cobalamin as a cofactor. The reaction demethylates 5-methyltetrahydrofolate to tetrahydrofolate, which is required for DNA and RNA synthesis. Deficiency of either of the cobalamin (Cbl) and/or folate cofactors results in elevated Hcy and megaloblastic anemia. Elevated Hcy is a sensitive biomarker of Cbl and/or folate status and more specific than serum vitamin assays. Elevated Hcy normalizes when the correct vitamin is given. Elevated Hcy is associated with alcohol use disorder and drugs that target folate or Cbl metabolism, and is a risk factor for thrombotic vascular disease. Elevated methionine and cystathionine are associated with liver disease. Elevated Hcy, cystathionine, and cysteine, but not methionine, are common in patients with chronic renal failure. Higher cysteine predicts obesity and future weight gain. Serum S-adenosylhomocysteine (AdoHcy) is elevated in Cbl deficiency and chronic renal failure. Drugs that require methylation for catabolism may deplete liver S-adenosylmethionine and raise AdoHcy and Hcy. Deficiency of Cbl or folate or perturbations of their metabolism cause major changes in sulfur amino acids.

Topics: Alcoholism; Amino Acids, Sulfur; Anemia, Megaloblastic; Biomarkers; Cardiovascular Diseases; Folic Acid; Folic Acid Deficiency; Humans; Hyperhomocysteinemia; Kidney Failure, Chronic; Liver Diseases; Nutritional Status; Obesity; S-Adenosylhomocysteine; Vitamin B 12; Vitamin B 12 Deficiency

Addiction research focusing on homocysteine metabolism and its association with aspects of alcohol dependence has revealed important findings. Recent literature on this topic has been taken into account for the review provided. Methylenetetrahydrofolate reductase (MTHFR) is a key enzyme in the homocysteine metabolism. Plasma homocysteine levels are influenced by the single-nucleotide polymorphism (SNP) MTHFR C677T. Besides genetic factors, environmental factors have an impact on homocysteine plasma levels too. Thus, chronic alcohol intake is associated with elevated homocysteine plasma concentrations. Elevation of plasma homocysteine concentration is considered as a predictor for the occurrence of alcohol withdrawal seizures and--as homocysteine is a cardiovascular risk factor--might contribute to the higher risk for myocardial infarction among alcohol dependent patients. Homocysteine acts as an N-methyl-D-aspartate (NMDA) receptor agonist and has excitotoxic effects. Furthermore, it has been demonstrated that homocysteine has neurotoxic effects especially on dopaminergic neurons. As the rewarding effects of alcohol are mediated by the dopaminergic system, a homocysteine-dependent impairment of the reward system possibly leads to an altered drinking behaviour according to the deficit hypothesis of addiction. Homocysteine is involved in the metabolism of methyl groups and DNA-methylation plays a role in regulation of gene expression. Therefore it has been suggested that homocysteine is an important epigenetic factor. It remains to be determined whether alcohol dependent patients benefit from homocysteine lowering strategies, e.g., via supplementation of folate, vitamin B6 and B12. In this respect it is not clear yet, if a supplementation therapy can reduce the risk for the occurrence of alcohol withdrawal seizures.

Topics: Alcohol Withdrawal Seizures; Alcoholism; Alleles; DNA Methylation; Dopamine; Epigenesis, Genetic; Ethanol; Folic Acid; Gene Expression Regulation, Enzymologic; Homocysteine; Humans; Methylenetetrahydrofolate Dehydrogenase (NADP); Myocardial Infarction; Polymorphism, Single Nucleotide; Receptors, N-Methyl-D-Aspartate; Reward; Risk Factors; Social Environment; Vitamin B 12; Vitamin B 6

Topics: Adult; Aged; Alcoholism; Anemia, Macrocytic; Female; Folic Acid; Folic Acid Deficiency; Humans; Hydroxocobalamin; Hypothyroidism; Infant, Newborn; Liver Failure; Male; Pregnancy; Risk Factors; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Aged; Alcoholism; Biological Transport; Central Nervous System; Dementia; Depressive Disorder; Drug Interactions; Ethnicity; Folic Acid; Folic Acid Deficiency; Humans; Intestinal Absorption; Mental Disorders; Neurocognitive Disorders; Neuropsychology; Nutrition Disorders; Vitamin B 12; Vitamin B 12 Deficiency

This monograph on the clinical chemistry of vitamin B12 reviews the literature on daily requirements, methods for measurement, the effects of drugs on vitamin B12 metabolism absorption, pregnancy, clinical conditions associated with vitamin B12 deficiency, errors of metabolism, and reactions to vitamin therapy. Although only very small quantities of vitamin B12 are required to satisfy the daily requirement, a sufficient supply is stored in the liver to meet normal requirements for at least a 3-year period. A number of drugs are known to affect the absorption of vitamin B12, including neomycin, potassium chloride, p-aminosalicylic acid, and colchicine. Significantly reduced serum concentrations of vitamin B12 have been noted in users of oral contraceptives (OCs), although concentrations still remain within the limits of normal. It appears that the vitamin B12 level in OC users reestablishes itself at a different and somewhat lower level. Vitamin B12 binding protein appears to remain unchanged. A vitamin B12 deficiency is unusual in pregnant women who consume a normal, varied diet. On the other hand, lactating women whose diets are low in animal protein and dairy products may have problems providing enough vitamin B12 to meet their own and their infant's needs; supplementary oral vitamins should be considered.

Topics: Absorption; Adult; Alcoholism; Anemia, Pernicious; Ascorbic Acid; Autoantibodies; Biguanides; Biological Transport; Chemical Phenomena; Chemistry; Chlorpromazine; Contraceptives, Oral; Diet; Female; Gastrectomy; Gastritis; Humans; Intrinsic Factor; Malabsorption Syndromes; Male; Metabolism, Inborn Errors; Middle Aged; Neoplasms; Nervous System Diseases; Nitrous Oxide; Nutritional Requirements; Pancreatic Diseases; Parasitic Diseases; Pregnancy; Pregnancy Complications; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

Deficiency of either folic acid or vitamin B12 may interfere with DNA synthesis and result in megaloblastic anemia or other conditions. These 2 vitamins have dissimilar molecular structures and are present in different foods; they are also absorbed and metabolized differently. In 201 consecutive cases of megaloblastic anemia, for 90% the cause was alcoholism and poor diet; 0.5% (1 case) was related to oral contraceptives (OCs). Megaloblastic anemia due to folate deficiency has occasionally been reported in patients with inflammatory bowel disease and has been attributed to poor diet, impaired absorption, and increased tissue utilization of folate. Sulfasalazine, a compound containing a sulfa drug and a salicylate that is broken down to its active components by the gut flora, is widely used in the treatment of inflammatory bowel disease and has been shown to impair the absorption of folic acid, polyglutamyl folate, and methyl-tetrahydrofolic acid in patients with these disorders. There is also evidence suggesting an interaction between anticonvulsant drugs and folate balance. A number of cases of megaloblastic anemia due to folate deficiency have been reported in women taking OCs. While in some cases no apparent cause for the megaloblastic anemia other than contraceptive therapy was demonstrated, in many patients other underlying disorders that were likely to disturb folate balance such as celiac disease, decreased dietary vitamin intake, and the administration of other drugs known to affect folate status have also been present. There is no convincing evidence that sex steroids affect folate absorption; about 20% of women taking OCs were found to have mild megaloblastic changes on Papanicolaou smears. These changes disappered after folic acid therapy, suggesting that OCs may cause an increased demand for folate limited to the reproductive system. Another finding is of low serum cobalamin levels in women using OCs; this appears however to be a laboratory abnormality of uncertain cause and of no clinical significance.

Topics: Alcoholism; Animals; Anticonvulsants; Ascorbic Acid; Contraceptives, Oral; Folic Acid; Folic Acid Antagonists; Folic Acid Deficiency; Humans; Intestinal Absorption; Nervous System; Nitrous Oxide; Sulfasalazine; Vitamin B 12

Topics: Alcoholism; Anemia, Hemolytic; Anticonvulsants; Bone Marrow Cells; Bone Marrow Diseases; Cells; Deoxyuridine; Erythrocytes, Abnormal; Female; Fluorouracil; Folic Acid; Folic Acid Deficiency; Formyltetrahydrofolates; Homocysteine; Humans; Hypothyroidism; Lymphocyte Activation; Methionine; Pregnancy; Pregnancy Complications; Statistics as Topic; Tetrahydrofolates; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Alcoholism; Animals; Beer; Bone Marrow Cells; Erythropoiesis; Folic Acid; Folic Acid Deficiency; Formiminoglutamic Acid; Humans; Intestinal Absorption; Liver Diseases, Alcoholic; Nutrition Disorders; Peripheral Nervous System Diseases; Psychoses, Alcoholic; Tetrahydrofolates; Thrombocytopenia; Vitamin B 12; Vitamin B 12 Deficiency; Wine

Topics: Alcoholism; Anemia, Macrocytic; Anemia, Megaloblastic; Anti-Bacterial Agents; Anticonvulsants; Antimetabolites, Antineoplastic; Contraceptives, Oral; Drug-Related Side Effects and Adverse Reactions; Folic Acid Antagonists; Humans; Malabsorption Syndromes; Pyrimethamine; Triamterene; Trimethoprim; Vitamin B 12

Topics: Achlorhydria; Alcoholism; Avitaminosis; Bone Marrow; Bone Marrow Cells; Carbohydrate Metabolism; Chronic Disease; Ethanol; Humans; Intestinal Absorption; Intestinal Mucosa; Intestine, Small; Iron; Vitamin B 12

Topics: Alcoholism; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Diagnosis, Differential; Folic Acid; Folic Acid Antagonists; Folic Acid Deficiency; Humans; Intestinal Absorption; Intrinsic Factor; Malabsorption Syndromes; Pyrimidine Nucleotides; Thymine Nucleotides; Uracil Nucleotides; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Alcoholism; Anticonvulsants; Cyanides; Deficiency Diseases; Electroencephalography; Erythrocytes; Folic Acid Deficiency; Humans; Isoniazid; Nervous System Diseases; Neurocognitive Disorders; Pellagra; Polyneuropathies; Schilling Test; Spinal Cord Diseases; Thiamine Deficiency; Transketolase; Tryptophan; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B 6 Deficiency; Vitamin B Deficiency; Wernicke Encephalopathy

Topics: Alcoholism; Animals; Blood Platelets; Bone Marrow; Dogs; Erythropoiesis; Ethanol; Folic Acid Antagonists; Hematopoiesis; Humans; Leukocytes; Leukopenia; Vitamin B 12

The investigation described in this paper has confirmed the existence of alcohol-induced bone marrow damage as a nosological entity in alcohol-dependent individuals. In our patients total abstinence from alcohol without disulfiram or similar drugs led to reversal of the pathological findings in peripheral blood and in bone marrow. In patients undergoing detoxification while taking disulfiram, on the other hand, the pathological bone marrow findings, especially erythropoiesis associated with impaired iron utilization, persisted. The metabolic pathway of disulfiram is discussed. It is probably justifiable to assume that the toxin responsible for alcohol-induced bone marrow damage is the ethanol metabolite acetaldehyde. The persistence of erythropoiesis with impaired iron utilization during abstinence from alcohol and treatment with disulfiram is also of importance in differential diagnosis from the myelodysplastic syndrome (MDS), and especially from refractory anaemia with ring sideroblasts (RARS). For this reason, where the situation is unclear, it is essential that a diagnosis of MDS be supported by specific investigations such as cell cultures, cytogenetic analyses, etc. It is the first time that the toxic, alcohol-like-effect of disulfiram on haematopoiesis is discussed.

Topics: Alcoholism; Bone Marrow; Disulfiram; Erythroblasts; Erythrocytes, Abnormal; Ethanol; Ferritins; Folic Acid; Hematocrit; Hematopoiesis; Humans; Leukocyte Count; Liver; Platelet Count; Vitamin B 12

Topics: Alcoholism; Arm; Dermatitis; Humans; Male; Middle Aged; Niacin; Niacinamide; Pellagra; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

Nutritional and toxic optic neuropathies are rare disorders characterized by visual impairment due to optic nerve damage by a toxin, usually with coexisting nutritional deficiencies. Its pathophysiology is still unclear, and multiple mechanisms implicated act synergistically to bring about this condition. The decline in its incidence and its confusing clinical appearance make diagnosing nutritional and toxic optic neuropathies challenging.. This is an observational clinical case report of an atypical clinical case of a nutritional and toxic optic neuropathy with a subacute presentation and papilledema at the time of diagnosis. The patient provided written informed consent for medical information and images to be published.. A 47-year-old man presented with progressive, painless bilateral decrease in central vision over 15 days. The patient had a long-standing history of alcohol abuse and was a heavy smoker. The examination revealed dyschromatopsia, 20/400 visual acuity on both eyes, and no relative afferent pupillary defect. Funduscopy revealed bilateral papilledema. A visual field test showed generalized depression with centrocecal involvement in the left eye. Laboratory studies evidenced decreased vitamin B12/B1 and red blood cell folate levels, increased acute phase reactants, hypertransaminasemia, and macrocytic anemia. Serologies and methanol in urine were negative. After the discontinuation of tobacco use and alcohol accompanied by vitamin supplementation, our patient's visual field, visual acuity, and papilledema improved remarkably. After 5 months, visual acuity and funduscopy were normal.. Although some hallmark signs were visible in this case, its subacute presentation and the presence of papilledema at diagnosis caused some diagnostic uncertainty. Nutritional and toxic optic neuropathy is a rare and challenging diagnosis because of a lack of biomarkers. Eye care clinicians should consider nutritional and toxic optic neuropathies to prevent severe and irreversible visual damage resulting from underdiagnosis and mismanagement.

Topics: Alcoholism; Folic Acid; Humans; Male; Middle Aged; Nutrition Disorders; Papilledema; Smoking; Thiamine; Toxic Optic Neuropathy; Vision, Low; Visual Acuity; Visual Field Tests; Visual Fields; Vitamin B 12

Our objective was to assess whether increased duration of metformin therapy is associated with incident peripheral neuropathy (PN) in older Veterans with diabetes.. Using national Veterans Affairs registry data from 2002 to 2015, we examined Veterans (50 + years) with diabetes. Long-term metformin therapy was defined as prescription ≥ 500 mg/day, filled for ≥ 6 consecutive months. Metformin therapy duration was examined both as continuous and categorical measures. Incident PN was defined by medical chart review. We estimated unadjusted and adjusted (variables selecteda priori)odds ratios (OR) and 95% confidence intervals (CI) using logistic regression.. The study included n = 210,004 individuals (mean ± SD: age: 66.2 ± 8.4 yrs, 96% male) prescribed metformin for 47.0 ± 34.0 months. Nineteen percent developed PN during follow-up. After adjusting for age, body mass index, duration of time receiving health care within the VA, smoking status, alcohol abuse, and vitamin B12 testing and treatment, the number of months of metformin treatment was associated with elevated odds for incident PN (aOR (metformin treatment - continuous) = 1.009 (95% CI = 1.009, 1.010); aOR (metformin treatment - categorical (ref: 6-<18 months): 18-<44.1 months = 1.57 (1.51-1.63), 44.1-<61 months = 2.05 (1.97-2.14), 61 + months = 2.69 (2.58-2.79), all p-values < 0.0001).. Our study suggests that Veterans treated for at least 18 months with metformin are approximately 2-3 times more likely to develop PN than those treated at least six, but<18 months. Future studies are needed to determine whether the association we found may be due to a decline in vitamin B12 status following metformin initiation.

Topics: Aged; Alcoholism; Body Mass Index; Diabetes Mellitus, Type 2; Diabetic Neuropathies; Female; Humans; Hypoglycemic Agents; Logistic Models; Male; Metformin; Middle Aged; Retrospective Studies; Risk Factors; Smoking; Time Factors; Veterans; Vitamin B 12; Vitamin B 12 Deficiency

In order to propose a course of action to be taken in the face of any hyperhomocysteinemia, we have reported for the first time in a French journal the recommendations made within the framework of the European E-HOD project for the diagnosis and treatment of remethylation disorders. The remethylation route ensures homocysteine-methionine conversion. It is linked to the folate cycle and the intracellular metabolism of cobalamins. Remethylation disorders can be classified into three groups: 1) isolated disorders (cblD-HC, cblE, cblG) corresponding to an isolated deficit in the production of methylcobalamin, cofactor of methionine synthase; 2) combined disorders (cblC, cblD-MMA/HC, cblF, cblJ) corresponding to an alteration of the transport and intracellular metabolism of cobalamins, which causes a defect in the synthesis of the two functional forms of cobalamin: methylcobalamin and adenosylcobalamin, a cofactor for methyl malonylCoA mutase; 3) MTHFR deficit, an abnormality of the folate cycle. The biological anomalies observed are hyperhomocysteinemia and hypomethioninaemia associated in the case of disorders combined with increased urinary excretion of methylmalonic acid. The clinical presentation is however heterogeneous according to the remethylation disorder but also for the same pathology according to the age. Given the large number of pathologies grouped together in remethylation disorders, this point is illustrated by only two clinical cases concerning the same deficit (deficit in MTHFR) but with different discovery circumstances: a neonatal form and a late form.

Topics: Alcoholism; Amino Acid Metabolism, Inborn Errors; Diagnosis, Differential; Female; Folic Acid; Folic Acid Deficiency; Homocysteine; Homocystinuria; Humans; Infant, Newborn; Metabolic Networks and Pathways; Methionine; Methylation; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Muscle Spasticity; Psychotic Disorders; Vitamin B 12

Alcohol dependent patients represent a high-risk group for vitamin deficiency, which could lead to variable cognitive dysfunctions and, as an extreme example, to an amnestic-confabulatory syndrome. In this case report, we report about an alcohol dependent 58-year-old patient without focal neurological symptoms with an amnestic-confabulatory syndrome. After substitution of thiamine, vitamin B12 and folic acid, cognitive symptoms completely vanish within a 22-month period of observation.. Alkoholabhängige sind eine Risikopopulation für Vitaminmangelzustände, die zu variablen kognitiven Defiziten bis hin zu einem amnestischen Syndrom führen können. Wir berichten über einen alkoholabhängigen, fokal-neurologisch unauffälligen 58-jährigen Patienten mit amnestischem Syndrom, das sich nach Substitution mit Thiamin, Vitamin B

Topics: Alcoholism; Ethanol; Folic Acid; Germany; Humans; Korsakoff Syndrome; Male; Middle Aged; Thiamine; Vitamin B 12

Hyperhomocysteinemia may be involved in the development of brain atrophy in alcoholics. Its pathogenesis is multifactorial. In the present study, we analyse the relationship between homocysteine levels and brain atrophy, and the relative weight of co-existing factors such as liver function impairment, the amount of ethanol consumed, serum vitamin B12, B6, and folic acid levels on homocysteine levels and brain alterations in alcoholic patients.. We included 59 patients admitted to this hospital for major withdrawal symptoms and 24 controls. The mini-mental state examination test and a brain computed tomography (CT) scan were performed and several indices were calculated. Serum levels of homocysteine, folic acid, vitamin B6 and vitamin B12 were determined. Liver function was assessed by Child-Pugh score. The daily consumption of ethanol in grams per day and years of addiction were recorded.. A total of 83.6% and 80% of the patients showed cerebellar or frontal atrophy, respectively. Patients showed altered values of brain indices, higher levels of homocysteine and vitamin B12, but lower levels of folic acid, compared with controls. Homocysteine, B12 and liver function variables showed significant correlations with brain CT indices. Multivariate analyses disclosed that Pugh's score, albumin and bilirubin were independently related to cerebellar atrophy, frontal atrophy, cella index or ventricular index. Serum vitamin B12 was the only factor independently related to Evans index. It was also related to cella index, but after bilirubin. Homocysteine levels were independently related to ventricular index, but after bilirubin.. Vitamin B12 and homocysteine levels are higher among alcoholics. Liver function derangement, vitamin B12 and homocysteine are all independently related to brain atrophy, although not to cognitive alterations.. Hyperhomocysteinemia has been described in alcoholics and may be related to brain atrophy, a reversible condition with an obscure pathogenesis. We studied 59 patients and found that liver function derangement, vitamin B12 and homocysteine levels are all independently related to brain atrophy assessed by computed tomography, although we found no association between these parameters and cognitive alterations.

Topics: Alcoholism; Atrophy; Brain; Case-Control Studies; Female; Folic Acid; Homocysteine; Humans; Liver; Male; Middle Aged; Tomography, X-Ray Computed; Vitamin B 12; Vitamin B 6

Topics: Alcoholism; Hematologic Neoplasms; Hospital Departments; Hospitalization; Humans; Kidney Diseases; Liver Diseases; Prospective Studies; Vitamin B 12

Topics: Alcohol Abstinence; Alcoholism; Homocysteine; Humans; Methylmalonic Acid; Optic Atrophy, Hereditary, Leber; Smoking; Vision Disorders; Vitamin B 12; Vitamin B 12 Deficiency

Chronic alcohol consumption leads to malnutrition and to the deficiency of many vitamins. One of the most important is folate deficiency. Folate deficiency disrupts the process of hematopoiesis, which can be evaluated by the changes of red cell indices. The aim of this study was to determine the hematological disturbances by the measurement of red blood cell indices in a Polish population of chronic alcoholics according to folate status. We studied 80 consecutive chronic alcoholic men and 30 healthy controls. Patients were divided into 2 groups according to the folate concentration. The serum folate and vitamin B12 concentration and the blood count were determined. We have shown that the serum folate concentration was decreased in 40% of alcoholics, but there was no folate deficiency and the level of vitamin B12 was normal. There was no correlation between folate, vitamin B12 and hematological indices. We have observed that most hematological parameters (Hb, RBCs, and Hct) in alcoholics were decreased and only two of them (MCV and MCHC) were increased in comparison with the controls. We observed no significant correlation between the RBCs indices and the weekly alcohol intake, but the correlation between RBCs, Hb, Hct and the duration of dependence have been shown. We concluded that, there is no folate deficiency in the Polish alcoholic population but the abusers with low folate levels may already have some RBCs indices affected. It means that the Polish alcoholic population consumes a sufficient amount of vitamins, which prevents the occurrence of hematological disturbances.

Topics: Adult; Aged; Alcohol Drinking; Alcoholics; Alcoholism; Case-Control Studies; Erythrocytes; Ethanol; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobins; Homocysteine; Humans; Male; Middle Aged; Poland; Vitamin B 12; Young Adult

Measurement of serum cobalamin levels is routinely used to diagnose cobalamin deficiency. Surprisingly, approximately 15% of patients have high cobalamin levels and no consensus exists regarding the clinical implications.. Hospital-treated patients above 18 years of age referred for serum cobalamin measurement were included in groups of patients [percentage cobalamin supplemented] with low (<200 pmol/L, n = 200 [6%]), normal (200-600, n = 202 [6%]) high (601-1000, n = 217 [27%]) and very high (>1000, n = 199 [53%]) cobalamin levels. Total and cobalamin-saturated (holo) transcobalamin, total haptocorrin, soluble TC receptor, sCD320, and methylmalonic acid were analyzed. Data on diagnoses and medical prescriptions was obtained through medical files and the Aarhus University Prescription Database.. Among patients not cobalamin supplemented median total haptocorrin and holo transcobalamin levels were markedly higher in the groups with high/very high cobalamin levels compared to groups with low/normal cobalamin levels. Median total transcobalamin and sCD320 levels were similar across the groups. A number of diagnoses were significantly associated to very high Cbl levels (odds ratio (95% confidence interval)): alcoholism (5.74 (2.76-11.96)), liver disease (8.53 (3.59-20.23)), and cancer (5.48 (2.85-10.55)). Elevated haptocorrin levels were seen in patients with alcoholism, cancer, liver-, renal-, autoimmune-, and bronchopulmonary disease. No clinical associations to sCD320 and total and holo transcobalamin levels were found.. In non-supplemented patients, high cobalamin levels were associated to high haptocorrin levels, and several diagnoses, including alcoholism, liver disease and cancer. Our study emphasizes that clinicians should take high serum cobalamin levels into consideration in the diagnostic process.

Topics: Aged; Alcoholism; Antigens, CD; Female; Humans; Liver Diseases; Male; Methylmalonic Acid; Middle Aged; Neoplasms; Receptors, Cell Surface; Transcobalamins; Vitamin B 12

Patients with alcohol abuse frequently suffer from malnutrition which may result in insufficient iron distribution and iron overload or deficiency. Iron metabolism can be described by a combination of biochemical soluble transferrin receptor, ferritin, C-reactive protein (CRP), and hematological parameters. Here, vitamin B12 and folic acid state were assessed. Results on iron metabolism in patients with alcohol dependence in comparison with social drinkers are presented.. Samples from 101 patients with dependent alcohol consumption were included. The control group comprised 115 social drinkers. Inclusion criteria for patients with chronic regular drinking/social drinkers were positive/negative score of the Alcohol Use Disorders Identification Test (AUDIT), and positive/negative score for alcohol abuse/dependence (DSM-IV criteria).. Absolute values for ferritin and sTfR are increased in patients with alcohol dependence with current consumption (ALC) compared with social drinkers. No major differences are observed in the ratio of sTfR/log ferritin in comparison with social drinkers. Hemoglobin concentrations correlated between the two groups. Mean corpuscular volume (MCV) was significantly increased in the ALC collective compared to social drinkers. Eighty patients of the alcohol-dependent group had sufficient iron repletion, 11 had iron overload, 6 are suspicious for functional iron deficiency, and 4 are suspicious for reduced iron supply. No vitamin B12/folate deficiencies are observed in alcohol-dependent patients.. No major abnormalities of iron metabolism are seen in patients with chronic alcohol ingestion besides the well-known macrocytic anemia. Iron overload is relatively frequent and observed in 9% of cases. No differences in vitamin B12 and folate levels were found between individuals with alcohol dependence and social drinkers.

Topics: Adolescent; Adult; Aged; Alcohol Drinking; Alcoholism; Cross-Sectional Studies; Erythrocyte Indices; Female; Ferritins; Folic Acid; Humans; Iron; Male; Middle Aged; Patient Selection; Statistics, Nonparametric; Transferrin; Vitamin B 12

Measurement of serum cobalamin levels is the standard investigation for assessing Vitamin B12 deficiency. However some patients with clinical evidence of cobalamin deficiency may have serum levels within the normal range. Since falsely increased values of cobalamin can be caused by alcoholic liver disease, we evaluated the impact of this disease on the diagnosis of cobalamin and folic acid deficiency.. We reviewed data of 101 adult patients with megaloblastic anemia assessed by measuring in parallel serum cobalamin, serum folate and red blood cell folate levels. Further tests were performed in order to find the cause of megaloblastosis. All patients were treated with cobalamin and/or folic acid therapy.. Vitamin B12, folate and both deficiency were found in 86, 5 and 6 cases respectively. Normal cobalamin serum levels, normal serum and erythrocyte folate levels were found only in 3 patients, all alcohol-dependent, while in another alcoholic borderline vitamin B12 serum levels were found. All the four patients responded to cobalamin treatment.. Some alcohol-dependent patients with megaloblastic anemia may respond to vitamin B12 treatment despite normal cobalamin serum levels; therefore in alcoholics caution is urged in the interpretation of these vitamin assays, because of possible functional vitamin B12 deficiency.

Topics: Adult; Aged; Aged, 80 and over; Alcoholism; Anemia, Megaloblastic; Erythrocytes; Female; Folic Acid; Hemoglobins; Humans; Male; Middle Aged; Retrospective Studies; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Vitamin B12 is an enzymatic cofactor for metabolism of homocysteine to methionine. The metabolism of homocysteine is affected by alcohol abuse. THE AIM of the study was to evaluate an effect of alcohol abuse and alcoholic liver disease on the serum level of vitamin B12. MATERIAL AND METHODS. The tested group consisted of 80 alcohol-dependent men who were admitted to detoxification ward. The diagnosis of dependency was made on the basis of ICD-10 criteria. The alcoholics were divided into two groups according to the presence or absence of alcoholic liver disease. The control group consisted of 30 healthy social drinkers. The vitamin B12 was determined by chemiluminescence method.. The mean concentration of vitamin B12 in the alcohol abuse patients was significantly higher than that of healthy controls but remains in the reference range (93.75% drinkers) in contrast to folic acid which level was decreased in 40% of patients and homocysteine which concentration was increased in 57.5% of alcoholics, whereas both levels are not in the normal range. The presence of alcoholic liver disease elevated the serum concentration of vitamin B12 but not the level of folic acid and homocysteine. The level of vitamin B12 negatively correlated with the homocysteine and positively with the markers of liver injury by alcohol. No correlation was found between folic acid and homocysteine.. The vitamin B12 concentrations in the alcohol abuse patients are significantly higher than that of healthy subjects, however, these still remain in the normal range. The level of this vitamin is connected with the homocysteine concentration but is not linked with the folic acid concentration in the blood. The vitamin B12 concentration reflects the degree of hepatocytes injury by alcohol.

Topics: Adult; Aged; Alcoholism; Biomarkers; Folic Acid; Homocysteine; Humans; Liver Diseases, Alcoholic; Male; Middle Aged; Reference Values; Vitamin B 12

Prior studies have associated 677C-T Methylenetetrahydrofolate reductase (MTHFR) gene polymorphism with decreased enzymatic activity and modified homocysteine regulation. This study determines and compares MTHFR 677C-T distribution and examines its consequences on homocysteine metabolism and alcohol dependence in alcoholic patients classified according to the Babor and Lesch typologies. MTHFR TT genotype was more prevalent in AD patients with milder alcohol dependence (Babor type A) and with Lesch type 3, associated with depression. MTHFR TT was also associated with hyperhomocysteinemia. Determining MTHFR 677C-T genotype, folate and vitamin B12 levels could assist physicians in identifying type 3 patients and improve addictions management.

Topics: Adult; Alcoholism; Depressive Disorder; Female; Genotype; Homocysteine; Humans; Male; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Polymorphism, Genetic; Vitamin B 12

Hyperhomocysteinemia is frequently observed in alcohol-dependent subjects, in particularly in those with marked withdrawal symptoms. The common C677T transition on the methylenetetrahydrofolate reductase (MTHFR) gene influences homocysteinemia. Our objective was to study the prevalence of the MTHFR C677T polymorphism in alcohol-dependent subjects and the influence of this polymorphism on symptoms associated with alcoholism.. MTHFR C677T polymorphism was determined in 93 control subjects and 242 alcohol-dependent subjects. Serum homocysteine, folate and vitamin B12 levels together with hepatic biological parameters were determined in the control and alcohol-dependent subjects.. Hyperhomocysteinemia is frequently observed in alcohol-dependent subjects, particularly in those with marked withdrawal symptoms. Alcohol-dependent subjects showed a significant decrease in MTHFR 677TT prevalence (9%, 21/242) compared to controls (18%, 17/93) (p<0.02). The relative risk estimated as an odds ratio for alcoholism in subjects with the TT genotype is 0.42 (odd ratio 95% confidence interval, 0.21-0.83). Moreover, drinkers with TT genotype presented lower values for markers of alcohol misuse (p<0.05), better liver function tests, a lower frequency of relapses and no marked withdrawal symptoms as assessed by the Lesch typology.. MTHFR 677TT genotype could play a protective role against alcohol dependence. Moreover, when subjects with MTHFR 677TT genotype become dependent to alcohol, they seem to constitute a subgroup of alcoholic patients with a decreased risk for developing neurotoxic withdrawal symptoms and hepatic toxicity.

Topics: Alcohol Drinking; Alcoholic Neuropathy; Alcoholism; Control Groups; Female; Folic Acid; Folic Acid Deficiency; Gene Frequency; Genetic Predisposition to Disease; Genotype; Homocysteine; Humans; Hyperhomocysteinemia; Liver Diseases, Alcoholic; Male; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Polymorphism, Genetic; Risk; Vitamin B 12

Alcohol abuse is a major cause of liver cirrhosis as well as chronic liver disease. The aim of the present study was to investigate the possible correlation, between liver dysfunction biological markers and vitamin B12, with interleukin-6, in the serum of alcohol-dependent individuals without liver disease (AWLD). In a sample of 43 alcohol abusing/dependent subjects (33 males and 10 females) treated on an inpatient basis according to a standard detoxification protocol, the serum activities of the hepatic enzymes (ASAT, ALAT, gamma-GT), as well as the concentration of B12 and IL-6, were determined on admission. A strong positive correlation has been observed between IL-6 and B12, ASAT, ALAT, and gamma-GT at the beginning of the detoxification period. The results confirmed that in alcohol-dependent individuals, the median serum concentration of IL-6, before the beginning of the treatment, had a significant positive correlation with the liver dysfunction biological markers and B12. In conclusion, IL-6 might be used as an additional diagnostic marker for the degree of liver dysfunction in alcohol dependent individuals.

Topics: Alanine Transaminase; Alcoholism; Aspartate Aminotransferases; Biomarkers; Female; gamma-Glutamyltransferase; Humans; Interleukin-6; Liver; Liver Diseases; Male; Middle Aged; Vitamin B 12

Topics: Administration, Oral; Alcoholism; Anti-Anxiety Agents; Biopsy; Depression; Diagnosis, Differential; Diazepam; Female; Follow-Up Studies; Humans; Magnesium; Middle Aged; Niacinamide; Pellagra; Skin; Substance Withdrawal Syndrome; Time Factors; Treatment Outcome; Vision Disorders; Vitamin B 12; Vitamin B Complex; Zinc

The purpose of this study was to investigate the effect of heavy alcohol consumption on peroxidation status in apolipoprotein B-containing lipoproteins (LDL+VLDL) and plasma as well as plasma homocysteine (HC) levels in patients with chronic alcoholism who drank raki, a national Turkish beverage. For this reason, endogenous diene conjugate (DC) and lipid hydroperoxide (LOOH) levels and lag phase, maximum DC formation and propagation rate following copper induction were measured in apolipoprotein B-containing lipoproteins (LDL+VLDL) isolated by precipitation with dextrane sulfate and MgCl2 from plasma. In addition, serum malondialdehyde (MDA), DC, HC, folate and vitamin B12 levels as well as paraoxonase activity were determined. Serum MDA and DC levels were higher in heavy raki drinkers compared to control subjects. Significant increases in endogenous DC and LOOH levels in LDL+VLDL together with shortened lag phase were also observed in patients. In addition, HDL-cholesterol, HC and vitamin B12 levels and HDL-associated paraoxonase activity were found to be higher, but folate levels to be lower in serum of heavy raki consumers. In conclusion, our results indicate that increases in LDL+VLDL oxidizability and plasma HC levels may enhance the susceptibility to vascular diseases in heavy raki drinkers.

Topics: Adult; Alcoholism; Apolipoproteins B; Aryldialkylphosphatase; Cholesterol, HDL; Female; Folic Acid; Homocysteine; Humans; Lipid Peroxidation; Lipoproteins, LDL; Lipoproteins, VLDL; Male; Malondialdehyde; Middle Aged; Oxidation-Reduction; Vitamin B 12

Both infection with Helicobacter pylori and alcohol abuse have been associated with low vitamin B12 serum levels. The interaction between both risk factors is unknown. The aim of this study was to determine whether Helicobacter pylori infection is associated with low vitamin B12 levels in alcohol dependent patients. Blood samples were obtained from adult alcohol dependent patients undergoing detoxification and analyzed for serum vitamin B12 levels. Helicobacter pylori infection was serologically measured. Patient characteristics, medication use and alcohol consumption at admission were assessed by interview. A total of 6 out of 89 patients included presented low vitamin B12 levels, all were sub clinical deficient (<250 pmol/L) and none were clinical deficient (<150 pmol/L). Infection with Helicobacter pylori was present in 29% of the patients. The average vitamin B12 levels in Helicobacter pylori seropositive and seronegative patients were 1,033 pmol/L (SD 741) and 971 pmol/L (SD 717), respectively. The relation between Helicobacter pylori infection and vitamin B12 deficiency was not of significance (OR=0.48; 95% CI [0.05-4.32]). In conclusion, Helicobacter pylori infection is not a risk factor for low vitamin B12 levels in alcohol dependent patients.

Topics: Adult; Alcoholism; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Risk Factors; Vitamin B 12; Vitamin B 12 Deficiency

Relationships of nutritional status with ethanol consumption and diet were studied in 33 chronic alcoholics with no clinical or laboratory evidence of liver disease.. Nutritional assessment included subjective global assessment, weight-height index, body mass index, and serum albumin measurements. Dietary intake included estimates of daily intake of substrates, folic acid, vitamins B1, B5, B6, and B12. Circulating concentrations of folate, pyridoxal-phosphate and vitamin B12 were evaluated as well.. Only 18.1% of patients were considered malnourished, with body mass indices lower than those with an average or good nutritional status (p < 0.0001). Body weight was under 90% of the ideal in 8/33 (24%) patients. Serum albumin values were within normal range in all patients. In terms of calories provided by nonalcoholic substrates, protein, or vitamin intake, we observed no differences between well and poorly nourished individuals. However, malnourished alcoholics consumed significantly more ethanol (p = 0.01) and an inverse correlation was found between ethanol intake and weight-height index (r = -0.35; p = 0.03). Low circulating concentrations of pyridoxal-phosphate and red blood cell folate were found in 51.5% and 60.6% of alcoholics, respectively. These were not correlated with vitamin dietary intake or ethanol consumption, but there was a trend toward malnourished patients to present lower concentrations of red blood cell folate (p = 0.13).. Although over malnutrition is infrequent in this group of chronic alcoholics, specific vitamin deficiencies are present in a substantial proportion of patients and are more likely related to alcohol consumption.

Topics: Adult; Alcohol Drinking; Alcoholism; Avitaminosis; Body Height; Body Mass Index; Body Weight; Diet; Dietary Proteins; Energy Intake; Erythrocytes; Ethanol; Female; Folic Acid; Folic Acid Deficiency; Humans; Male; Middle Aged; Nutrition Assessment; Nutrition Disorders; Nutritional Status; Prospective Studies; Pyridoxal Phosphate; Pyridoxine; Serum Albumin; Thiamine; Vitamin B 12

Serum homocysteine concentrations have been shown to be a sensitive functional indicator of intracellular folate, vitamin B-12, and vitamin B-6 status. Chronic alcoholism is known to interfere with one-carbon metabolism, for which the above vitamins serve as coenzymes. In the present study, these vitamins were assessed in 32 chronic alcoholics and 31 healthy volunteers by measuring blood vitamin concentrations as well as serum homocysteine concentrations. In chronic alcoholics, serum pyridoxal 5'-phosphate and red blood cell folate concentrations were significantly lower than in the control subjects (P < 0.001 and P = 0.008, respectively). Mean serum homocysteine was twice as high in chronic alcoholics than in nondrinkers (P < 0.001). Beer consumers had significantly lower concentrations of homocysteine compared with drinkers of wine or spirits (P = 0.05). These results suggest that by interfering with folate or vitamin B-6 metabolism, chronic alcohol intake may impair the disposal of homocysteine through the transmethylation or transsulfuration pathways.

Topics: Adult; Alcoholism; Blood Cell Count; Erythrocyte Indices; Female; Folic Acid; Homocysteine; Humans; Male; Middle Aged; Nutritional Status; Pyridoxine; Vitamin B 12

Topics: Adult; Alcoholism; Anemia, Macrocytic; Drug Therapy, Combination; Female; Folic Acid; Hematinics; Humans; Ileal Diseases; Malabsorption Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

Elderly patients with alcoholism often require surgery and receive nitrous oxide (N2O) as a component of their anesthetic. Since aging, ethanol, and N2O may all perturb folate and/or vitamin B12 metabolism, we examined the combined influence of these parameters on vitamin B12/folate status in a rodent model. Aged male Fischer 344 rats (24 months old) were given a liquid ethanol diet (35% of calories as ethanol) and control rats were pair-fed a liquid diet with carbohydrate substituting for the caloric content of ethanol. After receiving liquid diets for 7 weeks, rats were exposed to 60% N2O/40% 0(2) for 6 h. Urinary excretion of formic acid, formiminoglutamic acid (FIGLU), and methylmalonic acid (MMA) were used as indirect markers of folate/vitamin B12 status. In both the aged ethanol-fed and control groups, excretion of formic acid and FIGLU markedly increased the first day after N2O exposure and returned towards background values by the second day. No changes occurred in MMA excretion. Exposure to N2O decreased methionine synthase activities in liver, kidney and brain, and recovery of methionine synthase activities occurred over a period of 4 days in both the aged ethanol-fed and control groups. Ethanol treatment for 7 weeks combined with acute exposure to N2O did not deplete the aged rats of folate or vitamin B12 in blood, liver, kidney or brain. Thus, in this animal model, aging, chronic ethanol administration, and acute N2O exposure did not act synergistically to produce prolonged and severe disturbances in folate and vitamin B12 metabolism.

Topics: 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase; Aging; Alcoholism; Animals; Disease Models, Animal; Folic Acid; Male; Nitrous Oxide; Rats; Rats, Inbred F344; Vitamin B 12

The chronic administration of ethanol or brief exposure to nitrous oxide (N2O) decreases the activity of hepatic methionine synthase and disrupts normal metabolic processes that require folate and vitamin B12. This combination of drugs has clinical relevance since alcoholic patients often require surgery and receive N2O as a component of their anesthetic. To assess this clinical problem using a rodent model, rats were given a liquid ethanol diet (35% of calories as ethanol) and control rats were pair-fed a liquid diet with carbohydrate substituting for the caloric content of ethanol. After receiving liquid diets for 6 weeks, rats were exposed to 60% N2O/40% O2 for 6 hr. Urinary excretions of formic acid and formiminoglutamic acid (FIGLU) were used as indirect markers of folate status. In both the ethanol-fed and control groups, excretion of formic acid and FIGLU markedly increased the first day after N2O and returned towards background values by the second day after N2O exposure. Ethanol treatment alone decreased methionine synthase activities in liver, but not kidney or brain. Exposure to N2O further decreased methionine synthase activities, and recovery of methionine synthase activity after N2O occurred over a period of 4 days at the same rate in both the ethanol-fed and control groups. Ethanol treatment for 6 weeks combined with acute exposure to N2O did not deplete the rats of vitamin B12 in blood, liver, kidney, or brain. We conclude that in this animal model, chronic treatment with ethanol does not markedly exacerbate the disturbances in folate/vitamin B12 metabolism caused by brief exposure to N2O.

Topics: 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase; Alcoholism; Animals; Folic Acid; Formates; Formiminoglutamic Acid; Liver; Male; Nitrous Oxide; Rats; Rats, Inbred Strains; Vitamin B 12

The possible impact of long-term overexposure to ethanol was studied in a group of chronic alcoholics in the psychiatric hospital. The level of DNA methylation and unscheduled DNA synthesis (UDS) induced by N-methyl-N-nitrosourea (MNU) in lymphocytes and lipid peroxidation (LPO) in plasma were used as markers of injury caused by alcohol abuse. The data were correlated with plasma levels of some natural antioxidants (vitamins A, C and E) and vitamin B12. The following results were obtained. The degree of DNA methylation by MNU in lymphocytes was the same in the exposed and control groups under our experimental conditions. The DNA excision-repair capacity of lymphocytes measured as UDS was decreased in alcoholics (p less than 0.01) and LPO in plasma was significantly higher (p less than 0.01) as a consequence of alcohol overconsumption. By the simple regression method, a correlation was found between LPO and vitamin C levels (LPO = -0.078 x vit. C + 1.9; p less than 0.05) and between UDS and LPO values (UDS = -0.384 x LPO + 4.1; p less than 0.05). These results support the hypothesis of a connection of cell membrane status and DNA damage and repair and the possible role of active oxygen species in cell damage caused by ethanol.

Topics: Adult; Alcoholism; Ascorbic Acid; Cells, Cultured; DNA; DNA Repair; Humans; Lipid Peroxidation; Male; Methylation; Methylnitrosourea; Middle Aged; Regression Analysis; Vitamin A; Vitamin B 12; Vitamin E

Red cell folate and vitamin B12 estimations were performed on 243 successively admitted in-patients at a District General Hospital Psychiatric Unit and 42 out-patients (29 attending a lithium clinic). Patients were classified into five diagnostic groups. The mean ages of the manic and schizophrenic patients were lower than of the depressed or euthymic patients but age was not correlated with red cell folate or serum B12 levels in any group. There were 89 (31%) patients with red cell folate below 200 ng/ml and 35 (12%) with concentrations below 150 ng/ml. Significantly more of these low-folate patients were in-patients than out-patients. The mean red cell folate in the depressed patients was significantly lower than in the euthymic, manic and schizophrenic groups. Alcoholics had a similar mean red cell folate to depressed patients which was not quite significantly lower than the other groups. The mean serum B12 level in the alcoholics was, however, significantly raised. There were no significant differences in red cell folate or serum B12 between lithium-treated and untreated euthymic patients. The highest proportions of values below 200 ng/ml and 150 ng/ml were found in depressed and alcoholic patients. Endogenous depressives had the highest percentage of values below 150 ng/ml (folate-deficient) of all psychiatric groups and alcoholic patients. The significance of these findings is discussed.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Alcoholism; Bipolar Disorder; Depressive Disorder; Erythrocytes; Female; Folic Acid; Folic Acid Deficiency; Humans; Male; Mental Disorders; Middle Aged; Schizophrenia; Vitamin B 12

Forty-six male alcoholics hospitalized with polyneuropathy or intellectual impairment were studied after at least 2 wk of alcohol abstention. Neurological evaluation included neurophysiological examination of the sural nerve and tibial nerve, neurophysiological examinations, and CT-scanning of the brain. Alcohol and vitamin intakes were quantified by the interview method. Vitamin B-12 and folate status included examinations of peripheral blood and bone marrow aspirate, plasma vitamin B-12, plasma and erythrocyte folate, formiminoglutamic acid excretion test (FiGlu), methylmalonic acid excretion, and deoxyuridine suppression test (dU) on phytohemagglutinin-stimulated peripheral lymphocytes. The liver function was assessed by galactose elimination capacity and plasma clearance of antipyrine. There was no hematological sign of folate or vitamin B-12 deficiency. About 8% had low plasma folate, while neither erythrocyte folate nor plasma vitamin B-12 were decreased. However, half of the patients had functional folate deficiency as determined by abnormal FiGlu or dU. Compared to the remaining patients, those with abnormal FiGlu or dU had significantly more abnormal neurophysiological tests, and lower folate intake. There was no correlation between FiGlu or dU and the quantitative liver function tests. It is concluded that 1) folate deficiency may contribute to the development of alcoholic polyneuropathy, 2) the classical parameters for folate deficiency (blood concentrations, peripheral blood, and bone marrow examinations) are not reliable in diagnosing folate deficiency and 3) functional tests like FiGlu and dU are necessary to diagnose folate deficiency in alcoholics.

Topics: Adult; Alcoholism; Deoxyuridine; Folic Acid; Folic Acid Deficiency; Formiminoglutamic Acid; Hematologic Tests; Hepatic Encephalopathy; Humans; Liver Function Tests; Male; Middle Aged; Neurologic Examination; Peripheral Nervous System Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Alcoholism; Folic Acid; Humans; Vitamin B 12

The figures obtained in simultaneous radioimmunological assays of serum folate and vitamin B12 concentrations and erythrocyte folate concentration in 74 patients are presented. All these patients had a regular daily intake of over 80 g ethyl alcohol and presented an increase in mean blood cell volume. Most of the patients were males hospitalised with liver disease and/or anaemia. All were given bone narrow needle aspirations and liver biopsies. 46% of the patients presented a reduction in erythrocyte folates but vitamin B12 deficiency was rarely encountered. Megaloblastic transformation of the bone narrow was present in 56% of the alcoholics with reduced erythrocyte folates and in 10% of those with normal folate concentration. No correlation was found between serum and erythrocyte folate concentration and degree of liver damage. Serum vitamin B12 levels were higher in patients with cirrhosis. Inadequate diet was frequently found in the alcoholics with reduced folate concentrations. Due to variations in patient selection it is difficult to compare these data with those of other series but they do seem to confirm the hypothesis that the macrocytosis in most "healthy" alcoholics reflects a direct toxic action of the alcohol on erythropoiesis. In contrast folate deficiency is found among "derelict" chronic alcoholics in whom the vitamin deficiency has often not yet produced megaloblastosis of the bone marrow.

Topics: Adult; Aged; Aged, 80 and over; Alcoholism; Anemia, Macrocytic; Anemia, Megaloblastic; Erythrocytes; Female; Folic Acid; Humans; Male; Middle Aged; Vitamin B 12

A dual isotope vitamin B12 absorption test in which vitamin B12 is given both in aqueous solution and bound to protein (chicken serum), was evaluated in 26 controls and 68 patients with subnormal serum vitamin B12 concentrations (19 with pernicious anaemia, 13 with iron deficiency, seven after partial gastrectomy, seven with malabsorptive states, five with folate deficiency, four with chronic alcoholism and 13 in whom no cause was apparent). In control patients protein bound absorption decreased with age; isotope excretion was 1.0% or over in those aged under 60 and 0.5% or over in those aged 60 and above. Malabsorption of protein bound vitamin B12 with normal aqueous absorption occurred in five patients with iron deficiency, three with alcoholism, two after partial gastrectomy, two with folate deficiency and in one with a malabsorptive state. In alcoholics abstinence produced an improvement in protein bound absorption. All patients in the group for whom no cause could be found for the subnormal serum vitamin B12 concentration had normal aqueous absorption but four had malabsorption of protein bound vitamin. Although the dual isotope test gave reproducible results and was consistent with the standard Schilling test some anomalies were detected; nine patients had reduced aqueous absorption with normal protein bound absorption. Despite this the dual test may prove useful in determining the importance of a subnormal vitamin B12 concentration where the cause is not clinically apparent. Further development is needed before it can be considered for routine use.

Topics: Absorption; Alcoholism; Humans; Iron Deficiencies; Malabsorption Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

Serum, erythrocyte, and liver levels of total corrinoids, cobalamin (vitamin B12), and cobalamin analogues were determined by differential radioassay in 27 patients with alcoholism. Compared with normal subjects, liver content of total corrinoids and cobalamin in alcoholics was low. Conversely, serum total corrinoids and cobalamin were high. Compared with normal, levels of erythrocyte cobalamin analogue in alcoholics were elevated, but levels of cobalamin were not. Analogues in liver represented a similar percentage of total corrinoids in alcoholics as in normals. The data confirm prior work suggesting that, in alcoholism and in liver disease, cobalamin depletion in tissues may be masked by normal to high serum cobalamin and analogue levels. The failure of damaged liver to take up from the serum cobalamin and analogues, compounded by release of these compounds and their binders from damaged liver into the serum, can account for these findings.

Topics: Adult; Alcoholism; Corrinoids; Erythrocytes; Humans; Liver; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

In a prospective study, several parameters of small intestinal function have been assessed in 20 patients with chronic relapsing pancreatitis with and without steatorrhoea. By and large all routine parameters of small intestinal function were found to be normal. In particular, neither a previously reported high incidence of lactase deficiency, nor D-xylose malabsorption or vitamin B12 depletion was observed. However, there was a high incidence of abnormal 14C-cholylglycine breath tests (40%), suggesting the presence of mild bacterial overgrowth. Occasionally, this condition was associated with diarrhoea and steatorrhoea, thus indicating that steatorrhoea remaining after high-dosage pancreatin supplementation might sometimes be due to bacterial overgrowth.

Topics: Alcoholism; beta Carotene; Breath Tests; Carotenoids; Chronic Disease; Fats; Feces; Folic Acid; Glycocholic Acid; Humans; Intestinal Absorption; Intestine, Small; Pancreatitis; Prospective Studies; Recurrence; Vitamin B 12

Vitamin B1, Folic acid Vitamin B12, whole blood Lead level, and plasma Zinc level were determined in 82 patients admitted to an alcoholism rehabilitation program. Each patient was examined for an optic neuritis. Thirty-two of the patients had sub-clinical abnormalities suggestive of optic neuritis like dyschromatopsias and/or field visual defects. No differences were found in the blood levels of Vitamin B1, Folic acid, and Vitamin B12 between the 32% affected and the 68% unaffected subjects. Moreover vitamins blood levels were found to be within the limits of normal values in both groups. A negative correlation between whole blood Lead levels and plasma Zinc levels was found. When an optic neuritis occurs the lead level tends to be higher and the Zinc lower. Abnormalities of the more usual alcoholism tests: gamma glutamyl Transpeptidase (gamma GT), mean red cell volume (V.G.M.) and glutamic Oxaloacetic transferase (T.G.O.), were more pronounced in alcoholics with optic neuritis.

Topics: Adult; Alcoholism; Ethanol; Female; Folic Acid; Humans; Lead; Male; Middle Aged; Optic Neuritis; Thiamine; Vitamin B 12; Vitamin B Deficiency; Zinc

Topics: Aged; Aging; Alcoholism; Anemia; Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Animals; Blood Cell Count; Drug-Related Side Effects and Adverse Reactions; Female; Ferrous Compounds; Folic Acid; Folic Acid Deficiency; Gastrointestinal Hemorrhage; Humans; Male; Mice; Reference Values; Vitamin B 12

In three different groups of patients presenting severe folate deficiency (purely nutritional folate deficiency, chronic alcoholism or various intestinal diseases), vitamin B12 absorption has been tested by Schilling test in order to investigate the possible effect of folate deficiency on B12 absorption. Following this study, it appears that folate deficiency in itself, even severe, cannot induce vitamin B12 malabsorption, since in the first group, consisting of malnourished old people, the Schilling test was always normal even in those who presented a lowered B12 serum level; in the group of patients with intestinal disease, the Schilling test was abnormal as expected in some patients; 3 alcoholics out of 12 presented a malabsorption of B12 on the Schilling test; the follow-up of 2 of them exhibited complete correction after normal diet and alcohol suppression. Consequently, folate deficiency does not seem responsible for a secondary B12 malabsorption unless another etiological factor is present, such as alcohol or ileopathy.

Topics: Adult; Aged; Alcoholism; Erythrocyte Indices; Female; Folic Acid Deficiency; Humans; Intestinal Absorption; Intestinal Diseases; Iron; Malabsorption Syndromes; Male; Middle Aged; Schilling Test; Vitamin B 12

Blood vitamin status (B1, B2, B6, folic acid and B12) was assessed in 41 patients (M = 39; F = 2) with alcoholic liver disease. Biochemical evidence of thiamine deficiency was observed in all groups of patients. Deficiency of riboflavin was detected in patients with histologically normal liver but not in other groups. All the groups were found to be deficient in pyridoxal-5-phosphate--the active form of vitamin B6 (pyridoxine). Serum folate was decreased in all groups except in those with alcoholic hepatitis: red cell folate was, of course within normal limits in all the groups. Vitamin B12 levels were within normal limits in all groups except the cirrhotic one where it was raised. Clinico-biochemical implications of the findings are discussed. Biochemical changes in blood vitamin status may precede clinical manifestations of a disease process and may have prognostic value.

Topics: Adult; Alcoholism; Folic Acid; Hepatitis; Humans; Liver Cirrhosis, Alcoholic; Liver Diseases; Middle Aged; Pyridoxal Phosphate; Pyridoxine; Riboflavin; Thiamine; Vitamin B 12; Vitamin B Complex

Topics: Adult; Alcoholism; Folic Acid; Humans; Hypesthesia; Muscle Cramp; Neural Conduction; Polyneuropathies; Reflex, Abnormal; Sensation; Thiamine; Vitamin B 12

Topics: Alcoholism; Anemia, Macrocytic; Anemia, Megaloblastic; Bone Marrow; Folic Acid; Humans; Liver; Male; Middle Aged; Vitamin B 12

The facts known today about the occurrence and possible mechanisms of anaemias caused by medicaments are represented in a survey. In this connection toxic haemolytic anaemias, immunohaemolytic anaemias, toxic aplastic anaemias, megaloblastic anaemias, and some other, more rarely occurring types are referred to.

Topics: Alcoholism; Anemia; Anemia, Aplastic; Anemia, Hemolytic; Anemia, Hemolytic, Autoimmune; Anemia, Megaloblastic; Anemia, Sideroblastic; Antitubercular Agents; Benzenesulfonates; Bone Marrow; Chloramphenicol; Chromosome Aberrations; Contraceptives, Oral, Hormonal; Folic Acid Antagonists; Gastrointestinal Hemorrhage; Humans; Preleukemia; Purines; Pyrimidines; Vitamin B 12

Topics: Alcoholism; Animals; Biotin; Ethanol; Folic Acid; Humans; Liver; Male; Nicotinic Acids; Pantothenic Acid; Pyridoxine; Rats; Riboflavin; Thiamine; Vitamin B 12; Vitamin B Complex

Topics: Alcoholism; Celiac Disease; Exocrine Pancreatic Insufficiency; Folic Acid; Folic Acid Deficiency; Gastric Mucosa; Glutamates; Humans; Ileum; Intestinal Absorption; Intrinsic Factor; Malabsorption Syndromes; Protein Binding; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

The relationship of elevated serum vitamin B-12 concentration to alcoholism in general hospital patients was studied both in a retrospective and in a prospective group of patients. Alcoholism was the most common disease correlate of vitamin B-12 elevations in females. Of the unselected female alcoholics, 61% had a serum vitamin B-12 concentration larger than or equal to 1000 ng/liter at the time of admission; only 17% of the nonalcoholics, whatever their other disease, exhibited such high values. The sensitivity of high B-12 levels for alcoholism in females paralleled that of high SGOT, GGT and MCV values. In contrast, males (approximately 70% of our alcoholics) far less often exhibited B-12 elevations even when SGOT, GGT and MCV were abnormally high. Elevation of serum B-12 concentration should always raise the suspicion of alcohol abuse, especially in females.

Topics: Alcoholism; Aspartate Aminotransferases; Erythrocytes; Female; gamma-Glutamyltransferase; Humans; Male; Middle Aged; Prospective Studies; Radioimmunoassay; Retrospective Studies; Sex Factors; Vitamin B 12

Alcohol causes different hematologic alterations on each of the three bone marrow cellular series. Its effect on the red series leads to the appearance of megaloblastic disturbances, erythroblastic vacuolization, iron metabolism abnormalities, and hemolytic syndromes. Megaloblastic disturbances may arise as a consequence of folic acid or vitamin B12 deficiency or of a direct toxic effect of ethanol on the erythroblasts. Iron metabolism alterations include reversible sideroblastic anemia, and hemosiderosis. The three hemolytic syndromes related to the consumption of ethanol are: acanthocytosis, stomatocytosis, and Zieve's syndrome. Alcohol induces leukopenia and functional deffects of the leukocytes; these facts explain the frequent susceptibility of chronic alcoholics to infection. Ethanol may act upon the megakaryocytic series to produce reversible thrombopenia and various alterations in platelet function. Thus alcohol exerts toxic effects on bone marrow, which interfere with the proliferation, maturation, release and survival of the three cellular series, either directly or by means of complex mechanisms related to the metabolism of folic acid, vitamin B12, pyridoxine, or iron. Alcoholism should therefore be considered as a possible cause whenever an obscure hematological condition comes under scrutiny.

Topics: Alcoholism; Bone Marrow Diseases; Erythrocytes; Ethanol; Folic Acid; Hematologic Diseases; Humans; Intestinal Absorption; Iron; Leukocytes; Megakaryocytes; Pyridoxine; Vitamin B 12

Topics: Adult; Aged; Albumins; Alcoholism; Blood Glucose; Humans; Intestinal Absorption; Intestine, Small; Iron; Male; Middle Aged; Vitamin B 12

Topics: Adult; Aged; Alcoholism; Erythrocyte Count; Female; Folic Acid; Hematopoiesis; Hemoglobins; Hospitalization; Humans; Leukocyte Count; Male; Middle Aged; Nutrition Disorders; Vitamin B 12

Serum folate and B12 estimations were carried out on 272 admissions to a psychiatric unit during 1972 and 1973. 21.3% had serum folate below 2 ng/ml and 26.1% serum B12 below 150 pg/ml. The organic psychosis patients had a significantly lower mean B12 than the others, and were over-represented among the low B12 group. Low B12 status was also associated with low RBC and WBC. Low folate status was linked with depression, malnutrition, physical illness and low Hb, RBC and WBC. There were more chronic alcoholics than others with serum folate greater than 4-9 ng/ml, low RBC and macrocytosis. The presence of one or more haematological abnormalities (macrocytosis, low Hb, low RBC or low WBC) predicted low folate in 76%, and low B12 in 79%, but these were also found in 40% of the normal folate and 41% of the normal B12 patients. Macrocytosis may prove to be a reliable sign of alcoholic abuse.

Topics: Adult; Aged; Alcoholism; Depression; England; Folic Acid; Folic Acid Deficiency; Hospitals, Psychiatric; Humans; Mental Disorders; Middle Aged; Neurocognitive Disorders; Schizophrenia; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Aged; Alcoholism; Female; Glucose; Humans; Liver Diseases; Liver Extracts; Male; Middle Aged; Nucleosides; Vitamin B 12

In 64 chronic alcoholics folic acid and vitamin B12 in plasma and folic acid in erythrocytes were determined. The mean values of folic acid in plasma and in erythrocytes were significantly below normal. The determination of vitamin B12 showed normal results in a group of 20 cases treated with vitamin B12 containing drugs, whereas in the group of untreated alcoholics significantly reduced values were found. Comparison of folic acid and vitamin B12 concentrations in plasma revealed a more frequent deficiency of folic acid than of vitamin B12, which was combined with anemia in half the alcoholics investigated. The need to treat chronic alcoholics with folic acid and vitamin B12 is pointed out.

Topics: Adult; Aged; Alcoholism; Erythrocytes; Folic Acid; Folic Acid Deficiency; Humans; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

A patient with recurrent pulmonary abscess, weight loss, and alcoholism was found to have extremely high serum vitamin B12 and unsaturated vitamin B12-binding capacity (UBBC) levels. While transcobalamin (TC) II was also increased, most of his UBBC was due to an abnormal binding protein which carried greater than 80% of the endogenous vitamin B12 and was not found in his saliva, granulocytes, or urine. This protein was shown to be a complex of TC II and a circulating immunoglobulin (IgGkappa and IgGlambda). Each IgG molecule appeared to bind two TC II molecules. The reacting site did not interfere with the ability of TC II to bind vitamin B12, but did interfere with its ability to transfer the vitamin to cells in vitro. The site was not identical to that reacting with anti-human TC II antibody produced in rabbits. Because of this abnormal complex, 57Co-vitamin B12 injected intravenously was cleared slowly by the patient. However, no metabolic evidence for vitamin B12 deficiency was demonstrable, although the patient initially had megaloblastic anemia apparently due to folate deficiency. The course of the vitamin B12-binding abnormalities was followed over 4 yr and appeared to fluctuate with the status of the patient's illness. The IgG-TC II complex resembled one induced in some patients with pernicious anemia by intensive treatment with long-acting vitamin B12 preparations. The mechanism of induction of the antibody formation in our patient is unknown.

Topics: Adult; Alcoholism; Anemia, Megaloblastic; Antibodies; Blood Proteins; Humans; Male; Pneumonia; Transcobalamins; Vitamin B 12

A number of hematological variables have been investigated and followed during a hospital stay in a group of 34 non-cirrhotic male alcoholics after acute drinking bouts. The most prominent findings were a rise in reticulocytes, a fall in serum iron and a rise in WBC, especially with respect to the lymphocytes. HB and hematocrit values both fell during hospitalization, while ESR and serum haptoglobin rose. No change was observed in the platelet count. It is concluded that alcohol has marked effects on the hematological system even in subjects without serious liver damage. The results underline the importance of an adequate knowledge of the patient's alcohol habits in the investigation of obscure hematologic abnormalities.

Topics: Adult; Aged; Alcoholism; Blood Cell Count; Blood Cells; Erythropoiesis; Hematocrit; Hematopoiesis; Hemoglobin A; Humans; Iron; Leukocyte Count; Lymphocytes; Male; Middle Aged; Reticulocytes; Vitamin B 12

Topics: Alcoholism; Folic Acid; Humans; Vitamin B 12

A prospective study of the clinical significance of macrocytosis (mean corpuscular volume 100 fL or more) was carried out for 9 months in a teaching hospital in 1975. Of the 140 patients with macrocytosis at the time of admission (0l7% of all hospital admissions) 46 (33%) had low activity of serum or erythrocyte folate, or both, and 16 (11%) had low serum vitamin B12 concentrations. Among the 78 patients with normal B12 and folate values the most commonly associated significant clinical conditions were alcoholism or hepatic disease (36 patients), malignant disease or the effects of chemotherapy (25 patients) and chronic obstructive lung disease (10 patients).

Topics: Adolescent; Adult; Aged; Alcoholism; Anemia; Erythrocyte Volume; Erythrocytes; Female; Folic Acid; Hemoglobins; Humans; Liver Diseases; Lung Diseases, Obstructive; Male; Middle Aged; Neoplasms; Vitamin B 12

Topics: Adult; Alcoholism; Humans; Liver; Male; Middle Aged; Vitamin B 12

Topics: Alcohol Oxidoreductases; Alcoholism; Chronic Disease; Diet Therapy; Digestive System; Dose-Response Relationship, Drug; Ethanol; Folic Acid; Gastrointestinal Motility; Humans; Intestinal Absorption; Intestines; Malabsorption Syndromes; Methionine; Nutrition Disorders; Thiamine; Vitamin B 12; Xylose

Topics: Adult; Alcoholism; Biological Transport, Active; Chronic Disease; Cobalt Radioisotopes; Diet Therapy; Dose-Response Relationship, Drug; Ethanol; Humans; Intestinal Absorption; Intestine, Small; Intrinsic Factor; Lipid Metabolism; Malabsorption Syndromes; Male; Middle Aged; Nutrition Disorders; Pancreatin; Vitamin B 12; Vitamins; Xylose

Topics: Alcoholism; Chronic Disease; Diet Therapy; Enzyme Inhibitors; Erythrocytes; Ethanol; Female; Folic Acid; Humans; Iron; Male; Nutrition Disorders; Phosphotransferases; Pyridoxal Phosphate; Pyridoxine; Vitamin B 12; Vitamin B 6 Deficiency

New tests and test methods aid in the diagnosis of pancreatic disorders. Pancreatic carcinoma, especially, may have an improved prognosis with earlier detection as a result of refinements in arteriography, cytology, pancreatic radioisotopic scanning, and endoscopic retrograde cholangiopancreatography. Acute pancreatitis results most commonly from alcoholism, biliary tract disease, and trauma. Management is directed primarily at decreasing pancreatic exocrine secretion. Surgery is usually best avoided in the acute phase. Chronic pancreatitis is most often a result of recurrent attacks of acute pancreatitis. Diabetes and malassimilation become manifest as pancreatic destruction progresses. Management consists of replacement of pancreatic enzymes and diet supplements. Once chronic pancreatitis is established, surgery can only be directed at complications of the disease. Pancreatic ascites is usually associated with a break in the pancreatic ductal system. Ascites caused by trauma responds well to surgical intervention, but the alcoholic type is less amenable to treatment.

Topics: Acute Disease; Alcoholism; Antacids; Ascites; Carcinoembryonic Antigen; Cholangiography; Chronic Disease; Cysts; Diabetes Mellitus; Diet Therapy; Endoscopy; Gastrointestinal Hemorrhage; Humans; Metabolic Diseases; Methionine; Pancreatic Diseases; Pancreatic Juice; Pancreatic Neoplasms; Pancreatin; Pancreatitis; Prognosis; Selenium; Ultrasonics; Vitamin B 12

Topics: Alcoholism; Diarrhea; Folic Acid Deficiency; Humans; Intestinal Absorption; Intestinal Diseases; Intestine, Small; Malabsorption Syndromes; Vitamin B 12; Xylose

Topics: Alcoholism; Chronic Disease; Humans; Vitamin B 12

Topics: Adenosine Monophosphate; Alcohol Withdrawal Delirium; Alcoholism; Chemical and Drug Induced Liver Injury; Chlormethiazole; Deanol; Drug Combinations; Humans; Methionine; Psychoses, Alcoholic; Vitamin B 12

Topics: Alcoholism; Bone Marrow; Chronic Disease; Erythrocytes, Abnormal; Humans; Vitamin B 12

Topics: Adult; Aged; Alcohol Amnestic Disorder; Alcoholism; Alkaline Phosphatase; Aspartate Aminotransferases; Biological Assay; Epilepsy; Euglena gracilis; Female; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobins; Humans; Lacticaseibacillus casei; Liver Diseases; Male; Middle Aged; Pyridoxal; Vitamin B 12

Topics: Aged; Alcoholism; Ascorbic Acid; Avitaminosis; Child; Dose-Response Relationship, Drug; Evaluation Studies as Topic; Folic Acid; Humans; Mental Disorders; NAD; Nicotinic Acids; Psychiatry; Pyridoxine; Schizophrenia; Substance-Related Disorders; Vitamin B 12; Vitamins

Topics: Adolescent; Adult; Aged; Alcoholism; Anemia, Pernicious; Diagnostic Errors; Female; Folic Acid; Humans; Intrinsic Factor; Malabsorption Syndromes; Male; Middle Aged; Retrospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Alcoholism; Anemia; Automation; Erythrocyte Count; Erythrocytes, Abnormal; Ethanol; Fatty Liver; Female; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobinometry; Humans; Liver Function Tests; Male; Mass Screening; Sex Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Age Factors; Aged; Alcoholism; Color Perception Tests; Color Vision Defects; Fatty Liver; Folic Acid; Humans; Liver Cirrhosis; Male; Middle Aged; Smoking; Syndrome; Vitamin B 12

Topics: Aged; Alcoholism; Anemia, Macrocytic; Anemia, Pernicious; Female; Folic Acid; Hematocrit; Hemoglobins; Humans; Male; Middle Aged; Phenytoin; Reticulocytes; Vitamin B 12

Topics: Alcoholism; Blood Cell Count; Blood Platelets; Chromium Isotopes; Diet; Erythrocytes; Erythropoiesis; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobins; Humans; Iron; Iron Isotopes; Megakaryocytes; Pyridoxine; Vitamin B 12

Topics: Adult; Aged; Alcoholism; Bone Marrow Cells; Bone Marrow Examination; Female; Folic Acid Deficiency; Humans; Leukocyte Count; Leukopenia; Liver Function Tests; Male; Middle Aged; Protein Binding; Vitamin B 12

In a general medical hospital population the neurological status of 24 patients with severe folate deficiency was compared with that of a control group of 21 patients with normal serum folate. A significant increase of organic brain syndrome and pyramidal tract damage was found in the folate-deficient group. These findings were independent of the degree of anaemia or the presence of alcoholism. These data are consistent with the view that severe folate deficiency may cause neurological deficits.

Topics: Alcoholism; Anemia; Brain Diseases; Female; Folic Acid; Folic Acid Deficiency; Humans; Male; Middle Aged; Nervous System Diseases; Pyramidal Tracts; Reflex, Abnormal; Vitamin B 12

Topics: Alcoholism; Anemia, Macrocytic; Electronics, Medical; Erythrocytes; Folic Acid; Folic Acid Deficiency; Humans; Liver Diseases; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Aged; Alcoholism; Color Perception Tests; Electroretinography; Humans; Middle Aged; Optic Neuritis; Pyridoxine; Scotoma; Smoking; Strychnine; Thiamine; Vasodilator Agents; Vision Tests; Visual Field Tests; Vitamin B 12

Three probable cases of neuropathy in alcoholics are described. They are very atypical for three reasons. First, each developed an acute asymmetrical neuropathy for the first time well after ceasing to drink, and after routine saturation with the vitamin B group. Secondly, none had previously suffered from neuropathy while still drinking. If this puzzling reversal of the usual order of clinical events has been noticed before, no record has been found in the literature. Further study by psychiatrists treating alcoholics aided by their neurological colleagues is suggested.

Topics: Adult; Alcoholism; Female; Folic Acid; Humans; Male; Middle Aged; Peripheral Nervous System Diseases; Phenytoin; Substance Withdrawal Syndrome; Vitamin B 12; Vitamin B Complex

Topics: Adult; Aged; Alcoholism; Anemia, Macrocytic; Anemia, Pernicious; Blood Cell Count; Bone Marrow Cells; Erythroplasia; Female; Folic Acid; Folic Acid Deficiency; Hematopoietic Stem Cells; Humans; Hypothyroidism; Kidney Diseases; L-Lactate Dehydrogenase; Male; Neutrophils; Nutrition Disorders; Pregnancy; Pregnancy Complications, Hematologic; Reticulocytes; Vitamin B 12

Topics: Alcoholism; Cholecystectomy; Chronic Disease; Diabetes Mellitus; Gastrectomy; Hepatitis; Hepatitis A; Humans; Liver; Liver Cirrhosis; Vitamin B 12

Topics: Adult; Aged; Alcoholism; Avitaminosis; Female; Humans; Intestinal Absorption; Malabsorption Syndromes; Nutritional Physiological Phenomena; Nutritional Requirements; Pregnancy; Vitamin B 12; Vitamin B 12 Deficiency; Vitamins

Topics: Alcoholism; Cholelithiasis; Choline; Diabetes Complications; Drug Combinations; Homocysteine; Humans; Lactones; Liver Diseases; Phosphoric Acids; Vitamin B 12

Topics: Adolescent; Adult; Aged; Alcoholism; Chronic Disease; Humans; Intestinal Absorption; Male; Middle Aged; Vitamin B 12; Xylose

An investigation of 102 men comprising alcoholics, patients with non-ulcer dyspepsia, and healthy controls is reported. It demonstrates that alcohol is a cause of chronic gastritis and the severity of the mucosal lesion is directly related to the duration of excess drinking. Contrary to popular belief, chronic gastritis does not give rise to symptoms. The effect of alcohol on the gastric mucosa is a direct one and is not mediated by malnutrition, hepatic damage, intestinal malabsorption, anaemia, ascorbic acid deficiency, or any disturbance in immune tolerance. The natural history of chronic gastritis is described, involving an initial hypertrophy and hyperfunction of the gastric mucosa, followed by atrophy and hypofunction. Cigarette smoking is confirmed as another cause of chronic gastritis. The non-ulcer dyspepsia syndrome is unrelated to chronic gastritis.

Topics: Adolescent; Adult; Alcoholism; Atrophy; Chronic Disease; Dyspepsia; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Hypertrophy; Male; Middle Aged; Nutrition Disorders; Radiography; Smoking; Time Factors; Vitamin B 12

Topics: Alcoholism; Autopsy; Biotin; DNA; Fatty Liver; Folic Acid; Humans; Nicotinic Acids; Pantothenic Acid; Phosphorus; Pyridoxine; Thiamine; Vitamin B 12; Vitamin B Complex; Vitamin B Deficiency

Topics: Adult; Aged; Alcoholism; Humans; Male; Middle Aged; Neuralgia; Paralysis; Paresthesia; Polyneuropathies; Polyradiculopathy; Vitamin B 12

Topics: Adult; Alcoholism; Carotenoids; Deficiency Diseases; Diet; Ethanol; Feces; Folic Acid; Folic Acid Deficiency; Glucose; Hemoglobins; Humans; Intestinal Absorption; Jejunum; Lipids; Male; Middle Aged; Nutrition Disorders; Perfusion; Serum Albumin; Sodium; Tritium; Vitamin B 12; Xylose

A syndrome of choreoathetosis in association with alcoholism has been found in 12 patients. It appeared to occur more often in women, was transient, and may have been associated with alcohol withdrawal. It was not associated with gross liver disease, phenothiazine administration, or familial chorea, and no consistent abnormalities in whole blood thiamine or nicotinic acid, in serum magnesium, or in serum vitamin B(12) levels were present.

Topics: Adult; Aged; Alcoholism; Athetosis; Chorea; Female; Humans; Huntington Disease; Liver Diseases; Magnesium; Male; Middle Aged; Nicotinic Acids; Phenothiazines; Sex Factors; Substance Withdrawal Syndrome; Thiamine; Vitamin B 12

Topics: Aged; Alcoholism; Australia; Blood Cell Count; Blood Sedimentation; Female; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobinometry; Humans; Intellectual Disability; Male; Mental Disorders; Middle Aged; Substance-Related Disorders; Vitamin B 12

Topics: Adult; Alcoholism; Anemia, Macrocytic; Bone Marrow; Bone Marrow Examination; Deoxyuridine; DNA; Erythrocytes; Female; Folic Acid; Folic Acid Antagonists; Humans; Liver Cirrhosis; Pregnancy; Thymine; Triamterene; Tritium; Vitamin B 12

Topics: Adolescent; Adult; Aged; Alcoholism; Erythrocytes; Female; Folic Acid; Hemoglobins; Humans; Liver Function Tests; Male; Middle Aged; Vitamin B 12

Topics: Alcoholism; Humans; Liver Diseases; Liver Extracts; Liver Function Tests; Nucleosides; Pyrimidines; Sulfobromophthalein; Vitamin B 12

Topics: Adult; Aged; Alcoholism; Female; Folic Acid; Humans; Liver Diseases; Liver Function Tests; Male; Mental Disorders; Middle Aged; Neurocognitive Disorders; Nutritional Physiological Phenomena; Vitamin B 12

Topics: Alcoholism; Anemia, Hypochromic; Bone Diseases; Calcium; Female; Humans; Hypocalcemia; Intestinal Absorption; Malabsorption Syndromes; Middle Aged; Vitamin B 12

Topics: Aged; Alcoholism; Anemia, Macrocytic; Biopsy; Blood Cell Count; Fatty Liver; Female; FIGLU Test; Folic Acid; Folic Acid Deficiency; Humans; Liver; Liver Cirrhosis; Liver Function Tests; Vitamin B 12

Topics: Alcoholism; Amblyopia; Blindness; Cyanides; History, 18th Century; History, 19th Century; History, 20th Century; Humans; Nicotiana; Nicotine; Nutrition Disorders; Plants, Toxic; Smoking; Vitamin B 12

Topics: Alcoholism; Blood Sedimentation; Divorce; Dumping Syndrome; Duodenal Ulcer; Humans; Intestinal Absorption; Iron; Leukocyte Count; Mycobacterium tuberculosis; Nutrition Disorders; Social Conditions; Sputum; Stomach Ulcer; Sweden; Tuberculosis; Tuberculosis, Pulmonary; Vitamin A; Vitamin B 12

Topics: Adult; Alcoholism; Body Weight; Coenzymes; Deficiency Diseases; Feeding and Eating Disorders; Humans; Male; Middle Aged; Substance Withdrawal Syndrome; Vitamin B 12

Topics: Alcoholism; Chronic Disease; Dietary Fats; Feces; Gastric Acidity Determination; Histamine; Humans; Intestinal Absorption; Malabsorption Syndromes; Male; Nitrogen; Vitamin B 12; Xylose

Topics: Alcoholism; Arginine; Drug Synergism; Humans; Male; Middle Aged; Pyridoxine; Thiamine; Vitamin B 12

Topics: Alcoholism; Anemia; Bone Marrow; Bone Marrow Cells; Cytoplasm; Diet; Erythrocyte Count; Fatty Liver; Folic Acid; Humans; Male; Vitamin B 12

Topics: Aged; Alcoholism; Ethanol; Gastrectomy; Humans; Male; Middle Aged; Vitamin B 12

Topics: Alcoholism; Anticonvulsants; Chlordiazepoxide; Epilepsy, Tonic-Clonic; Humans; Hydroxyzine; Injections, Intramuscular; Male; Middle Aged; Substance Withdrawal Syndrome; Vitamin B 12

Topics: Adult; Alcoholic Intoxication; Alcoholism; Blood Chemical Analysis; Bone Marrow Examination; Folic Acid; Hematopoiesis; Humans; Iron; Iron Isotopes; Liver Function Tests; Male; Middle Aged; Vitamin B 12

Topics: Alcoholism; Female; Humans; Male; Nicotinic Acids; Peptic Ulcer; Transaminases; Vitamin B 12

Topics: Alcoholism; Anemia; Anemia, Hypochromic; Blood Chemical Analysis; Blood Volume; Bone Marrow Examination; Erythropoiesis; Folic Acid; Folic Acid Deficiency; Gastric Juice; Hematocrit; Hemochromatosis; Hemolysis; Humans; Iron; Liver; Liver Cirrhosis; Liver Diseases; Melena; Metabolism; Splenomegaly; Vitamin B 12

Topics: Alcoholism; Autoradiography; Biopsy; Biotin; Blood Chemical Analysis; DNA; Drug Therapy; Fatty Liver; Folic Acid; Folic Acid Deficiency; Liver Cirrhosis; Niacin; Nicotinic Acids; Pantothenic Acid; Pyridoxine; Rats; Riboflavin; Thiamine; Tritium; Vitamin B 12; Vitamin B Complex; Vitamin B Deficiency; Vitamins

Topics: Alcoholism; Anemia; Anemia, Macrocytic; Ankyrins; Blood Transfusion; Drug Therapy; Folic Acid; Folic Acid Deficiency; Hematinics; Humans; Injections; Spherocytosis, Hereditary; Vitamin B 12

Topics: Alcoholism; Biological Assay; Biopsy; Biotin; Fatty Liver; Folic Acid; Humans; Liver; Liver Cirrhosis; Niacin; Nicotinic Acids; Pantothenic Acid; Thiamine; Vitamin B 12; Vitamin B Complex; Vitamin B Deficiency; Vitamins

Topics: Alcoholism; Anemia; Anemia, Macrocytic; Anorexia Nervosa; Ascorbic Acid; Avitaminosis; Celiac Disease; Deficiency Diseases; Diet; Diet Therapy; Female; Folic Acid; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Pregnancy; Pregnancy Complications; Sprue, Tropical; United Kingdom; Vitamin A; Vitamin B 12; Vitamin B Complex; Vitamin D; Vitamin K; Vitamins; Vomiting

Topics: Alcoholic Intoxication; Alcoholism; Anemia; Aspartic Acid; Asthenia; Humans; Liver Cirrhosis; Liver Diseases; Liver Extracts; Magnesium; Nutrition Disorders; Postoperative Care; Potassium; Vitamin B 12; Yeast, Dried

Topics: Alcoholism; Anemia; Anemia, Hypochromic; Avitaminosis; Cholestyramine Resin; Common Bile Duct; Diet; Diet Therapy; Diuretics; Folic Acid; Folic Acid Deficiency; Gastrointestinal Hemorrhage; Humans; Hydrochlorothiazide; Ion Exchange Resins; Jaundice; Liver Cirrhosis; Liver Cirrhosis, Biliary; Postoperative Complications; Prothrombin Time; Vitamin B 12; Vitamin B Complex; Vitamin K

Topics: Alcoholism; Biotin; Blood Chemical Analysis; Corrinoids; Folic Acid; Hematinics; Humans; Niacin; Nicotinic Acids; Pantothenic Acid; Peripheral Nervous System Diseases; Pyridoxine; Riboflavin; Thiamine; Vitamin B 12; Vitamin B Complex; Vitamin B Deficiency; Vitamins

Topics: Alanine Transaminase; Alcoholism; Aspartate Aminotransferases; Biopsy; Blood; Clinical Enzyme Tests; Copper; D-Alanine Transaminase; Humans; Iron; Liver Cirrhosis; Liver Cirrhosis, Alcoholic; Liver Function Tests; Ornithine; Ornithine Carbamoyltransferase; Vitamin B 12

Topics: Alcoholism; Ascorbic Acid; Brain; Corrinoids; Drug Therapy; Humans; Liver Extracts; Mental Disorders; Psychoses, Alcoholic; Pyridoxine; Skin; Spleen; Thiamine; Tissue Extracts; Vitamin B 12; Vitamin B Complex

Topics: Adolescent; Alcoholism; Corrinoids; Depression; Depressive Disorder; Drug Therapy; Geriatrics; Hematinics; Neurasthenia; Neuritis; Vitamin B 12

Topics: Alcoholic Neuropathy; Alcoholism; Humans; Neuritis; Nicotiana; Optic Nerve; Optic Nerve Diseases; Smoking; Vitamin B 12; Vitamin B Complex

Topics: Alcohol Withdrawal Delirium; Alcoholism; Corrinoids; Humans; Psychoses, Alcoholic; Psychotic Disorders; Pyridoxine; Vitamin B 12; Vitamin B Complex

Topics: Alcoholism; Humans; Nervous System Diseases; Vitamin B 12

Topics: Alcoholic Neuropathy; Alcoholism; Corrinoids; Hematinics; Humans; Neuritis; Vitamin B 12; Vitamin B Complex