vitamin-b-12 and Substance-Related-Disorders

Nitrous oxide (N

Topics: Humans; Illicit Drugs; Neurotoxicity Syndromes; Nitrous Oxide; Recreational Drug Use; Substance-Related Disorders; Treatment Outcome; Vitamin B 12

Topics: Administration, Inhalation; Adolescent; Adult; Anesthetics, Inhalation; Dietary Supplements; Female; Humans; Male; Mental Disorders; Middle Aged; Nitrous Oxide; Prognosis; Recreational Drug Use; Risk Assessment; Risk Factors; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Nitrous oxide (N. Patients under 20 years of age who were diagnosed with N. Nine patients were included, all of whom presented with symptoms of myeloneuropathy including limb numbness, limb weakness or unsteady gait. Six patients had low or low-normal vitamin B. Chronic N

Topics: Adolescent; Adult; Female; Humans; Male; Nitrous Oxide; Outcome Assessment, Health Care; Subacute Combined Degeneration; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex; Young Adult

Beginning with a case report of nitrous oxide (N₂O)-induced B₁₂ deficiency myelopathy, this article reviews the clinical biochemistry of vitamin B₁₂, and examines the pathogenetic mechanisms by which B₁₂ deficiency leads to neurologic damage, and how this damage is potentiated by N₂O exposure. The article systematically examines the available experimental data relating to the two main coenzyme mechanisms that are usually suggested in clinical articles, particularly the deficient methylation hypothesis. The article demonstrates that neither of these mechanisms is fully consistent with the available data. The article then presents a novel mechanism based on new data from the neuroimmunology basic science literature which suggests that the pathogenesis of B₁₂ deficiency myelopathy may not be related to its role as a coenzyme, but rather to newly discovered functions of B₁₂ in regulating cytokines and growth factors.

Topics: 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase; Animals; Cobamides; Cytokines; Folic Acid; Gait Ataxia; Humans; Illicit Drugs; Intercellular Signaling Peptides and Proteins; Magnetic Resonance Imaging; Male; Methylation; Methylmalonic Acid; Methylmalonyl-CoA Mutase; Models, Animal; Models, Biological; Nitrous Oxide; Postgastrectomy Syndromes; Pyramidal Tracts; Spinal Cord; Subacute Combined Degeneration; Substance-Related Disorders; Vitamin B 12; Young Adult

Recreational use of nitrous oxide (N. We retrospectively collected clinical and biological data from 52 patients with known, documented chronic N. Plasma homocysteine was almost consistently increased in case of N. There is no specific marker of nitrous oxide abuse according to levels of consumption, total vitamin B12 decrease could not be used either as consumption or as severity marker. However, we showed that homocysteine is consistently increased and could be used as marker of recent N

Topics: Biomarkers; Humans; Methylmalonic Acid; Nitrous Oxide; Retrospective Studies; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency

A 27-year-old man presented with altered mental status and unilateral right lower limb swelling. Brain imaging and cerebrospinal fluid analysis were unremarkable. He reported history of nitrous oxide misuse after he recovered from his delirium. The diagnosis of drug induced psychosis was made. The right lower limb swelling was found to be due to extensive deep vein thrombosis. In another case, a 21-year-old woman presented with headache, vomiting and dipoplia. Brain imaging showed extensive cerebral venous sinus thrombosis. She also misused nitrous oxide. Both cases had low-normal vitamin B12 and elevated methylmalonic acid, consistent with nitrous oxide misuse. The woman was found to have elevated homocysteine because of functional vitamin B12 deficiency. Homocysteine was not measured in the man. Raised homocysteine is associated with increased thrombosis risk. Fourteen cases of nitrous oxide misuse associated arterial and venous thrombosis have been reported. These two cases highlighted the importance of inquiring about recreational drug use in young patients who presented with apparently unprovoked venous thromboembolism.

Topics: Adult; Female; Humans; Male; Nitrous Oxide; Substance-Related Disorders; Venous Thromboembolism; Venous Thrombosis; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Nitrous oxide (N. Poison Center medical records from four patients are reviewed in this series. Four patients presented with lower extremity weakness, paresthesias and gait abnormalities in the setting of chronic N. All patients had clinical signs of neurotoxicity including weakness and ataxia. Additionally, all had elevated methylmalonic acid and homocysteine concentrations with normal B12 indicating a functional B12 deficiency. Three had imaging consistent with SCD despite home supplementation The MRI in the fourth case was inconclusive due to movement artifact.. We report four cases of subacute combined degeneration induced by recreational nitrous oxide abuse despite self-administered vitamin B12 supplementation.

Topics: Dietary Supplements; Humans; Illicit Drugs; Nitrous Oxide; Subacute Combined Degeneration; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency

Although several case series have described nitrous-oxide-associated neurological disorders, a comprehensive assessment of exposure characteristics (e.g., time to onset, level of exposure) in substance abusers has not been performed. The aim of this study was to describe the onset patterns of recreational use of nitrous-oxide-induced neurological disorders.. All cases of neurological disorders related to nitrous oxide recreational use reported to the Hauts-de-France addictovigilance center between January 2019 and August 2020 were selected. Only cases requiring hospitalization with informative data to perform the nitrous oxide causality assessment were included.. A total of 20 cases from five hospitals were included. The male-to-female ratio was 6:1 and the median age was 19 years (range 16-34). The neurological presentation (myeloneuropathy 64%, 7/11; sensorimotor neuropathy 36%, 4/11) included for all patients gait disorders due to proprioceptive ataxia and limb hypoesthesia. The median dose used per occasion was 100 cartridges (range 5-960; n = 19). The median time from the start of nitrous oxide use to the onset of neurological symptoms was 6 months (range 0.7-54; n = 16). The cumulative dose was significantly higher in patients with damage to all four limbs than in patients with lower limb symptoms only (p = 0.042).. A low intermittent exposure may be sufficient to cause neurological damage in some subjects, suggesting that, at the population level, there is no safe exposure to nitrous oxide in recreational settings. The severity of neurological impairment could increase once used at high doses and for prolonged durations of nitrous oxide.

Topics: Adolescent; Adult; Ataxia; Female; Humans; Male; Nervous System Diseases; Nitrous Oxide; Peripheral Nervous System Diseases; Substance-Related Disorders; Vitamin B 12; Young Adult

People with severe substance use disorder (SUD) have a higher burden of micronutrient deficiency compared with the general population. The aim of this study was to investigate vitamin B12 status and risk factors of deficiency related to substance use, opioid agonist therapy (OAT), as well as hepatitis C infection and liver fibrosis. In this prospective cohort study, participants were recruited from outpatient OAT and SUD clinics in western Norway, and assessed annually with a clinical interview and exam, including venous blood sampling. Data were collected between March 2016 and June 2020, and a total of 2451 serum vitamin B12 measurements from 672 participants were included. The median serum vitamin B12 concentration was 396 (standard deviation 198) pmol/L at baseline, 22% of the population had suboptimal levels (<300 pmol/L) and 1.2% were deficient at baseline (<175 pmol/L). No clear associations were seen with substance use patterns, but liver disease and younger age were associated with higher vitamin B12 levels. Although the majority of participants had satisfactory vitamin B12 levels, about a fifth had suboptimal levels that might or might not be adequate for metabolic needs. Future studies could investigate potential gains in interventions among patients with suboptimal but non-deficient levels.

Topics: Cohort Studies; Folic Acid; Humans; Prospective Studies; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Humans; Illicit Drugs; Nitrous Oxide; Substance-Related Disorders; Vitamin B 12

Chronic nitrous oxide abuse is a known cause of myeloneuropathy. Nitrous oxide irreversibly inactivates vitamin B12 causing demyelination of the dorsal spinal columns, clinically indistinguishable from that which is caused by vitamin B12 deficiency. We report a 37-year-old female who presented with ataxia, loss of lower extremity proprioception, demyelination of her cervical dorsal spinal columns, and other laboratory and physical exam findings consistent with nitrous oxide abuse. The patient reported daily use in excess of 500 nitrous oxide cartridges, also known as "whippits". Nitrous oxide myeloneuropathy should be included in the differential diagnoses for emergency medicine physicians when evaluating a patient with bilateral neurologic deficits and ataxia.

Topics: Adult; Analgesics, Non-Narcotic; Emergency Service, Hospital; Female; Humans; Magnetic Resonance Imaging; Myelitis, Transverse; Nitrous Oxide; Spinal Cord; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency

Topics: China; Female; Humans; Hyperpigmentation; Illicit Drugs; Male; Nervous System Diseases; Nitrous Oxide; Retrospective Studies; Substance-Related Disorders; Vitamin B 12; Young Adult

Schizophrenia (SCH) and drug addiction are chronic disorders that are frequently accompanied by physical diseases, poor nutrition and reduced self-care, all of which are likely to result in vitamin deficiencies. The objective of this study was to compare vitamin levels in SCH patients, substance use disorder (SUD) patients and healthy controls (HCs). The study included 189 SCH patients, 119 SUD patients and 109 HCs. Information on vitamin B12, folic acid and vitamin D levels were retrieved from the hospital's database, and mean values and deficiency/insufficiency were evaluated. Vitamin D deficiency (<30 ng/ml) was more common in the SCH group than in the SUD and HC groups (88.4%, 74.8% and 86.4%, respectively). Although there were no significant differences in folic acid deficiency (<3.0 ng/ml) in the SUD and SCH groups (15.1% and 8.5%, respectively), the incidence of folic acid deficiency was significantly higher in both groups as compared with that in the HC group (5.8%). Significantly higher numbers of patients in the SCH group than in the SUD group had vitamin B12 deficiency (45.5% vs. 28.3%). The prevalence of vitamin B12 deficiency in the SUD group was significantly higher than that the HC group (28.3% vs.11.5%). As compared with the HC group, vitamin D and B12 levels were significantly lower in SCH group, and folic acid and B12 levels were significantly lower in the SUD group. Several vitamin deficiencies appear to be common in both SCH and SUD. Possible reasons should be investigated.

Topics: Adult; Female; Folic Acid; Folic Acid Deficiency; Humans; Incidence; Male; Middle Aged; Prevalence; Schizophrenia; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency

Whilst the dangers of 'legal highs' have been widely publicised in the media, very few cases of the neurological syndrome associated with the inhalation of nitrous oxide (N. Case series documenting the clinical and investigational features of ten consecutive cases of subacute degeneration of the spinal cord presenting to a hospital with a tertiary neurosciences service in East London.. Sensory disturbance in the lower (± upper) limbs was the commonest presenting feature, along with gait abnormalities and sensory ataxia. MRI imaging of the spine showed the characteristic features of dorsal column hyperintensity on T. A high index of suspicion is required to prompt appropriate investigation, make the diagnosis and commence treatment early. This is the largest reported series of patients with subacute degeneration of the spinal cord induced by recreational use of N

Topics: Adolescent; Adult; Ataxia; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Male; Neurodegenerative Diseases; Nitrous Oxide; Retrospective Studies; Spinal Cord; Spinal Cord Diseases; Substance-Related Disorders; Vitamin B 12; Young Adult

Topics: Administration, Inhalation; Adult; Anesthetics; Humans; Magnetic Resonance Imaging; Male; Nitrous Oxide; Subacute Combined Degeneration; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency

Nitrous oxide (N2O) is neurotoxic by interfering with vitamin B12 bioavailability. The clinical picture is indistinguishable to that of subacute combined degeneration (SCD). A movement disorder might occur though it is not a characteristic feature. We report a patient with N2O-induced SCD, exhibiting a combination of different involuntary movements.. A 20-year-old woman presented with one month of progressive unsteady gait, involuntary movements and tingling sensation in a stocking-glove distribution. She had used N2O and ketamine intermittently for recreational purposes for about two years. Neurological examination demonstrated normal cranial nerve functions except for dystonia in the facial muscle and tongue. Her muscle strength was full, but there were bilateral hyperreflexia and extensor plantar response. She exhibited dystonia in four limbs with athetoid movement in fingers and toes, worsened by eye closure. Vibration and proprioception were impaired. Laboratory tests revealed anemia (Hb: 9.9 g/dl) with normal mean corpuscular volume (85.7 fL) and decreased iron level (22 μg/dl) while other results were normal including serum vitamin B12 level (626 pg/ml). Magnetic resonance imaging showed a hyperintense lesion from C1 to C6 level in the posterior column. She was diagnosed as having SCD caused by N2O abuse, presenting with generalized dystonia and pseudoathetosis. The involuntary movements disappeared with vitamin B12 supplementation.. Movement disorders may be the rare manifestations of SCD associated with N2O abuse. Early recognition of the etiology is vital because it is treatable with vitamin B12 and methionine.

Topics: Adult; Athetosis; Dystonia; Female; Gait Disorders, Neurologic; Humans; Nitrous Oxide; Subacute Combined Degeneration; Substance-Related Disorders; Vitamin B 12; Vitamin B Complex; Young Adult

A case of subacute combined degeneration (SCD) of the spinal cord manifesting as severe ataxia and urinary retention in a patient with a history of heavy nitrous oxide abuse and self-supplementation with cyanocobalamin is reported.. A 27-year-old woman was treated in the emergency department for complaints of abdominal pain and inability to urinate for about 12 hours. The patient also complained of worsening lower-extremity weakness for 10 days and a "pins and needles" sensation in the lower extremities for approximately 1 year. She reported nitrous oxide abuse over 3 years (an average of 100-200 "whippit" cartridges daily on 3 or 4 days per week), as well as long-term self-medication with oral and i.m. cyanocobalamin for the purpose of preventing nitrous oxide-induced neurologic symptoms. Results of magnetic resonance imaging (MRI) were highly suggestive of SCD, which is typically seen in primary vitamin B12 deficiency but has been reported in the context of chronic nitrous oxide exposure. Treatment was initiated with cyanocobalamin 1000 μg i.m. daily, to be continued for 5 days and followed by a four-week regimen of 1000 μg i.m. weekly. The patient was discharged after 3 days, despite continued symptoms, with instructions to obtain ongoing care but was lost to follow-up.. A patient who abused nitrous oxide chronically developed ataxia, paresthesia, and urinary retention while self-medicating with cyanocobalamin. A diagnosis of SCD was supported by MRI findings, symptoms, and the known relationship between nitrous oxide exposure and vitamin B12 deficiency.

Topics: Adult; Female; Humans; Magnetic Resonance Imaging; Nitrous Oxide; Self Medication; Spinal Cord Diseases; Subacute Combined Degeneration; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency

Herein, we report a case of a 20-year-old (ethnicity not reported) woman with a history of nitrous oxide abuse and clinical symptoms consistent with spinal cord subacute combined degeneration with associated low serum concentrations of vitamin B12, elevated methylmalonic acid levels, and radiologic evidence of demyelination of the dorsal region of the spinal column. The health of the patient improved dramatically with B12 supplementation. In this case, we discuss the interaction of nitrous oxide with the enzymatic pathways involved in the biochemistry of vitamin B12.

Topics: Adult; Demyelinating Diseases; Female; Humans; Methylmalonic Acid; Nitrous Oxide; Paresthesia; Spinal Cord Diseases; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Topics: Aerosol Propellants; Gait Ataxia; Hematinics; Humans; Male; Nitrous Oxide; Paresthesia; Substance-Related Disorders; Vitamin B 12; Young Adult

Although cobalamin (cbl) C deficiency is the most common inherited disorder of vitamin B12 metabolism, the late-onset form of the disease can be difficult to recognize because it has a broad phenotypic spectrum. In this report, we describe an adolescent female exposed to unknown illicit substances and sexual abuse who presented with psychosis, anorexia, seizures, and ataxia. The patient's diagnosis was delayed until a metabolic workup was initiated, revealing hyperhomocysteinemia, low normal plasma methionine, and methylmalonic aciduria. Ultimately, cblC deficiency was confirmed when molecular testing showed compound heterozygosity for mutations (c.271dupA and c.482G>A) in the MMACHC gene. This diagnosis led to appropriate treatment with hydroxocobalamin, betaine, and folate, which resulted in improvement of her clinical symptoms and laboratory values. This patient demonstrates a previously unrecognized presentation of late-onset cblC deficiency. Although neuropsychiatric symptoms are common in late-onset disease, seizures and cerebellar involvement are not. Furthermore, anorexia has not been previously described in these patients. This case emphasizes that inborn errors of metabolism should be part of the differential diagnosis for a teenager presenting with altered mental status, especially when the diagnosis is challenging or neurologic symptoms are unexplained. Correct diagnosis of this condition is important because treatment is available and can result in clinical improvement.(1.)

Topics: Adolescent; Anorexia; Carrier Proteins; Child Abuse, Sexual; Comorbidity; Cooperative Behavior; Diagnosis, Differential; Epilepsy, Temporal Lobe; Female; Genetic Carrier Screening; Humans; Illicit Drugs; Interdisciplinary Communication; Oxidoreductases; Psychotic Disorders; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency

We describe a case of a young woman who developed myelopathy and peripheral neuropathy following 1 year of recreational nitrous oxide (N2O) use. She presented with uncomfortable tingling sensation in her feet and poor balance. Physical examination revealed mild weakness and hyper-reflexia in the lower limbs. Proprioception and vibration were absent in the lower limbs. Pinprick and light touch sensations were reduced below the sixth thoracic dermatome. A broad-based gait and a positive Romberg sign were noted. The level of vitamin B12 was low (76 pmol/l). T2-weighted MRI scans showed hyperintensity changes at the posterior column from the second to the fifth cervical vertebrae. She made a full recovery following injections of vitamin B12 and physiotherapy. This case discusses subacute combined degeneration of the spinal cord on a background of N2O abuse.

Topics: Female; Humans; Magnetic Resonance Imaging; Nitrous Oxide; Physical Therapy Modalities; Spinal Cord; Subacute Combined Degeneration; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Topics: Chemical and Drug Induced Liver Injury; Ethanol; Humans; Liver; Protective Agents; Psychotropic Drugs; S-Adenosylmethionine; Substance-Related Disorders; Vitamin B 12; Vitamin B Complex

Topics: 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase; Anesthetics, Inhalation; Dentistry; Dentists; Humans; Nitrous Oxide; Occupational Diseases; Polyneuropathies; Receptors, Opioid; Substance-Related Disorders; Vitamin B 12

Chronic exposure to nitrous oxide (N2O) is known to be associated with hematologic and neurologic abnormalities. When this syndrome occurs, it is generally seen in health care workers, especially dentists and anesthesiologists, who have access to nitrous oxide. Here, however, we report a case of a 55-year-old non-healthcare worker who presented with multiple neurological abnormalities. His serum vitamin B12 level was low but his Shilling test was normal. His neurologic symptoms improved after cessation of inhaling nitrous oxide and starting vitamin B12 therapy. Physicians should consider nitrous oxide abuse in non-healthcare workers presenting with neurologic symptom of unclear cause.

Topics: Humans; Inhalation Exposure; Male; Middle Aged; Nervous System Diseases; Nitrous Oxide; Substance-Related Disorders; Syndrome; Vitamin B 12; Vitamin B 12 Deficiency

A 23 year old man presented with a severe posterior column myelopathy related to prolonged nitrous oxide abuse obtained from whipped cream bulbs. The site of pathology was identified by magnetic resonance imaging (MRI) and somatosensory evoked potentials. The mechanism of toxicity involves inactivation of vitamin B12 dependent enzymes. Appropriate treatment with methionine and vitamin B12 was instituted quickly with good neurological outcome. There are major concerns regarding the availability of nitrous oxide in supermarkets.

Topics: Adult; Cervical Vertebrae; Humans; Male; Methionine; Nitrous Oxide; Spinal Cord Diseases; Substance-Related Disorders; Vitamin B 12

We describe a case of myeloneuropathy resulting from nitrous oxide abuse. MR imaging of the spine revealed symmetric abnormal signal in the posterior columns of the cervical cord. Myeloneuropathy is caused by inactivation of vitamin B12 by nitrous oxide. This syndrome can also be seen in patients with borderline vitamin B12 deficiency who have recently been anesthetized with nitrous oxide.

Topics: Adult; Humans; Magnetic Resonance Imaging; Male; Neck; Nitrous Oxide; Spinal Cord; Spinal Cord Diseases; Substance-Related Disorders; Vitamin B 12

Findings reported are for a subset of African American subjects, residing in the urban area of Washington, D. C., who participated in a Program Project designed to study nutrition, other factors, and the outcome of pregnancy. Fasting blood samples, drawn during each trimester of pregnancy and at delivery, were screened for concentrations of cocaine, phencyclidine (PCP) and marijuana. Since substance abusers are expected to consume inadequate diets, these samples were also analyzed for serum folate, vitamin B12, ferritin and ascorbic acid. Data for these biochemical variables were compared for subjects whose serum values for drugs were either above or below the drug screening threshold concentrations established by ADAMHA/NIDA. Pearson's correlations were used to determine relationships between pregnancy outcome variables and maternal serum drug concentrations. Blood samples drawn at delivery showed higher maternal: cord ratios (mean +/- SEM) for marijuana (3.3 +/- 2.2) and PCP (2.9 +/- 1.0) than for cocaine (1.0 +/- 0.2). The subjects whose serum values were above the ADAMHA/NIDA ranges for marijuana, PCP and cocaine had concentrations of folate and ferritin that were significantly less than those of subjects with lower serum drug levels (P < or = 0.05). High maternal serum concentrations of illicit drugs were accompanied by a significant increase in leukocyte count (P < or = 0.05). The level of maternal cocaine during the third trimester was inversely correlated with birthweight (r = -0.29; n = 52; P = 0.038) and head circumference (r = -0.28; n = 52; P = 0.047).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Ascorbic Acid; Birth Weight; Black or African American; Cannabis; Cocaine; District of Columbia; Female; Ferritins; Fetal Blood; Folic Acid; Gestational Age; Humans; Infant, Newborn; Labor, Obstetric; Nutritional Status; Phencyclidine; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Substance-Related Disorders; Vitamin B 12

Detailed electrophysiological studies were performed in 4 patients with myeloneuropathy induced by abuse of nitrous oxide for 1 to 4 years. All presented with paresthesias, weakness, and Lhermitte's phenomena, and exhibited signs of sensorimotor polyneuropathy, ataxia, and arreflexia. Two had subnormal serum vitamin B12 levels. Baseline electrophysiologic testing revealed reduced motor unit potentials, prolonged F wave latencies, absent H reflexes, denervation potentials, and delays in motor and sensory conduction. Three had peripheral and nuchal delay after median nerve stimulation. All were reevaluated after 3 to 12 months' abstinence and treatment with vitamin B12, and all showed substantial clinical improvement. Parallel improvement in electrophysiologic findings occurred, but residual minor conduction delays, loss of H reflexes, electromyographic evidence of denervation, or abnormalities of posterior tibial SEP were noted. These findings confirm the reversibility of myeloneuropathy of nitrous oxide abuse and describe the profile of electrophysiologic recovery in subjects who abstain from further neurotoxic exposure.

Topics: Adult; Ataxia; Electromyography; Electrophysiology; Female; Humans; Male; Neural Conduction; Nitrous Oxide; Paresthesia; Spinal Cord Diseases; Substance-Related Disorders; Vitamin B 12

Topics: Hematopoiesis; Humans; Nervous System Diseases; Nitrous Oxide; Students, Dental; Students, Medical; Substance-Related Disorders; United States; Vitamin B 12

Topics: Adult; Depressive Disorder; Humans; Male; Methyl n-Butyl Ketone; Occupational Diseases; Occupational Exposure; Substance-Related Disorders; Vitamin B 12

The nutritional status of 82 marihuana-smoking students from two establishments of tertiary education was studied and compared with 63 controls. There was little difference between these two groups of students. Thirty-four per cent of those taking drugs had a diet which was deficient in one or more nutrients, compared with 30% of the controls. Four of the students who took drugs and three controls had a marginally reduced serum level of vitamin B12, but all were taking oral contraceptive agents. Sixteen marihuana-smokers had either a low folate or low pyridoxal serum level, and another three had reduced serum levels of both vitamins compared with a total of eleven among the controls. Forty-three students (52%) had used, or were using, lysergic acid diethylamide (LSD) in addition to marihuana, and 10 had used mushrooms (Psilocybe cubensis). Thirteen students appeared to be "stoned" at interview.

Topics: Adolescent; Adult; Australia; Cannabis; Female; Folic Acid; Hemoglobins; Humans; Male; Nutritional Physiological Phenomena; Pyridoxal; Students; Substance-Related Disorders; Vitamin B 12

Topics: Humans; South Africa; Substance-Related Disorders; 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; Ascorbic Acid; Humans; Male; Methadone; Nicotinic Acids; Pantothenic Acid; Private Practice; Substance-Related Disorders; Vitamin B 12; Vitamins

Topics: Adolescent; Adult; Anemia; Anemia, Hypochromic; Child; Child, Preschool; Diagnosis, Differential; Female; Folic Acid; Folic Acid Deficiency; Humans; Infant; Infant, Newborn; Iron; Male; Nonprescription Drugs; Pregnancy; Substance-Related Disorders; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Humans; Neuritis; Substance-Related Disorders; 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: Anemia; Folic Acid; Hematinics; Humans; Liver Extracts; Mental Disorders; Substance-Related Disorders; Vitamin B 12

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 B(12)) and folic acid have not been defined at this time. Vitamin B(12) 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 B(12) 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.

Topics: Anemia; Anemia, Iron-Deficiency; Anemia, Megaloblastic; Anemia, Pernicious; Folic Acid; Hematinics; Humans; Intrinsic Factor; Iron; Iron Compounds; Iron Metabolism Disorders; Liver Extracts; Substance-Related Disorders; Vitamin B 12; Vitamins