Eugene L. Lozner

Negative Effect of Synthetic Vitamin B6 Hydrochloride in Nutritional Deficiency in Man.

Spies and his associates 1 have recently reported observations on 4 patients with pellagra, who following treatment with nicotinic acid, riboflavin and thiamin chloride while they were taking a deficient diet, continued to complain of nervousness, insomnia, irritability, abdominal pain, weakness and difficulty in walking. These symptoms were relieved within 4 hours by a single dose of 50 mg of synthetic vitamin B6 hydrochloride (2-methyl-3-hydroxy-4, 5-(hydroxymethyl)-pyridine) intravenously. Fouts and his coworkers 2 have reported the development of a microcytic hypochromic anemia in puppies taking a synthetic diet deficient in vitamin B6, which was cured by the administration of this factor. This communication records observations on the ineffectiveness of synthetic vitamin B6 hydrochloride† administered to 6 patients with nutritional deficiency of types described in Table I, 5 of whom had very definite anemia. Each patient on admission to the hospital was placed on a standard 3000 calorie diet containing only traces of the water soluble vitamins. Reticulocyte counts were done daily and counts of the red and the white blood cells and hematocrit and hemoglobin determinations were made every other day. The clinical and hematological findings are summarized in Table I. There was no evidence of a reticulocyte response in any case and the reticulocytes were always less than 2%. Four of the patients received ferrous sulfate, nicotinic acid, thia-min chloride, riboflavin and ascorbic acid prior to and during vitamin B6therapy. These substances were given in order that a possible synergistic effect might not be overlooked. No toxic symptoms were encountered referable to vitamin B6 administration in the doses tabulated. In none of the 6 cases was any improvement observed either in the anemia or in the subjective symptoms and objective signs following vitamin B6 administration.