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Vitamin metabolism and the effects of multivitamin supplementation in oral contraceptive users.

The effect of combined oral contraceptives containing 158 micrograms of levonorgestrel and 38 micrograms of ethinyl estradiol on vitamin B-1, B-2, B-6, B-12, folates, vitamin A, carotenoids, vitamin E and tryptophan load test was studied in a group of 34 healthy non-lactating women. This was compared to an identical study conducted in another group of 19 subjects who used IUCDs for contraception, and also in two other groups of subjects who were given an additional multivitamin preparation on a daily basis (33 subjects) and on the days when OC was not taken (29 subjects). Assessments were made prior to, and during the third week of the 4th, 7th and the 13th cycles of OC treatment. Urinary xanthurenic acid excretion (XA), plasma vitamin A and the folate content of the sera and red blood cells were significantly increased by OC treatment, although this excessive XA excretion was adequately corrected with 18 mg of daily vitamin B-6 supplementation. The metabolism of the rest of the vitamins was not significantly altered by OC usage. This suggests that a routine use of multivitamin supplement may not be necessary.

Adult↗

Vitamin supplements to Indian women using low dosage oral contraceptives.

Effect of continuous and intermittent vitamin supplements on vitamin status, serum proteins and lipids were examined in Indian women of low-income group, receiving a low-dose oral contraceptive over a period of 3-6 months. To find out non-specific time related changes, vitamin supplemented and unsupplemented control groups of non-OC users were also examined. OC treatment did not change serum chemistry significantly. The significant biochemical changes were: altered tryptophan metabolism and elevated plasma vitamin A levels. Former could be prevented by administering multivitamins containing 10 mg vitamin B6 daily or twice the dose daily for the 7 non-hormone days in the cycle. Vitamin supplements produced significant improvement in pre-existing deficiencies of riboflavin, pyridoxine and folic acid. Continuous supplementation regimen was slightly superior, but more expensive than the intermittent supplementation regimen. In view of the high prevalence of vitamin deficiency among the low-income group women of developing countries, the delivery system for oral contraceptive can be effectively used for giving vitamin supplements as well.

Adult↗

An epidemic in Cuba of optic neuropathy, sensorineural deafness, peripheral sensory neuropathy and dorsolateral myeloneuropathy.

An epidemic outbreak of peripheral neuropathy affected Cuba in 1992-93 resulting in 50,862 cases (national cumulative incidence rate (CIR) 461.4 per 100,000). Clinical forms included retrobulbar optic neuropathy, sensory and dysautonomic peripheral neuropathy, dorsolateral myeloneuropathy, sensorineural deafness, dysphonia and dysphagia, spastic paraparesis, and mixed forms. For epidemiological purposes, cases were classified as optic forms (CIR 242.39) or peripheral forms (CIR 219.25). Increased risk was found among smokers (odds ratio (OR) 4.9), those with history of missing meals (OR 4.7) resulting in lower intake of animal protein, fat, and foods that contain B-vitamins, combined drinking and smoking (OR 3.5), weight loss (OR 2.8), excessive sugar consumption (OR 2.7) and heavy drinking (OR 2.3). Optic neuropathy was characterized by decreased vision, bilateral and symmetric central or cecocentral scotomata, and loss of color vision due to selective lesion of the maculopapillary bundles. Peripheral neuropathy was a distal axonopathy lesion affecting predominantly large myelinated axons. Deafness produced selective high frequency (4-8 kHz) hearing loss. Myelopathy lesions combined dorsal column deficits and pyramidal involvement of lower limbs with spastic bladder. Clinical features were those of Strachan syndrome and beriberi. Intensive search for neurotoxic agents, in particular organophosphorus esters, chronic cyanide, and trichloroethylene intoxication, yielded negative results. Treatment of patients with B-group vitamins and folate produced rewarding results. Most patients improved significantly and less than 0.1% of them remained with sequelae; there were no fatal cases. Supplementation of multivitamins to the entire Cuban population resulted in curbing of the epidemic. Overt malnutrition was not present, but a deficit of micronutrients, in particular thiamine, cobalamine, folate and sulfur amino acids appears to have been a primary determinant of this epidemic.

Adolescent↗

Effect of vitamin D on gastrin and gastric somatostatin secretion from the isolated perfused rat stomach.

We have studied the role of vitamin D in the regulation of gastrin and gastric somatostatin secretion from the isolated perfused rat stomach. In Ca-deficient vitamin D-deficient rats (Ca(-)D(-) group), the basal and bombesin-stimulated gastrin and gastric somatostatin release (basal IRGa, basal IRS, sigma delta IRGa, and sigma delta IRS) all were significantly lower than in Ca-replete vitamin D-replete rats (Ca(+)D(+) group), and also lower than in Ca-replete vitamin D-deficient rats (Ca(+)D(-) group) except for the basal IRGa. In the Ca(+)D(-) group, the basal IRGa and IRS, and sigma delta IRS were not significantly lower than in the Ca(+)D(+) group. Although there was no significant impairment in basal IRGa, sigma delta IRGa in the Ca(+)D(-) group was significantly lower than in the Ca(+)D(+) control group. Thus, the gastrin and gastric somatostatin secretion from the Ca-deficient vitamin D-deficient rats were impaired. In addition, the impaired gastrin and gastric somatostatin secretions seem to be caused not only by a decrease in serum Ca but also by the reduced effect of the vitamin D on the G and gastric D cells.

Animals↗

Vitamin metabolism and therapy in ophthalmology.

Vitamin deficiency states are important in the genesis of many ocular disorders. Deficiencies may be due to poor dietary intake, or to alterations in metabolism produced by some commonly prescribed medications or by certain diseases. Furthermore, some vitamins may exert important pharmacologic effects on the normal eye. The ocular effects of deficiencies and excesses of specific vitamins, and the therapeutic uses of each vitamin, are reviewed.

Animals↗