Effect of Vitamin B12 on Neuropathy in Pernicious Anaemia Treated with Folic Acid

Fuld, H.

doi:10.1136/bmj.2.4671.147

Cited by 5 publications

(2 citation statements)

References 3 publications

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“…Persons who are marginal in vitamin B 12 and are given large folic acid supplements will first present with severe and irreversible neurological disease rather than the normal presentation of anemia [367][368][369], although the evidence comes mainly from the older literature; the levels of folate intake recommended have not been shown to precipitate B 12 -deficient neurological disease [370], although it remains a theoretical possibility [371]. In the presence of vitamin B 12 deficiency, folate is not recycled in the body, as it becomes "trapped" in its methyl form so that the person becomes dependent upon the daily intake of "fresh" folate.…”

Section: Cobalamin (Vitamin B 12 )mentioning

confidence: 99%

Proposed Recommended Nutrient Densities for Moderately Malnourished Children

2009

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Recommended Nutrient Intakes (RNIs) Key words: Ascorbate, biotin, calcium, catch-up growth, cobalamin, convalescence, copper, DRV, essential fatty acid, folic acid, growth, iodine, iron, magnesium, malnutrition, manganese, niacin, nutrient density, nutrition, nutritional deficiency, nutritional requirements, pantothenic acid, phosphorus, potassium, protein, protein-energy malnutrition, pyridoxine, RDA, recommendations, riboflavin, RNI, selenium, sodium, stunting, sulfur, thiamine, vitamin A, vitamin D, vitamin E, vitamin K, wasting, zinc SummaryThe objective is to derive nutrient requirements for moderately malnourished children that will allow them to have catch-up growth in weight and height, prevent their death from nutritional disease, strengthen their resistance to infection, allow for convalescence from prior illness, and promote normal mental, physical, and metabolic development.The malnourished population will have been exposed to nutritional stress and seasonal shortages and will have been living in unhygienic conditions; a proportion will have been severely malnourished. Typically, from 5% to 15% of children aged 6 to 59 months are moderately wasted, and 20% to 50% are stunted in height.There has been little published on the requirements for the moderately wasted or stunted child per se. However, with the change in definition of severe malnutrition from the Wellcome classification [1] based upon weight-for-age to one based upon weight-forheight, reanalysis of the data shows that many of the studies of children with less than 60% weight-for-age included children who were moderately wasted by modern criteria, albeit stunted. The physiological and other data from the older literature therefore are likely to apply to those with moderate as well as those with severe wasting.In order to derive the requirements of each nutrient for moderately malnourished children, the lower and upper boundaries were assumed to lie between the requirement for a normal, healthy child living in a clean environment and the requirement for treatment of a severely malnourished child living in a contaminated environment. The therapeutic diets used for treatment of the severely malnourished in the developing world have been remarkably successful and are capable of sustaining rates of weight gain of more than 10 g/kg/day and returning the children to physiological normality.The requirements for normal Western individuals (Recommended Nutrient Intake, RNI) were used as the minimum requirements. They were converted into nutrient:energy densities with the use of the energy

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Section: Cobalamin (Vitamin B 12 )mentioning

confidence: 99%

Proposed Recommended Nutrient Densities for Moderately Malnourished Children

2009

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“…The haematological state not infrequently remains unsatisfactory (Wilkinson, 1948), and the neurological state is not prevented from deteriorating (Davidson, 1948;Israels and Wilkinson, 1949). Since then Fuld (1950) and Schwartz et al (1950) have reported poor haematological and neurological results with folic acid therapy. The latter reported 72 cases followed for three and a half years and treated with 5 mg. of folic acid daily: 23 cases developed cord degeneration, in 23 the red cell count and marrow showed relapse, and in 9 cases both occurred.…”

Section: Discussionmentioning

confidence: 99%