Vitamin B12 excretion as index of hepatic disorder.

DtmING A STUDY concerning the role of vitamin B1, in diabetes (1), it was noted that a number of cases in this study failed to excrete more than 10 gig. of a 50Lg. intramuscular load dose of the vitamin. All of these patients had a history of liver disease or some form of hepatic insufficiency. The storage of vitamin B1, by the liver has been studied extensively by Meyer et at. (2) and by Glass et at. (3) using radioactive Cola as tracer for the vitamin. They demonstrated that the radioactive material accumulates in the liver and can be measured with a directional scintillation counter over this organ. This was especially prominent in patients with pernicious anemia when a potent source of intrinsic factor was given at the same time. Rachmilewitz et at. (4) studied cases of acute hepatitis and cirrhosis of the liver and found that in these cases, the vitamin B1, content of the serum was very high; with subsidence of jaundice, the B1, concentration decreased to normal levels. This study points to the additional binding of B1. in liver disease and indicates the importance of a healthy liver for B1. storage. In liver disease the liver B1. stores are apparently depleted; hence the increased bound B1, in the serum. This paper reports the decreased excretion of intramuscular B1, in cases of liver involvement and the gradual increase to normal levels during the period of convalescence.