The Relation of Therapy in Pernicious Anemia to Changes in the Nervous System. Early and Late Results in a Series of Cases Observed for Periods of Not Less Than Ten Years, and Early Results of Treatment With Folic Acid

Bethell, Frank H.; Sturgis, Cyrus C.

doi:10.1182/blood.v3.1.57.57

Cited by 36 publications

(7 citation statements)

References 3 publications

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“…This goes to the direction of observation of Bagé et al, [23]. The treatment of neuromyelopathy by deficiency of Vitamin B12 must be introduced early because of the relationship found between severity of neurological symptoms and duration [24,25]. Neurologic disorders in patients with Cobalamin deficiency not related to overall severity of deficiency of vitamin [7].…”

Section: Discussionmentioning

confidence: 99%

Postural Disorders in Neuromyelopathy by Deficiency in Vitamin B12

Diagne¹

2016

PMRD

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Section: Discussionmentioning

confidence: 99%

Postural Disorders in Neuromyelopathy by Deficiency in Vitamin B12

Diagne¹

2016

PMRD

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“…Sixteen publications reported on prospective case series (Berk et al, 1948;Bethell & Sturgis, 1948;Chodos & Ross, 1951;Davidson & Girdwood, 1947;Hall & Watkins, 1947;Heinle et al, 1947;Israëls & Wilkinson, 1949;Meyer, 1947;Ross et al, 1948;Schwartz et al, 1950;Spies et al, 1948;Spies & Stone, 1947;Vilter et al, 1947;Wagley, 1947;Wilkinson, 1948;Will et al, 1959).…”

Section: Prospective Case Seriesmentioning

confidence: 99%

“…Sixteen publications reported on prospective case series (Berk et al., 1948; Bethell & Sturgis, 1948; Chodos & Ross, 1951; Davidson & Girdwood, 1947; Hall & Watkins, 1947; Heinle et al., 1947; Israëls & Wilkinson, 1949; Meyer, 1947; Ross et al., 1948; Schwartz et al., 1950; Spies et al., 1948; Spies & Stone, 1947; Vilter et al., 1947; Wagley, 1947; Wilkinson, 1948; Will et al., 1959). The vast majority of cases were PA patients (Bethell & Sturgis, 1948; Chodos & Ross, 1951; Hall & Watkins, 1947; Heinle et al., 1947; Israëls & Wilkinson, 1949; Meyer, 1947; Ross et al., 1948; Spies et al., 1948; Wilkinson, 1948; Will et al., 1959), while a few cases were related to patients with gastric resection (Chodos & Ross, 1951; Heinle et al., 1947; Meyer, 1947; Ross et al., 1948; Wagley, 1947) or sprue (Chodos & Ross, 1951; Davidson & Girdwood, 1947; Spies et al., 1948; Wagley, 1947). Cases were patients treated with folic acid as an alternative to liver extract, which was the standard treatment for PA at that time (Berk et al., 1948; Bethell & Sturgis, 1948; Chodos & Ross, 1951; Davidson & Girdwood, 1947; Heinle et al., 1947; Ross et al., 1948; Will et al., 1959) or patients treated with folic acid as first therapy or after an interruption of the therapy with a liver extract (Berk et al., 1948; Bethell & Sturgis, 1948; Hall & Watkins, 1947; Heinle et al., 1947; Israëls & Wilkinson, 1949; Meyer, 1947; Spies & Stone, 1947; Wagley, 1947; Wilkinson, …”

Section: Assessmentmentioning

confidence: 99%

“…In the period following the substitution of liver extract by folic acid, the haematological status of the majority of patients was found to be maintained (Berk et al., 1948 ; Bethell & Sturgis, 1948 ; Chodos & Ross, 1951 ; Heinle et al., 1947 ; Ross et al., 1948 ; Wilkinson, 1948 ; Will et al., 1959 ), although deterioration (Bethell & Sturgis, 1948 ; Heinle et al., 1947 ) or, in contrast, further improvement were also described in some cases (Berk et al., 1948 ; Bethell & Sturgis, 1948 ; Heinle et al., 1947 ). An improvement of the haematological signs of PA was also observed in most patients who had not been previously treated with liver extracts (Bethell & Sturgis, 1948 ; Hall & Watkins, 1947 ; Heinle et al., 1947 ; Israëls & Wilkinson, 1949 ; Meyer, 1947 ; Spies et al., 1948 ;Wagley, 1947 ; Will et al., 1959 ). The effectiveness and speed of the haematological responses were found to vary substantially among patients.…”

Section: Assessmentmentioning

confidence: 99%

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Scientific opinion on the tolerable upper intake level for folate

Turck,

Bohn,

Castenmiller

et al. 2023

EFS2

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Following a request from the European Commission (EC), the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a scientific opinion on the revision of the tolerable upper intake level (UL) for folic acid/folate. Systematic reviews of the literature were conducted to assess evidence on priority adverse health effects of excess intake of folate (including folic acid and the other authorised forms, (6S)-5-methyltetrahydrofolic acid glucosamine and l-5-methyltetrahydrofolic acid calcium salts), namely risk of cobalamin-dependent neuropathy, cognitive decline among people with low cobalamin status, and colorectal cancer and prostate cancer. The evidence is insufficient to conclude on a positive and causal relationship between the dietary intake of folate and impaired cognitive function, risk of colorectal and prostate cancer. The risk of progression of neurological symptoms in cobalamin-deficient patients is considered as the critical effect to establish an UL for folic acid. No new evidence has been published that could improve the characterisation of the dose-response between folic acid intake and resolution of megaloblastic anaemia in cobalamin-deficient individuals. The ULs for folic acid previously established by the Scientific Committee on Food are retained for all population groups, i.e. 1000 μg/day for adults, including pregnant and lactating women, 200 μg/day for children aged 1-3 years, 300 μg/day for 4-6 years, 400 μg/day for 7-10 years, 600 μg/day for 11-14 years and 800 μg/ day for 15-17 years. A UL of 200 μg/day is established for infants aged 4-11 months. The ULs apply to the combined intake of folic acid, (6S)-5-methyltetrahydrofolic acid glucosamine and l-5-methyltetrahydrofolic acid calcium salts, under their authorised conditions of use.It is unlikely that the ULs for supplemental folate are exceeded in European populations, except for regular users of food supplements containing high doses of folic acid/5-methyltetrahydrofolic acid salts. K E Y W O R D S folate, folic acid, 5-methyltetrahydrofolic acid salt, tolerable upper intake level 2 of 119 |

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“…Few systematic data exist regarding the level of folate intake required to mask vitamin B 12 deficiency (Koehler et al, 1997). The majority of available information relates to early case reports of folic acid therapy for the treatment of pernicious anaemia (mostly high doses, for example 5 mg/day) (Heinle et al, 1947;Vilter et al, 1947;Bethell et al, 1948;Ross et al, 1948;Vilter et al, 1950;Will et al, 1959;Schwartz et al, 1950;Ellison and Curry, 1960;Marshall and Jandl, 1960;Baldwin et al, 1961;Hansen & Weinfeld, 1962;Vilter et al, 1963). In general, data taken from these reports suggest that supplementation with 1 mg/day folic acid does not mask vitamin B 12 -associated anaemia in the majority of subjects.…”

Section: Dose Response Characterisationmentioning

confidence: 99%

Determination of Heavy Metals and Ascorbic Acids in Some Soft Drinks Sold Within Bauchi Metropolis, Nigeria

Saleh

Abubakar²,

Daniel³

et al. 2022

PoS

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The Expert Group on Vitamins and Minerals first met in 1999 to consider the safety in long-term use of vitamin and mineral supplements sold under food law with a view to recommending maximum advisable levels of intake. Since then it has endeavoured to work as openly as possible. Thus, its agendas and working papers have been freely available, and observers, nominated by Interest groups, took a full part in reviewing pertinent evidence, all with the objective of ensuring as full and balanced a review of evidence as was practicable. In keeping, the draft report was then made freely available for comment, so giving a second opportunity to ensure all relevant evidence was addressed, and addressed properly.As a result of that consultation in the autumn of last year significant modifications were made to the draft. The determination of Safe Upper Levels or if that was not possible, Guidance Levels of intake had, of necessity, to take account of the possible effects on potentially susceptible individuals who could freely obtain vitamins and minerals and take them on a long-term basis. This implied that good quality large studies of appropriate duration were needed. The group could only work within the confines of existing evidence, and robust conclusions depended on the availability of adequate and relevant data, but in many cases the necessary information was incomplete.The final version of the report was agreed unanimously by members, it will be for others to decide if our recommendations, which are, in essence, risk assessments, should be followed by the adoption of altered risk management strategies. In this context it should be emphasised that our recommendations do not address the medicinal uses of vitamins and minerals, which lie within the remit of the Medicines and Healthcare products Regulatory Agency. Expert Group on Vitamins and Minerals 2003 Introductory Chapters Introductory Chapters Chapter 1 -Background to the establishment of EVM Chapter 1 -Background to the establishment of EVM UK regulation of products containing added vitamins and minerals In the UK, products containing added vitamins and minerals can be regarded in law as either foods or medicines 2 . Those products for which claims are made for the treatment or prevention of disease, or which are administered to restore, correct or modify physiological functions, fall within the definition of a 'relevant medicinal product' and are subject to the requirements of the Medicines Act 1968, Directive 65/65/EEC. Such products require a marketing authorisation (licence) before they can be sold or supplied and are regulated in accordance with the Medicines for Human Use (Marketing Authorisations, etc.) Regulations 1994 [SI 1884/3144]. Products that are licensed as medicines are excluded from the definition of food in the Food Safety Act 1990. The control of medicines is the responsibility of the Medicines and Healthcare products Regulatory Agency (MHRA), which is an executive agency of the Department of Health.In Great Britain, products that are not regulat...

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The Relation of Therapy in Pernicious Anemia to Changes in the Nervous System. Early and Late Results in a Series of Cases Observed for Periods of Not Less Than Ten Years, and Early Results of Treatment With Folic Acid

Cited by 36 publications

References 3 publications

Postural Disorders in Neuromyelopathy by Deficiency in Vitamin B12

Postural Disorders in Neuromyelopathy by Deficiency in Vitamin B12

Scientific opinion on the tolerable upper intake level for folate

Determination of Heavy Metals and Ascorbic Acids in Some Soft Drinks Sold Within Bauchi Metropolis, Nigeria

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