Efficacy of Vitamin Supplementation in Chronic Alcoholics Undergoing Detoxification

Ninety-seven admissions to an alcoholic unit were allocated to one of three groups receiving either oral vitamin supplements, intravenous vitamin therapy or placebo during a fiveday detoxification regime. Thiamine, riboflavin and pyridoxine status was assessed by measurement of erythrocyte transketolase (ETK), glutathione reductase (EGR) and glutamateoxaloacetate transaminasc (EGOT) activities on Days 0, 2 and 5. Vitamin status as assessed by these parameters improved in most patients by Day 5 irrespective of the treatment regime. However, two-thirds of those patients originally thiamine-deficient, as assessed by basal ETK, were still deficient after fivedays, irrespective of vitamin therapy received. Assessment of thiamine status by basal ETK yielded more patients rated as deficient than did assessment by the activation coefficient for transketolase ( a -ETK or ‘TPP effect’). EGOT was elevated in nearly all patients studied, whilst erythrocyte pyridoxal-5-phosphate concentrations were low, indicating that in alcoholics, EGOT is a poor indicator of pyridoxine status.