Supplementary Memorandum submitted by
Dr Jean Monro (E13)
OFFER TO THE MINISTRY OF AGRICULTURE, FISHERIES
AND FOODS TO ALLOW THEM TO UNDERTAKE A RETROSPECTIVE ANALYSIS
OF DATA HELD AT BREAKSPEAR HOSPITAL IN CONNECTION WITH THE VITAMIN
B6 DEBATE
Amongst our patients, some 12,000, we have studied
vitamin B6 from a functional point of view for many years. I wish
to offer the opportunity to scrutinise our records to the Ministry
because this will give them insight into the value of this vitamin.
The importance of this is that most general practitioners are
inhibited from recommending any dose in excess of 10 mg now because
of the bad publicity that this vitamin has had. In my experience
it is inhibited by various xenobiotics, in particular products
of fungal metabolism as these can be competitive for its site
of reception. The requirement of it can be heightened therefore
by anybody who has had an extra requirement for antibiotics. After
all, vitamin B6 was available in man's diet for aeons, yet antibiotics
are only a recent innovation!
The pathological evaluations which we have undertaken
of functional availability of vitamin B6 (by erythrocyte transaminase
activity and other methods) have proved that the patients have
a deficiency status. Hence, not only would this not have been
picked up by other practitioners who may have believed their supplements
to be adequate, but also similar patients would now be debarred
from their own self-protection.
In addition I am offering a prospective evaluation
to corroborate findings. Our facility should be regarded as a
National Resource Centre in many respects as we have a unique
and comprehensive documentation of such people at the outset prior
to any prescribed treatment.
People are defined as patients when they attend
a doctor. They do not change state in that instant from being
well to ill. They present with symptoms anywhere along a continuum
of health to illness, but they may simply be regarded at that
moment as "public". The patients who come to me may
have seen many other doctors before they attend me. In fact in
an independent market research survey 12.5 years on average had
elapsed before their first seeking any help and attending me.
None of the doctors had prescribed vitamin products. This is because
most doctors have between three and 10 hours education on nutrition
in their undergraduate curriculum, despite the fact that the majority
of illnesses have a component of lifestyle and nutritional input.
These patients have generally, in desperation, been attempting
to take dietary supplements sold under food law to improve their
condition or well-being.
There is no such data-bank as ours available
elsewhere, I believe, because we tend to assess a patient's nutritional
status when they first attend. Therefore, before any treatment
is undertaken for whatever their condition, these patients are
simply members of the public who may or may not have taken vitamin
B6 prior to attending.
We have assessed the functional status of B6
in these patients by its effect on red cell enzymes, whose performance
is impaired in a deficiency state. We therefore have, amongst
our 12,000 patients group, a large number of people who have been
assessed in this way. We also now have a large number of people
whose vitamin B6 status has been assessed through lymphocyte growth
factors following mitogen stimulation, which is another technique
for B6 evaluation. The reason why these two methods are chosen
is because it is difficult to assess the level of a vitamin which
is only in trace amounts in the tissues of the body.
Our data, therefore, has documentation of random
members of the population who have happened to attend this hospital
for evaluation, and whose nutritional status, including vitamin
B6 levels, has been established before they receive any treatment.
This is therefore an evaluation of the random, untreated population,
only skewed by the fact that they attend the Breakspear Hospital.
All these patients will also have been neurologically examined
and whether or not a neuropathy is present will have been established.
Because this is a population whose B6 levels have been evaluated
before any treatment has been received, it therefore reflects
the population at large who are able to get to health food shops
to buy dietary supplements under the food law, and should be of
interest to the Ministry of Agriculture, Fisheries and Foods.
THE EVALUATIONS
WILL PROVE
THAT WHAT
HAS BEEN
AVAILABLE TO
THIS POPULATION
HAS BEEN
SAFE FOR
THE POPULATION
AT LARGE
IN THIS
COUNTRY.
Scrutiny of our records as a retrospective analysis
of the population's B6 levels and functional requirements from
a random selection of the people would provide a more definitive
evaluation than has previously been available of a population
study. It may also be a real breakthrough for people in this country,
the Ministry of Agriculture Fisheries and Foods, and might solve
the controversy over vitamin B6.
If the Ministry were to avail itself in this
offer, the Environmental Medicine Foundation can be an intermediary
as they have agreed to act as a collaborator.
7 April 1998
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