Inability of chronic alcoholics with liver disease to use food as a source of folates, thiamin and vitamin B6.

Absorption of folates, thiamin, vitamin B6, pantothenate and riboflavin from a natural food source--yeast--and their respective synthetic forms was studied in 37 patients with liver disease due to alcoholism, and 12 healthy, nonalcoholic subjects. All alcoholics absorbed riboflavin and pantothenate but had a significantly lowered absorption of thiamin and vitamin B6 from yeast. Alcoholics absorbed synthetic vitamin B6, but not thiamin. Ingested folylpolyglutamates (the predominant folates in yeast) could not serve as a source of folate for the alcoholics, but synthetic folylmonoglutamate served. We suggest that the folate, vitamin B6, and thiamin deficits so common in alcoholic liver disease ensue from inability to absorb these specific vitamins from foods.