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 36 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. It was suggested that the folate, vitamin B₆ and thiamin deficits so common in alcoholic liver disease ensue from inability to absorb these specific vitamins from foods.