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From: B. Harris)
Subject: Re: Vitamin Infusion???
Date: 14 May 1998 01:18:02 GMT

In <6jcif3$hko$> writes:

>Granted, there is no reason to think that this person has either of these
>conditions, but what we *do* know is that there are conditions in which
>an unhealthy gut prevents proper absorption of vitamins, *and* we know
>that he has allergies. There are physicians out there who are aware of
>the link between allergies and gut permeability (see abstracts below).
>Thus, it is possible that this physician believes this patient has a gut
>that is in poor condition (which plays a role in the allergies), which is
>not properly absorbing vitamins, and thus parenteral vitamins are
>considered as an alternative to oral.
>It isn't necessarily the case, but it is also not out of the question.

    I would say it's out of the question until you get me a bit better
evidence than you've posted!  Yes, people with no bowel don't absorb
oral vitamins.  People who haven't had their small bowel removed can
always be repleated with oral megadoses.  I know of no papers to the
contrary, and you've failed to post any.  You can even treat pernicious
anemia with enough oral B12, as has been demonstrated in several

    What I want from you is a paper where some group of patients, who
HAD guts, could not be repleted orally with nutrients, no matter what
their doctors tried, and so HAD to be given parenterals.  Failing such
a paper, you're out to lunch.  There-- have I said this clearly enough?

>Calling it "snake oil" without knowing all the facts is, well, par
>for the course I guess.

   If the guy has a gut, I have all the facts I need.  If you need to
give him vitamins, use his gut.  Proof otherwise is your
responsibility, not mine.  If you want to claim there is some syndrome
(other than having no gut) which MUST be treated with parenteral
nutrients, it's up to you to name, and describe it.  No hinting and
smirking and arguing by implication.

                                       Steve Harris, M.D.

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