Water soluble vitamin requirements in home parenteral nutrition patients

Ascorbic acid, thiamin, niacin, pyridoxine, and folic acid status was evaluated in eight physiologically stable home parenteral nutrition patients. Six of these subjects received these vitamins as a twice weekly bolus and were studied over a period of 6 days. All vitamin levels were normal except for blood thiamin which was low, 72 h after each bolus. Since transketolase levels remained normal, this fall in blood thiamin probably had no functional significance. The urine excretion pattern of niacin and pyridoxine indicated normal metabolism and retention of these vitamins. Two patients, who required only parenteral fluid and electrolytes to remain weight stable, received none of these vitamins parenterally, but also maintained adequate vitamin status. These results suggest that in long term home parenteral nutrition patients these five vitamins can safely be given twice weekly, rather than daily, and that short bowel patients who maintain their weight without intravenous calories and protein also assimilate adequate amounts of these proximally absorbed water soluble vitamins from their diet.