THYROTOXIC MYOPATHY AND VITAMIN B 6 METABOLISM

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Abstract
A case of thyrotoxic myopathy (with earlier attacks of periodic paralysis) is described. The tryptophan test was found to be abnormal, while the pyridoxal phosphate concentration in plasma was normal. When pyridoxine was administered to the patient the tryptophan tolerance test was normalized, the pyridoxal phosphate level increased and the patient gained considerably in muscle strength. This finding is interpreted either as an hypothetic intracellular deficiency of pyridoxal phosphate, in which the plasma level does not reflect the intracellular content of pyridoxal phosphate, and/or as an increase in metabolism demanding a higher level of pyridoxal phosphate to satisfy all the pyridoxal phosphate-dependent enzymes in the metabolism.

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