Enzymology of the response of the carpal tunnel syndrome to riboflavin and to combined riboflavin and pyridoxine.

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Abstract
Differential enzymic analyses of the erythrocyte glutamic-oxaloactic transaminase and the erythrocyte glutathione reductase of a patient with a 3-yr history of carpal tunnel syndrome (CTS) revealed high deficiencies of both vitamin B-6 and riboflavin as based on .apprxeq. 30% levels of the specific activities of these enzymes. Riboflavin for 5 mo. caused nearly complete disappearance of the CTS and caused no change in the specific activity of erythrocyte glutamic-oxaloacetic transaminase. Combined riboflavin and pyridoxine treatment increased (P < 0.001) the specific activities of erythrocyte glutathione reductase and erythrocyte glutamic-oxaloacetic transaminase to normal levels with total disappearance of the CTS. Objectively, the strength of pinch of both hands increased (P < 0.001) on treatment with riboflavin and further increased (P < 0.001) on the combined treatment. For the first time, a significant riboflavin deficiency has been found to be related to CTS. Riboflavin therapy was effective biochemically, subjectively, and objectively, and riboflavin and pyridoxine were even more effective when concomitantly administered.