Abstract
Marmite, whose active principle is thought to be folic acid, gave haematological response in only five of nine patients suffering from nutritional megaloblastic anaemia with normal vitamin B12 levels in the serum. In three of the reacting patients this response was so good that no other haemopoietic drug could be tested. In the two other patients a further reaction was observed after folic acid. Of the four non-reacting patients two responded to folic acid and two to vitamin B12. Of the latter two, one died before folic acid could be tested. As no differences in the type of anaemia could be detected, and analysis of the second batch of Marmite showed it to contain very little folic acid and conjugates, it seemed possible that Marmite contains a third, undefined, haemopoietic agent. However, as Sheehy et al. demonstrated in patients with tropical sprue that some of their cases responded to minute doses of folic acid, it seemed more likely that three types of nutritional megaloblastic anaemia exist. One is a deficiency in vitamin B12, the other two are deficiencies in folic acid, one of these reacting to minute doses of folic acid, the other to high doses.
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