A 32-year-old woman who has been on oral contraceptive pills for 5 years, developed symptoms of depression, irritability, nervousness and mental confusion. Her hemoglobin level was 8g/dl. Biochemical investigations revealed that she was excreting highly elevated concentrations of xanthurenic acid in urine. She also showed high levels of triglycerides and cholesterol in serum. All of the above are most probably related to a vitamin B6 deficiency caused by prolonged oral contraceptive use except:
Vit B6 deficiency will not cause increased triglyceride and cholesterol levels in serum. It is best attributed to the metabolic effects of steroidal contraceptives. Pyridoxal phosphate is a coenzyme involved in the metabolism of protein, carbohydrates and fat. In protein metabolism, Vit B6 paicipates in the decarboxylation of amino acids and the conversion of tryptophan to niacin or serotonin. Ref: Harper's Biochemistry Pages 258, 491 ; Textbook of Therapeutics: Drug and Disease Management By Richard A. Helms, David J. Quan, 2006, Page 737 ; Psychology and Schizophrenia By Janet E. Pletson, 2007, Page 110
Increased urinary xanthurenic acid excretion
Neurological symptoms by decreased synthesis of biogenic amines
Decreased hemoglobin level
Increased triglyceride and cholesterol levels