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Splitting doses also dilutes the fasted-state metabolic advantage the evening dose occurs during fed state when insulin is elevated, reducing fat oxidation efficiency

History [edit] Descriptions of deficiency effects [edit] Between 1849 and 1887, Thomas Addison described a case of pernicious anemia, William Osler and William Gardner first described a case of neuropathy, Hayem described large red cells in the peripheral blood in this condition, which he called "giant blood corpuscles" (now called macrocytes), Paul Ehrlich identified megaloblasts in the bone marrow, and Ludwig Lichtheim described a case of myelopathy

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