Anti-Inflammatory Diet

All health care starts with diet. My recommendations for a healthy diet are here:
Anti-Inflammatory Diet and Lifestyle.
There are over 190 articles on diet, inflammation and disease on this blog
(find topics using search [upper left] or index [lower right]), and
more articles by Prof. Ayers on Suite101 .

Wednesday, August 5, 2009

Inflammation and Vitamin D Deficiency

Does Dietary Inflammation Reduce Skin Production of Vitamin D?

The media discovered the vitamin D deficiency pandemic last week. Amazingly researchers were recorded on camera saying that the D deficiencies are caused by insufficient exposure to ultraviolet in sunlight and inadequate consumption of vitamin D-laced milk. Have all of these people been avoiding the biomedical journals?

Have they noticed that my tan improved since I started eating anti-inflammatory?

Let’s shine some sunlight on these knowledge deficiencies:
  • Serum vitamin D levels have been dropping (as chronic inflammation has been increasing) over the last three decades -- has something changed in our diets?
  • Vitamin D deficiencies occur globally (not restricted to Northern latitudes or winter) -- related to diet?
  • Women are more vulnerable, because of cultural modesty in some countries, but males are still D-deficient.
  • A subset of people exposed to ample sunshine are still D-deficient.
  • Vitamin D deficient individuals also have elevated TNF.
  • Vitamin D deficiency and inflammation are risk factors in the same diseases.
It seems that the simplest conclusion is that chronic inflammation leads to vitamin D deficiency, even though vitamin D deficiency may also contribute to inflammation.

This also probably means that chronic inflammation makes it harder for skin to produce vitamin D during exposure to sunlight.

One would expect those who are inflamed to get sunburned more readily and people who eat plenty of omega-3 rich seafood probably produce more vitamin D, even if they are not in the sun as much.

Inflammatory starvation (or American fast food) diets high in starch and omega-6 vegetable oils, should produce vitamin D deficiency even on the Equator.

We should not be surprised that inflammatory degenerative diseases are associated with vitamin D deficiency. It would be interesting if vitamin D supplementation to eliminate deficiency, reduced inflammation and reversed degenerative disease.

Do statins reverse vitamin D deficiencies (and improve tanning) as they lower inflammation? [Statin lowering of LDL is unrelated to reduction in cardiovascular disease. Only the anti-inflammatory side-effect is important.]

Does NFkB activation (inflammatory signaling) inhibit vitamin D receptor activity and vice versa?

You can forget all of this confusion, if you just stick with an anti-inflammatory diet (that includes vitamin D supplements) and exercise frequently in the great outdoors.


Jake said...

I read a study that showed that phytic acid in wheat leaches out the Vitamin D in your body. This could be another reason that our Vitamin D levels are dropping.

Of course, that problem can be eliminated by your anti-inflammatory diet which I try to follow to the T.

Daniel said...

Interesting post. Reading it I wasn't clear whether the theory that systemic inflammation antagonizes vitamin D levels was speculation based on the points that you made or if there is more concrete evidence out there? Either way, it's thought provoking. Thanks

Dr. Art Ayers said...

I am speculating in order to fill in the blanks. A simple search of the biomed literature shows dozens of reports of vitamin D deficiency from all over the world. In the US, people in California and Florida with high exposure to midday sun, show vitamin D deficiency. Why isn't their skin working to produce vitamin D?

Many of the researchers exposing the pandemic of vitamin D deficiency and the link to degenerative disease, just point to sunblock and video games.

Inflammation makes more sense.

Thanks for the comment.

TedHutchinson said...

Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004.National data demonstrate a marked decrease in serum 25(OH)D levels from the 1988-1994 to the 2001-2004 NHANES data collections

I think it is clear the vitamin d deficiency situation is getting worse.
It may be partly a result of obesity levels increasing, as vitamin d is fat soluble it is prone to getting locked up in fat cells.
People who are obese almost without exception have low vitamin d status but this also could be both cause and effect.
The optimal, Vitamin D, range for thyroid receptor function is 50-70ng/ml 125~175nmol/l.
But the Melamed study that has just caught the media attention shows 70% of kids have levels below 30ng 75nmol/l and as it's the case that darker skin are less able to make vitamin d, this means Black kids will have even lower vitamin d status and will also be more likely to be obese.

Dr. Art Ayers said...

Thanks for checking out my vitamin D comments. I always appreciate your perspective.

I think that all of the issues that you bring up contribute, but the individual cases, I think reveal something more profound than a gradual diminution of vitamin D with fat dilution.

The chicken and egg relationship of vitamin D and obesity and/or inflammation is unclear. HFCS and mineral deficiencies or the interplay of other vitamins/hormones also contribute.

I find it more productive in my attempts to provide molecular mechanisms that integrate many different diseases, to lay down the signaling for inflammation and regulate inflammatory signaling with the other inputs. That would mean that the molecular machinery for vitamin D synthesis using UV radiation in the skin is turned off by inputs that turn up inflammation.

Thus, I shudder at the potential for rickets when I see the stack of food rations for AIDS orphans in South Africa. In the stack is a liter of omega-6 cooking oil and a kilo of white wheat flour. All that is missing is a bottle of HFCS -- hot cakes! This is a prescription for inflammation to allergy/autoimmunity to metabolic syndrome to obesity to type II diabetes to cardiovascular and degenerative diseases to early death.

TedHutchinson said...

Sugar: The Bitter Truth Dr Lustig Not sure if you have seen this 80 minute video.
or looked at the slides he uses in in his presentation
but we are stuck in a situation where no one in authority will want to accept the inflammatory nature of modern foods.
What is worse is that as well as dumping surplus nutritionally depleted foods in third world countries, we also want them to grow nutritionally depleted modern varieties
Evidence of decreasing mineral density in wheat grain over the last 160 years.

Kevin said...

Hi Dr A,

Dr. William Davis from The Heart Scan Blog showed a photo of a retired man living in Florida. He has a deep tan but he is deficient in Vitamin D.

I spend 2-3 hours a day jogging outdoors, usually during the hottest part of the day. I don't wear a hat or use sunscreen. I always assumed I was storing up Vitamin D to carry me through the winter months.

Any theory as to how you can develop a summer tan and not have decent Vitamin D levels?


Dr. Art Ayers said...

I think that it comes down to the fact that vitamin D metabolism is separate from the radiation damage system that triggers melanin accumulation. It may be the case that tanning is preceded by damage-induced inflammation. Diet-induced chronic inflammation could predispose to tanning or be independent. At the same time, chronic inflammation may minimize the production in the skin of enzymes needed to produce vitamin D in response to sunlight.

It also seems quite possible that people could be tanning and the inflammation needed to stimulate tanning may inhibit vitamin D production. Since tanning damages and ages the skin, some people indulge in cosmetic overexposure to sunlight to produce enough inflammatory swelling to give the impression that their skin is more youthful. The damaged skin may not produce much vitamin D.

So, tanning may be independent from good vitamin D production, especially since vitamin D production requires so much less sun exposure.

The bottom line to me, after having two skin tumors surgically removed from high solar exposure areas, is to always wear a hat in the sun. Expose other areas to the sun for a few minutes to get vitamin D.

TedHutchinson said...

Your experience is not unique see
Low vitamin D status despite abundant sun exposure.
As Dr Art has already explained, there may well be something about our diets that is switching off the molecular machinery for vitamin D synthesis using UV radiation in the skin. Something is going on that is lowering the 25(OH)D level of the general population and we have to understand that the old adage 15~20 minutes sun exposure provides sufficient D3 simply doesn't work anymore. There could be other reasons such as upper atmospheric haze absorbing UVB thus preventing Vit d synthesis.

You also have to understand that there is a NATURAL overdose protection mechanism that is explained in detail here
that turns unabsorbed D3 remaining near the surface of the skin, into products the body does NOT use.
Ideally covering your skin by covering in with clothing or going indoors is more efficient than staying in the sun for more than 20mins.

Given the lack of complete understanding, the sensible thing to do would be to get your 25(OH)D level checked regularly. and then you would be sure you kept around the 55ng/mL associated with least disease incidence.

I see that Dr Art has replied while I was writing this and I can confirm that tanning beds use mainly UVA radiation. UVA produces a quicker tan but without any vitamin d3 production.
Skin cancer tumors are more likely to be the result of high omega 6 low omega 3 levels.
Stephan has talked about this here
but Art is absolutely correct several SHORT sun sessions are FAR FAR better than longer sessions.
Anyone wanting to TAN quickly with the least UVA exposure needs to raise 25(OH)D status by using 1000iu/daily/D3 for each 25lbs weight for a few weeks before going in the sun or under UVB radiation. If your body's vitamin D status is optimum before you expose your skin to UVB you will tan faster.
This is purely from personal experience but I do assure you it's what I've found works in practice.

Dr. Art Ayers said...

Your comment is so nicely counter intuitive, i.e. lowering inflammation by supplementing with adequate vitamin D permits your skin to use UV to produce vitamin D and then tan, if there is excess exposure.

Melchior Meijer said...


Thank you for this idea. It would explain a lot. Recently I have read on several places that the conversion of cholesterol into cholecalciferol at least parly takes place on the surface of the skin and that the vitamin D is then slowly absorbed. If this is true (I have not found references to back up this claim), it could mean that washing with soap removes an important source of vitamin D. Any thoughts on this?



Dr. Art Ayers said...

I don't think that washing would usually remove vitamin D from skin. But birds and some other animals do the light reactions in secreted oils and then groom to internalize the products. So maybe cleansing the bulk of the body exposed to the sun is a bad idea with soap. Maybe rinsing everywhere that is exposed and using soap on the rest is sensible.

On the other hand, in most cases washing is more problematical than it is helpful. Removing the normal bacteria on skin is usually a disadvantage, because those bacteria are the first line of defense against pathogens. It is probably a good idea to wash your hands after handling objects or touching public surfaces, to minimize bringing pathogens into your home. It is like taking off your shoes, so that you don't track dirt around your home.
Most people wash too frequently and have more skin problems from the washing than from pathogens. The trend in marketing antibacterial cleaners is predominately unhealthy in my perspective. It would make more sense to carefully cultivate healthy skin flora, just like it is very important to cultivate good gut flora.

So regardless of whether vitamin D is lost by washing, it is probably best to wash as little as necessary. Most washing is probably done, just as the use of perfume, to remove/mask odors that mark people as part of the same "family". Spreading around exotic perfumes increases the number of non-familiar smelling, potential mates, by eliminating the natural inbreeding taboos.

Thanks for the comments.

Melchior Meijer said...


;-) So the perfume epidemic might be linked to the increase in allergies and autoimmune disorders. By masking their natural body odour, people can't rely on their olfactory gatekeeper and are thus prone to select an immuno-incompatible mate, resulting in immunologicaly inferior offspring. Reminds me of Claus Wedekind. He states that oral anticonception, which fools the female body into thinking it is pregnant, leads to unhappy mate choices. In the woods (without the pill) a fertile woman is attracted to the smell of a man with a different immune system. This guarantees strong offspring. Pregnant women, on the the other hand, are attracted to men with similar immunesystems, i.e. family, probably for the non sexually motivated protection they offer. So if a fertile woman's body thinks it is pregnant (the pill), it selects the wrong mate. And he doesn't care ;-).

Thanks for your answer. It also explains why swimming in a chlorinated pool seems to make people extra prone to athlete's foot.

Anne said...

Dear Dr Ayers,

You wrote: "people who eat plenty of omega-3 rich seafood probably produce more vitamin D, even if they are not in the sun as much."

I wonder if you could tell where where you found this out, what study or reference, please. I am getting abnormally high levels of D with raised alkaline phosphatase over the past 18 months. When my serum D is more normal level my alk phos becomes normal, but when the D is high alk phos goes up. Currently my serum D is 250 nmol/L (100 ng/mL) and that is with 2,000 iu per day of D3 and very limited sun exposure - I live in the UK, not much sun and I hardly ever go out in it. I eat a lot of fish though, mainly sardines and salmon, a portion at least once and sometimes twice per day. I also take omega-3 supplements providing me with 1680 mg EPA + DHA.

I am under an endocrinologist (for osteoporosis and diabetes - the diabetes is not typical as I am thin and have never eaten a junk diet) who is as mystified as me I think by my raised serum D and he is having my serum D retested in a month's time.

Many thanks,

Dr. Art Ayers said...

Sorry I can't provide a reference, because I am merely interpreting the general trends in the literature. Researchers observed that people in the sun for the same amount of time produce different amounts of vitamin D. I am providing an explanation that makes sense to me. I don't know of any studies that attempted to test differences in vitamin D production in groups of people with different CRP levels, for example.

Thanks for the comment.

Anne said...

Hi Dr Ayers,

Well, even if there is no reference, my experience would appear to bear out what you are saying !


Natalia said...

Hi Dr Ayers,
for some reason I'm doing MUCH better with NO vitamin D.
I'm 53, low carbing since 2002, no grains no vegetable oils.
My eczema came with the menopause one summer, then was gone for the winter time, then again on in summer - off in winter.
Last summer, I've learned about vit D, started sunbathing and supplements. As a result my eczema progressed through the winter plus I've got 'tennis elbow', low energy, sleepiness in the morning and late afternoon...
Last months, I read 'Marshall Protocol' and now doing much better without vit D - energy is back, tennis elbow gone, eczema calming down.

My friend's granddaughter 3,5 yo has morning hacking cough and dry skin. This summer they take her to the beach every weekend and now she is coughing in the day time also.

What do you think about vit D receptors blockage?
Thanks a lot for what you do and please excuse my English.

TedHutchinson said...

Hidden Risks and Dangers of the Marshall Protocol

Information About Trevor Marshall, Ph.D

The Marshall Protocol and other fairy tales

Dr. Art Ayers said...

Thanks for the info on the Marshall Plan. Lowering vitamin D doesn't make sense and the MP arguments aren't persuasive.

But that gets back to Nalalie's observations.
She claims lowering vitamin D supplements lowers her symptoms for several inflammatory conditions and she has taken initiatives in an anti-inflammatory diet.

The onset of her eczema is, however associated with menopause. This would make sense because the steroid hormones are anti-inflammatory, so menopause removed suppression of inflammation to make her more inflamed and hence the eczema and tennis elbow.

It seems to me that the vitamin D supplements that she was taking were not sufficient to have an impact. She also does not mention omega-3 supplements. Winter symptoms were probably differences in exercise.

I would say that blood work would show a low vitamin D and perhaps elevated CRP and maybe even HbC1a. Low carb should produce a low triglycerides.

What has changed to lower inflammation and decrease symptoms of eczema and tennis elbow?

Natalia said...

Dr Ayers, Tad,
thank you for reply.
I did strongly believe that LC diet will protect me from menopausal symptoms and I still doing much much better than any woman I know. After I learned from Ray Pit about immune suppressive properties of estrogen, I've got prescription for topical estradiol. It started to work like a charm - no more vasomotor symptoms, less of eczema - but unfortunately it is based on a soybean oil, so I will change it soon - don't want that extra 3 gr bad oil in my system.
Interestingly, progesterone works just opposite - gives me histamine surge. And, by the way, Marshall has mentioned this too.
Omega 3 - yes, 4 gr/d, love fish also. Now consider to get more EPA.
Vit D dose was 2000 - 4000 iu. Do you think I should try up to 10000?
Never had blood sugar problem, never HbC1a was checked, CRP is probably high now.
I was overwighted only 25 lb before LC diet, lost it very easy.
I'm just trying to paint whole picture about my health-illness, so you may want to dig dipper in chronic inflammation problem. It looks like other low carbers are not protected from autoimmune condition ether.
I spent some time on the LC forum, particularly on the topic about vit D, and I didn't see anybody reported remarkable improvement in whatever condition they have by taking megadoses of it.
I'm not desperate to jump on MP wagon right away. I am just curious and doing homework.
And IF I ever will, I would check my D vitamin level first, both - 25(OH)D and 1,25(OH)D as MP suggests.

Sorry for such long comment and thank you.

Dr. Art Ayers said...

Thanks for the additional info and clarification.
I would skip the MP as too full of problems.
If you want to get to the bottom of the vitamin D, as you indicate, you need to start with a blood test. Then it is typical to use higher doses until you get a good blood test. At that point the 2000-5000 IU per day should maintain your level.

I don't think that increasing blood levels above optimum is useful, but below a certain point, it is hard to get the anti-inflammatory benefits of the rest of an anti-inflammatory diet and lifestyle. So, you basically have to have a reasonable vitamin D metabolism before the rest makes sense.

TedHutchinson said...

Grassrootshealth D Action
This is the cheapest source of Vitamin D Testing I'm aware of. It's part of a trial trying to be more precise about what level of 25(OH)D is associated with fewest adverse medical outcomes. But it only takes a few minutes to fill answer the questions.

It's a simple finger prick test with 2 drops of blood being collected on the sample sheet. You post this back and they email a link to the results.

Ideally people will sign up for the full 5yrs and then maybe, if they manage to get sufficient people participating, we may have some useful information.

Heaney's video
What's a Vitamin D deficiency will help you understand why 32ng/mL should be the minimum acceptable level but also why levels around 55ng/mL that provide a reservoir of D3 in the body, and allow human breast milk to contain vitamin d3 are probably natural.

Because for many years more than 2000iu/daily was thought to be unsafe there simply isn't yet sufficient research like this showing the benefit, for those fighting cancer, of maintaining levels around 60~70ng/mL but Vitamin D research is moving very fast and it's a full time job just keeping up to date reading new papers as they appear.

TedHutchinson said...

I should perhaps have commented on the need for 25(OH)D as the correct vitamin d test.

We all know and take for granted that vitamin D from food is absorbed into the body and hydroxylated by the liver to CALIDIOL from where it circulates round the body and is further hydroxylated into CALCITRIOL by the kidneys if required.

Calcidiol is the form that circulates has a half life of around 3 weeks. A 25(OH)D test measuring this reflects your current Vitamin D status in response to sun/uvb/supplement/diet intakes and your body's ability to absorb and metabolise it.

Calcitriol has a half life measured in hours, so measuring this indicates only if your body generally is currently requiring and using the active hormone.

However, that is only PART of the story.
People ignore the fact that certain skin cells can perform the whole synthesis of Vitamin D3 from cholesterol through to the active hormone without intervention from liver/kidneys.
The Physiology of Vitamin D Receptor Activation.

There is a difference between having a fire prevention system that instantly deals with the smallest amount of inflammation on site, as and when detected, and having a response that only reacts to major inflammation and floods the whole building to douse the flames only after the building is well alight.

The 1.25 test can only detect if the whole body is being flooded with Calcitriol at that particular moment.

A few hours before or later and the measurement will be different.

It's a bit like measuring the oil flow into your central heating boiler and expecting that to tell you if you have sufficient stored oil to last the winter.
It won't, that's only going to tell you if the thermostat is (at that particular moment) calling for more heat and confirms the boiler is actually firing at the time of the test.

Measuring calcitriol only tells you if your body generally is using calcitriol at that moment.

Measuring Calcidiol, tells you if you have sufficient reserves to call on if a controlled regulated response with Calcitriol is required.

In addition to its endocrine effects, vitamin D has important autocrine/paracrine roles.

Natalia said...

Dr Ayers, Tad,

Take a look at this paper

HIV patients have very low calcitriol, but their calcidiol is OK. Just opposite from sarcoidosis.
Definitely, vit D and immune system are tightly related.

Natalia said...

something went wrong when i tried to make clickable link

TedHutchinson said...

From the paper we see
25(OH)D3 (nmol/L) of the aids group were 70.1nmol/L (39.9–100) and the reference group 70.0nmol/L (50–90)

So although there wasn't a significant difference between the groups we can see that virtually none of them had sufficient vitamin d3 available to store or sufficient to power the production of calcitriol for a sustained period.
Circulating Vitamin D3 and 25-hydroxyvitamin D in Humans
If you look at the graphs in those papers you see significant stores of D3 are only available at levels above 125nmol/l and all this studies participants had insufficient vitamin d to provide a reliable supply of Calcitrtiol through the year.
Bear in mind also the date on the study you linked to.
We have learnt a lot since that date about other tissues that can supply calcitriol directly as required.

Please watch
YouTube - Whats a Vitamin D Deficiency? and perhaps study The Vitamin D requirement in health and disease Robert P. Heaney and perhaps you will understand why it isn't surprising if there were some defect in PTH production/secretion in people with insufficient vitamin D status.

Dr. Art Ayers said...

Thanks for your expert comments and added resources.

Natalia said...

Hi Dr.Art and Ted,
Thank you for all information, a lot to investigate and think over. Every day, I'm doing better and better so decided to stick to my regiment for a while and see where it will get me. And, of course, to check my vit D level.
By the way, I found Heparin Ointment from Russian pharmacy in US (it is OTC in Russia). I'm going to order and try it. If anyone is interested - here it is

Anna said...

Your comment about relief "food" in Africa reminded me of the post below, which has some sad information about the UN's "Plumpy-nut", a food-like product for starving children. Sigh...

Natalia, how is your Vitamin A intake? Not carotenes from plant foods, but real vitamin A from animal-sourced foods? Chris Masterjohn ( has some posts about the interplay of Vit A & D and why both need to be in ratio to each other.

I had a some exzema & strange rashes and *intense* itching for a few years after I turned 40 yoa that was definitely related to my cycle and I suspect, the first strong pangs of perimenopause. Of course, no real help after being bounced around the HMO drug pushers, but eventually it just subsided (replaced by new more classic perimenopause symptoms which are more manageable, especially now with some bioidentical progesterone).

Enjoying the Vit D discussions. Living in sunny San Diego and knowing so many people who are Vit D deficient (some are tan), I think you are onto something.

Dr. Art Ayers said...

I enjoyed your comments, especially because I grew up in San Diego and enjoyed La Jolla Shores as an undergrad.

Some women notice a symptom of inflammation, such as acne or depression, that waxes and wanes with the menstrual cycle or is gone with birth control pills.

Menopause means that the suppression of inflammation by progesterone stops. Then women tend to notice their underlying sources of inflammation.

Vitamin A seems to always need a reminder in the context of vitamin D supplementation.

Thanks for the comments.

Natalia said...

Hi, Dr.Art.
I was wrong about vitamin D.
After my symptoms vanished, I started to take vitD again little-by-little and now I'm up to 8K - my symptoms DID NOT come back!
Then I recall, I started glucosamine (thanks to your blog) at the same time I stopped vitD. Mystery solved, I think.
First time in my live I'm so happy to be wrong :-)
By the way, my blood test result was 35.3 ng/ml. Working on it.

Anna, thanks for your input, my vitA comes from eggs-cheese-butter-yogurt-cream - my favorite foods. I think I'm getting enough. said...

After reading this and The Heart Scan Blog, I've ordered vitamin D supplements.

Cristian said...

Could it be a taurine deficient diet the reason why some people fail to improve their vit D status despite a heavy supplementation?

Influence of dietary taurine on vitamin D absorption.

Dr. Art Ayers said...

A taurine deficiency in preterm newborns may lead to inflammation, since newborns are usually fed formula, which leads to inflammatory gut flora/biofilms. Taurine deficiency will lead to cysteine deficiency, which will lead to limited glutathione, which will lead to oxidation stress. Inflammatory gut flora plus oxidation stress means inflammation.

So taurine deficiency is the same as chronic inflammation. Somehow inflammation interferes with vitamin D absorption in the gut, perhaps by inhibiting normal villi development. I think that it also interferes with vitamin D production in the skin. Once the vitamin D supplements finally subdue the chronic inflammation, there seems to be a sudden rise in serum vit.D, which would be explained by increased absorption and light-based synthesis.

Thanks for making the connection.

Cristian said...

The link between inflammation and vitamin D deficiency

J Cell Biochem. 2004 Jul 1;92(4):833-48

Integration of the NfkappaB p65 subunit into the vitamin D receptor
transcriptional complex: identification of p65 domains that inhibit
1,25-dihydroxyvitamin D3-stimulated transcription.


CONCLUSION: These results show that TNF-alpha inhibition of vitamin D-action
includes stable integration of p65 in the VDR transcription complex.
Once anchored to proteins within the complex, p65 disrupts VDR binding
to SRC-1, thus decreasing the efficiency of D-stimulated gene

PMID: 15211579

TedHutchinson said...
This comment has been removed by the author.
TedHutchinson said...

On rereading Cristian Stremiz post I suspect I misunderstood the point he makes

However it may still be helpful to others if I supply the animated tutorial on nuclear receptors Although it is somewhat technical does help show how nuclear receptors work.

I found the link from Nephropal who posts from a PALEOLITHIC STANDPOINT and so his understanding of how we evolved from a relatively outdoor existence to our current levels of ill health is helpful.

dim said...

An interesting excerpt from L. Cordain Paleo Diet Newsletter (originally published May, 15 2006), about the impact of grain lectins on the vitamin D metabolism:

"The EGF-R, WGA and Rickets

Mechanistically, scientists have never really understood why excessive consumption of whole grains, particularly wheat, could cause rickets. However, with the recent discovery that WGA gains access to the systemic circulation by binding the EGF-R in the gut, it became increasingly clear that WGA and similar whole grain lectins could impair vitamin D metabolism.
Because of its affinity to the EGF-R, WGA circulating in the bloodstream has the capacity to gain entry into any cell expressing the EGF-R. It should be noted that epithelial cells located in skin tissue express the EGF-R. Consequently the keratinocytes within the epidermis, because of their expression of the EGF-R will internalize WGA if it is present in peripheral blood. Keratinocytes are also the site of vitamin D synthesis upon ultraviolet (sunlight) irradiation of 7-dehydrocholesterol in the cell.
Once within skin keratinocytes, WGA blocks the nuclear pore (22, 23), a structure that normally allows passage of certain cellular hormones and large molecules into the nucleus which then cause gene transcription. In particular, WGA blocks the cellular transport of the vitamin D receptor and its endogenous ligand (vitamin D) to the nucleus(24, 25) which may result in impaired vitamin D utilization, and systemically increases the risk for rickets".

And the related referenced articles:

22. Guinez C, Morelle W, Michalski JC, Lefebvre T. O-GlcNAc glycosylation: a signal for the nuclear transport of cytosolic proteins? Int J Biochem Cell Biol. 2005 Apr;37(4):765-74.
23. Finlay DR, Newmeyer DD, Price TM, Forbes DJ. Inhibition of in vitro nuclear transport by a lectin that binds to nuclear pores. J Cell Biol. 1987 Feb;104(2):189-200.
24. Barsony J, Pike JW, DeLuca HF, Marx SJ. Immunocytology with microwave-fixed fibroblasts shows 1 alpha, 25-dihydroxyvitamin D3-dependent rapid and estrogen-dependent slow reorganization of vitamin D receptors. J Cell Biol. 1990 Dec;111(6 Pt 1):2385-95.
25. Luo Z, Rouvinen J, Maenpaa PH. A peptide C-terminal to the second Zn finger of human vitamin D receptor is able to specify nuclear localization. Eur J Biochem. 1994 Jul 15;223(2):381-7.

TedHutchinson said...

Another route for vitamin D depletion is a high fibre diet.
Reduced plasma half-life of radio-labelled 25-hydroxyvitamin D3 in subjects receiving a high-fibre diet

However fructose may be a more relevant factor for the recent decline in 25(OH)D3 levels see where Nephropal has been talking this about recently.25-OH Vitamin D (nutritional Vitamin D or Vitamin D3) was decreased by 30-40% in the CKD, fructose fed rats in comparison to the other three groups
Here's a link to the paper.
Dietary Fructose Inhibits Intestinal Calcium Absorption and Induces Vitamin D Insufficiency in CKD

Dr. Art Ayers said...

Your references provide an interesting case for the the toxicity of WGA in intestinal heat shock protein function and nuclear localization. It is unlikely that WGA can travel from intestine to blood to many other site, since it is so sticky and there are so many potential binding targets. It probably just has an impact on enterocytes.

Most of the targets also involve heparin, which is of particular interest to me. The sugar binding domain of the WGA is in the middle of a potential complex heparin binding domain. I would not be surprised if a defense against WGA is heparin. That would suggest that enterocytes are most susceptible to WGA, when heparin is depleted during inflammation.

Thanks for the articles.

Dr. Art Ayers said...

Hi Ted,
It would make a lot of sense if increases in dietary fructose were contributing to vitD deficiencies.

Thanks for watching and contributing.

Anonymous said...

I don't have enough education with this stuff to be able to derive conclusions, but it gets me to thinking: If cholesterol is converted to vitamin D and too much of something is usually bad then maybe high cholesterol is caused by lack of sunshine?

On the flip side I struggle to figure out what would happen if you take vitamin D supplements concurrently with high cholesterol: does the cholesterol stay high?

Also, re: tanning. I can say anecdotally that any tan I might have *lasts longer* if I take vitamin D supplements...


Dr. Art Ayers said...

Cholesterol metabolism takes place on a vast scale throughout your body and vitamin D production takes place in just a small fraction of the cells of the skin exposed to UV. Thus eating cholesterol or vitamin D is not going to contribute significantly. The production of vitamin D is tiny relative to the total cholesterol production, so vitamin D and cholesterol are essentially independent.

It seems to me that the huge variability of vitD production of different people exposed to huge amounts of UV, suggests that inflammation may alter the ability to produce vitD in sunlight. Thus, inadequate vitD associated with inflammation leads to sunburn and not tanning. Ample vitD and low inflammation leads to tanning. Tanning is a type of wound repair, reflecting damage to the skin and this type of repair is promoted by vitD/low inflammation. Also note that vitC is helpful to avoid skin damage in the sun and vitC minimizes oxidative stress.

Thanks for your comments and personal observations.

TedHutchinson said...

Dr Davis's explanation of how taking vitamin d affects cholesterol numbers

The latest research showing total cholesterol was positively associated with Vitamin D production was expected but that skin pigmentation wasn't surprised me.

There is a regulatory process in Vitamin D production in the skin. People with high vitamin d make LESS vitamin D than people with low vitamin d status given the same measured UVB exposure. Similarly the process of tanning is associated with vitamin D status. My tan lasts more or less through the winter and although it's a bit faded now, it will improve immediately in April as soon as the weather picks up and it's warm enough to grab a few minutes midday sun exposure.

Correcting vitamin D status BEFORE going into the sun is a good idea as vitamin D improves your photo protection as does higher Omega 3 status.

Dr Ayer's take on inflammation levels being an underlying factor in skin damage and the propensity to burn is supported by Dr Guyenet in this blog Skin Texture, Cancer and Dietary Fat

Dr. Art Ayers said...

Hi Ted,
Thanks for the updates and insights. I am glad to see that some of my extrapolation and interpolations are supported by clinical observations.

guoda said...

I have recently found this blog and got really interested in trying out the anti -inflammatory diet as I have CFS. I am only sceptic about vitamin D, because I seem to be sensitive to the sun (feels like rays are burning my skin, but leaves no traces, except tanning). Another young woman had sun sensivity as the first symptom of CFS. I tan easily, so I think I will avoid being in the sun and skip vit D. Nevertheless, the diet seems to make a lot of sense, regarding the stories of people who overcame CFS. Most of them were on a specific diet - be it cavemen, low carb or gluten free diet.

fay said...

Dr Art, this is very interesting.
At 27 (i am generally healthy and active) i have been forced to take Voltaren (anti-inflammatory medicine) twice a day as my back/spine seems to stiffen over night and cause so much back pain in the mornings.
The longer i sleep in, the worse the pain is. Some days i cannot get out of bed, even breathing or rolling to the side is painful.

I found out about 8 months ago that i am badly Vit D deficient, and have been on supplements since. As it takes 4 months for your levels to raise, i dont think i am within the normal range.
The back pain started 6 months ago and was getting worse progressively.

I also just found out that i am extremely Iodine deficient, so i wonder if that has impacted my Thyroid and caused inflammation???

I am on a anti-inflammatory diet, and will report back to you about the effects it has on my back, as i plan to come off the Voltaren.

Regarding the note someone else made out the pill affecting womens ability to find a compatible partner, i am also living proof of it.
I was put on the pill at 16 and my doctors just left me on it for 10 years. When i did my own research into what it does to your organs, i decided to come off it myself last year.
Since coming off it, i am attracted to the opposite men i was always attracted to. I used to find big buff guys attractive, and now they put me off. I am also much calmer, and my liver has started to normalise.
If only i knew not to take my doctors advice....

Dr. Art Ayers said...

I would suspect that your sun sensitivity is related to inadequate processing of sunlight into vitamin D, with the result being damage in the skin and tanning. I don't understand why you would avoid vit. D, if your sun sensitivity might be the result of a dysfunction in the vit.D production in your skin due to chronic inflammation? It all fits with CFS.

I would suggest that you have your serum vit. D level measured to test for vit. D deficiency. Vit. D deficiency is also very common in people with chronic inflammation and contributes to the symptoms of chronic inflammation.

It also makes sense to use your diet to maintain the gut flora that you need for a healthy immune system.

Thanks for your comments.

Dr. Art Ayers said...

Problems with the connective tissue in the back are commonly associated with celiac and inflammatory diseases. Your vitamin D deficiency can also produce/contribute to inflammatory symptoms.

I would expect that your inflammation and vit.D deficiency will be linked until both are under control. Chronic inflammation reduces production of vit.D in response to sunlight. I expect that your serum vit.D level will not increase until your vit.D3 supplement and anti-inflammatory diet reduce your inflammation. So, I would expect your back pain to be an indicator both of your serum vit.D level and your inflammation.

What "anti-inflammatory" diet are you following. Many are actually inflammatory diets with added plant "antioxidants"? Did you mean the low carb, saturated fat-based diet (meat/fish/eggs/dairy/veggies, no vegetable oils, no/low grain) that I recommend as anti-inflammatory?

You suggest that female preference in men, which has been attributed to cyclical sex hormones, may actually be related to inflammation as a consequence of the anti-inflammatory impact of progesterone. Very interesting. This would suggest that the increase in inflammation due to diet will also have an impact on the type of men that are preferred by women. This preference would mean that diets of some nations may lead to significant changes in gene frequencies to favor particular behaviors, e.g. risk taking.

Thanks for your comments.

fay said...

Hi Dr Art

The diet i try to follow is a combination of what i have read on your blog, heard from my natropath and researched myself.

I try to eat nutritionally rich foods, especially alkaline foods. So most days for breakfast i eat a banana and nother fruit. As a snack i have a big bowel of salad (green lettuce, green beans, tomatoes, carrots, avocado, cucumber), then for lunch if i need to buy out, usually i buy a ceaser salad. Most days i also buy a large veggie juice (freshly juiced infront of me, usually carrots and celery). I do eat meats but, and white rice a number of times a week.
I drink green tea, over 2 litres of eko water (which is supposed to have a pH of 9.2), take about 4 pure fish oil capsules, vitamin D, iodine, about 20 mil of Chlorophyll.
The only processed or packaged thing that i might eat a few times a week is a tiny cube of chocolate.

I have eliminated dairy completely (except for the occasional hot chocolate as its freezing in sydney).

Each morning i get up, take a teaspoon of the best probiotic (its called Symbac), 30 min before food.
Also during the day i chop about 4 cloves of garlic finely, and swallow it down with water.

I find the garlic has been very beneficial for my gut.

Having stopped the pill and aldactone (which i took for years to stop the acne and hair), i was struggling with acne this past year.
I am finding this diet of greens is a miracle for my skin, as long as i eat plenty of greens, even if i have any bad foods on the weekend, my body can handle it.

Also i think my extreme iodine defficiency was the cause of my polycystic ovary syndrome 10 years ago (which was why my doctor put me on the pill).

I have noticed that this past month, my body hair has reduced considerably. I have a feeling the iodine has started helping my body/hormones.

The only issue i have now is that the past 3 months, my mensturation has been absent. I think once my iodine levels return to normal, that will solve itself also.

Do you think my inflammation could have stopped the mensturation?

fay said...

O and i forgot to mention, i rarely eat bread (if i do, its wheat free), i have very little pasta or fries (or anything deep fried).
I prefer grilled fish and we only ever cook with olive oil or grape seed oil (due to its high boiling point).
I work full time so on weekends i make veggie soup (pretty much every veggie in the fridge gets thrown in), and if we buy chicken, its organic.
I also eat alot of organic eggs (i work out so i need the protein) and sometimes take protein powder (from soy).

My natropath said i have a leaky gut and although i dont see her anymore (it was too costly), i know from my research that the raw garlic i eat, the probiotic and the elimination of sugar/dairy/wheat are helping my gut.

I can also see that my iodine defficeincy, has lead to the leaky gut, PCOS, the inflammation, the vit D defficiency.

I am going to follow your advice and increase my fish oil to 8 per day and see if it helps with my back.
I can manage the pain with Tiger Balm for now, until its fully healed. My sports doctor wanted me to take Voltaren for 4 weeks, but so far i have avoided it for 2 weeks.

Dr. Art Ayers said...

I wouldn't say that your diet is anti-inflammatory, because it still has substantial sources of starch: banana and white rice, and saturated fats are not the major source of calories. Also grape seed oil is very inflammatory, since it is high in omega-6 fatty acids.

It looks like you have switched from a high carb diet to a low calorie diet. The greens were only feeding your gut flora. The result is using dietary proteins and muscle for calories and loss of body fat to the extent that you have suppressed your menstrual cycle. I think that you would be healthier with higher fat meats/fish/dairy. I don't see the reason for excluding dairy, e.g. full fat live yogurt.

Let me know how your diet changes work out.

fay said...

Hi Dr Art

My reason for excluding dairy is acne related. For some reason it creates so much acne for me.

I am quite slim but i have always been slim, i have not noticed any weight loss due to this diet, just clearer skin.

Thanks for letting me know about the diet, i didnt realise the grapeseed oil is inflammatory.

But i will take you advice on eating more fatting meats, and see how that goes.


Unknown said...

Dr. Ayers,
I had someone pick me up some extra vitamin D on the way home, and by accident the tablet and not gels were purchased. Does this make a difference? I was only able to find this on the heart scan blog, but I'm not sure I trust it 100%. Thanks.

Dr. Art Ayers said...

I am not familiar with the vit.D3 tablets.

fay said...

Hi Dr Art,

It looks like your blog has some spam on it (above).
i took your advice and started eating full fat yogurt amongst other things because i found it hard to maintain the high veggie diet, especially in winter. Although my skin is doing well (very minimal breakouts) and my mensturation started last month, my back pain has not changed. So it seems the inflammation is still there.
One thing though, i did a blood test, and although my Vit D has returned to normal, it seems i now have high cholestrol (for the first time).
Do you still think i should eat full fat yogurt? I very rarely eat cheese/butter, and drink milk every few days.

TedHutchinson said...

Vitamin D increased my cholesterol Dr Davis (Heartscanblog) did a post on this very issue.

There is also a nice blog post here with some excellent graphs showing Lowest mortality observed when total cholesterol (t-C) is 200-240 mg/dl, low t-C linked to more infectious and parasitic diseases and also low t-C maybe associated with higher CHD (could atherosclerosis be an infectious disease?)

fay said...

Thanks very much Ted

I think my cholestral should drop over time, its probably a combination of stress and the vit D which ive been on for 1 year. My diet is good and im very slim and exercise, so im not too worried

Mrs. Ed said...

My son and I, both pasty pale redheads, have been less prone to sunburn since being on the Specific Carb Diet. Some other SCD bloggers have commented on the same thing. I definately think there's something to this.

Dr. Art Ayers said...

Hi Mrs.Ed,
It is interesting that manipulating gut flora by providing different nutrients alters the inflammation of the gut and thereby affects the metabolism of cholesterol (vit.D) and damage repair (killing/wounding skin cells with solar UV) in the skin to produce less apoptosis and inflammation in the skin. Vitamin C also reduces sun burn, by lowering oxidation damage in response to solar exposure.

Thanks for the comments.

teachertikasblog said...

I have a question concerning the vitamin d link to autoimmunes..
Once you have been diagnoised with an autoimmune, does vitamin d exerbate the disease or reverse it? I have read both theories.

Dr. Art Ayers said...

My guess is that vitamin D deficiency, which contributes to inflammation, would also support autoimmunity. Thus, adequate vitamin D would lower chronic inflammation and reduce autoimmunity.

I think that a more significant issue with autoimmune diseases is the healthy production of Treg cells developing in the gut in response to healthy gut flora. Repairing the gut flora is probably the single most important intervention in curing autoimmunity.

Thanks for your questions.

Unknown said...

The best way to ease chronic
Inflammation symptoms
and to have a sustainable and healthy way to help eradicate them in the future is to use quality omega 3 oils on a regular basis.

Unknown said...

Really great work to read your article here. ,I would like to join your blog read your article here.
Dr. Oz

Unknown said...

Nice information, valuable and excellent design, as share good stuff with good ideas and concepts, lots of great information and inspiration, both of which we all need, thanks for all the enthusiasm to offer such helpful information here.
Dr. Oz

Ana Pajarita said...

Hello Dr. Ayers:
I would like to suggest a quick read about Dr. Cicero Galli Coimbra.
He is a Brazilian neurologist that has been treating multiple sclerosis patients with Vit D alone. He uses very high doses of D3.
He has thousands of patients and you can see lots and lots of testimonials on the net. Most of them have MS but he treats autoimune diseases in general with it.
He says that 95% of the patients respond to it. He actually says that cure can be achieved for most of them.