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 .

Thursday, April 5, 2012

Dr. Oz, Vitamins, Biofilms

Vitamins supplement enzyme action, but they are produced by gut flora for biofilm communication.

Dr. Oz and the general biomedical community promote the idea that vitamin supplements or in foods are needed or improve health. Of course, several research studies show that typical multivitamin supplements or the levels of vitamins in "enriched" foods do not provide improvements in health. Since gut flora produce all of the needed vitamins, this should be no surprise. But why do gut bacteria release vitamins needed for the normal functions of the human body?

Vitamins are Enzyme Cofactors

Vitamins are small molecules that bind to particular cellular enzymes and provide functions that can't be provided by proteins. Enzymes are linear strings, polymers, of about a thousand amino acids. The 23,000 human genes code for the sequence of amino acids in as many enzymes. The amino acid strings fold up systematically into three dimensional balls that bring together chemical groups of the amino acids that can catalyze biochemical reactions. The twenty different amino acids in proteins are limited in the scope of their reactions. Binding of some metabolic products, such as vitamins, expands the types of reactions possible. Vitamins are enzyme cofactors. Bacteria can synthesize all of the vitamins needed for metabolism, but humans can't.

Vitamin D is a Hormone

Vitamin D is not a typical vitamin.  It is not an enzyme cofactor, but rather it is a steroid hormone that is produced in the skin from cholesterol through the action of ultraviolet light. The production of antibacterial peptides in the small intestines, for example, is a response of intestinal cells to vitamin D. Exposing arms and legs to sunlight produces about 10,000 IU of vitamin D per minute. (Typical supplements contain only 1,000 IU.) Production of vitamin D is reduced by skin pigmentation, sunscreen and inflammation. People exposed to daily sunlight for hours in San Diego, for example, may still be deficient in vitamin D, if their production of vitamin D has been shut down by chronic inflammation, as indicated by typical inflammatory conditions, such as arthritis, allergies, inflammatory bowel diseases, obesity, dental/oral infections, prostatitis, thyroiditis and other autoimmune diseases.

Vitamins are Produced by Gut Biofilms

People with healthy, diet-adapted gut flora, can subsist on very limited diets without vitamin deficiency diseases, because all of the vitamins can be obtained from bacteria growing in films coating the lining of the gut. These biofilms are complex communities of dozens of different bacteria and fungi. The bacteria synthesize polysaccharides in which these and other bacteria and fungi become embedded. The biofilms release vitamins that are taken up by intestinal cells to provide the needs of the body.

Vitamins are Chemical Signals for Biofilm Assembly

Bacteria, such as E. coli, do not form biofilms, if they are just grown at low concentrations on laboratory nutrients. If the concentrations of bacteria become very high, however, the bacteria respond by activating genes that coordinate biofilm formation. Bacteria detect the presence of other bacteria by releasing and detecting chemical signals in a process called quorum sensing. The chemical signals used in quorum sensing and biofilm maintenance are vitamins. Thus, human intestines are adapted to exploit the presence of biofilms and vitamin secretion. Humans need not synthesize vitamins, because they are always produced by gut biofilms as an essential biofilm function.

Antibiotics and Multivitamin Supplements

Antibiotic use is known to disrupt gut flora and produce vitamin deficiencies. Killing off healthy gut biofilms with casual use of antibiotics should be anticipated. The medical industry is remiss, however, in not repairing gut flora after medically mandated antibiotic use. Probiotics can temporarily supply some of the functions of the hundreds of bacterial species in each healthy individual, but they do not replace complex biofilms.

 The vitamin production of some of the bacterial species eliminated from the gut by antibiotics can be replaced by vitamin supplements, but supplements may disrupt the normal vitamin/quorum sensing communication and further disrupt biofilms. Thus, vitamin supplements may be unhealthy, if they disrupt biofilms that are necessary for healthy function of the gut-based immune system, which is needed to avoid, for example, allergies and autoimmune diseases.

Major Points about Vitamins, Biofilms and Health

  • Health requires gut biofilms to supply vitamins and control the immune system.
  • Biofilms produce and use vitamins for maintenance of biofilms.
  • Eating vitamins may disrupt normal biofilm formation.
  • Antibiotics disrupt gut biofilms and cause vitamin deficiencies and immune system disfunction.
  • Biofilm repair requires ingestion of missing bacterial species (150 total) and may be inhibited by excessive hygiene.


Anonymous said...

Did I just read this right in that vitamin supplementation can disrupt the gut microbiome?

Ok, so aside from maybe using vitamin supplementation temporarily after antibiotic use, do you therefor not generally recommend vitamin supplementation?

I assume none of this applies to mineral needs of the body?

Thank you.

Anek Dodl said...

Dr. Ayers,

My dentist and hygienist find it remarkable that I have no sign of dental bacteria and barely any plaque.

A recent link in a comment on your previous article ( states: “Dental, gum and mouth problems - one is likely to have similar bacteria in the mouth as the gut. If you have a clean tongue and no dental plaque then you are likely to have good gut flora.” Do you agree?

I currently take NAC, glutathione, L-glutamine, magnesium, potassium, B complex, vitamin C, kelp, Oregon Grape, CoQ10, lysine and a senior probiotic.

Would you recommend I stop taking any or all of them?

I’m currently reading Nick Lane’s “Power, Sex and Suicide: Mitochondria and the Meaning of Life” and realize life is a delicate balance I don’t want to tamper with unnecessarily. Your article has me concerned that I may be doing just that – am I?

Thank you for your continuing support and education.


Mrs. Ed said...

Very Interesting. I suppose this is referring to a normal, healthy gut flora. What about in autism, when the gut has the wrong types of biofilms? My son kept getting reocurring bouts of anemia. A biofilm protocol and supplements has brought his iron levels back to the mid normal range (and iron wasn't even in the supplements). What about in scurvy or beriberi? Would malnutrition wear down the gut flora, which would them lead to poor vitamin productionZ?

I would love to read more about this, is there any suggested reading regarding your post?

Anonymous said...

"People can subsist on very limited diets without vitamin deficiency diseases, because all of the vitamins can be obtained from bacteria growing in films coating the lining of the gut"

i infer meat would not be necessary then? a vegetarian diet would suffice.

"A person exposed to daily sunlight for hours in San Diego, may still be deficient in vitamin D, if their production of vitamin D has been shut down by chronic inflammation"

caffeine shuts down VDR system. So that would be another very common reason for low vitamin D manufacture in the skin i guess.


Chuck said...

Thanks for the information. If Dr. Oz gets you to post then please watch him often.

You should not feel that writing a blog post obligates you to answer everyone's very specific questions or requests for clarification.

I like the info you provide and it spurs me to learn more.


Vicki Keller said...

Does this apply to whole plant based vitamin supplementation from organic food or is this talking about synthetic vitamin supplemention?

I would think if a supplement was produced from a whole plant based (organic) food, and not a synthesized vitamin, it would be the same as eating food full of nutrients and vitamins. Foods (healthy ones as described in the anti-inflamatory diet in this blog) certainly do not disrupt the gut harmony. Same for whole plant/food based minerals I would think.

Dr. Art Ayers said...

Hi Mrs. Ed,
It is nice to hear from you!

I think that one major way to damage gut biofilms and gut flora is with abrupt changes in simple diets. Shifting from meat to vegetables or from one kind of predominant vegetable to another, for example, would not be healthy. It might be very disruptive to take a long trip and eat only stored food to which you and your gut flora have not been previously adapted.

Autism is a disease of the gut and gut flora. Some successful treatments include total bowel irrigation that also strips existing gut biofilms with PEG. I would expect the addition of a fecal transplant from a healthy donor outside of the family, to be very effective.

My speculation that vitamins are quorum sensing signals was confirmed by searching the biomedical literature to see if vitamins blocked the corresponding receptors. Lo and behold, a different vitamin was found to be used with each different bacterium in common gut biofilms.

I would also expect that plants accumulate some vitamins as protection against pathogenic biofilms and end up as vitamin rich foods featured on Dr. Oz's shows.

Thanks for following my meanderings.

Anonymous said...

Very sensible stuff. esp regarding avoidance of vitamins. although i'm reading such a concept for the first time it rings as true.

Just imagine a Hollywood studio behind you to take your message to every home in 3D animation hahaha.


Dr. Art Ayers said...

Food is a good source of minerals.

I think that vitamins should be used to temporarily compensate for a problem in diet or after damaging biofilms, but should not be needed routinely.

I just take specific vitamins, such as vit.D3 to compensate for sloppy eating or vit. C to compensate for any extra oxidative stress that I may be producing, such as excess exposure to the sun. I think that most phytochemicals that are lauded as antioxidants are also toxic to other bodily functions. Plants are not safe, just because they are natural. All plants produce very toxic defensive compounds.

In general, it is more effective to maintain your gut flora rather than attempt to compensate for deficiencies by using supplements.

Thanks for your questions/comments.

Dr. Art Ayers said...

I don't know what is going on in your gut, so it is hard to tell if you need supplements to compensate for gut flora problems.

The goal, from my perspective, is to cultivate gut flora that permit health without supplements.

Dental health is a reflection of overall health and may relate to good gut health. I wouldn't conclude that good oral health also demonstrates that the gut flora is healthy. I would also check for any signs of chronic inflammation prior to a least age 80.

The supplements that you take seem to be a wise choice to compensate for various sources of inflammation and gut damage. Most should also be prophylactic, but the B vitamins are biofilm signals.

I would counsel against sudden changes in supplements, because biofilms are very adaptive and can compensate for most dietary problems. The adaptations may, however, be very slow, so the changes may be problematic.

Thanks for your comments.

Asim said...

Dr. Ayers,

In relation to anti-biotic usage, should one worry about anti-biotic usage in animals that are eaten as it relates to damaging our own gut flora? Or do you believe cooking effectively negate this problem?

Can't wait for some articles on sleep and inflammation from yuor perspective...

- Asim

Jeremy said...

Dr Ayers, Can you recommend a probiotic for those trying to rebuild gut bacteria and biofilms?

Anonymous said...

Thats interesting so we might suffer B-Complex withdrawal too? i wonder how that might look?

i've been taking some of those supplements :-(

Do you have any knowledge about anti helminths like alendazole or pyrantel in respect to their effects on gut biofilms?

i've been feeling extremely hungry yet not sure what to eat, seem to be losing muscle after taking 1 400 mg albendazole coming from high carb SAD to lacto vegetarianism. Protein deficiency? hypoglycemia? :-(

i've started eating more yogurt from today.

any recommendations?


Anonymous said...

nd ive also stopped drinking peppermint tea recently. could the hunger pangs be due to withdrwal from it?

it is a funny hungry, i feel it in my throat not stomach and causes light headedness.

i never smoke or drink though.

Thankfully i dont have anxiety since stopping caffeine.

is it just funny gut flora growth due to excessive vitamins and minerals?


Enrique C. said...

Gut flora can't produce minerals, vitamin A, C, E, probably the vitamin K is not even usable.

So you cant't live out of your gut flora and fiber, but it can help providing you with some B vitamins and other nutrients like SCFAs.

The idea of avoiding supplements might do more harm than good, IMHO, unless you correctly implement a diet that includes all nutrients without deficiencies, both micro and macro.

Most "paleo" advice in my opinion, is flawed because it promotes hypothyroidism, oxidative stress (too much fat, AA, and oxidized fat and damaged food components due to bad cooking, everything in the context of 6-delta desaturase deficiency) and nutrient deficiencies because they tend to dismiss the value of plants to provide nutrients.

If you avoid supplements, then avoid Liver, because it's extremely rich in nutrients too.

Something off topic, but really important is Vitamin A, which works in tandem with Vitamin D. Supplementing only vitamin D may do more harm than good, specially in the long run. BTW Vitamin K is also needed for the Vitamin K dependent proteins (thanks Chris Masterjohn).

Vitamin A is ESSENTIAL for mucosal immunity. Dr Ayers hopefully you can write about this important vitamin in the near feature.

In my case, I think I started to get receding gums after some time of Vitamin D3 supplementation. After adding Vitamin A in a proper ratio with Vitamin D, the problem resolved.

JanelleH said...

Dr. Ayers,

Your blog is so interesting! your ideologies seem so different, and I like that! I was hoping maybe you could help me figure out my acid reflux condition. I am 28 weeks pregnant and it started a few weeks after a night of horrible nausea and indigestion that also caused a racing heart after eating, which resolved after a few days of rest. I have tried figuring out what exactly caused it, after my meal of chinese food I took a small glass of apple cider vinegar in water with some diatemaceous earth supposedly good for minerals, it also has the ability of wiping out parasites and thats when my battle with my stomach began 2 months ago.

A nutritionist said not to rule out H. Pylori, but from reading your posts on it you seem to be of the opinion that most people have it and are asympotmatic.. maybe I wiped out something in my stomach causing a very bad reaction? I have taken things since then to try and eliminate any infections and heal my stomach like zinc l-carnosine, mastic gum, and raw manuka honey. I thought I was having some success with the zinc, but then it got bad again a couple days ago. I know that pregnancy is going to cause some relaxation of the LES but I wouldn't think it would also cause indigestion and nausea with meals, I know thats not a normal symptom of pregnancy. I can't handle taking HCL so I have not tried anything aggressive in terms of upping stomach acid. The only probiotics I've gotten is through Kombucha and raw milk lately. I would appreciate any insight you have!
Thanks so much

Anonymous said...

Love reading your posts.

I currently have rosacea, some eczema, dry skin etc. I have had a terrible diet since I was very young. Always a picky eater and wouldn't touch a lot of healthy foods.

I have started the anti-inflammatory diet last week, and am supplementing with with fish oil, glucosamine,vitamin D, Coq10, primrose oil, apple cider vinegar tablets and kombucha tea everyday. Also started taking anti-histamines daily.

Is the above sufficient enough to try and concur my skin ailments? I'm 22, and just looking for advice. Any suggestions for me? Advice? Appreciated!

Anek Dodl said...
This comment has been removed by the author.
Anonymous said...

i read more and my symptoms seem to be related to caffeine withdrawal mainly since stopping it 3-4 days back. what a trip!

what about vitamin B3? does it also affect the gutflora? what do you think about taking a b-complex a day?

so you use vit c and caffeine to protect yourself from the sun yet use vit d to get the benefits of the sun? this runs counter intuitive to the basic principle in your idea of just letting gut flora generate all the vitamins. similarly let sun exposure decide your vit d status alone. no?


Medjoub said...

Dr. Ayers -

Wouldn't seasonal eating constitute something like an "abrupt shift" in diet? I would think that hunter-gather/nomadic peoples (perhaps even early ag)would've had very inconsistent dietary patterns, changing by region, availability, and season. Obviously that 'fact', if it is one, doesn't argue for the superiority of such a diet but does suggest some kind of potential for adaptability. Perhaps constant exposure to parasites and manifold bacteria is enough to override any of the problematic effects of sudden dietary change.

Having traveled and experimented with diets a great deal, I definitely notice dramatic digestive changes according to diet composition/locale. Personally, the worst was the transition from a very low-carb, predominantly meat diet to a more heterogenous diet allowing for a variety of plants. It took several weeks, but my digestion eventually returned to normal (for me - which still might be an abnormal state for many).

I find it interesting that there are so many drastically - and subtly - contrasting suggested diets, even in the given tiny circle of interested, knowledgable science bloggers. Still, so many of us are struggling to find the "right" one -- and just can't quite seem to do it. I imagine that this either reflects the incomplete state of our epistemology or that some damage simply can't be repaired.

Vitamins said...

By "excessive hygiene" I assume you are referring to the overuse of hand sanitizer which kills not only the bad germs but the good germs as well!

Pieter said...

Enrique C,

Your comment caught my attention.

I have seborrheic dermatitis since age 20 (I only changed my way of eating when I was 30, so that is certainly not the cause).

I'm currently investigating if this could be due to 6-delta desaturase deficiency.

Could you tell me more about 6-delta desaturase deficiency, and how you would change eating pattern to "handle" this.

Thanks in advance.


Vitamins for Skin said...

It is amazing how after decades of research, we are still learning about the importance of vitamins in the body.

Todd Platzer said...

What is a protocol to develop a good, healthy gut flora? Apparently this is the most important thing, and you recommend maintaining it, but how to create it or check that it's functioning well?

Todd Platzer said...

Hi Dr. Ayers,
I listened to your interview with Billy Moore and I agree the future of healthcare will be in preventive medicine, the economic situation may force this on us, but ultimately the prospect of cutting up to 90% of the healthcare budget is enough to grab anyones attention.
Is research, therefore, on all of the bacteria found in the gut and the function of each, along with their symbiotic functions, being undertaken? Is a more palatable approach to bacteriotherapy, or fecal transplant, being developed to elicit universal support? (for example the appropriate bacteria in pill form taken orally or as a suppository)
I am under the impression this science is in its infancy. I look forward to your views. As a future public health practitioner I find your work fascinating and relevant.

Enrique said...


I found that seborrheic dermatitis (which I also have since I was also around 20, mild) is caused by a "bad" gut flora.

I found that people with SB have high counts of yeast in their stools. Your flora influences the oiliness and other characteristics of the skin, and I bet 6-delta-desaturase expression too. I found a few months ago that taking high quality enteric coated garlic pills 3 times per day with meals, cured acne and dandruff *completely*. But you have to keep taking them, and I would advice the use of high quality probiotics and after some time, fermented foods.

Fermented foods can make things worse initially for some, because they contain yeast and will cause additional reactions probably due to gene transfer. Some people have reported getting dandruff from kefir that disappears after a while (probably flora reshaping).

Yeast like Candida can destroy the protective SIgA produced by the gut through proteases. Causing increased translocation of toxins and the organisms themselves.

This is a big topic but this is my recommendation:

- Follow an antiinflammatory diet (the one recommended in this blog)
- Take chelated zinc, p5p (b6), magnesium (chelated)
- Eat fish with Omega 3 and/or krill oil
- Take GLA from Borage Seed Oil (this promotes the creation of antiinflamatory prostaglandids), probably 300 mg or more per day with food
- Take enteric coated garlic pills with each meal, a total of 3 per day
- Vitamin A (preformed) for gut integrity, 10,000 IU per day (probably people like use need more)
- Vitamin D3, 2,000-4,000 IU per day or more depending on your needs
- Add a good non-yeast probiotic

This should greatly reduce or completely erradicate the problem.

Ray Peat on his own, related dandruff to food intolerance, Vitamin A deficiency (and I would say dysbiosis).

There's much to talk about this...

Cristian said...

l-Glutamine regulates amino acid utilization by intestinal bacteria

Todd P said...

Hi All,
To answer my previous question, and if anyone is interested, there is a concerted effort underway to identify and describe the microflora of the gut and other body locations, it is called the Human Microbiome Project and is funded at $115 million for 5 years beginning in 2008.

Anonymous said...

confused a little regarding biofilms.. I've read in your posts that using natto (enzyme) is beneficial for breaking up "bad" biofilms and cleaning out other nasty stuff from your system. But wouldn't natto also affect the "good" that you want to keep? I've supplemented with this in the past...

Rebecca Magliozzi said...

So what do you do if both your kids have an autoimmune disease like PANDAS or rheumatic fever, where you have to use Antibiotics to protect their hearts or brains from getting damaged by their own immune systems?

Unknown said...

Inflammation is the result of the body trying to protect us from illness and is normally perfectly normal as the white blood cells and chemicals are sent to fight of the invaders.

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Anonymous said...

Since 1) we get bacteria from others, 2) a person's bacteria is altered by diet/obesity, and 3) bacteria from obese person will cause a thin person to gain weight, is there some sense in which obesity has a bacterially "contagious" factor?

Anonymous said...

Dr. Ayers,

I can think of many examples of observations that seem inconsistent with your assertion that a healthy gut can produce all the vitamins required and would like to get your opinion on just a couple of them.

Regarding vitamin C: When Weston Price visited the American Indians in the northern Yukon who existed completely on their traditional diet which was devoid of carbohydrates, he asked one of them if they ever got scurvy as the white men living in the Yukon often did. The Indian replied that they could get scurvy but they knew how to prevent it. After getting permission form the chief, the Indian demonstrated how they removed and ate the adrenal gland of the moose (a main part of their diet) to avoid scurvy. Price subsequently determined that adrenal glands are very high in vitamin C.

Question: Why did the Indians, who were the picture of robust health, need to eat vitamin C to prevent scurvy if their gut can make vitamin C?

Regarding vitamin K2. The Heidelberg study determined dietary intake of vitamin K2 of thousands of men and evaluated the effect of intake of vitamin K1 and K2 on risk of prostate cancer over a period of eight years. It was found the risk of advanced prostate cancer was inversely related to vitamin K2 intake. The lowest quartile of K2 intake had a 250% increased risk of advanced prostate cancer compared to the highest quartile. Intake of vitamin K1 had no effect on risk.

Cheese is high in K2 and more than half the K2 intake of participants came from cheese. It was also found that advanced prostate cancer risk was independently inversely related to cheese intake.

The validity of the vitamin K intake estimates was supported by measurement of activated osteocalcin which is a measure of vitamin K status.

It was concluded that intake ofvitamin K2 reduced the risk of advanced prostate cancer. Subsequently is was also found that K2 greatly reduced risk of lung caner mortality. Apparently K2 reduces the progression of these two cancers.

Why would those who consumed very little cheese (and hence little K2) be at such high risk for advanced prostate cancer of their gut can make all the K2 they need?

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majkinetor said...

The notion that bacteria can synthesize enough vitamin C is nonsensical. There is only one paper 30 years ago from Japanese scientist that show some bacteria indeed produce some very small amounts of C, around 5mg/day, which may be enough only to delay scurvy (its was very hard in old times to prevent scurvy on boats, even with lemons on board etc.)

Its also questionable how much of those vitamins are actually used by the body and what is lost in feces - for instance you can make animals deficient by preventing coprophagy.

The notion that you don't need vitamins because gut microbiota produce it is product of wild imagination. I don't doubt changes in the microbiota produce changes in vitamin profile but food, not microbiota is dominant factor here, microbiota production probably only delays ultimate deficiencies.

Also, the claim that multivitamins do not produce measurable effects on health is cherry picking. There are far more positive outcomes then negative ones. I read this blog to have alternative views but so far arguments are not compelling. said...

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