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, July 31, 2013

Vitamin C, Guinea Pigs, Limeys and Gut Worms

Scurvy and the Need for Vitamin C
Old timey sailors got the symptoms of scurvy, defective collagen and connective tissue, presumably because they stopped eating leafy greens that contained the needed vitamin C, aka ascorbic acid.  Primates/humans and guinea pigs are among the few animals that lack the ability to make their own ascorbic acid and therefore must eat a diet with a minimum amount of the vitamin to avoid a deficiency disease.  This is the conventional wisdom partially based on observation and experiment, but also founded on conjecture.

Parasitic Gut Worms Were the Natural Source of Vitamin C
I don't believe that vitamins are essential ingredients of a healthy diet, but rather I contend that all of the necessary nutritional chemicals are produced by the microorganisms of the gut.  I have previously discussed the gut flora (bacteria and fungi) as the source of most vitamins.  I wish to expand vitamin production to include gut fauna (animals).  I think that it is likely that intestinal worms are the historically natural source of human vitamin C.

Gut Bacteria Control the Development of the Immune System
The human gut actively communicates with the biofilms of bacteria and fungi that form a lining for the healthy gut.  The aggressive cells of the immune system that attack invading pathogens, develop in response to chemical signals from filamentous gut bacteria, and the suppressive cells of the other half of the immune system, which prevents attack on innocuous food antigens (to avoid allergies) or the human body itself (autoimmunity), develop in response to Clostridium ssp.  Thus, the immune system can be highly compromised, if the gut flora bacteria are damaged, e.g. by antibiotics.

Vitamins are Signaling Chemicals of Gut Biofilms
The communities of bacteria in gut biofilms are self-regulating by exchanging chemicals called quorum sensing signaling molecules.  Different species of bacteria and fungi in the biofilms produce and detect different chemical signals.  Since the biofilms are in intimate contact with the cells that line the gut and absorb dietary nutrients, it is not surprising that the biofilm signaling molecules are also absorbed by intestine cells.  Many of these biofilm signal molecules are vitamins, e.g. the B vitamins.  Gut bacteria are the natural source of most vitamins and healthy gut flora eliminates the need for eating vitamins in food or supplements.  Vitamin deficiencies are a symptom of a damaged gut flora.  Antibiotics and vitamin supplements can damage healthy gut biofilms.

Dietary Soluble Fiber Feeds Gut Flora
The human gut flora consists of a couple of hundred different species of bacteria in each person.  Those bacteria in aggregate can produce about a hundred thousand different proteins that focus on the digestion of food molecules that the upper gut cannot digest and absorb.  Since the upper gut can only digest proteins, fats and starch/sugars, that means that the gut flora eat the rest, undigested plant/animal polysaccharides.  Soluble fiber is the plant polysaccharides, e.g. inulin and pectin, that are digested and feed the gut flora.  The undigested polysaccharides include cellulose.  Lignin and some other plant polymers also pass through the gut and are eliminated.  The undigested stuff is called insoluble fiber and it also has bound phytate, which drags some metals such as zinc out with it.  That is why insoluble fiber, such as wheat bran, is not nutritious or healthy.  Insoluble fiber is also a minor contributor to the bulk of stools, which are made up predominately of the gut bacteria that have grown on soluble fiber.

Sea Voyages Damage Gut Organisms
The hundred of different species of bacteria in the gut change in proportions to adapt to different foods in each meal.  If the diet is fairly constant, then the diversity of the population gradually increases, just as the diversity of species in a tropical rain forest is greater than in a temperate forest.  This also explains why gut flora diversity is far less in the USA than in other parts of the world.  Americans are encouraged to eat diverse diets in the search for vitamins and superfoods.  Each dramatic change in diet makes it hard for the gut flora to adapt and the remaining bacteria are those that are generalists.  It might also be expected that early sailors who changed their diets dramatically when they went to sea, ended up with a highly compromised ship-board gut flora (and fauna.)

The Perils of Hygiene
I have a fascination for stories involving the potential of rampaging tigers.  Images of a tiger attempting to drag a hunter from his seat on an elephant or the need of a colleague to employ an armed bodyguard when capturing crabs from Malaysian Mangrove roots at night, linger in my imagination.  I still think about the report of Wallace guarding his derrière while collecting beetles in Bukit Timah, Singapore, in “The Malay Archipelago.”  Humans tend to be incompatible with lions and tigers and bears, and we wipe them out.  We do the same with bacteria, fungi and worms.  We wash our hands, flush the toilet, use hand sanitizers, kill weeds, spray pesticides, grow meticulous lawns/crops, dose ourselves with antibiotics and cleanse.  We are free of the threat of tigers, but we failed to see what else was lost during their extermination.

Probiotics Don’t Fix the Damage of Antibiotics
Antibiotics ravage gut flora.  It is no surprise that a course of antibiotics frequently leads to diarrhea or constipation, since normal stools require normal gut flora.  What is surprising is that physicians, e.g. Dr. Oz, seem to think that antibiotic decimated gut flora can be fixed with probiotics.  Sure, probiotics can provide a temporary bandaid, since Lactobacilli that would normally live on milk in the gut of newborns, are able to provide most of the functions of an adult gut flora.  But probiotics don’t survive in the adult gut and probiotics to not repair damaged gut flora.

Changes to Gut Flora are Permanent, Unless....
Gut bacteria are like wolves in Idaho.  If you don’t bring in new wolves and stop hunting them, you never again have wolves in the wilderness.  If you don’t bring in new bacteria and feed them, damaged gut flora does not repair.  Antibiotic treatment that wipes out the bacteria needed for development of the suppressive immune system will lead to autoimmune disease.  However, repairing the gut flora by flushing in new bacteria (fecal transplant) or gradually reintroducing new diverse bacteria with fermented foods, can also reverse autoimmune diseases as the immune system is repaired.

Parasitic Worms Were Lost at Sea
We think that vitamin C is only provided by plants that we eat, because we didn’t notice what was lost when we cleaned out the worms that typically inhabit the human gut.  Who would have thought that those inconvenient creatures were there for our own good?  We unknowingly compensated for the lost vitamin C production of the worms by incorporating foods rich in vitamin C in our diets.  Shipboard diets that eliminated bowel worms were augmented with limes rich in ascorbic acid.

Guinea Pigs Also Need Worms
It is interesting to note that the experimental animal used to replicate human nutritional requirements for vitamin C is the guinea pig, which is one of the few animals (in addition to bats and primates) that doesn’t make its own.  It is also interesting that guinea pigs (and bats?) commonly have intestinal worms that have to be purged from their bowels before they are used in the lab. 

Gut Flora and Fauna Provide Vitamins
My bottom line is that a normal, healthy gut contains all of the bacteria, fungi and worms to supply all of the needed vitamins.  I do, however, think that dietary vitamin C is a good replacement for one function of intestinal worms, even though I will be watching for other benefits ( Helminth therapy?) that were lost with the removal of these parasites.

Some points:
  •   Many vitamins are signal molecules for gut biofilm quorum sensing.
  •   Intestinal worms are the typical source for human vitamin C.
  •   Vitamin D is a hormone produced in the skin in response to sunlight.
  •   Vitamin supplements are unnecessary (problem?), if gut flora and fauna are healthy.
  •   Modern diets and hygiene eliminate gut parasites, so food needs to supply vitamin C.
  •   Chronic inflammation consumes vitamin C and eliminates production of vitamin D.


George Henderson said...

Great to have you back blogging again. I have long suspected that the idea that vitamin C is never synthesised endogeously in humans is an unproven hypothesis. This does not mean it is wrong, just that it has been accepted without the kind of investigation that might verify or rule out the factors you suggest.
Some bacteria, such as E. Coli, actually ferment (consume) ascorbate, as if it were a soluble fibre. This may be a factor in the bowel tolerance effect. And another reason why microbial balance is important for good nutrition.

majkinetor said...

That vitamin C is NEVER EVER synthesized in humans is not correct and it follows from works on genetic gradients for instance. There are mentions of some subpopulations in literature with suspected ability to still produce vitamin C. The similar might be true for some g.pigs because sometimes its impossible to induce experimental scurvy in some of them (although almost all will get it quite fast on scorbutic diet).

Japanese study from 80s looked into bacterial production of bifidobacteria species in the gut and the result was that there is net production of maybe 5mg/day at most, clearly not enough to prevent scurvy. The notion that parasitic worms contribute to human vitamin C status is not something I ever hear and I would like to see any info on that. I quickly searched several medical databases and found 0 results on it so I guess its wild speculation

Vitamin C deficiency (or more common thing - mild insuficiency) is almost the norm in population due to extensive use of pharmaceuticals - aspirin is the well known cause of vitamin C loss (thats the reason why some pharmacies produced aspirin+C versions, NSAIDs, antacids and so on). Helicobacter is well known cause of deficiency (as it rises pH and low pH is needed for absorption) so in this case killing it of will improve C status. There are number of intestinal creatures that actually steal your dietary vitamin C.

Furthermore its questionable how much of bacterial products are available for humans. Many animals practice coprophagy (some normally, some in disease states) and prevention of it leads to vitamin deficiencies.

Furthermore, normal dietary habits of wild primates includes intake of 2-6g of vitamin C per day.

So I don't think the notion that we don't need supplements is right. Maybe in ideal world we don't.

George Henderson said...

Steffanson, in his half of the all-meat diet experiment, ate only well-cooked meat for nearly 2 years, without developing scurvy.
Sailors knew fresh meat would cure scurvy, even cooked.
These ascorbate intakes must have been v. low, but meat supplies all the known products of ascorbate-catalysed reactions; creatine, hydroxyproline, carnitine. Provision of these products must lower ascorbate requirement to levels found in fresh meat.
But not salted meat, wormy cheese, and rock-hard biscuits.

Anonymous said...

Great to have you back Dr. Ayers.

Please keep writing posts, your blog is my favorite;)

Anonymous said...

Really glad to see that you are posting again. I often check your old posts for information. Have been taking fermented foods as a result of the information here to combat periodic flares of eczema. Wish I could convince my wife to stop allowing my son to take antibiotics to treat normal teenage acne.

Anonymous said...

Great to see you back Art!

[K] Dee said...

Are Fermented foods more diverse than "milk derived" probiotics?
Do they provide others Bacteria than lactobacilli/bifodobacteria?

Please keep writing posts - best resource ever

[K] Dee

majkinetor said...

+George Handerson

That may be so because Stefenson is in very good health generally (being low carb and living some time in Arctic).

Also, its very hard to induce scurvy in humans due to very efficient recycling of vitamin C when its near the deficiency.

However, with modern toxin levels, drug (ab)use and high carb intake today its very easy to get insufficient. This is also evident by the fact that cats and dogs (on the bottom related to the endogenous production among all animals) can get scurvy in some scenarios (diabets, infection, poisons etc..)

JEAN said...

Great to have you back, Dr. Ayers, I was getting tired of the hippo, not to mention Dr. Oz, but the naked mole rats are still the winners. The blogosphere has deteriorated to the point of screaming matches between bloggers, commenters, and lurkers. Hope all is well with you, we've missed you. Now, to read the blog entry!
And really, I am NOT a robot, but some of the captchas are incomprehensible.

Johan said...

Thanks for writing such an informative blog.

Is excessive gas after eating certain vegetables a symptom of a deficient gut flora or just a normal byproduct of a healthy bacterial metabolism?

Anonymous said...

I love your blog. Please keep writing. Your insights are brilliant.

I recently stopped eating fermented foods after many years (except for yogurt) due to possible reactions (histamine intolerance?). Will my gut flora remain healthy as long as I include sufficient soluble fiber (fruits & veg) or are fermented foods an absolute necessity, in your view?

Susan Laswell said...

Dr. Ayers,

So glad to see you blogging again.

I started reading you 3 years ago, when DXed with RA.

Following your advice put me in remission after 3 short months.

In two years time my health improved. I went from needed help getting out of bed, to doing a week long backpacking trip on the Appalacian Trail with a 35 pound pack!

You truely changed my life, and I am ever grateful.

Thank you.

Viktor said...

Dr Ayers - great to have you back.

It would be very interesting to get your view on a recent discussion regarding resistant starch within the "ancestral health community":

Seems like resitant starch is a also a missing component in most modern diets.

Kind regards,

Anonymous said...


It's incontrovertible that the malaria parasite can be killed easily in 4 hours 100% of the time with a simple water purification product. (google: 'uganda maleria cure red cross')

This 'chlorine dioxide' purportedly oxidizes the bad pathogens and leaves the good ones alone.

Seems to me we ought to kill the 'wolves' and add 'fuzzy little lambs' (Bacterially speaking of course.)

I'd sure appreciate your take on this method of killing bad pathogens and neutralizing heavy metals. They are curing autism with it too! link:

Thanks, Ramsay

Anonymous said...

You seem to equate probiotics with yogurt and so-forth. But what about the pills claiming to provide thousands of different species? Can they repopulate a damaged gut?

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Anonymous said...

how great to find you. have recently been wondering if the daughters' asperbers, PFAPA (childhood periodic fever syndrome w high CRP), grass/tree allergies and my pre-eclampisa are all shades of same gene/environment pool - something about us makes us over-react. will begin working the inflammatory protocol you recommend. thank you!

Anonymous said...

Dear Dr., I also would check in from time to time to see the hippo over and over. Glad you are back. Thank you. What do you think about Mutaflor? It has been on the market for decades and now with the enteric coating that helps with its survival of the ph kill shot. So wouldn't you say that this was the pill form of a fecal transplant?
Thanks for reading,

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Anonymous said...

inflammation from a lifetime of endurance exercise? my husband had his first atrial flutter at 52. he is incredibly fit and all traditional blood metrics strong. none of the heart drugs/depressants worked and they did cardioversion. no we are wondering if his episode was brought on by inflammation/electrolyte balance (he had bruised a rib, proceeded to ride 100 miles, and later that month fly to Japan and back). is traditional anti-inflamm diet enough or should we go beyond given now sl. elevated risk of stroke?

Bill Raybar said...

You are a crackpot milio. The same goes for the rest of you psedoscience, conspiracy crackpots. Milo says humans synthesize vitamin c. Gotta love it. I want peer reviewed research from the author of this blog. Lol.

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Tanya said...

Great to see you posting! I thought of you today when I read this article and came to check on you.
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Anonymous said...

New insights into the mechanisms of the benefits of breastmilk:

You might have seen this already, but it is very fascinating ... and bugs are involved.


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El Librero said...

Today in Science:

M said...

Hello, Dr., I thought you might find this study interesting. It says that cooked papaya may have an anti-inflammatory effect.

"There is a long history of research into papaya’s histamine blocking abilities. Histamines are known to trigger allergic responses, in­creased vascular permeability, itch­ing, sneezing, and also excess pro­duction of stomach acid, leading to peptic ulcers and gastroesophageal reflux disease (GERD). According to a 2006 review of histamine in the 20th century, “histamine has been shown to have a key physiological role in the control of gastric acid secretion and a pathophysiological role in a range of allergic disorders. The synthesis of, and pharmacolog­ical studies on, selective agonists and antagonists has established the existence of four types of histamine receptor and histamine receptor an­tagonists have found very import­ant therapeutic applications."

Anonymous said...

Dr. Ayers,
Do you think a fecal transplant will help put alopecia areata universalis into remission especially since the individual has leaky gut and gut dysbiosis. GFCF diet, probiotics and all kinds of supplements prescribed by the functional doctor has done nothing. This kid is very disheartened by 4 years of treatments that do work, and desperately wants her hair back.


Chema Caillet-Bois said...

Hello Dr. Ayers

I can't seem to find contact information for you anywhere so I'll leave a comment.

Chris Kresser is launching his first book, Your Personal Paleo Code (, on December 31st. We'd like to send you a free pre-release copy.
We've already begun shipping, so if you'd like, please provide me with an address where you'd like to receive your book asap. If you have any questions, don't hesitate to ask.

Best regards from a treasure valley local,
Chema Caillet-Bois

Marketing Coordinator

Ed said...

Hi Dr Ayers,

I'm wondering what you think of the Prescript-Assist probiotic? Here are the bacteria included:

Arthrobacter agilis, Arthrobacter citreus, Arthrobacter globiformis, Arthrobacter luteus, Arthrobacter simplex, Acinetobacter calcoaceticus, Azotobacter chroococcum, Azotobacter paspali, Azospirillum brasiliense, Azospirillum lipoferum, Bacillus brevis, Bacillus marcerans, Bacillus pumilus, Bacillus polymyxa, Bacillus subtilis, Bacteroides lipolyticum, Bacteriodes succinogenes, Brevibacterium lipolyticum, Brevibacterium stationis, Kurthia zopfii, Myrothecium verrucaria, Pseudomonas calcis, Pseudomonas dentrificans, Pseudomonas fluorescens, Pseudomonas glathei, Phanerochaete chrysosporium, Streptomyces fradiae, Streptomyces cellulosae, Streptomyces griseoflavus

marybeth said...

Susan, I have RA and would like to know all that you have done to keep it in remission. Could you please email me at
Thanks, Marybeth

Anonymous said...

i once read some postulated that some people (esp. from ancestry from arid regions) may retain some ability of synthesize C.

also not every one develop scurvy in long ocean voyage. &

yes, fresh meat prevented scurvy. (i read a few books antarctic exploration)

but worms make C for us? never heard of it. interesting.

Nica Gasmidari said...

I have learned a lot from this post. Great information, very informative.