Vitamins? Why?

vitaminsDo you take vitamins? Yes? Why? No? Why not?  Confusing, isn’t it? Can we ever get to the bottom of the yes-no controversy?

First of all, let’s find out what we’re talking about.

The word “vitamins” describes organic substances that are quite diverse in function and structure.  It was initially felt that these compounds could be obtained through a normal diet, and that they were capable of promoting growth and development, and of maintaining life.  The word itself was coined by a Polish biochemist named Casimir Funk, in 1911.  He deemed these substances to be chemical amines, thinking that all contained a nitrogen atom.  Since they were considered to be vital to existence (“vita” means “life” in Latin), they were called “vitamines.”  After it was discovered that they all did not have a nitrogen atom, and, therefore, were not amines, the terminal “e” was dropped.  Funk was working in London at the time, at the Lister Institute, where he isolated a substance without which chickens would suffer neurological inflammation.

The lettered names of the vitamins were ascribed to them in the order of their discovery.  Vitamin K, however, is the exception.  Its label was given by the Danish researcher Henrik Dam, from the word “koagulation.”

If a vitamin is improperly absorbed, or is absent from the diet, a deficiency exists and a specific disease may surface, such as Beriberi, which was noted by William Fletcher in 1905 when symptoms appeared in populations whose diet consisted mostly of polished rice, lacking the thiamine-rich husk.  Lack of thiamine, or vitamin B1, causes emotional disturbances, physical weakness, heart failure, impaired sensory perception, and, in severe circumstances, eventual death.

Scurvy, a deficiency of vitamin C, was once a common ailment of sailors and others who were out to sea for a longer time than their fruits and vegetables could remain edible.  The Latin name of this condition that caused bleeding from the mucus membranes and spongy gums is “scorbutus,” from which we get “ascorbic acid.”  James Lind, a surgeon in the Royal Navy, learned in the 1750s that scurvy could be treated with citrus fruits, and he wrote about his experiments in his 1753 book, “A Treatise of the Scurvy.”

If vitamins are so “vital,” what, exactly, are their roles in human health and well-being?  Vitamin A was first synthesized in 1947, though discovered around 1912 by researchers Elmer McCollum and M. Davis, and later isolated from butter by Yale scientists Thomas Osborne and Lafayette Mendel.  This nutrient contains carotene compounds that are responsible for transmitting light signals to the retina of the eye.  McCollum also uncovered the B vitamins, but later researchers isolated each of the individual factors.

We already know that a lack of B1 causes Beriberi, while a deficiency of B2 may lead to inflammation of the lining of the mouth.  Also called riboflavin, B2 is responsible for the reactions of enzymes, as is its partner, B3 (niacin).  In general, the gamut of B vitamins is involved in the same metabolic processes.  It was decided that a B vitamin must meet specific criteria:  it must be water-soluble, must be essential for all cells, and must function as a coenzyme.  B12 and folate have the added responsibility of being involved in the synthesis of nucleic acid.  Folate is the form of the nutrient naturally found in food, while folic acid is synthetic. Great excesses of one B vitamin can cause deficiencies of the others.  Therefore, if taken as supplements, it is recommended that they be taken together.

Besides preventing scurvy, as mentioned, vitamin C helps the body to make collagen, the protein that acts as the framework for the body.  Collagen is a major component of ligaments and cartilage, it strengthens blood vessels, and it is responsible for skin strength and elasticity.  Vitamin C was the first to be artificially made, in 1935.

Vitamin D is not actually a vitamin, but a prohormone, meaning that it is a precursor to a hormone, called 1,25-D, which helps the body to make its own steroids, such as cholesterol, a substance absolutely necessary to the integrity of each of our trillions of cells.  Vitamin D is needed to maintain correct calcium and phosphorus levels, to assure proper bone mineralization, and to support the immune system.  A severe deficiency leads to rickets, a softening of the bones—usually in children—that was studied in 1922 by Edward Mellanby.

Vitamin E is actually a group of isomers (like-structured molecules) that function as antioxidants.  Study of this fat-soluble nutrient has focused on its purported benefits to the cardiovascular system. University of California researchers discovered vitamin E while studying green, leafy vegetables, in the 1920s.

Another fat-soluble substance, vitamin K is used by the body to assist in the manufacture of bone, and in the manufacture of blood clotting proteins, without which serious bleeding episodes may occur.  This nutrient has been available from green leafy vegetables and from the brassica family, such as broccoli, cauliflower, and kale.

Now the question is, “Can we get all these nutrients from our food, or is supplementation necessary?”

Working at the University of Texas Biochemical Institute, Dr. Donald Davis led a crop-nutrient study in 2004.  He and his team found that the nutrient value of forty-three garden crops has declined considerably over the past fifty years.  As reported in the “Journal of the American College of Nutrition” in December of that year, the forty-three crops showed “statistically reliable declines” in protein, calcium, iron, phosphorus, riboflavin (vitamin B2), and ascorbic acid (vitamin C).  Some nutrients could not be compared because their values were not reported in the 1950s.  They include magnesium, zinc, vitamin B6, vitamin E, dietary fiber, and phytochemicals.

After accounting for possible confounders, the study concluded that the change in nutrient value could be ascribed to changes in cultivated varieties, in which there could have been a trade-off between crop yield and nutrient value.  Dr. Davis added that farmers are paid by the weight of a crop, not by its food value.

Some innovative farming techniques have given rise to faster-growing crops, which, by virtue of their seed-to-market time, do not have sufficient time to develop their nutrients.  They do not have the chance to absorb everything they need from the soil.

Crop rotation has fallen into disfavor by some farms because it requires more planning and management skills than are at hand, thus increasing the complexity of farming.  Rotation of crops helps to reduce insect and disease problems, improves soil fertility, reduces soil erosion, and limits biocide carryover.  If, however, a single crop is a big moneymaker for the farm, why should it bother even to try to grow something else?  Why bother to rotate crops when chemical fertilizers, herbicides, fungicides, and insecticides can help to guarantee a bumper crop?  Could nutrient value be affected by using these artificial chemicals?  Do these materials come into our bodies?  Do we have the proper kinds and amounts of nutrients to detoxify them?  Maybe we do; maybe not.

Nitrogen-fixing bacteria convert atmospheric nitrogen to organic nitrogen, thus contributing to the food value of the crop.  Certain crops, like the legumes, are better than others at replacing nitrogen lost from the soil.  Nitrogen is part of a protein molecule.  Without nitrogen there is no protein.  While it is beneficial to the food and the soil to plant a legume following the harvest of a more lucrative planting, it is not often done.

Therefore, the same plant in place continues to withdraw the same minerals repeatedly, year after year, with little chance for replenishment except by chemical means, if at all.  How many of us would prefer to get our dietary needs from unnatural sources, like iron from rusted nails, or zinc from galvanized wire?

In a study of peaches and pears published in the “Journal of Agriculture and Food Chemistry” in 2002, Marina Carbonaro, of the National Institute for Nutrition Studies, in Rome, reported a difference in the nutrition content of organic versus traditionally raised fruits.  Amounts of polyphenols, citric and ascorbic acids, and alpha-tocopherol were increased in the organically grown crops.  She and her colleagues concluded that the improved antioxidant defense of the plants developed as a result of organic cultivation methods.  Which do you think has more vitamin C?

Here is a sampling of how the nutrient content of broccoli and potatoes sold in Canada has changed from 1951 to 1999.  This information was compiled by Jeffrey Christian.

Broccoli, Raw, 3 spears, 93g. 100/93=1.08
Calcium (mg) Iron
Vitamin A (I.U.) Vitamin C (mg) Thiamine (mg) Riboflavin (mg) Niacin (mg)
1951 130.00 1.30 3500 104.0 0.10 0.21 1.10
1972 87.78 0.78 2500 90.0 0.09 0.20 0.78
1999 48.30 0.86 1542 93.5 0.06 0.12 1.07
% Change -62.85 -33.85 -55.94 -10.10 -40.00 -42.86 -2.73
Potatoes, one potato, peeled before boiling, 136g. 100/136=.74
Calcium (mg) Iron
Vitamin A (I.U.) Vitamin C (mg) Thiamine (mg) Riboflavin (mg) Niacin (mg)
1951 11.00 0.70 20.00 17.00 0.11 0.04 1.20
1972 5.74 0.49 0.00 16.39 0.09 0.03 1.15
1999 7.97 0.30 0.00 7.25 0.09 0.02 1.74

The USDA, in its statistical bulletin # 978, made public in June, 2002, titled “The Changing Landscape of U. S. Milk Production,” admitted that milk production has increased because of “advances in animal nutrition and health, improved artificial breeding techniques, and the recent addition of biotechnology, such as…rbST…”
rbST is a hormone that is administered to cows to increase milk production.  Take a look at how milk production has changed, and then decide if there might be implications that could involve humans.

In 1950, a single cow (I mean one cow, not an unmarried cow.) produced 5,314 pounds of milk.  By 1975, she increased her output to 10,360 pounds.  In 2000, that amount increased to 18,204 pounds.  The USDA admits that “…a 76-percent increase in milk per cow since 1975 is substantial.”  Substantial?  How about phenomenal, even miraculous?  Could a factory have increased its output by seventy-five percent in twenty-five years?  Could a weight lifter elevate that much of a weight increase in a military press as he did twenty-five years ago?  Could recombinant bovine somatotropin enter the milk supply and affect human growth and development, or even contribute to human misery?

Not only do modern agricultural techniques affect the quality of food, but also do the processes by which food is processed and packaged.  To prevent the growth of pathogenic bacteria, some canned foods are exposed to temperatures that compromise their nutritional value.  Acidic foods, like tomatoes, are excused from excessive heat because their nature does not support the growth of food poisoning bacteria.  Others are heated to temperatures high enough to destroy bacteria, yeasts, and molds that could cause foods to spoil.  Heating to 250 degrees Fahrenheit for three minutes not only kills pathogens, but also denigrates the potency of water-soluble vitamins.  If these foods are consumed without also consuming the water in which they are prepared, nutrition is sacrificed.

The USDA has a table of nutrient retention factors that compare the nutritional value of processed foods.  This table includes most nutrients from alpha-tocopherol to zinc.  It is noted that folate, for example, a nutrient easily lost in food preservation and preparation, is diminished by almost 50% in canned fruits as compared to fresh and frozen.  Additionally, canned foods are higher in sodium, and their texture is softer than either fresh or frozen.  The mineral and protein values of canned foods are usually undisturbed.  In rare instances, as with tomatoes and pumpkin, nutrient value is retained, or even increased, by canning.  We should note that canned fruits and vegetables are better than none at all.

Frozen foods, on the other hand, retain much of the nutrition they are destined to have.  The folate retention factor for frozen fruits is ninety-five, contrasted to fifty for canned.  There are some compromises, though, because frozen foods need to be blanched prior to being frozen.  Blanching, however, is no worse than what happens to foods during normal cooking activity.  This means that frozen vegetables provide levels of nutrition similar to fresh, provided they are stored and handled properly.  The “International Journal of Food Science and Technology,” reported in June of 2007 that the freezing process alone does not affect vitamin levels, but that the initial processing and later storage do.  About 25% of vitamin C and a higher percentage of folate are lost through the blanching process.  These numbers will vary according to the processing techniques.

An advantage to canned and frozen foods is that the foods themselves are harvested at their maximum stage of development, containing all the vitamins and minerals they could possibly extract from their environments.  What we call “fresh” vegetables are usually anything but.  They have been picked before their maximum ripeness so that they can be shipped across the country.  If not harvested locally, “fresh” vegetables are more accurately labeled as “raw,” or “unprocessed.”  Water-soluble vitamins, like the B complex and vitamin C, are affected by exposure to light and air.  Vitamin A is jeopardized by exposure to light, as well.  The amount of time that a raw vegetable spends in storage may take its toll on nutrient integrity, also.

Typical Maximum Nutrient Losses (as compared to raw food)
Vitamins Freeze Dry Cook Cook+Drain Reheat
Vitamin A 5% 50% 25% 35% 10%
  Retinol Activity Equivalent 5% 50% 25% 35% 10%
  Alpha Carotene 5% 50% 25% 35% 10%
  Beta Carotene 5% 50% 25% 35% 10%
  Beta Cryptoxanthin 5% 50% 25% 35% 10%
  Lycopene 5% 50% 25% 35% 10%
  Lutein+Zeaxanthin 5% 50% 25% 35% 10%
Vitamin C 30% 80% 50% 75% 50%
Thiamin 5% 30% 55% 70% 40%
Riboflavin 0% 10% 25% 45% 5%
Niacin 0% 10% 40% 55% 5%
Vitamin B6 0% 10% 50% 65% 45%
Folate 5% 50% 70% 75% 30%
  Food Folate 5% 50% 70% 75% 30%
  Folic Acid 5% 50% 70% 75% 30%
Vitamin B12 0% 0% 45% 50% 45%
Minerals Freeze Dry Cook Cook+Drain Reheat
Calcium 5% 0% 20% 25% 0%
Iron 0% 0% 35% 40% 0%
Magnesium 0% 0% 25% 40% 0%
Phosphorus 0% 0% 25% 35% 0%
Potassium 10% 0% 30% 70% 0%
Sodium 0% 0% 25% 55% 0%
Zinc 0% 0% 25% 25% 0%
Copper 10% 0% 40% 45% 0%

Can we get all the vitamins and minerals we need from food?  No.

Take a look at vitamin C, one of the most-studied nutrients.  Because of its fragile nature, vitamin C, a popular water-soluble supplement, needs special handling.  This characteristic may explain why it seems to have been a major focus of the food business for years.  It is extremely sensitive to heat, and slightly less so to light, and time.  Loss of vitamin C during processing ranges from about 10% in beets to almost 90% in carrots.  The amount of vitamin C at the start has no bearing on the outcome.  It’s the percentage that makes the matter a real concern.  Since this vitamin is easily oxidized, it is difficult to measure levels in drained liquids.  That goes for the cooking water, as well.  Canned foods are further insulted by cooking at high temperatures for a long time, without a lid.  It is nutritionally prudent to include the water from the can in the meal.  Otherwise, the ascorbic acid goes down the drain.  The table below demonstrates changes in vitamin C levels resulting from canning alone.

Ascorbic acid (g / kg−1 wet weight) in fresh and canned vegetables
Commodity Fresh Canned % Loss
Broccoli 1.12 0.18 84
Corn 0.042 0.032 0.25
Carrots 0.041 0.005 88
Green peas 0.40 0.096 73
Spinach 0.281 0.143 62
Green beans 0.163 0.048 63
Beets 0.148 0.132 10
J Sci Food Agric 87:930–944 (2007) Nutritional comparison of fresh, frozen and canned fruits and vegetables. Part 1. Vitamins C and B and phenolic compounds. Joy C Rickman, Diane M Barrett and Christine M Bruhn

 Freezing has less impact on nutrient levels than other types of processing. Because foods are harvested at their maximum maturity stage before freezing, they already contain the most nutritive value they can be expected to have. The table that follows shows losses of ascorbic acid (vitamin C) after periods of storage at various temperatures, starting at room temperature (20° C; 68° F), through the refrigerator crisper drawer (4° C; 39° F), to the freezer (-20° C; -4° F).

Losses of ascorbic acid (% dry weight) due to fresh and frozen storage
Commodity Fresh, 20 ◦C,
7 Days
Fresh, 4 ◦C,
7 Days
Frozen, −20 ◦C,
12 Months
Broccoli 56 0 10
Carrots 27 10
Green beans 55 77 20
Green peas 60 15 10
Spinach 100 75 30
J Sci Food Agric 87:930–944 (2007) Nutritional comparison of fresh, frozen and canned fruits and vegetables. Part 1. Vitamins C and B and phenolic compounds. Joy C Rickman, Diane M Barrett and Christine M Bruhn

Vitamin C does continue to degrade after long periods of freezing, but at a slower rate. What seems to be the main factor in this process is the moisture content of the food at the outset. Notice that refrigerating foods as soon as they come home from the market plays a serious role in maintaining nutritive value. The cook is the penultimate figure in the saga of a food’s life. The method of cooking can cause loss of ascorbic acid at the rate of 15% to 55%. Losses in canned products are probably minimal because the food already sits in water. Oddly, unheated canned products are occasionally comparable to that which is cooked fresh. But who has the wherewithal to determine that at home? Remember that, because vitamin C oxidizes in air, the value of frozen foods may be substantially higher than fresh foods that have been stored for a long time or under sub-optimal conditions. So…fresh (raw) may not always be the best. Whatever the case, additional research is expected to substantiate changes in vitamin C levels caused by cooking habits. Microwaving, for example, may have an unexpected influence, based on the solubility and diffusion of certain food solids, such as sugars that may diminish faster than ascorbic acid, leaving vitamin C behind.

It is necessary to realize that carrots are not exactly heralded for their vitamin C value in the first place, so losses are relatively insignificant. Also, note that sources of information may present nonconcurring results due to variations in measurement techniques, quality of raw ingredients, and other variables.

The water-soluble B vitamins (all are water-soluble) suffer a fate similar to that of ascorbic acid. Thiamin, the least stable of the vitamins to thermal indignity, is most sensitive to degradation caused by food processing. But, since fruits and vegetables are not exceptional sources of this nutrient, its retention or loss does not represent overall nutrient retention or loss of a particular food. Riboflavin is unstable in the presence of light. Processing and storage / display play a role in its stability. Clear glass containers can cause this vitamin to dwindle. Realization of this fact by the food industry is one reason that certain foods are now in opaque containers. The exception to the B-vitamin family is vitamin B12 because it is found mostly in animal products. The same considerations that apply to vitamin C are appropriate for the B vitamins.

The normal eating habits of Americans suggest that we are woefully inadequate in meeting dietary recommendations to achieve optimum well-being and health.  Most of us do not eat the recommended number of daily servings of fruits and vegetables.  For some nutrients, daily intake needs may be higher for some populations than for others, especially those in particularly vulnerable groups, such as those with gastrointestinal problems or poor absorption, those who are chronically ill, those who are alcohol or drug dependent, and the elderly.

The June 19, 2002 edition of the “Journal of the American Medical Association” recanted that august body’s negative position on vitamin supplements when it advised all adults to take at least one multivitamin tablet a day.  The article, “Vitamins for Chronic Disease Prevention in Adults,” authored by Robert H. Fletcher, MD, MSc, and others, agreed that suboptimal levels of folic acid and vitamins B6 and B12 are a risk factor for cardiovascular disease, neural tube defects, and colon and breast cancers.  It added that risks for other chronic diseases are increased by low levels of the antioxidant vitamins A, C, and E.

Because it is accepted that high homocysteine levels are associated with increased risk of heart disease, the AMA’s recommendation for optimal levels of cardio-specific supplements are well founded.

Depending on a person’s physiological state, he or she may need more of a particular nutrient than is available from a multivitamin alone.  The bioavailability of a specific nutrient from a high quality supplement is close to one hundred percent, compared to a food whose life experiences might have been less than ideal.  In a society that falls short of consuming the five to nine servings of fruits and vegetables that are recommended, it would be inane to ask them to eat more fruits and vegetables to get the nutrients they lack.

This does not mean that a person should take a little of this and a little of that because he read about it somewhere.  On the contrary, supplementation with vitamins, minerals, and herbs is a scientific enterprise that entails one’s medical history, both distant and recent past, one’s current physiological state, and even one’s blood chemistry.

Do you take vitamins?

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Flu and Vitamin D3

Flu and Vitamin DIn a sequestered environment such as a classroom or dormitory, influenza can evoke concerns that are more than just casual. It has been noted by scientists and physicians that seasonal variations in ultraviolet radiation from the sun parallel the outbreak of the flu. The more obvious the sun’s activity, the less pronounced are viral infections. The converse is also true. Places at high latitudes do not receive enough sunlight to help the body produce vitamin D, known for its ability to cause an immune response to pathogens.

Studies performed in Norway, at the Institute for Cancer Research at Oslo University Hospital, in 2010, stated definitively that, “Seasonal variations in ultraviolet B (UVB) radiation cause seasonal variations in vitamin D status.”  Immune response and seasonal influenza infection were directly related to vitamin D levels.  This conclusion was drawn from weekly records that monitored the number of influenza cases and flu-related deaths in Sweden, Norway, the United States, Singapore, and Japan in light of concomitant changes in UVB strength. Results of this study indicated that, “…influenzas mostly occur in the winter season in temperate regions,” adding that, “…at high latitudes very little, if any, vitamin D is produced in the skin during the winter.”  (Juzeniene. 2010)

Vitamin D deficiency is related to other matters besides the flu, including some cancers, heart disease, multiple sclerosis, diabetes, autism, and a host of others. (Cannell. 2008)  This pro-hormone has been produced by life forms since the Creation, and is vital to the growth and development of the organism, from gestation to the grave.  Of the common forms, D2 and D3, the latter is more biologically significant, since it is the one made by the skin in response to sunlight exposure.  The supplement is usually derived from either lanolin or cod liver oil.  This—D3— is the form that should be used to treat deficit.  The former, D2, comes from fungal sources by activating ergosterol with UV light, and is not naturally present in humans.  Synthetic, Rx forms are also available.

After being formed in the skin, vitamin D is converted into two different substances in the body. 25-hydroxyvitamin D (calcidiol) is the main storage form made by the liver.  1,25-dihydroxyvitamin D (calcitriol) is the most potent human steroid in the body, usually made in the kidneys. Calcitriol levels should not be used to determine vitamin D status.

Japanese research looked into seasonal flu among school children, from December 2008 to March 2009, and found that those who had not been taking vitamin D3 supplements were considerably more likely to get the flu than those who did supplement. Asthma sufferers experienced fewer exacerbations if they supplemented with the vitamin. (Urashima. 2010)

The sun has an eleven-year cycle during which its radiation level waxes or wanes.  Discovered in the 1840’s by Samuel Schwabe, the cycle can change the amount of UVB light reaching the earth by as much as 400%, more than enough to influence vitamin D stores.  The hypothesis that flu pandemics are associated with solar control of vitamin D levels has been developed and accepted. (Hayes. 2010)  Part of this is based on vitamin D’s ability to help the body make an innate antimicrobial peptide called cathelicidin, which depends upon vitamin D levels of 40 – 70 nanograms per milliliter.  (Cannell)  European researchers believe that the economic burden of the flu on that continent could be reduced by 187 billion euros a year by supplementing with 2000-3000 IU of vitamin D a day.  (Grant. 2009)  Food fortification, artificial UVB, and, of course, supplements are practical options when the sun is unable to do what we expect.


Int J Infect Dis. 2010 Dec;14(12):e1099-105. Epub 2010 Oct 29. The seasonality of pandemic and non-pandemic influenzas: the roles of solar radiation and vitamin D. Juzeniene A, Ma LW, Kwitniewski M, Polev GA, Lagunova Z, Dahlback A, Moan J.

Department of Radiation Biology, Institute for Cancer Research, the Norwegian Radium Hospital, Oslo University Hospital, Montebello, N-0310 Oslo, Norway. [email protected]

Altern Med Rev. 2008 Mar;13(1):6-20.
Use of vitamin D in clinical practice.
Cannell JJ, Hollis BW.

Am J Clin Nutr. 2010 May;91(5):1255-60. Epub 2010 Mar 10.
Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren.
Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H.

Medical Hypotheses. Volume 74, Issue 5, May 2010, Pages 831-834
Influenza pandemics, solar activity cycles, and vitamin D Daniel P. Hayes

Progress in Biophysics and Molecular Biology. 99(2-1); Feb-May 2009: 104-113
Estimated benefit of increased vitamin Dnext term status in reducing the economic burden of disease in western Europe William B. Grant, Heide S. Cross, Cedric F. Garland, et al

Journal of Clinical Virology Volume 50, Issue 3, March 2011, Pages 194-200
Vitamin D and the anti-viral state Jeremy A. Beard, Allison Bearden, and Rob Striker

Archives of Gerontology and Geriatrics
Article in Press, Corrected Proof – Received 15 October 2010; revised 25 February 2011; accepted 28 February 2011. Available online 1 April 2011.
Vitamin D: drug of the future. A new therapeutic approach N. Gueli, W. Verrusioa, A. Linguanti, F. Di Maio, A. Martinez, B. Marigliano and M. Cacciafesta

FASEB J. 2005 Jul;19(9):1067-77.
Human cathelicidin antimicrobial peptide (CAMP) gene is a direct target of the vitamin D receptor and is strongly up-regulated in myeloid cells by 1,25-dihydroxyvitamin D3. Gombart AF, Borregaard N, Koeffler HP

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Vitamin D & The Brain

Vitamin D DeficiencyVitamin D deficiency has hit an epidemic level. Not only are intakes devastatingly low, but also exposure to the sun has become increasingly limited for fear of contracting skin cancer. In his June 23, 1011, newsletter at Newsmax Health, Dr.Russell Blaylock educates his readers when he states that vitamin D3 is actually a hormone rather than a vitamin, and that a deficit of this compound may result in undesirable consequences in the brain, including depression.

Dr.Blaylock is a renowned neurosurgeon with a keen desire for people to take some control over their own health.  He implies that supplemental vitamin D3, “…lowers risk of infections, which would reduce the incidence of brain inflammation.”   He adds that research can place behavioral disorders in the lap of vitamin D deficiency, and  suggests that all of us get a vitamin D blood-level test to find out where we stand, noting that current accepted values are too low to be any benefit.   About the conditions, Dr. Blaylock says, “…depression, anxiety, panic attacks, obsessive-compulsive disorder, suicide risk, and even criminal behavior…can be traced to chronic brain inflammation.”  The good doctor would like to see blood vitamin D levels between 70 and 100 nanograms per milliliter.  That means that most of us need to take at least 2000 IU of vitamin D3 a day, with as much as 10,000 IU for severe deficiency.

The body needs cholesterol to make vitamin D from the sun’s ultra-violet radiation.  When the resulting chemical mix gets to the liver it becomes vitamin D3, the active form of the hormone, which the body uses to help maintain bone integrity, to increase neuromuscular function, and to modulate the immune system.  There has been considerable support over the past decade for the role of vitamin D in brain development and function.  It was noted by Kesby and colleagues at Australia’s Queensland Brain Institute that, “…this vitamin is actually a neuroactive steroid that acts on brain development, leading to alterations in brain neurochemistry and adult brain function.”  (Kesby. 2011)  Deficiencies have been related to depression, as well as to Parkinson’s disease and cognitive decline.

Of particular interest to American researchers at the U. of South Carolina is the relationship of vitamin D deficit to postpartum depression as one of the several mood disorders studied in 2010.  Using a moderate sample size at the outset, scientists found that low levels of vitamin D are associated with increased postpartum depression, as measured by evaluation on the Edinburgh Postpartum Depression Scale. (Murphy. 2010)  Even though larger studies are encouraged, the outcomes are likely to be the similar.

When the immune system abandons its competence because of nutritional deficit, inflammation ensues, often with a mighty wrath.  Such is the case with deficit of vitamin D in various maladies that include diabetes and multiple sclerosis, as well as depression.  Depression is a family affair characterized by feelings of hopelessness, despair, anxiety, irritability and restlessness.  Depression understandably accompanies degenerative disease, in part by the hopelessness is may engender.  If vitamin D is able to address depression, might it also be able to help get a handle on these conditions?   Whatever the cause of vitamin D deficiency, levels lower than 30 nanograms per milliliter have been associated with heart disease, type 2 diabetes, infectious diseases, autoimmune disorders, and neurological conditions. (Nimitphong. 2011)


Dr. Blaylock
Up Vitamin D3 for Your Brain
Thursday, June 23, 2011 10:11 AM

Mol Cell Endocrinol. 2011 Jun 1. [Epub ahead of print]
The effects of vitamin D on brain development and adult brain function.
Kesby JP, Eyles DW, Burne TH, McGrath JJ.

Source Queensland Brain Institute, University of Queensland, St. Lucia, Qld 4076, Australia.

J Am Psychiatr Nurses Assoc. 2010 May;16(3):170-7.
An exploratory study of postpartum depression and vitamin d.
Murphy PK, Mueller M, Hulsey TC, Ebeling MD, Wagner CL.

SourceMedical University of South Carolina, Charleston, SC, USA, [email protected]

Curr Opin Clin Nutr Metab Care. 2011 Jan;14(1):7-14.
Vitamin D, neurocognitive functioning and immunocompetence.
Nimitphong H, Holick MF.

SourceSection of Endocrinology, Diabetes, Nutrition, Department of Medicine, Boston University Medical Center, Boston, Massachusetts, USA.

Acta Psychiatr Scand. 2011 Apr 12. doi: 10.1111/j.1600-0447.2011.01705.x. [Epub ahead of print]
D’ for depression: any role for vitamin D?: ‘Food for Thought’ II.
Parker G, Brotchie H.

SourceSchool of Psychiatry, University of New South Wales, and Black Dog Institute, Randwick, Sydney, NSW, Australia.

Psychopharmacology (Berl). 2011 Jun;215(4):733-7. Epub 2011 Jan 29.
Exploring the relationship between vitamin D and basic personality traits.
Ubbenhorst A, Striebich S, Lang F, Lang UE.

SourceDepartment of Physiology, University of Tuebingen, Gmelinstr. 5, 72076, Tuebingen, Germany.

FASEB J. 2008 Apr;22(4):982-1001. Epub 2007 Dec 4.
Is there convincing biological or behavioral evidence linking vitamin D deficiency to brain dysfunction?
McCann JC, Ames BN.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Winterize Your Immune System

chilly-womanThe relationship between vitamin D status and the strength of the immune system is a hot topic. Actually a steroid hormone more than a vitamin, vitamin D is made by the skin after exposure to the ultraviolet radiation of the sun. Because the sun’s angle of incidence outside the tropics is considerably lower in winter, the skin’s response is too weak to manufacture sufficient stores of this vital nutrient.

In the early 1980’s, British physician R. Edgar Hope-Simpson proposed a relationship between solar radiation and the seasonality of influenza.  Without sufficient sunlight, the skin does not produce vitamin D, deficiency of which is common in winter.  This steroid hormone has considerable influence on immunity, where it prevents excessive expression of inflammation and is able to, “…stimulate the expression of potent anti-microbial peptides, which exist in neutrophils, monocytes, natural killer cells, and in epithelial cells lining the respiratory tract where they play a major role in protecting the lung from infection.”   (Cannell. 2006)   This study, performed at California’s Atascadero State Hospital, states that deficiency of vitamin D predisposes children to respiratory infections.  UV radiation, either natural or artificial, increases vitamin D levels and thereby reduces the incidence of pulmonary infections.

Vitamin D deficiency has been associated with many of the diseases of modern society, but traditional medicine has been reluctant to address this concern, or even to recognize it.  This vitamin is the only known precursor to a potent steroid hormone that is able to regulate expression in a number of tissues.  It does not exist in appreciable amounts in the diet, not even in fortified foods like dairy.  People used to make enormous amounts of vitamin D until they were warned to stay out of the sun.  If not exposed to the sun, we need to get it from supplements.  The flu epidemic of 1918 took a great toll.  Autopsies on some of the fifty million people who died revealed destruction of the respiratory tract.  This is the inflammation that vitamin D has been found to prevent.

Randomized, double-blind, placebo-controlled studies done in Japan in 2010 found that vitamin D3 supplementation not only reduced incidence of influenza type A, but also reduced asthma attacks as a secondary outcome. (Urashima. 2010).  The elderly tend to have suboptimal levels of vitamin D, which is associated with an increased risk of falls as well as seasonal virus attacks.  Vitamin D supplementation in this group is a realistic intervention that can pay large dividends.  2000 IU a day has been suggested as a minimal dose also to help prevent osteoporosis, increased risk of certain cancers, aberrant glucose and lipid metabolism and to improve quality of life.  (Lawless. 2011)  (Cherniak.  2008). Solar activities of the sun have a cycle of about eleven years, and an interesting phenomenon is that flu epidemics seems to follow the pattern.  (Hayes.  2010).

Vitamin D is not the sole player in the winterizing game.  Viruses need to get into your cells to make copies of themselves, using your cellular materials.   Replication of the flu virus is interrupted by a standardized elderberry extract called Sambucol, the use of which brought improvement to more than 90% of the persons in a study group within two days.  Since there is no satisfactory medication to cure the flu, this natural substance is nearly miraculous because it’s also inexpensive, has no side effects, and works on both A and B strains of influenza.  (Zakay-Rones.  1995)  (Zakay-Rones.  2004). The anti-viral properties of elderberry are attributed to its flavonoids content, some of which are peculiar to that plant alone. (Roschek. 2009).

A considerable part of the immune system resides in the gut, where intestinal microflora work to maintain the status quo.  Keeping those bacteria happy and healthy makes sense, so probiotics have been examined as a support system.  In a controlled study in Wisconsin, scientists found that six months of supplementation with a probiotic resulted in reduced fever, runny nose, and cough incidence in youngsters aged 3 to 5 years.  Duration of prescription medications and missed school days also were reduced.  (Leyer. 2009)  Day care centers across the Atlantic also fared well in the reduction of childhood infections with probiotic use. In Finland, researchers saw a substantial reduction in respiratory infections and their severity among children under 6 years old, accompanied by a reduction in the need for antibiotic treatment in those who received probiotic dairy products.  (Hatakka.  2001)

Investigations of echinacea as treatment for flu were not as positive as those for prevention.  It was discovered that early intervention, at the fist symptoms, brought the best results using an echinacea compound tea, namely one called Echinacea Plus.  (Lindenmuth.  2000).  Because there are too many variables, including the part or parts of the plant used, the brewing times and techniques, the variety of the plant used, its cultivation conditions, and other factors, test results are likely to differ.  Even in trials with sound methodology, results may conflict.  (Melchart.  2000)  (Linde. 2006) Using echinacea as prevention or as treatment, then, may be an uncertain proposition.

There is more to consider.  Garlic and onions have putative anti-bacterial and anti-viral properties. (Goncagul. 2010). (Harris. 2001)  Exercise, regardless of intensity or duration, and sound sleep of uninterrupted duration help the lymphatic system to clear impurities and to boost immunity.  One or all of these suggestions might be your ounce of prevention.  Oh, yeah, one last thing.  The higher the humidity in your house in the winter, the less likely viruses are to be transmitted.  (Lowen,. 2007)  (Yang. 2011)


Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, Garland CF, Giovannucci E. Epidemic influenza and vitamin D. Epidemiol Infect. 2006 Dec;134(6):1129-40.

Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H.
Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren.
Am J Clin Nutr. 2010 May;91(5):1255-60. Epub 2010 Mar 10.

Lawless S, White P, Murdoch P, Leitch S.
(Preventing) two birds with one stone: improving vitamin D levels in the elderly.
J Prim Health Care. 2011 Jun 1;3(2):150-2.

Cherniack EP, Levis S, Troen BR.
Hypovitaminosis D: a widespread epidemic.
Geriatrics. 2008 Apr;63(4):24-30.

Hayes DP.
Influenza pandemics, solar activity cycles, and vitamin D.
Med Hypotheses. 2010 May;74(5):831-4. Epub 2009 Dec 28.

Zakay-Rones Z, Varsano N, Zlotnik M, Manor O, Regev L, Schlesinger M, Mumcuoglu M.
Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama.
J Altern Complement Med. 1995 Winter;1(4):361-9.

Zakay-Rones Z, Thom E, Wollan T, Wadstein J.
Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections.
J Int Med Res. 2004 Mar-Apr;32(2):132-40.

Roschek B Jr, Fink RC, McMichael MD, Li D, Alberte RS.
Elderberry flavonoids bind to and prevent H1N1 infection in vitro.
Phytochemistry. 2009 Jul;70(10):1255-61.

Leyer GJ, Li S, Mubasher ME, Reifer C, Ouwehand AC
Probiotic effects on cold and influenza-like symptom incidence and duration in children.
Pediatrics. 2009 Aug;124(2):e172-9.

Hatakka K, Savilahti E, Pönkä A, Meurman JH, Poussa T, Näse L, Saxelin M, Korpela R.
Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial.
BMJ. 2001 Jun 2;322(7298):1327

Brinkeborn RM, Shah DV, Degenring FH.
Echinaforce and other Echinacea fresh plant preparations in the treatment of the common cold. A randomized, placebo controlled, double-blind clinical trial.
Phytomedicine. 1999 Mar;6(1):1-6.

Lindenmuth GF, Lindenmuth EB
The efficacy of echinacea compound herbal tea preparation on the severity and duration of upper respiratory and flu symptoms: a randomized, double-blind placebo-controlled study.
J Altern Complement Med. 2000 Aug;6(4):327-34.

Melchart D, Linde K, Fischer P, Kaesmayr J.
Echinacea for preventing and treating the common cold.
Cochrane Database Syst Rev. 2000;(2):CD000530.

Linde K, Barrett B, Wölkart K, Bauer R, Melchart D.
Echinacea for preventing and treating the common cold.
Cochrane Database Syst Rev. 2006 Jan 25;(1):CD000530.

Goncagul G, Ayaz E.
Antimicrobial effect of garlic (Allium sativum).
Recent Pat Antiinfect Drug Discov. 2010 Jan;5(1):91-3.

Harris JC, Cottrell SL, Plummer S, Lloyd D.
Antimicrobial properties of Allium sativum (garlic).
Appl Microbiol Biotechnol. 2001 Oct;57(3):282-6.

Lowen AC, Mubareka S, Steel J, Palese P.
Influenza virus transmission is dependent on relative humidity and temperature.
PLoS Pathog. 2007 Oct 19;3(10):1470-6.

Wan Yang, Linsey C. Marr
Dynamics of Airborne Influenza A Viruses Indoors and Dependence on Humidity
PLoS ONE: Research Article, published 24 Jun 2011 10.1371/journal.pone.0021481

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Shift Work and Your Health

overworked-workerRotating shifts causes difficulties because it works in opposition to the body’s normal circadian rhythms, the most influential being the sleep/wake cycle.  There is also the matter of social isolation that comes from working when everybody else is asleep, and vice-versa.  One of the complications of changing shifts is the incidence of gastrointestinal upset.  Shift workers have a notoriously high occurrence of ulcers, based partly on disruption of sleep patterns and partly on the activation of H. pylori infection if it is at all present and waiting for the opportunity to strike.  (Pietroiusti, 2006)  (Segawa, 1987)  Chronic fatigue, untimely sleepiness, and even failure to fall asleep are some other physical interruptions caused by shift work.  Among the worst social perturbations is divorce, an element that hits some jobs more than others, law enforcement being a prime example.

Canada’s Institute for Work and Health delved into this topic and found that night work is associated with an increase in breast cancer among women who work rotating shifts for long durations.  (IWH, 2010)  The etiology of breast cancer is mostly uncertain, but about one fourth its incidences can be attributed to genetic factors.  At least a little blame has been put on light at night and its effect on melatonin, the hormone produced by the pineal gland that communicates information about light to different parts of the body in order to regulate biologic rhythms.  When the eye’s pupil detects changes in brightness—night—it sends the sleep message to the brain by way of melatonin.  When this activity gets stymied, melatonin is not able to exert its anti-cancer character, and the risk of breast cancer is elevated after a prolonged time. (Schernhammer, 2001)   (Hansen, 2001)   Melatonin is a popular sleep aid, especially for those experiencing jet lag, but few have associated it with anti-cancer function.  (Knower, 2012)  An interesting realization in this circumstance is the body’s inability to manufacture vitamin D from exposure to natural light, raising the question of the appropriateness of supplementation.  (Shao, 2012)  Among researchers’ quests is the determination of the actual concentrations of vitamin D in women who have survived breast cancer and whether or not insufficiency is prevalent among sufferers, survivors, and healthy controls.  (Trukova, 2012)  (Blask, 2009)

Little is known about sleep taken at night, and even less about sleep taken during the day, when years of natural law dictate otherwise.  Nobody really knows how much sleep is necessary for optimal health.  But there is evidence that long sleepers and very short sleepers have increased mortality.  (Ferrie, 2007)  The first part of sleep lasts about fifteen minutes, and is labeled as Stage 1.  If you are awakened from this stage, you may even deny having been asleep.  Stage 2 occupies about half of sleep time, yet is the least understood part.  Being deprived of this stage results in almost total sleep loss because this is the part from which other stages develop.  This, by the way, is the stage affected by medications and sleep aids.  Stages 3 and 4 are combined into the slow-wave-sleep stage, differing only by the number of delta waves measureable by an EEG.  Contrasted to Stage 2, this is the one common to most persons, and is the one compensated after long periods of sleep deprivation.  This is the one needed for body repair and the activity of growth hormone(s).  Rapid eye movement (REM) sleep is the best known stage and throughout its duration the body is virtually paralyzed and loses its ability to regulate heat.  Dreams, which are deemed necessary to psychological well-being, occur here.  REM, dominating the late stages of sleep episodes, is strongly influenced by circadian rhythm.   Daytime sleep is normally one or two hours shorter than night time sleep.  REM, therefore, is shortened.  This adds to the alertness problems of the night shift.

A modern concern about shift work is increased risk of type 2 diabetes and the metabolic syndrome, compounded by the possible elevation of cardiovascular jeopardy.  This affects women more than men, but the combination of obesity, high triglycerides, and low HDL cholesterol is common to both.  (Karlsson, 2001)  Years of rotating night shift work are associated with weight gain that comes from failed attempts to eat right and from limited time for exercise.  And to think that all this is precipitated by disturbed circadian periodicity.  Eating on the run and mindless snacking are more common among night workers than their daytime counterparts.  Even if day and night workers had the same major CVD factors, the night workers admit to increased job strain and greater at-work physical exertion, both of which contribute to the altered parameters that incite metabolic syndrome.  (Esquirol, 2009)  In Japan, where the work ethic is ubiquitously strong, different work schedules have been associated with a rise in the incidence of diabetes.  (Morikawa, 2005)  (Suwazono, 2006)  Over the long term, changes are evident not only in daily glucose levels, but also in glycosylated hemoglobin (HbA1c), which measures glucose over an extended time.  (Suwazono, 2009)

Workplace cafeterias commonly close at night.  Workers are then left to their own culinary devices, and that often translates to unhealthy eating habits by virtue of convenience and time constraints.  A healthy work force is a boon to productivity and accident prevention, areas in which companies can demonstrate an interest that supersedes complaining about the opposite.  If a company is reactive, it can get you to the First-Aid station or to the HR person for failure to perform.  By being proactive, it can prevent both while saving money on bandages and the expense of training a replacement.

If there is a best-case scenario for shift work, scheduling a rotation that lasts at least six weeks seems to work by affording enough time to adapt one’s circadian dance to the situation.  There are those who prefer steady nights, but that breed is rare.  If we think adapting to factory work schedules is tough, we should look at those who work in the emergency room.  At least some of us have a scapegoat for tight trousers.


Blask DE.
Melatonin, sleep disturbance and cancer risk.
Sleep Med Rev. 2009 Aug;13(4):257-64. Epub 2008 Dec 17.

Costa G.
Shift work and breast cancer. 
G Ital Med Lav Ergon. 2010 Oct-Dec;32(4):454-7.

Esquirol Y, Bongard V, Mabile L, Jonnier B, Soulat JM, Perret B.
Shift work and metabolic syndrome: respective impacts of job strain, physical activity, and dietary rhythms.
Chronobiol Int. 2009 Apr;26(3):544-59.

Ferrie JE, Shipley MJ, Cappuccio FP, Brunner E, Miller MA, Kumari M, Marmot MG.
A prospective study of change in sleep duration: associations with mortality in the Whitehall II cohort.
Sleep. 2007 Dec;30(12):1659-66.

Ha M, Park J.
Shiftwork and metabolic risk factors of cardiovascular disease.
J Occup Health. 2005 Mar;47(2):89-95.

Hansen J.
Light at night, shiftwork, and breast cancer risk.
J Natl Cancer Inst. 2001 Oct 17;93(20):1513-5.

Institute for Work and Health (IWH)
Scientific Symposium, Toronto, 12 April, 2010
Scientific Symposium on the Health Effects of Shift Work

Karlsson B, Knutsson A, Lindahl B.
Is there an association between shift work and having a metabolic syndrome? Results from a population based study of 27,485 people.
Occup Environ Med. 2001 Nov;58(11):747-52.

Knower KC, To SQ, Takagi K, Miki Y, Sasano H, Simpson ER, Clyne CD.
Melatonin suppresses aromatase expression and activity in breast cancer associated fibroblasts.
Breast Cancer Res Treat. 2012 Jan 12.

Kroenke CH, Spiegelman D, Manson J, Schernhammer ES, Colditz GA, Kawachi I.
Work characteristics and incidence of type 2 diabetes in women.
Am J Epidemiol. 2007 Jan 15;165(2):175-83.

Morikawa Y, Nakagawa H, Miura K, Soyama Y, Ishizaki M, Kido T, Naruse Y, Suwazono Y, Nogawa K
Shift work and the risk of diabetes mellitus among Japanese male factory workers.
Scand J Work Environ Health. 2005 Jun;31(3):179-83.

Paul A. Schulte, PhD, Gregory R. Wagner, MD, Aleck Ostry, PhD, et al
Work, Obesity, and Occupational Safety and Health
American Journal of Public Health. Mar 2007; 97:3, 428-436

Pietroiusti A, Forlini A, Magrini A, Galante A, Coppeta L, Gemma G, Romeo E, Bergamaschi A.
Shift work increases the frequency of duodenal ulcer in H pylori infected workers.
Occup Environ Med. 2006 Nov;63(11):773-5.

Prasai MJ, George JT, Scott EM.
Molecular clocks, type 2 diabetes and cardiovascular disease.
Diab Vasc Dis Res. 2008 Jun;5(2):89-95.

Schernhammer ES, Laden F, Speizer FE, Willett WC, Hunter DJ, Kawachi I, Colditz GA.
Rotating night shifts and risk of breast cancer in women participating in the nurses’ health study.
J Natl Cancer Inst. 2001 Oct 17;93(20):1563-8.

Scott AJ.
Shift work and health.
Prim Care. 2000 Dec;27(4):1057-79.

Segawa K, Nakazawa S, Tsukamoto Y, Kurita Y, Goto H, Fukui A, Takano K.
Peptic ulcer is prevalent among shift workers.
Dig Dis Sci. 1987 May;32(5):449-53.

Shao T, Klein P, Grossbard ML.
Vitamin D and Breast Cancer.
Oncologist. 2012 Jan 10.

Suwazono Y, Sakata K, Okubo Y, Harada H, Oishi M, Kobayashi E, Uetani M, Kido T, Nogawa K.
Long-term longitudinal study on the relationship between alternating shift work and the onset of diabetes mellitus in male Japanese workers.
J Occup Environ Med. 2006 May;48(5):455-61.

Suwazono Y, Dochi M, Oishi M, Tanaka K, Kobayashi E, Sakata K.
Shiftwork and impaired glucose metabolism: a 14-year cohort study on 7104 male workers.
Chronobiol Int. 2009 Jul;26(5):926-41.

Trukova KP, Grutsch J, Lammersfeld C, Liepa G.
Prevalence of Vitamin D Insufficiency Among Breast Cancer Survivors.
Nutr Clin Pract. 2012 Jan 6.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Allergy and Inflammation

allergiesIf you’re among the susceptible, the first whack in the face by a giant pollen ball is enough to set you back.  You get the runny nose, the watery eyes, the headaches and all the accessories.  If they were temporary symptoms, you wouldn’t pay much attention.  A handful of tissues and a couple of antihistamines, and you’re on your way.  Few of us understand, though, that seasonal allergies incite an inflammatory response, which is a protective attempt by the body to remove the enemy and clean up the place where it was.  Inflammation is not infection, but may be caused by it.  It’s considered part of the innate immune system, which activates as a function of your natural biological makeup.

Allergic disorders, which include hay fever, eczema and asthma, afflict almost a quarter of the population in the developed world (Holgate, 1999) (Galli, 2008).  Persistent exposure to allergens, basically innocuous substances in the environment, results in chronic allergic inflammation.  This can cause the affected organ(s) to go through substantial changes in function.  In fact, some people can develop a potentially fatal systemic reaction, called anaphylaxis, within seconds of exposure to an allergen (Simons, 2011).  Certain foods, as well as other non-infectious substances, may be involved.  In allergic responses, allergen-specific immunoglobulin E (IgE) and T helper cells (Th2) are switched on.

An acute response to an allergen that happens after a single exposure is called an early-phase reaction, or a Type-1 immediate hypersensitivity reaction.  Histamine is released here during mast cell degranulation. These molecules hook up with IgE and eventually cause itching, mucus production, swelling of blood vessels (vasodilation), edema and the airway constriction seen in allergic asthma (Hansen, 2004)  (Katelaris, 2003).  Chronic inflammation may be characterized by a continuum of tissue destruction and healing that may lead to loss of function, but this is not often seen with seasonal allergies, called allergic rhinitis. Allergic rhinitis is linked to decreased learning, poor performance at work and school, and of course, reduced quality of life.  The course of action taken by a doctor offers several pharmacologic options (Sadeq, 2004), many of which are shunned by patients in favor of natural alternatives.  Allergen-specific immunotherapy is designed to suppress the mechanism that responds to allergen attack.  This entails the use of chemical agents to regulate body function (Fujita, 2012), and this engenders a jaundiced eye among the holistic crowd.

Within the domain of complementary and alternative medicine is a plant whose use predates medieval times—stinging nettle, scientifically known as Urtica dioica.   For hundreds of years it’s been used to treat gout, painful joints, arthritis, eczema and anemia.  In modern times, nettle has been used to treat urinary problems during the early stages of benign prostate hyperplasia, and to treat urinary infections and hay fever.  It’s also been used in compresses to address joint pains, sprains and strains, tendinitis and insect bites.  Freeze-dried preparations were matched against placebo in a double-blinded randomized allergic rhinitis study performed at the National College of Naturopathic Medicine, and were found to be more effective than placebo at relieving symptoms (Mittman, 1990).  Cytokines are regulatory proteins that are released by cells of the immune system, where they act as mediators in the generation of an immune response, and may be assayed by the measurement of Th1 and Th2 cells, as well as by other markers of immune activation.  Extracts of stinging nettle, registered in Germany for therapy of rheumatic disease, were found to inhibit the inflammatory cascade identified by these artifacts (Klingelhoefer, 1999).

Quercetin is a bioflavonoid derived from red wine, citrus, onions, parsley, apples and tea, demonstrating several noble qualities, anti-inflammation and anti-oxidation among them.  The anti-inflammatory property arises from its inhibition of the production and activity of leukotrienes and pro-inflammatory prostaglandins, and inhibition of histamine release by basophils and mast cells.  Additionally, quercitin represses expression of the COX2 enzyme that is responsible for the manufacture of pro-inflammatory substances, and it stems the interleukins that characterize inflammation (Nieman, 2007).  Studies at Northwestern University agree that quercitin has its place as a primary therapy or as an adjunct in the treatment of allergic rhinitis (Thornhill, 2000).  Ocular symptoms of allergy are uncomfortable and often more bothersome than nasal symptoms.  Japanese scientists found that quercitin, in a double-blind placebo-controlled study, was substantially more effective than placebo at ameliorating the ocular symptoms that can plague sufferers of allergic rhinitis.  Ocular scores that rated tearing, itching and ocular congestion were low, while nasal scores differed little from the control group (Hirano, 2009).

Complementary medicine is not without allies in the allopathic medical community, especially when a supplement has proven efficacy against a traditional modality.  In the conventional medical sector, where raised eyebrows are the norm after the mention of complementary approaches, bromelain, the proteolytic enzyme from pineapple that digests proteins and tenderizes meat, has found favor in the treatment of otolaryngology disorders that include allergic rhinitis.  In a multicenter trial composed of 116 children, bromelain monotherapy (used by itself) effected faster recovery from sinusitis compared with standard therapy (Karkos, 2007).  As adjunctive to traditional therapy, bromelain exhibited supportive strength against acute rhinosinusitis (Guo, 2006).  Although marketed as a digestive aid, bromelain appears to have systemic anti-inflammatory activity (Hale, 2005) (Kumakura, 1988) (Onken, 2008).

In recent announcements, oral vitamin D added to regular intranasal corticosteroid dosing improves symptoms beyond that seen with corticosteroids alone, leading researchers to conclude that vitamin D affords benefit to patients with allergies (Baroody, 2012).  Treating inflammation may be nearer at hand than previously thought, and that just might eliminate, or at least reduce, the misery of seasonal allergy.


Ahmadiafshar A, Taghiloo D, Esmailzadeh A, Falakaflaki B.
Nasal eosinophilia as a marker for allergic rhinitis: A controlled study of 50 patients.
Ear Nose Throat J. 2012 Mar;91(3):122-4.

F. M. Baroody, J. Lane, S. Watanabe, M. DeTineo, J. Pinto, R. M. Naclerio;
The Addition of Vitamin D (VitD) to an Intranasal Steroid (INS) Improves Control of Symptoms in Seasonal Allergic Rhinitis (SAR)

G. Walter Canonica, MD
Treating Asthma as an Inflammatory Disease
CHEST July 2006 vol. 130 no. 1 suppl 21S-28S

Fujita H, Meyer N, Akdis M, Akdis CA.
Mechanisms of immune tolerance to allergens.
Chem Immunol Allergy. 2012;96:30-8.

Fujita H, Soyka MB, Akdis M, Akdis CA.
Mechanisms of allergen-specific immunotherapy.
Clin Transl Allergy. 2012 Jan 5;2(1):2

Stephen J. Galli, Mindy Tsai & Adrian M. Piliponsky
The development of allergic inflammation
Nature 454, 445-454 (24 July 2008)

Granado-Serrano AB, Martín MA, Bravo L, Goya L, Ramos S.
Quercetin Attenuates TNF-Induced Inflammation in Hepatic Cells by Inhibiting the NF-κB Pathway.
Nutr Cancer. 2012 Mar 27.

Guo R, Canter PH, Ernst E.
Herbal medicines for the treatment of rhinosinusitis: a systematic review.
Otolaryngol Head Neck Surg. 2006 Oct;135(4):496-506.

Hale LP, Greer PK, Trinh CT, Gottfried MR.
Treatment with oral bromelain decreases colonic inflammation in the IL-10-deficient murine model of inflammatory bowel disease.
Clin Immunol. 2005 Aug;116(2):135-42.

Hansen I, Klimek L, Mösges R, Hörmann K.
Mediators of inflammation in the early and the late phase of allergic rhinitis.
Curr Opin Allergy Clin Immunol. 2004 Jun;4(3):159-63.

Hirano T, Kawai M, Arimitsu J, Ogawa M, Kuwahara Y, Hagihara K, Shima Y, Narazaki M, Ogata A, Koyanagi M, Kai T, Shimizu R, Moriwaki M, Suzuki Y, Ogino S, Kawase I, Tanaka T.
Preventative effect of a flavonoid, enzymatically modified isoquercitrin on ocular symptoms of Japanese cedar pollinosis.
Allergol Int. 2009 Sep;58(3):373-82. Epub 2009 May 25.

Holgate ST.
The epidemic of allergy and asthma.
Nature. 1999 Nov 25;402(6760 Suppl):B2-4.

Jaber R.
Respiratory and allergic diseases: from upper respiratory tract infections to asthma.
Prim Care. 2002 Jun;29(2):231-61.

Jutel M, Akdis CA.
T-cell regulatory mechanisms in specific immunotherapy.
Chem Immunol Allergy. 2008;94:158-77.

Karkos PD, Leong SC, Arya AK, Papouliakos SM, Apostolidou MT, Issing WJ.
‘Complementary ENT’: a systematic review of commonly used supplements.
J Laryngol Otol. 2007 Aug;121(8):779-82. Epub 2006 Nov 24.

Katelaris CH.
Ocular allergy: implications for the clinical immunologist.
Ann Allergy Asthma Immunol. 2003 Jun;90(6 Suppl 3):23-7.

Klingelhoefer S, Obertreis B, Quast S, Behnke B.
Antirheumatic effect of IDS 23, a stinging nettle leaf extract, on in vitro expression of T helper cytokines.
J Rheumatol. 1999 Dec;26(12):2517-22.

Kostyuk VA, Potapovich AI, Suhan TO, de Luca C, Korkina LG.
Antioxidant and signal modulation properties of plant polyphenols in controlling vascular inflammation.
Eur J Pharmacol. 2011 May 11;658(2-3):248-56.

Kumakura S, Yamashita M, Tsurufuji S.
Effect of bromelain on kaolin-induced inflammation in rats.
Eur J Pharmacol. 1988 Jun 10;150(3):295-301.

Mittman P.
Randomized, double-blind study of freeze-dried Urtica dioica in the treatment of allergic rhinitis.
Planta Med. 1990 Feb;56(1):44-7.

Nieman DC, Henson DA, Davis JM, Angela Murphy E, Jenkins DP, Gross SJ, Carmichael MD, Quindry JC, Dumke CL, Utter AC, McAnulty SR, McAnulty LS, Triplett NT, Mayer EP.
Quercetin’s influence on exercise-induced changes in plasma cytokines and muscle and leukocyte cytokine mRNA.
J Appl Physiol. 2007 Nov;103(5):1728-35. Epub 2007 Aug 23.

Obertreis B, Giller K, Teucher T, Behnke B, Schmitz H.
Anti-inflammatory effect of Urtica dioica folia extract in comparison to caffeic malic acid.
Arzneimittelforschung. 1996 Jan;46(1):52-6.

Jane E Onken, Paula K Greer, Brian Calingaert, Laura P Hale
Bromelain treatment decreases secretion of pro-inflammatory cytokines and chemokines by colon biopsies in vitro.
Clin Immunol. Volume 126, Issue 3, March 2008, Pages 345–352

Overman A, Chuang CC, McIntosh M.
Quercetin attenuates inflammation in human macrophages and adipocytes exposed to macrophage-conditioned media.
Int J Obes (Lond). 2011 Sep;35(9):1165-72.

Sadeq A. Quraishi, MHA;  Michael J. Davies, MD;  Timothy J. Craig, DO
Inflammatory Responses in Allergic Rhinitis: Traditional Approaches and Novel Treatment Strategies
J Am Osteopath Assoc May 1, 2004 vol. 104 no. 5 suppl 7S-15S

Simons FE.
Anaphylaxis pathogenesis and treatment.
Allergy. 2011 Jul;66 Suppl 95:31-4.

Skiepko R, Zietkowski Z, Tomasiak-Lozowska MM, Tomasiak M, Bodzenta-Lukaszyk A.
Bronchial hyperresponsiveness and airway inflammation in patients with seasonal allergic rhinitis.
J Investig Allergol Clin Immunol. 2011;21(7):532-9.

Thornhill SM, Kelly AM.
Natural treatment of perennial allergic rhinitis.
Altern Med Rev. 2000 Oct;5(5):448-54.

tYoon JS, Lee HJ, Choi SH, Chang EJ, Lee SY, Lee EJ.
Quercetin inhibits IL-1β-induced inflammation, hyaluronan production and adipogenesis in orbital fibroblasts from Graves’ orbitopathy.
PLoS One. 2011;6(10):e26261.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Special Vitamin K?

Eat Your GreensMany people think that vitamin K is used by the body only to clot blood after getting a cut.  That’s true, but this nutrient is much more complicated than that.  Because it’s fat-soluble, it requires fat to be absorbed, but unlike some other fat-soluble vitamins, it doesn’t get stored anywhere in large amounts.  Its name came from the German word koagulation in 1929, immediately after its newly discovered function.

Vitamin K is not a single substance, but a group of structurally similar vitamins that are necessary for the regulation of several proteins involved in metabolic pathways other than blood clotting, including bone and coronary health.  If all it did was to clot blood, vitamin K would be one of the more boring substances related to body function.  There are two natural forms of vitamin K—K1, also known as phylloquinone, and K2, also called menaquinone.   The former is made by plants; the latter, by animals, including humans.

The main dietary source of vitamin K as phylloquinone is plants, the bioavailability of which is questionable and lower than generally assumed.  The absorption of phylloquinone from plants is about one and a half times slower than the vitamin K from a supplement.  (Gijsbers, et al. 1996)  The liver absorbs it quickly and maintains the highest concentration, though significant amounts may be found in the heart.  Whether it is secreted by the liver and transported to other tissue is not known.  (Davidson. 1998)  Green leafy vegetables are rich in K1, and contribute almost half of the total dietary intake.

Vitamin K2, or menaquinone, is a collection of a few vitaminers, the most publicized of which are MK-4 and MK-7, although there are several other MK forms.  Found in egg yolks, butter, liver, certain cheeses and fermented soy products, K2 is also produced by bacteria that live in the gut.  The amount contributed by intestinal microflora is unclear, but dietary contribution of K2 is considerably less than that of K1.  The MK numeration refers to the number of side units that are attached to the main ring-like body of the molecule— MK-4 has four units; MK-7 has seven.  They range from one to ten.  These side chains are called isoprenoids, and are made from two or more hydrocarbons, each containing five carbon atoms.  MK-4 is not produced in significant amounts by bacteria, but appears to be made from phylloquinone.  There are at least three synthetic forms of vitamin K: K3, K4, and K5.  Vitamin K3, known as menadione and metabolized to vitamin K2, has demonstrated moderate toxicity, although it is being used in pet food.  Concentrations of menaquinones in tissue are higher than the phylloquinones, especially menaquinone-4 (MK-4), which is the major tissue-bound form.   Despite the difference, the origin of MK-4 is somewhat elusive.  Investigators in Japan determined that MK-4 is converted from phylloquinone by a metabolic removal of a side chain.  (Okano. 2008)

Deficiencies of vitamin K are uncommon, but are more likely to happen as a result of drug therapy or some diseases.  The most significant instances of deficiency manifest in newborns as an acquired disease, the hemorrhagic activity of which is quelled by oral and intramuscular administration of vitamin K at birth.  Efficiency of vitamin K absorption covers a wide range, from 10% to 80%.  The recommended allowances for this nutrient are set to forestall deficiency diseases, which concern themselves with blood clotting and little else.  The optimal amounts needed to address skeletal and arterial needs have been ignored.

The most studied subtypes of vitamin K2 are MK-4 and MK-7.  MK-4 comes from K1, where its conversion may occur in the testes, pancreas, and arterial walls.  Because scientists have seen the conversion in germ-free mice (having no intestinal microflora), they concluded that bacterial activity is not necessary to make MK-4.  (Ronden. 1998)

Antibiotics are generally non-selective, and will kill the intestinal microflora upon which we depend to manufacture vitamin K from plants.  This can reduce vitamin K (menaquinone) production by more than 70% when compared to those who are not taking antibiotics.  (Conly. 1994)

Vitamin K helps to regulate calcium in both bone and the arteries, working by way of an amino acid called “Gla,” which stands for gamma-carboxyglutamic acid, or gamma-carboxyglutamyl.  Gla responds to changes in dietary intake, an age-dependent process, but several days are needed to observe any alterations.  (Ferland. 1993)   Vitamin K has a modulating effect on several proteins, where it performs an action called carboxylation.  This gives the proteins a kind of claw-like function that enables them to hold on to calcium and move it around.  Without enough vitamin K, the proteins lack their claws.  If this happens, calcium migrates away from bones and teeth, and degradation becomes an issue.  Of all the Gla proteins, osteocalcin (OC) is best known.  It’s synthesized by osteoblasts, the bone-forming cells.  Although everything about osteocalcin is not known, it is believed to be related to bone mineralization.  Osteocalcin that is under-carboxylated, labeled ucOC, is a marker for vitamin K status. High levels of ucOC are indicative of reduced bone mineral density (BMD) and increased risk for fractures.  Vitamin K intake of the general population may not be sufficient to guarantee the carboxylation needed to maintain osteocalcin activity.  (Bach. 1996)  The player in the background of all this activity is vitamin D, which regulates osteocalcin transcription.

(Lian.  1989)  Lian and his team found a large region of nucleotides directly upstream from the transcription start area that supports a ten-fold stimulation of transcription of the OC gene by 1,25-dihydroxy vitamin D.

The vitaminer MK-4 has demonstrated the capacity to reduce bone fracture risks, and even to reverse bone loss.  The synergy of vitamins K and D was recognized in studies performed by the University of California, where MK-4 received the nod as the leader of the pack.  (Kidd. 2010)  Japanese researchers who preceded that study reported that a dose of 45 mg a day of vitamin K, accompanied by calcium supplementation, would increase BMD and lead to the prevention of nonvertebral fractures. (Sato. 2005)  Additionally, K2 was found to reduce the incidence of vertebral fractures without having a substantial effect on BMD.  (Iwamoto. 2006)

Not to be outdone by its analog MK-4, MK-7, sourced from fermented soy, has been found to stimulate osteoblastic bone formation while inhibiting osteoclastic bone resorption, all the while limiting calcium depletion by modulating prostaglandin E2.
(Yamaguchi. 2006)   (Tsukamoto. 2004)

Some individuals with osteoporosis are likely to have an excess of calcium in their arteries.  Vascular calcification might even be viewed as vascular ossification—the formation of bone inside an artery.  The appearance of atherosclerotic plaques in arterial walls is a hallmark of cardiovascular disease (CVD).  The plaques cause decreased elasticity of the affected vessel and increased risk of clot formation.  In Dutch studies it was discovered that women with atherosclerotic calcifications have a lower bone mass, which, of course, puts them at greater risk for fractures.  Deficiency of vitamin K causes an increase of ucOC, leading to deposition of calcium in arteries, an activity that would be halted by carboxylated OC.  Menaquinone, including MK-4, but probably not phylloquinone, is associated with reduced coronary calcification.  (Beulens. 2009)  (Geleijnse. 2004)  These studies show that those who ingested the greatest amounts of vitamin K2 experienced a 57% reduction in cardiac fatalities.  No such relationship was found for K1.  In these studies, though, MK-4 and MK-7 were not separately analyzed, but were grouped together.  But in earlier studies it was learned that MK-4 has a distinct effect on plaque prevention in warfarin treatment, where MK-4 was three times more efficiently utilized in the aorta than vitamin K1, mostly by virtue of its bioavailability and use in carboxylation.  (Spronk. 2003)

Warfarin and other anticoagulants interfere with the activity of vitamin K.  Unfortunately, warfarin has the capacity to cause arterial calcification in the long run.  (Price. 1998)  (Danziger. 2008)   Generally, there are enough data to suggest that a constant dietary intake of 65-80 mcg of vitamin K a day during warfarin therapy is an acceptable practice, while avoiding fluctuations in vitamin K intake that would interfere with the activity of the drug.  (Booth. 1999)  It is strongly recommended that such patients work closely with their physicians to monitor prothrombin time, perhaps better known as INR.  It is accepted that vitamin K replacement is an important part of warfarin therapy. (Patriquin. 2011)  In some instances, aspirin may be the better choice.  (Chimowitz. 2005)

The activities of the special K vitamin extend beyond the scope of this newsletter.  Maybe that can be addressed another time.


Adams J, Pepping J.
Vitamin K in the treatment and prevention of osteoporosis and arterial calcification.
Am J Health Syst Pharm. 2005 Aug 1;62(15):1574-81.

Arunakul M, Niempoog S, Arunakul P, Bunyaratavej N.
Level of undercarboxylated osteocalcin in hip fracture Thai female patients.
J Med Assoc Thai. 2009 Sep;92 Suppl5:S7-11.

Bach AU, Anderson SA, Foley AL, Williams EC, Suttie JW.
Assessment of vitamin K status in human subjects administered “minidose” warfarin.
Am J Clin Nutr. 1996 Dec;64(6):894-902.

Berkner KL.
The vitamin K-dependent carboxylase.
J Nutr. 2000 Aug;130(8):1877-80.

Beulens JW, Bots ML, Atsma F, Bartelink ML, Prokop M, Geleijnse JM, Witteman JC, Grobbee DE, van der Schouw YT.
High dietary menaquinone intake is associated with reduced coronary calcification.
Atherosclerosis. 2009 Apr;203(2):489-93. Epub 2008 Jul 19.

Booth SL, Centurelli MA
Vitamin K: a practical guide to the dietary management of patients on warfarin.
Nutr Rev. 1999 Sep;57(9 Pt 1):288-96.

Brody T. Nutritional Biochemistry. 2nd ed. San Diego: Academic Press; 1999.

Chatrou ML, Reutelingsperger CP, Schurgers LJ.
Role of vitamin K-dependent proteins in the arterial vessel wall.
Hamostaseologie. 2011 Nov;31(4):251-7.

Cheung AM, Tile L, Lee Y, Tomlinson G, Hawker G, Scher J, Hu H, Vieth R, Thompson L, Jamal S, Josse R.
Vitamin K supplementation in postmenopausal women with osteopenia (ECKO trial): a randomized controlled trial.
PLoS Med. 2008 Oct 14;5(10):e196.

Marc I. Chimowitz, M.B., Ch.B., Michael J. Lynn, M.S., Harriet Howlett-Smith, R.N., Barney J. Stern, M.D., Vicki S. Hertzberg, Ph.D., et al
Comparison of Warfarin and Aspirin for Symptomatic Intracranial Arterial Stenosis
N Engl J Med 2005; 352:1305-1316 March 31, 2005

Conly J, Stein K.
Reduction of vitamin K2 concentrations in human liver associated with the use of broad spectrum antimicrobials.
Clin Invest Med. 1994 Dec;17(6):531-9.

Danziger J.
Vitamin K-dependent proteins, warfarin, and vascular calcification.
Clin J Am Soc Nephrol. 2008 Sep;3(5):1504-10.

Davidson RT, Foley AL, Engelke JA, Suttie JW.
Conversion of dietary phylloquinone to tissue menaquinone-4 in rats is not dependent on gut bacteria.
J Nutr. 1998 Feb;128(2):220-3.

Ferland G, Sadowski JA, O’Brien ME.
Dietary induced subclinical vitamin K deficiency in normal human subjects.
J Clin Invest. 1993 Apr;91(4):1761-8.

Feskanich D, Weber P, Willett WC, Rockett H, Booth SL, Colditz GA.
Vitamin K intake and hip fractures in women: a prospective study.
Am J Clin Nutr. 1999 Jan;69(1):74-9.

Geleijnse JM, Vermeer C, Grobbee DE, Schurgers LJ, Knapen MH, van der Meer IM, Hofman A, Witteman JC.
Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: the Rotterdam Study.
J Nutr. 2004 Nov;134(11):3100-5.

Gijsbers BL, Jie KS, Vermeer C.
Effect of food composition on vitamin K absorption in human volunteers.
Br J Nutr. 1996 Aug;76(2):223-9.

Iwamoto J, Takeda T, Sato Y.
Menatetrenone (vitamin K2) and bone quality in the treatment of postmenopausal osteoporosis.
Nutr Rev. 2006 Dec;64(12):509-17.

Iwamoto J, Sato Y, Takeda T, Matsumoto H.
High-dose vitamin K supplementation reduces fracture incidence in postmenopausal women: a review of the literature.
Nutr Res. 2009 Apr;29(4):221-8.

Je SH, Joo NS, Choi BH, Kim KM, Kim BT, Park SB, Cho DY, Kim KN, Lee DJ.
Vitamin K supplement along with vitamin D and calcium reduced serum concentration of undercarboxylated osteocalcin while increasing bone mineral density in Korean postmenopausal women over sixty-years-old.
J Korean Med Sci. 2011 Aug;26(8):1093-8.

Jie KG, Bots ML, Vermeer C, Witteman JC, Grobbee DE.
Vitamin K status and bone mass in women with and without aortic atherosclerosis: a population-based study.
Calcif Tissue Int. 1996 Nov;59(5):352-6.

Jin DY, Tie JK, Stafford DW.
The conversion of vitamin K epoxide to vitamin K quinone and vitamin K quinone to vitamin K hydroquinone uses the same active site cysteines.
Biochemistry. 2007 Jun 19;46(24):7279-83.

Kanai T, Takagi T, Masuhiro K, Nakamura M, Iwata M, Saji F.
Serum vitamin K level and bone mineral density in post-menopausal women.
Int J Gynaecol Obstet. 1997 Jan;56(1):25-30.

Kidd PM.
Vitamins D and K as pleiotropic nutrients: clinical importance to the skeletal and cardiovascular systems and preliminary evidence for synergy.
Altern Med Rev. 2010 Sep;15(3):199-222.

Knapen MH, Schurgers LJ, Vermeer C.
Vitamin K2 supplementation improves hip bone geometry and bone strength indices in postmenopausal women.
Osteoporos Int. 2007 Jul;18(7):963-72.

Lian J, Stewart C, Puchacz E, Mackowiak S, Shalhoub V, Collart D, Zambetti G, Stein G.
Structure of the rat osteocalcin gene and regulation of vitamin D-dependent expression.
Proc Natl Acad Sci U S A. 1989 Feb;86(4):1143-7.

Luo LZ, Xu L.
Vitamin K and osteoporosis.   [Article in Chinese]
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2003 Jun;25(3):346-9.

Patriquin C, Crowther M.
Treatment of warfarin-associated coagulopathy with vitamin K.
Expert Rev Hematol. 2011 Dec;4(6):657-67.

Price PA, Faus SA, Williamson MK.
Warfarin causes rapid calcification of the elastic lamellae in rat arteries and heart valves.
Arterioscler Thromb Vasc Biol. 1998 Sep;18(9):1400-7.

Price PA, Faus SA, Williamson MK.
Warfarin-induced artery calcification is accelerated by growth and vitamin D.
Arterioscler Thromb Vasc Biol. 2000 Feb;20(2):317-27.

Ronden JE, Drittij-Reijnders MJ, Vermeer C, Thijssen HH.
Intestinal flora is not an intermediate in the phylloquinone-menaquinone-4 conversion in the rat.
Biochim Biophys Acta. 1998 Jan 8;1379(1):69-75.

Sato Y, Kanoko T, Satoh K, Iwamoto J.
Menatetrenone and vitamin D2 with calcium supplements prevent nonvertebral fracture in elderly women with Alzheimer’s disease.
Bone. 2005 Jan;36(1):61-8. Epub 2004 Nov 24.

Shiomi S, Nishiguchi S, Kubo S, Tamori A, Habu D, Takeda T, Ochi H.
Vitamin K2 (menatetrenone) for bone loss in patients with cirrhosis of the liver.
Am J Gastroenterol. 2002 Apr;97(4):978-81.

Spronk HM, Soute BA, Schurgers LJ, Thijssen HH, De Mey JG, Vermeer C.
Tissue-specific utilization of menaquinone-4 results in the prevention of arterial calcification in warfarin-treated rats.
J Vasc Res. 2003 Nov-Dec;40(6):531-7. Epub 2003 Dec 3.

Toshio Okano, Yuka Shimomura, Makiko Yamane, Yoshitomo Suhara, Maya Kamao, Makiko Sugiura and Kimie Nakagawa
Conversion of Phylloquinone (Vitamin K1) into Menaquinone-4 (Vitamin K2) in Mice

The Journal of Biological Chemistry, April 25, 2008, 283, 11270-11279

Tsukamoto Y.
Studies on action of menaquinone-7 in regulation of bone metabolism and its preventive role of osteoporosis.
Biofactors. 2004;22(1-4):5-19.

Yamaguchi M.
Regulatory mechanism of food factors in bone metabolism and prevention of osteoporosis.
Yakugaku Zasshi. 2006 Nov;126(11):1117-37.

Vermeer C, Schurgers LJ.
A comprehensive review of vitamin K and vitamin K antagonists.
Hematol Oncol Clin North Am. 2000 Apr;14(2):339-53.

Wallin R, Schurgers L, Wajih N.
Effects of the blood coagulation vitamin K as an inhibitor of arterial calcification.
Thromb Res. 2008;122(3):411-7.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Fat Blocking Soda?

pepsi141112_insideNow we can eat all the fat we want in a meal and still lose weight. Forget that two cheeseburgers, fries and a soda, or fried onions rings/mushrooms and a juicy prime cut of beef with a gooey baked potato smothered in cheese sauce will render your blood as thick as petroleum jelly in a matter of minutes. The magic in this dining extravaganza is the soda, a new variety of cola that contains a fat blocker known as dextrin. But wait, first you have to travel to Japan to get this treat from Pepsi and its affiliate, Suntory, a company that distills booze “to bring happiness into the lives of our customers…in harmony with people and nature.” Yup, makes sense, eh?

This is a group of carbohydrates that can be made by breaking down starch in the presence of water…hydrolysis. Dextrin also appears in the company of heat under acidic conditions, as happens to the crust on a loaf of bread, rendering flavor, color and crunch. Commercially, dextrins are used to make the glue on an envelope flap, the crispness enhancer in breaded frozen foods, and the cement that holds the pyrotechnics together in fireworks and sparklers. Because they are indigestible, dextrins are added to soluble fiber supplements, such as Benefiber. Whether they can help a person lose weight or not is another question; fiber’s claim to fame is increasing satiety and making you feel fuller faster. Fiber doesn’t actually push food through the system more quickly. Instead, it slows transit time through the stomach and small intestine, where digestion takes place. This is why fiber-rich foods keep you feeling full longer.  Once fiber gets to the large intestine, it keeps things in motion until they come out. It is true, though, that fiber can absorb some fat, but probably not enough to cause a significant weight loss in a short amount of time.

What About Fat?
Eliminating fat from the diet completely is not prudent. We need it to digest, absorb and transport vitamins A, D, E, and K, which are fat-soluble. The body demands the essential fatty acids, the omega-6’s and omega-3’s, to make substances that address inflammation, affect cell signaling, and add fluidity to the cell membrane. Furthermore, fat is an insulator and it provides a place for organs to attach while acting as a cushion, and it helps to keep the skin supple. If there is a problem with fat, it’s that one gram has 9 calories, contrasted to the 4 calories of carbohydrates and proteins. Fat gets broken down by enzymes, pancreatic lipase being the primary one. In the absence of this enzyme, fat molecules remain too large to be absorbed, so are excreted. The objective of the dextrins is to absorb some of this fat and usher it out the back door.

There are substances that do not absorb fats but prevent their breakdown, keeping their molecules too large to be metabolized so that they get eliminated quickly. One of the first of these was Orlistat, a prescription drug named Xenical that prevents the absorption of fat by inhibiting the enzymes that make the fat particles small enough to be metabolized.  But the side effects of drugs like this can be embarrassing, especially the urgent explosive diarrhea and gas, among a few other neat ones, like fainting or scratching yourself silly.  Alli is an over-the-counter version of Orlistat.

Does Dextrin Work?
According to the researchers at Japan’s NIH who studied this stuff, it works. The test animals were fed a high-cholesterol diet containing dextrin and a diglyceride, the latter molecule a fat used in foods to blend certain ingredients together, such as oil and water, which otherwise would not mix. Upon examination of the animals, the group found that serum triglycerides decreased and, strikingly, that the length of intestinal villi increased (Nagata, 2006).  Basically, less of the fat was absorbed. You can buy dextrin, either as Benefiber or Nutriose, and make your own soda or other high-fiber beverage (even one from Suntory).

What About The Vitamins?
Vitamin A, retinol, helps with night vision, bone growth, tooth development, reproduction, cell division and gene expression. It’s great for the skin and mucous membranes. It’s even recommended to treat acne. Vitamin D is needed to help the body to use calcium and phosphorus in the structure of bones. It supports the immune system and may help to prevent hypertension and common cancers. Vitamin E is an anti-oxidant that protects vitamins A and C, red blood cells and essential fatty acids from destruction via oxidative stress. Vitamin K is naturally produced by gut bacteria, but is also found in foods and as a supplement. It not only helps blood to clot normally, but also escorts calcium to bones where it can’t contribute to arterial plaque. There‘s more, but we don’t have the room for that right now. None of these can be utilized without fat in the diet, so if you choose to use dextrin to absorb fat from a meal, be deliberate, keep things in balance, and supplement.


Carter R, Mouralidarane A, Ray S, Soeda J, Oben J.
Recent advancements in drug treatment of obesity.
Clin Med. 2012 Oct;12(5):456-60.

Carvalho MA, Zecchin KG, Seguin F, Bastos DC, Agostini M, Rangel AL, Veiga SS, Raposo HF, Oliveira HC, Loda M, Coletta RD, Graner E.
Fatty acid synthase inhibition with Orlistat promotes apoptosis and reduces cell growth and lymph node metastasis in a mouse melanoma model.
Int J Cancer. 2008 Dec 1;123(11):2557-65.

Kimura Y, Nagata Y, Buddington RK.
Some dietary fibers increase elimination of orally administered polychlorinated biphenyls but not that of retinol in mice.
J Nutr. 2004 Jan;134(1):135-42.

Lefranc-Millot C, Guérin-Deremaux L, Wils D, Neut C, Miller LE, Saniez-Degrave MH.
Impact of a resistant dextrin on intestinal ecology: how altering the digestive ecosystem with NUTRIOSE®, a soluble fibre with prebiotic properties, may be beneficial for health.
J Int Med Res. 2012;40(1):211-24.

Nagata J, Saito M.
Effects of simultaneous intakes of indigestible dextrin and diacylglycerol on lipid profiles in rats fed cholesterol diets.
Nutrition. 2006 Apr;22(4):395-400. Epub 2006 Feb 2.

Sheikh-Taha M, Ghosn S, Zeitoun A.
Oral aphthous ulcers associated with orlistat.
Am J Health Syst Pharm. 2012 Sep 1;69(17):1462, 1464. doi: 10.2146/ajhp120073.

Seguin F, Carvalho MA, Bastos DC, Agostini M, Zecchin KG, Alvarez-Flores MP, Chudzinski-Tavassi AM, Coletta RD, Graner E.
The fatty acid synthase inhibitor orlistat reduces experimental metastases and angiogenesis in B16-F10 melanomas.
Br J Cancer. 2012 Sep 4;107(6):977-87. doi: 10.1038/bjc.2012.355. Epub 2012 Aug 14.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Calcium and CVD, Is There a Connection?

dairy-productsIs there a difference between, “I have blue paint in my bedroom,” and “My bedroom walls are painted blue?”  A gallon of paint in the closet or on the floor in your bedroom verifies the first quote. An empty can and blue walls verify the second. Maybe this isn’t the best analogy, but you can apply it to the calcium in your body, which is either part of your bones or used as an electrolyte, or not. It’s either where it belongs, or not. The body has a remarkable system for keeping the concentrations of calcium in the blood and tissues just right, for ensuring that calcium is where it belongs. If the balance gets upset, certain organs will suffer. You see, besides bones and teeth, calcium helps muscles by keeping nerve impulses firing properly; otherwise the muscles can twitch and cramp. This is the last thing we want to happen to the heart muscle. If necessary, calcium is drawn from bone, where ninety-nine percent is stored, to maintain body pH in times of calcium deficiency. The protein-bound calcium of the blood is a secondary reservoir of calcium, usually becoming available locally to meet needs, as in clotting after getting cut. In the electrophysiology of the heart, calcium works with sodium to enable a heartbeat.

Research on calcium in the last ten years, particularly on supplements, has raised eyebrows about calcium intake and the form in which it is taken. Whether inadvertently or by design, co-factors that enhance calcium bioavailability and absorption from supplements were overlooked by some researchers and the supplements were accused of causing heart attacks. One study, published in the British Medical Journal in 2008, decided that adverse cardiac events were attributable to calcium supplements. The study included almost fifteen hundred women over seventy years old, and reported that those who used calcium supplements experienced more heart problems than those who did not (Bolland, 2008). Neither health conditions, smoking habits, environmental and lifestyle status, prior illnesses, family history, dietary regimens, type of supplement used (carbonate, malate, citrate, etc.), nor other influences were scrutinized. Later study by the same group added vitamin D to the equation and arrived at the same conclusion, that calcium supplements with or without vitamin D modestly increased the risk of cardiovascular episodes, but only in women who did not take calcium supplements regularly and scrupulously prior to the study. It seems, then, that the sudden onrush of calcium nutrition was too much for the body of a geriatric subject, who might even have suffered a different pathology, to handle at one time, and that instead of moving to bone, the mineral clogged up the works (Bolland, 2011). These papers recommended that the role of calcium supplementation in the management of osteoporosis be reassessed. But it doesn’t stop here.

Critics of these studies question the accuracy of the conclusions by closely examining coronary artery calcification, wondering how the calcium got there in the first place, when it’s supposed to make bone, not arterial plaques. When comparing / contrasting dietary calcium and supplemental calcium, the results were similar:  there is no support for the hypothesis that high calcium intake increases risk for coronary artery calcification, held to be a definitive measure of atherosclerosis burden (Samelson, 2012) (Prince, 2011).

We know that vitamin D is necessary for the absorption of calcium and that its insufficiency is common in the northern latitudes. Oddly, insufficiency also occurs in the sub-tropical areas of the planet, partly because of sun avoidance and partly because of sunscreen use, though other factors weigh in, such as cloud cover, altitude and air pollution. Vitamin D is supposed to regulate serum calcium and phosphorus concentrations. In the absence of vitamin D, only about 10% of calcium is absorbed. Maybe the rest goes to places where it doesn’t belong, like your arteries. But you have to get enough vitamin D to make a difference.  The 400 IU used in the study (Bolland, 2011) is barely enough to prevent outright deficiency.

An inflammatory model of CVD has challenged the cholesterol model, and vitamin D plays a role in sequestering the cascade of activities that lead to cardiac episodes. When monocytes rush to the site of inflammation they become macrophages that swallow oxidized LDL and then provide the basis for plaque formation, part of which is trapped calcium. Because vitamin D can suppress macrophage cholesterol uptake, it can interrupt the foam cell cycle and subsequent plaques (Oh, 2009), thereby disrupting the cardiac incident. That’s cool. Hold on, there’s more…vitamin K. Most of us consider blood clotting and vitamin K in the same thought. While that’s true, this compound, associated with green leafy vegetables, does a few more things. There is evidence that low vitamin K levels are associated with reduced bone mineral density and increased arterial calcification (Jie, 1996). Concurrent work shows that vitamin K is able to escort calcium to the place where it belongs—bone. Although deficiency of this vitamin is infrequent, insufficiency is common, and that almost certainly would account for the presence of calcium where it isn’t supposed to be (Vermeer, 2000). Proteins that rely on vitamin K for their activity have shown the ability to inhibit vascular calcification. Even accounting for smoking, diabetes, age, dietary habits and other factors, it was found that subjects with the highest vitamin K levels in the menaquinone form (vitamin K2) experienced fewer incidents of all-cause mortality (Geleijnse, 2004), especially coronary heart disease (Beulens, 2009).

Humans can absorb only about 500 mg of supplemental calcium at a time, with the citrate form having better assimilation than the carbonate. Taking it with food, which encourages stomach acid formation to aid mineral metabolism, practically evens the field (Heaney, 2001, 1999). Considering that calcium is essential to human health, that dairy is not a significant player in most adult diets, that some vegetables high in calcium are also high in oxalates that bind the calcium,  that produce with available calcium contains only small amounts, and that too many of us shun beans for social reasons, supplementation remains the option. Get a dietitian to look at your diet and determine your calcium sources and values. Then take a supplement to bring daily intake up to about a thousand milligrams.  By monitoring vitamins D and K, too, vascular calcification becomes a relative non-issue. An important matter, though, remains for those taking warfarin. It might thin your blood and prevent a clot, but it also interferes with the activity of the proteins supported by menaquinone, and replaces the clot with a plaque.


Bo Abrahamsen, Opinder Sahota
Do calcium plus vitamin D supplements increase cardiovascular risk?
BMJ 2011; 342; (19 April 2011): d2080

Beulens JW, Bots ML, Atsma F, Bartelink ML, Prokop M, Geleijnse JM, Witteman JC, Grobbee DE, van der Schouw YT.
High dietary menaquinone intake is associated with reduced coronary calcification.
Atherosclerosis. 2009 Apr;203(2):489-93. Epub 2008 Jul 19.

Mark J Bolland, P Alan Barber, Robert N Doughty,  Barbara Mason,  Anne Horne,  Ruth Ames, Gregory D Gamble, Andrew Grey,  Ian R Reid
Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial
BMJ. 31 Jan 2008; 336:262

Bolland MJ, Avenell A, Baron JA, Grey A, MacLennan GS, Gamble GD, Reid IR.
Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis.
BMJ. 2010 Jul 29;341:c3691. doi: 10.1136/bmj.c3691.

Bolland MJ, Grey A, Avenell A, Gamble GD, Reid IR.
Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis.
BMJ. 2011 Apr 19;342:d2040. doi: 10.1136/bmj.d2040.

Geleijnse JM, Vermeer C, Grobbee DE, Schurgers LJ, Knapen MH, van der Meer IM, Hofman A, Witteman JC.
Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: the Rotterdam Study.
J Nutr. 2004 Nov;134(11):3100-5.

Heaney RP, Dowell MS, Barger-Lux MJ.
Absorption of calcium as the carbonate and citrate salts, with some observations on method.
Osteoporos Int. 1999;9(1):19-23.

Heaney RP, Dowell MS, Bierman J, Hale CA, Bendich A.
Absorbability and cost effectiveness in calcium supplementation.
J Am Coll Nutr. 2001 Jun;20(3):239-46.

Heller HJ, Greer LG, Haynes SD, Poindexter JR, Pak CY.
Pharmacokinetic and pharmacodynamic comparison of two calcium supplements in postmenopausal women.
J Clin Pharmacol. 2000 Nov;40(11):1237-44.

Jie KG, Bots ML, Vermeer C, Witteman JC, Grobbee DE.
Vitamin K status and bone mass in women with and without aortic atherosclerosis: a population-based study.
Calcif Tissue Int. 1996 Nov;59(5):352-6.

Khurana C, Rosenbaum CG, Howard BV, Adams-Campbell LL, Detrano RC, Klouj A, Hsia J.
Coronary artery calcification in black women and white women.
Am Heart J. 2003 Apr;145(4):724-9.

Li K, Kaaks R, Linseisen J, Rohrmann S.
Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg).
Heart. 2012 Jun;98(12):920-5.

Oh J, Weng S, Felton SK, Bhandare S, Riek A, Butler B, Proctor BM, Petty M, Chen Z, Schechtman KB, Bernal-Mizrachi L, Bernal-Mizrachi C.
1,25(OH)2 vitamin d inhibits foam cell formation and suppresses macrophage cholesterol uptake in patients with type 2 diabetes mellitus.
Circulation. 2009 Aug 25;120(8):687-98. Epub 2009 Aug 10.

Richard L Prince,  Kun Zhu,  Joshua R Lewis
Calcium, vitamin D, and risk: Evidence of harm is unconvincing
BMJ. 7 Jun 2011; 342:  d3541 

Elizabeth J Samelson, Sarah L Booth, Caroline S Fox, Katherine L Tucker, Thomas J Wang, Udo Hoffmann, L Adrienne Cupples, Christopher J O’Donnell, and Douglas P Kiel
Calcium intake is not associated with increased coronary artery calcification: the Framingham Study
Am J Clin Nutr December 2012 vol. 96 no. 6 1274-1280

Vermeer C, Schurgers LJ.
A comprehensive review of vitamin K and vitamin K antagonists.
Hematol Oncol Clin North Am. 2000 Apr;14(2):339-53.

Weber P.
Vitamin K and bone health.
Nutrition. 2001 Oct;17(10):880-7.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

The Skinny On Skin

Summer beautyUnlike other organs of the body, skin nutrition can be enhanced by “direct deposit” through topical application of micronutrients, which can complement dietary acquisition and result in a stronger, healthier barrier to the world. Did you know that, when you look at a person, you are looking at dead skin? That would be the horny, keratinized outer layer called the stratum corneum. Keratin is a protein that helps to keep skin hydrated by preventing water evaporation. You might recognize it as the major component of wool, nails, rhino horns, and quill pens. The cells of the stratum corneum can also absorb water, which explains the puffiness and wrinkling you get in your fingers from sitting in the tub too long. Be glad this doesn’t happen all over. Sometimes, when your skin gets dry and itchy, you can see flakes of it when you scratch. That is the stratum corneum, part of the epidermis, which also contains the skin pigmentation chemical called melanin. Since people who look at you are seeing the walking dead, you might as well try to make it at least a little bit attractive.

Dry skin can be caused by harsh detergents and soaps, and by nutritional deficiencies, especially of essential fatty acids. Diet aside, at least for now, topical treatments can help to keep skin moist and pliable. There are no blood vessels in the epidermis to deliver nutrients to the stratum corneum, which usually prevents the passage of many types of molecules to layers below. Sometimes, though, a compound will pass through. Changes in temperature, air flow and humidity can pull water away from the skin and interrupt its integrity. If ignored, this can lead to more serious concerns, including cell damage and inflammation that perpetuate the condition. An important strategy is to address dry skin by maintaining the lipid components of what is termed the natural moisturizing factor.

The outer layers of the epidermis receive less nutritional support than underlying cells, hence the slowness and limitation of dietary interventions to offer positive effects. On the bright side, concentrations of nutrients in the skin can eventually be met through oral avenues. On the other hand, topical application may be more efficient, especially to ameliorate the ravages of photodamage (Pinell, 2003) (Zussman, 2010). Long before other insults were considered, poor nutrition was associated with changes in skin appearance, with the vitamin C deficit known as scurvy being among the first to be identified. Later associations, such as pellagra and ariboflavinosis, were found to be correctible through diet.

The topical use of micronutrients is a relatively new area of study (Boelsma, 2001). Much has been discussed and publicized about vitamins C, D, and E for skin health. Fatty acids have also been part of the conversation, and ceramides are slowly coming into the limelight (Coderch, 2003) (Guillou, 2011). This is warranted because the stratum corneum contains high levels of ceramides, constituting as much as half the total lipids, where they serve as a kind of glue that holds surface skin cells together.

But a not-so-new-kid on the block is gaining recognition for participation in the parade that leads to rescue of failing skin—the B-vitamins, 3 and 5. Nicotinamide (B3) is the amide of nicotinic acid, which is the form of niacin able to lower cholesterol and to cause flushing.  Nicotinamide is also called niacinamide, known to reduce glucose levels. Metabolically, nicotinamide is convertible to nicotinic acid. Though pharmacologically different, niacin/nicotinic acid and nicotinamide/niacinamide have the same vitamin activity. In a Japanese study conducted about a decade ago, it was found that topical nicotinamide is able to improve the permeability barrier of skin by stimulating the synthesis of ceramides, free fatty acids and cholesterol, with a subsequent decrease in transepidermal water loss (Tanno, 2000).

Not to be left out of the mix, panthenol likewise lends its magic to a topical lotion. Panthenol is the alcohol analog of pantothenic acid, also known as vitamin B5, that acts as a provitamin since it is quickly converted to vitamin B5. Only the D- form is biologically active, but both it and the L- form have moisturizing properties. In cosmetics, it may appear as DL-panthenol. Combined with niacinamide, this nutrient was shown to reduce a few obvious signs of aging skin, notably hyperpigmentation and redness. In a blinded study carried out in India, researchers found that subjects who applied such a lotion to the face daily for ten weeks experienced a significant reduction in redness and hyperpigmentation, an improvement in skin tone evenness, and positive effects on skin texture (Jerajani, 2010). Even in the absence of B5, the B3 application (niacinamide) alone was able to reduce the same negative features while simultaneously diminishing fine lines and wrinkles (Bissett, 2005) (Kawada, 2008).

Traditionally, vitamins have played the role of co-enzymes. You still need to eat food to give the vitamins something to work with. Several vitamins, however, assume the role of endocrine mimics. Biotin is one of these. Critical to carboxylation—replacing a hydrogen atom (H) with a carboxyl group (COOH), as in the oxidation of products that result from the decomposition of carbohydrates, fats and proteins—biotin also induces epidermal cell differentiation (Bolander, 2006), a process that helps to make new cells. This is especially noticeable in the health of fingernails and animals’ hooves, which become increasingly brittle and friable in the absence of biotin (Colombo, 1990) (Hochman, 1993).

We all know that exposure to the sun helps to make vitamin D. But we also know that too much exposure can cause the skin problems we’re trying to prevent or to rectify. The sun’s ultraviolet light is part of the invisible band of radiation. Most (~95%) of the UV that reaches the earth is the lower-frequency, longer-length UVA, sometimes called black light, that penetrates more deeply into the skin than UVB, but is less intense. UVA is the tanning ray that plays a major role in photoaging. UVB is responsible for sunburn and reddening, damaging the superficial layers of the epidermis. Both are culprits. Nicotinamide has been involved in cellular energy restoration after UV irradiation and is found to be immune protective, but riboflavin—vitamin B2—has similar virtue in that it is vital to cellular energy metabolism. Scientists who speculated that B2 could offer immune protection as well as B3 after insult by UV light were correct. Topical riboflavin protected against both wavebands (Diona, 2010) (Yoshikawa, 1999), and oral riboflavin can prevent dermatitis (Lo, 1984).

Taking a single B vitamin orally may have undesirable results; taking it as part of the entire complex, or adding it to the complex, is not a concern. Deficiency of B vitamins can be related to acne, cracked lips, dryness, wrinkles and an uneven complexion, among other dermatological (and metabolic) involvements. Avoiding these issues may be as easy as taking a supplement or finding a fortified lotion.


Bissett DL, Miyamoto K, Sun P, Li J, Berge CA.
Topical niacinamide reduces yellowing, wrinkling, red blotchiness, and hyperpigmented spots in aging facial skin.
Int J Cosmet Sci. 2004 Oct;26(5):231-8. doi: 10.1111/j.1467-2494.2004.00228.x.

Bissett DL, Oblong JE, Berge CA.
Niacinamide: A B vitamin that improves aging facial skin appearance.
Dermatol Surg. 2005 Jul;31(7 Pt 2):860-5; discussion 865.

Boelsma E, Hendriks HF, Roza L.
Nutritional skin care: health effects of micronutrients and fatty acids.
Am J Clin Nutr. 2001 May;73(5):853-64.

Bolander FF.
Vitamins: not just for enzymes.
Curr Opin Investig Drugs. 2006 Oct;7(10):912-5.

Coderch L, López O, de la Maza A, Parra JL.
Ceramides and skin function.
Am J Clin Dermatol. 2003;4(2):107-29.

Colombo VE, Gerber F, Bronhofer M, Floersheim GL.
Treatment of brittle fingernails and onychoschizia with biotin: scanning electron microscopy.
J Am Acad Dermatol. 1990 Dec;23(6 Pt 1):1127-32.

Diona L. Damian, Yasmin J. Matthews, Gary M. Halliday
Topical riboflavin attenuates ultraviolet B- and ultraviolet A-induced immunosuppression in humans
Photodermatology, Photoimmunology, & Photomedicine. Apr 2010; 26(2): 66-69

Guillou S, Ghabri S, Jannot C, Gaillard E, Lamour I, Boisnic S.
The moisturizing effect of a wheat extract food supplement on women’s skin: a randomized, double-blind placebo-controlled trial.
Int J Cosmet Sci. 2011 Apr;33(2):138-43. doi: 10.1111/j.1468-2494.2010.00600.x.

Hochman LG, Scher RK, Meyerson MS.
Brittle nails: response to daily biotin supplementation.
Cutis. 1993 Apr;51(4):303-5.

Jerajani HR, Mizoguchi H, Li J, Whittenbarger DJ, Marmor MJ.
The effects of a daily facial lotion containing vitamins B3 and E and provitamin B5 on the facial skin of Indian women: a randomized, double-blind trial.
Indian J Dermatol Venereol Leprol. 2010 Jan-Feb;76(1):20-6. doi: 10.4103/0378-6323.58674.

Kawada A, Konishi N, Oiso N, Kawara S, Date A.
Evaluation of anti-wrinkle effects of a novel cosmetic containing niacinamide.
J Dermatol. 2008 Oct;35(10):637-42. doi: 10.1111/j.1346-8138.2008.00537.x.

Lacroix B, Didier E, Grenier JF.
Role of pantothenic and ascorbic acid in wound healing processes: in vitro study on fibroblasts.
Int J Vitam Nutr Res. 1988;58(4):407-13.

Lo CS.
Riboflavin status of adolescents in southern China. Average intake of riboflavin and clinical findings.
Med J Aust. 1984 Nov 10;141(10):635-7.

Mori K, Ando I, Kukita A.
Generalized hyperpigmentation of the skin due to vitamin B12 deficiency.
J Dermatol. 2001 May;28(5):282-5.

New D, Eaton P, Knable A, Callen JP.
The use of B vitamins for cutaneous ulcerations mimicking pyoderma gangrenosum in patients with MTHFR polymorphism.
Arch Dermatol. 2011 Apr;147(4):450-3. doi: 10.1001/archdermatol.2011.77.

Pinnell SR.
Cutaneous photodamage, oxidative stress, and topical antioxidant protection.
J Am Acad Dermatol. 2003 Jan;48(1):1-19; quiz 20-2.

Rajendran Kannan, MB BS MD and Matthew Joo Ming Ng, MB BS M Med Dip OccMed FCFPS
Cutaneous lesions and vitamin B12 deficiency
An often-forgotten link

Can Fam Physician. 2008 April; 54(4): 529–532.

Tanno O, Ota Y, Kitamura N, Katsube T, Inoue S.
Nicotinamide increases biosynthesis of ceramides as well as other stratum corneum lipids to improve the epidermal permeability barrier.
Br J Dermatol. 2000 Sep;143(3):524-31.

Yoshikawa K.
Vitamin and dermatology
Nihon Rinsho. 1999 Oct;57(10):2385-9.

Zussman J, Ahdout J, Kim J.
Vitamins and photoaging: do scientific data support their use?
J Am Acad Dermatol. 2010 Sep;63(3):507-25.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.