Arachidonic Acid (AA) Deficiency

What Is Arachidonic Acid?

[dropcap]A[/dropcap]rachidonic acid is a major essential (must have/can’t make) omega-6 fatty acid.

Structurally, arachidonic acid is a key component of nerve membranes, together with docosahexaenoic acid (DHA), a major opposing omega-3 fatty acid, making up 15-20% of the brain’s dry mass and more than 30% of the retina.

In healthy human volunteers, positron emission tomography (PET) has shown that the normal human brain consumes 17.8 mg/day of arachidonic acid.¹

Arachidonic acid is particularly concentrated in highly active membranes such as nerve synapses (junctions) and in photoreceptors in the eye retina.²

Arachidonic acid is an important building substance for the eicosanoids.

Q: What function do the eicosanoids have that are derived from arachidonic acid?

A: Eicosanoids are a large group of highly bioactive hormone-like substances including prostaglandins, leukotrienes, and thromboxanes that are involved in blood clotting, inflammation, and vasoconstriction. Eicosanoids derived from arachidonic acid are pro-inflammatory, pro-blood clotting, and constrict blood vessels in opposition to those derived from the omega-3 fatty acids which do the opposite in order to keep a balance in the body.

What Is Arachidonic Acid Deficiency In Celiac Disease and/or Gluten Sensitivity?

• Relationship between arachidonic acid deficiency and celiac disease. Arachidonic acid deficiency is a symptom of celiac disease that results when the level within cells is too low to meet metabolic needs of the body for this fatty acid.
• Relationship between arachidonic acid deficiency and features. Deficiency is characterized by altered brain development, brain function and vision, and impaired inflammatory response to injury or invasion, blood clotting response, blood flow regulation, autoimmune reactivity, and reproduction.
• Relationship between arachidonic acid deficiency and diet. Research in newly detected celiac disease before and after treatment with gluten free diet showed the proportion of arachidonic acid was especially decreased in patients with active celiac disease. Serum levels increased during remission but still remained significantly lower than control values.³
• Relationship between arachidonic acid deficiency and vitamin E. Animal research showed that while vitamin E protects the embryo against arachidonic acid deficiency, vitamin E deficiency depleted arachidonic acid.⁴

How Prevalent Is Arachidonic Acid Deficiency In Celiac Disease and/or Gluten Sensitivity?

Serum concentration of arachidonic acid was found reduced in 100% of patients with celiac disease.⁵⁶

How Does The Body Get Arachidonic Acid?

• Arachidonic acid should be obtained in the diet but can be synthesized in the body from its precursor (parent) linoleic acid, provided there is sufficient linoleic acid.⁷
• However, in the brain, arachidonic acid is not synthesized de novo (from scratch) or converted significantly from linoleic acid.⁸

What Are The Symptoms Of Arachidonic Acid Deficiency?

• Reduced cognition (mental function) including faulty memory, thinking, and learning also called brain fog.
• Low blood pressure.
• Poor inflammatory response to injury.
• Prolonged bleeding with trauma.
• Excessive thirst.
• Thin muscles.
• Low birth weight and reduced head circumference in infants.
• In children, growth retardation and short stature may develop.

What Does Arachidonic Acid Do In The Body?

Arachidonic acid performs these functions:

1. Crucial to fetal brain growth, and mild deficiencies are associated with low birth weight and reduced head circumference.
2. Plays a role in the cellular processes underlying learning and memory.
3. Required for inflammatory response to tissue injury and infection. Arachidonic Acid is an important building block for the eicosanoids, a large group of highly bioactive hormone-like substances including prostaglandins, leukotrienes, and thromboxanes that are involved in inflammation.
4. Required for blood clotting.
5. Opposing action to eicosapentaenoic acid (EPA), an omega-3 fatty acid, in acting as second messenger in chemical neurotransmitter systems as well as contributing to numerous other aspects of cell signaling.
6. Needed for skin, nail and hair health.
7. Required for the growth and repair of skeletal (voluntary) muscle tissue, such as those of the arms and legs.

How Does Arachidonic Acid Deficiency Develop in Celiac Disease?

• Arachidonic acid deficiency results from fat malabsorption in celiac disease and
• Lack of necessary vitamin and mineral co-factors needed in its metabolism, which includes zinc, magnesium, manganese, and vitamin B3,  vitamin B6 and vitamin C.
• Vitamin E deficiency may play a part according to animal studies.

Does Arachidonic Acid Deficiency Respond To Gluten-Free Diet?

Yes. Arachidonic acid deficiency responds to a nutritious gluten free diet containing arachidonic acid. However, supplementation is suggested because serum levels of these fatty acids increased during remission, but still remained significantly lower than control values.⁹

6 Steps To Correct Arachidonic Acid Deficiency:

• [dropcap]1[/dropcap]Meet, or Exceed the AI (Adequate Intake) Requirement for Arachidonic Acid Deficiency in milligrams (mg) per day:

[box type=”success” ]Requirements are not established.[/box]

• [dropcap]2[/dropcap]Diet – Include Food Sources Richest in Arachidonic Acid:

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Plants Are Not a Source of Arachidonic Acid.

Animal Sources:

• Meat.
• Milk products.
• Arachidonic acid is a component of breast milk.¹⁰[/box]

• [dropcap]3[/dropcap] Diet – Avoid  or Limit These Foods That Deplete or Interfere With Absorption:

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• Green and black tea if used excessively.
• Foods containing the flavonoid quercetin such as capers, lovage, parsley, red onions, sage, citrus fruits, and tomatoes.
• Foods containing tumeric.

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• [dropcap]4[/dropcap]Monitor Medications That Deplete. or Interfere With Absorption:

Ask your doctor or pharmacist about possible interactions between arachidonic supplements and medications you’re taking.

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Here are common medications that deplete arachidonic acid. Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below. Do not stop prescribed medications without supervision.

This is not a complete listing.

• Aspirin
• Ibuprofen®.[/box]

• [dropcap]5[/dropcap]Manage Nutritional Supplements to Obtain Arachidonic Acid:

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• Arachidonic acid comes in capsule and liquid form.

Caution: Women who are pregnant should not take arachidonic acid supplements. It is contraindicated in any inflammatory disease or conditions that can be made worse, such as high blood pressure, high cholesterol, heart disease, diabetes, asthma, prostate enlargement, or cancer.[/box]

• [dropcap]6[/dropcap]Other Supplements That Deplete or Interfere With Absorption:

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These supplements block the metabolism or conversion of arachidonic acid to eicosinoids. Check with your pharmacist for others.

• Vitamin E.
• Fish oil.
• Curcumin.
• Tumeric supplements which contain curcumin (giving the bright yellow color).  [/box]

What Do Medical Research Studies Tell About Arachidonic Acid Deficiency in Celiac Disease?

RESEARCH STUDY SUMMARIES

“Serum fatty acid profile in celiac disease patients before and after a gluten-free diet.” This study investigating the profile of serum fatty acids in patients with newly detected celiac disease before and after treatment with a gluten-free diet found that proportions of arachidonic acid were decreased in subjects with active celiac disease. In the same patients in remission, blood levels of this fatty acid increased, but still remained significantly lower than control values.

Blood samples were obtained from 50 adults with active celiac disease showing small-bowel mucosal villous atrophy, from the same patients in remission after treatment with a gluten-free diet, and from 59 controls. Serum fatty acids were analyzed by capillary gas-liquid chromatography.¹¹

“Abnormal fatty acid pattern in intestinal mucosa of children with celiac disease is not reflected in serum phospholipids.” This study investigating whether the abnormal fatty acid pattern in intestinal mucosa of children with celiac disease is reflected in blood values showed that it is not. The fatty acid composition of intestinal membranes is important for enzymes and epithelial transport. Linoleic acid level was decreased, whereas those of its derivatives were elevated (arachidonic acid), indicating increased transformation of omega-6 fatty acid. Mead acid level was increased, with an increased ratio of Mead acid to arachidonic acid  levels, suggesting essential fatty acid deficiency.

Altered fatty acid content may contribute to the pathophysiology of celiac disease because omega-6 fatty acids are important for enzymes and for the transport and receptor functions of epithelial membranes.¹²

Sources:

1. Rapoport SI. Brain arachidonic and docosahexaenoic acid cascades are selectively altered by drugs, diet and disease. Prostaglandins Leukot Essent Fatty Acids. 2008 Sep-Nov;79(3-5):153-6. Epub 2008 Oct 29. [↩]
2. Richardson AJ. The importance of omega-3 fatty acids for behavior, cognition, and mood. Scandinavian Journal of Nutrition. 2003;47(2):92-8. [↩]
3. Solakivi T, Kaukinen K, Kunnas T, Lehtimäki T, Mäki M, Nikkari ST. Serum fatty acid profile in celiac disease patients before and after a gluten-free diet. Scand J Gastroenterol. 2009; 44(7):826-30. [↩]
4. Lebold KM, Kirkwood JS, Taylor AW, et al. Novel liquid chromatography-mass spectrometry method shows that vitamin E deficiency depletes arachidonic and docosahexaenoic acids in zebrafish (Danio rerio) embryos. Redox Biol. 2013 Dec 17;2:105-13. doi: 10.1016/j.redox.2013.12.007. [↩]
5. Krums LM, Pafenov AI, Ekisenina NI. Disorders in lipid metabolism in patients with chronic diseases of the small intestine. Klinicheskaia Meditsina. Nov 1990; 68(11):54-7. [↩]
6. Solakivi T, Kaukinen K, Kunnas T, Lehtimäki T, Mäki M, Nikkari ST. Serum fatty acid profile in celiac disease patients before and after a gluten-free diet. Scand J Gastroenterol. 2009; 44(7):826-30. [↩]
7. Kathleen Mahan and Sylvia Escott-Stump, ed. Krause’s Food, Nutrition & Diet Therapy, 10th Edition. Philadelphia, PA. USA: W.B. Saunders Company, 2000. [↩]
8. Rapoport SI. Brain arachidonic and docosahexaenoic acid cascades are selectively altered by drugs, diet and disease. Prostaglandins Leukot Essent Fatty Acids. 2008 Sep-Nov; 79(3-5):153-6. Epub 2008 Oct 29. [↩]
9. Solakivi T, Kaukinen K, Kunnas T, Lehtimäki T, Mäki M, Nikkari ST. Serum fatty acid profile in celiac disease patients before and after a gluten-free diet. Scand J Gastroenterol. 2009;44(7):826-30. [↩]
10. Kathleen Mahan and Sylvia Escott-Stump, ed.   Krause’s Food, Nutrition & Diet Therapy, 10th Edition. Philadelphia, PA. USA: W.B. Saunders Company, 2000. [↩]
11. Solakivi T, Kaukinen K, Kunnas T, Lehtimäki T, Mäki M, Nikkari ST. Serum fatty acid profile in celiac disease patients before and after a gluten-free diet. Scand J Gastroenterol. 2009;44(7):826-30. doi: 10.1080/00365520902912589. [↩]
12. Steel DM, Ryd W, Ascher H, Strandvik B. Abnormal fatty acid pattern in intestinal mucosa of children with celiac disease is not reflected in serum phospholipids. J Pediatr Gastroenterol Nutr. 2006 Sep;43(3):318-23. [↩]