What Is Vitamin D?

[dropcap]V itamin D is the principle regulator of calcium homeostasis (balance) in the body.  This “vitamin” is really a prohormone, meaning it acts like a hormone but is not. Vitamin D does, however, contain cholesterol in its molecular structure like steroid hormones.

The physiological importance of vitamin D encompasses much more than the regulation of bone metabolism although this is a mighty function.

Q: How does vitamin D regulate bone metabolism?

A: In regulation of bone metabolism, vitamin D works in three ways: 1) enables active absorption of calcium from the small intestine, 2) enhances reabsortion of calcium by the kidneys that would otherwise be excreted in urine, and 3) plays an active role in skeletal development and bone mineralization. Mineralization gives strength to living bone tissue.

Vitamin D interacts with receptors within cells to effect transcriptional changes in many cell types including those in gut, bone, breast, prostate, brain, skeletal muscle, and the immune system.¹

In regards to the essential role of vitamin D in muscle tissue, it has been recently shown that vitamin D regulates both muscle function and structure of primary myofibers.²

Vitamin D is converted in the body to a molecule that is biologically active. The active form is 1,25-dihydroxyvitamin D, usually referred to as vitamin D3. About 80% comes from sun exposure and the remaining from food.

Vitamin D3 is synthesized in the skin from 7-dehydrocholesterol via photochemical reactions requiring UV light (sunlight). That is, light that contains energy from the sun is incorporated into molecules of  7-dehydrocholesterol in the underlying dermis of skin to make this vitamin. This is why inadequate exposure to sunlight contributes to vitamin D deficiency.

Blood concentration of 25(OH)D is the best indicator of vitamin D status. It reflects vitamin D produced in the skin and that obtained from food and supplements and has a fairly long circulating half-life of 15 days.³

What Is Vitamin D Deficiency In Celiac Disease and/or Gluten Sensitivity?

Sources:

1. McCarty DE, Chesson AL Jr, Jain SK, Marino AA. The link between vitamin D metabolism and sleep medicine. Sleep Med Rev. 2014 Aug;18(4):311-9. doi: 10.1016/j.smrv.2013.07.001. [↩]
2. Girgis CM, Mokbel N, Cha KM, Houweling PJ, Abboud M, Fraser DR, Mason RS, Clifton-Bligh RJ, Gunton JE. The vitamin D receptor (VDR) is expressed in skeletal muscle of male mice and modulates 25-hydroxyvitamin D (25OHD) uptake in myofibers. Endocrinology. 2014 Sep;155(9):3227-37 [↩]
3. http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/ [↩]

What Is Vitamin E?

[dropcap]V itamin E is not a single vitamin but naturally occurs as a fat-soluble vitamin family that consists of at least 8 distinct molecules.

These molecules include 4 tocopherols (alpha, beta, gamma, and delta) and 4 tocotrienols (alpha, beta, gamma, and delta).

Generally, tocotrienols are more active against chronic disease while tocopherols are more protective of the nervous system.

Vitamin E (for short) is a powerful antioxidant that protects cell membranes and other fat-soluble compounds from oxidative damage by free radicals (molecules that damage cells).

Q: How does vitamin E protect cells from oxidative damage by free radicals?

A: As an example, the oxidative damage to low density cholesterol (LDL – bad type) appears to lead to the deposition of cholesterol in the arterial wall (plaque formation) leading to atherosclerotic disease, commonly called hardening of the arteries.

Regarding inflammation, mast cells are activated by oxidized LDL which results in increased expression of inflammatory cytokines. This finding suggests that vitamin E antioxidant activity in reducing oxidation of LDL lipoprotein may also reduce mast cell activation. Mast cells reside near small blood vessels and, when activated, release potent mediators involved in allergy and inflammation.¹

In neutralizing free radicals, vitamin E itself is oxidized (changed) to a free radical. Importantly, conversion of vitamin E back to the original form occurs by reaction with vitamin C. These two vital anti-oxidants go hand in hand.

Vitamin E is essential for normal cerebellar brain function (lower brain), peripheral nerve health and healthy skin.

What Is Vitamin E Deficiency In Celiac Disease and/or Gluten Sensitivity?

Sources:

1. Shaik-Dasthagirisaheb YB, Varvara G, Murmura G, Saggini A, Caraffa A, Antinolfi P, Tete’ S, Tripodi D, Conti F, Cianchetti E, Toniato E, Rosati M, Speranza L,Pantalone A, Saggini R, Tei M, Speziali A, Conti P, Theoharides TC, Pandolfi F. Role of vitamins D, E and C in immunity and inflammation. J Biol Regul Homeost Agents. 2013 Apr-Jun;27(2):291-5. [↩]

What Is Vitamin K?

[dropcap]V itamin K is a family of fat-soluble vitamins, called K vitamers, that exists in three forms:

• K1 is a natural form found in plants (phylloquinone);
• K2, found in some animal foods, is synthesized in the intestine (menaquinone); and
• K3, is a synthetic form that must be activated in the liver (menadione).

Vitamin K is essential for the formation of clotting factors in blood and bone proteins and serves as a cofactor in the production of  proteins that regulate blood clotting.

Q: What are the clotting factors that require vitamin K in the regulation of blood clotting?

A: The clotting factors that require vitamin K in the regulation of  blood clotting are factors II, VII, IX, and X.   Low coagulation factors on blood assay indicate an altered secondary coagulation disorder that is characterized by impaired clot formation.

Each coagulation factor must be present in sufficient quantity in order for normal clotting to occur.

What Is Vitamin K Deficiency In Celiac Disease and/or Gluten Sensitivity?

What Is Thiamin?

[dropcap]T hiamin, also called vitamin B1, is an essential vitamin that is required to convert foodstuffs into energy and for the health and proper functioning of the nervous, muscular and cardiovascular systems.

In the bloodstream, 90% of active thiamin (TPP) is carried by red blood cells while 10% is transported in the bloodstream as free thiamin and thiamin monophosphate bound mostly to the protein albumin.

In the diet, animal food sources provide active thiamin while plant food sources provide free thiamin.¹

Urinary excretion of thiamin cannot be detected when vitamin intake is below the required levels. On the other hand, when intake exceeds saturation in the body, thiamin and/or its metabolites are actively excreted into urine to prevent excessive toxicity of the vitamins.²

In patients who have thiamin deficiency, the most common conditions that bring them to a clinician include neuropathies, depression, myalgia, cardiomyopathies or takes diuretics and/or eat a high carbohydrate diet.³

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

Sources:

1. Kathleen Mahan and Sylvia Escott-Stump, ed. Krause’s Food, Nutrition & Diet Therapy, 10th Edition. Philadelphia, PA. USA: W.B. Saunders Company, 2000. [↩]
2. Shibata K, Hirose J, Fukuwatari T. Relationship Between Urinary Concentrations of Nine Water-soluble Vitamins and their Vitamin Intakes in Japanese Adult Males. Nutr Metab Insights. 2014 Aug 5;7:61-75. doi: 10.4137/NMI.S17245. [↩]
3. Spectracell Labs, Inc. [↩]

What Is Riboflavin?

[dropcap]R iboflavin, also called vitamin B2, is fundamentally required for the breakdown of carbohydrates, amino acids, and fats in metabolism, enables oxygen to be used by cells, and acts as a component of more than a dozen enzymes involved in energy production and use.

Some enzymes needing riboflavin also require magnesium to properly function.

In other activities, riboflavin is required for healthy cardiovascular and nervous systems, eye health, and supports antioxidant protection.  Functions are more fully described below.

Urinary excretion of riboflavin cannot be detected when vitamin intake is below the required levels. On the other hand, when intake exceeds saturation in the body, the vitamin and/or its metabolites are actively excreted into urine to prevent excessive toxicity of the vitamins.¹

There is no specific name for riboflavin deficiency disease.

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

Sources:

1. Shibata K, Hirose J, Fukuwatari T. Relationship Between Urinary Concentrations of Nine Water-soluble Vitamins and their Vitamin Intakes in Japanese Adult Males. Nutr Metab Insights. 2014 Aug 5;7:61-75. doi: 10.4137/NMI.S17245. [↩]

What Is Vitamin B3 (Niacin)?

[dropcap]N iacin is an essential water-soluble B vitamin that is required by all cells of the body.

During digestion of food containing it, niacin (the form in food) is changed in the small intestines to the active form niacinamide (niacin plus an amide group), which is then absorbed into the bloodstream. 

Niacinamide is converted by the body into co-enzymes which are present in all cells. These are niacinimide adenine dinucleotide (NAD) and NADP. NADP is formed when the body adds a phosphate to NAD.

Q: How do these enzymes work?

A: These enzymes function in oxidation-reduction reactions essential for release of energy from carbohydrates, fats, and proteins and are needed as components for more than 200 enzymes involved in metabolism.

In addition to producing energy, niacinamide is essential for healthy skin and the mucosal lining of the digestive tract, normal functioning of the brain and nervous system, and production of steroid hormones in adrenal glands and hormones in sex glands.  Functions are more fully described below.

Urinary excretion of niacin cannot be detected when vitamin intake is below the required levels. On the other hand, when intake exceeds saturation in the body, the vitamin and/or its metabolites are actively excreted into urine to prevent excessive toxicity of the vitamins.¹

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

Sources:

1. Shibata K, Hirose J, Fukuwatari T. Relationship Between Urinary Concentrations of Nine Water-soluble Vitamins and their Vitamin Intakes in Japanese Adult Males. Nutr Metab Insights. 2014 Aug 5;7:61-75. doi: 10.4137/NMI.S17245. eCollection 2014. [↩]

What Is Vitamin B6 (Pyridoxine)?

[dropcap]P yridoxine is an essential vitamin that is required for the health of nerves, bones, blood, arteries, blood sugar, the immune system and metabolism of proteins.

Two important functions of pyridoxine involve coenzymes that are involved in regulating the metabolism of proteins like methionine and tryptophan and their intermediate amino acid building blocks.

In total, the coenzymic form of vitamin B-6, pyridoxal phosphate (PLP), serves as a coenzyme for over 140 enzymes in human metabolism.¹  Functions are more fully described below.

Magnesium is required for pyridoxine to actually attach to enzymes dependent on it.

Because pyridoxine is excreted from the body by the kidneys, urinary excretion of it cannot be detected when vitamin intake is below the required levels. On the other hand, when intake exceeds saturation in the body, the vitamin and/or its metabolites are actively excreted into urine to prevent excessive toxicity of the vitamins.²

Smoking blocks use of pyridoxine.

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

Sources:

1. Gregory JF 3rd1, Park Y, Lamers Y, Bandyopadhyay N, Chi YY, Lee K, Kim S, da Silva V, Hove N, Ranka S, Kahveci T, Muller KE, Stevens RD, Newgard CB, Stacpoole PW, Jones DP. Metabolomic analysis reveals extended metabolic consequences of marginal vitamin B-6 deficiency in healthy human subjects. PLoS One. 2013 Jun 11;8(6):e63544. doi: 10.1371/journal.pone.0063544. [↩]
2. Shibata K, Hirose J, Fukuwatari T. Relationship Between Urinary Concentrations of Nine Water-soluble Vitamins and their Vitamin Intakes in Japanese Adult Males. Nutr Metab Insights. 2014 Aug 5;7:61-75. doi: 10.4137/NMI.S17245. [↩]