Vitamin D deficiency changes the intestinal microbiome reducing B vitamin production in the gut. The resulting lack of pantothenic acid adversely affects the immune system, producing a “pro-inflammatory” state associated with atherosclerosis and autoimmunity

Abstract

Study objectives

Vitamin D blood levels of 60–80 ng/ml promote normal sleep. The present study was undertaken to explore why this beneficial effect waned after 2 years as arthritic pain increased. Pantothenic acid becomes coenzyme A, a cofactor necessary for cortisol and acetylcholine production. 1950s experiments suggested a connection between pantothenic acid deficiency, autoimmune arthritis and insomnia. The B vitamins have been shown to have an intestinal bacterial source and a food source, suggesting that the normal intestinal microbiome may have always been the primary source of B vitamins. Review of the scientific literature shows that pantothenic acid does not have a natural food source, it is supplied by the normal intestinal bacteria. In order to test the hypothesis that vitamin D replacement slowly induced a secondary pantothenic acid deficiency, B100 (100 mg of all B vitamins except 100 mcg of B12 and biotin and 400 mcg of folate) was added to vitamin D supplementation.

Methods

Vitamin D and B100 were recommended to over 1000 neurology patients. Sleep characteristics, pain levels, neurologic symptoms, and bowel complaints were recorded by the author at routine appointments.

Results

Three months of vitamin D plus B100 resulted in improved sleep, reduced pain and unexpected resolution of bowel symptoms. These results suggest that the combination of vitamin D plus B100 creates an intestinal environment that favors the return of the four specific species, Actinobacteria, Bacteroidetes, Firmicutes and Proteobacteria that make up the normal human microbiome.

Hypotheses

1) Seasonal fluctuations in vitamin D levels have normally produced changes in the intestinal microbiome that promoted weight gain in winter. Years of vitamin D deficiency, however, results in a permanently altered intestinal environment that no longer favors the “healthy foursome”. 2) Humans have always had a commensal relationship with their intestinal microbiome. We supplied them vitamin D, they supplied us B vitamins. 3) The four species that make up the normal microbiome are also commensal, each excretes at least one B vitamin that the other three need but cannot make. 4) Improved sleep and more cellular repairs eventually depletes body stores of pantothenic acid, causing reduced cortisol production, increased arthritic pain and widespread “pro-inflammatory” effects on the immune system. 5) Pantothenic acid deficiency also decreases available acetylcholine, the neurotransmitter used by the parasympathetic nervous system. Unopposed, increased sympathetic tone then produces hypertension, tachycardia, atrial arrhythmias and a “hyper-adrenergic” state known to predispose to heart disease and stroke.

Introduction

Vitamin D deficiency is a global epidemic and has been linked to numerous diseases including sleep disorders [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11]. There has been a parallel change in the human intestinal microbiome thought to be linked to the increasing incidence of obesity, hypertension, high cholesterol, autoimmune disorders, and atherosclerotic heart disease [12], [13], [14], [15], [16], [17]. Recent reports documenting that 7 of the 8 B vitamins have a colonic bacterial source and a food source suggest that a population with the “wrong” intestinal microbiome might have unexpected B vitamin deficiencies, unrelated to food sources, that might play a role in the etiology of those diseases [18].

In 2012 we reported a successful, uncontrolled trial of vitamin D supplementation (in doses to maintain a blood level of 60–80 ng/ml) as treatment for sleep disorders [1]. This current report documents the continued treatment of the same patient population for another four years. Despite maintaining a vitamin D blood level of 60–80 ng/ml, most patients’ sleep complaints began to return by the end of the second year. Because of 1950s reports of insomnia produced by pantothenic acid (B5) deficiency B100 (a non-proprietary over-the-counter B complex of 100 mg of thiamine, riboflavin, niacin, pantothenic acid, pyridoxine, 100 mcg of cyanocobalamin, 100 mcg biotin, and 400 mcg of folic acid) was added to the vitamin D regimen [19], [20], [21], [22]. Vitamin B5 is needed to make Coenzyme A, a metabolic cofactor used in over one hundred metabolic processes, including the production of cortisol, melatonin and acetylcholine [23], [24], [25]. Acetylcholine is a neurotransmitter responsible for our level of alertness during the day as well as the normal completion of rapid eye movement (REM) sleep at night [26], [27], [28]. The addition of B100 led to rapid improvement in sleep as well as an unexpected resolution of irritable bowel syndrome (IBS) symptoms.