Highly interesting study from Gominak (2016), thinking in regulatory circles:

“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”

This study followed 1000 patients over the course of 6 years, and linked (necessary) vitamin D substitution and changed gut microbiome with a theoretically rare decline in panthotenic acid (B5).

Particularly: “An excellent review of the production and absorption of the B vitamins states (as do most modern references) that ‘‘pantothenic acid deficiency doesn’t exist because it’s ubiquitous in food” (Said, 2011). But that same review makes a very thought provoking observation: 7 of the 8 B vitamins, (not niacin, which can made from tryptophan) have an intestinal bacterial source and a food source.” (p. 105).

Gominak hypothesized, that a changed gut microbiome led to a deficiency in pantothenic acid. Despite Vitamin D supplementation, patients still suffered from sleep and intenstinal bowel syndrome problems. After 3 months of Vitamin B supplementation, IBS symptoms disappeared in the majority of patients. However, continued over-supplementation re-introduced sleep problems, speaking for a narrow bandwidth of optimal dosage. Vitamin B supplementation could be discontinued as gut microbiota appeared to have been rebalanced.

Sheppard et al. report pantothenic acid (B5) to be abundant in grains and cereal, but found some microbes in grass-feeding animals to genetically adapt to this B5 depletion. For human diets, it should be abundant in dairy and meats. However, it is hypothsized that the conversion to from the ubiquitous coenzyme A to its physiologically active D-enantiomer depends on gut microbes. As a further hypothesis, gut microbiome changes may lead to a negative reinforcing circle of IBS via B5 depletion.

Conclusion

Altered gut microbiomes appear to be behind a whole range of modern conditions, and the cause is yet unknown. One popular hypothesis is the use of antibiotics and the emergence of new, resistant strands that overgrow in the intestine during antibiotics use, throwing off the natural gut microbiome. One culprit may be Clostridia, as has been reported by a variety of sources. On the other hand, human nutrition has changed during the last 50 years as it has never been before. Main driver of this nutritional change was a reductionist model of carbs, proteins and fats. It turns out that nutrition is not simply a process of getting some substances into the human body, but maintaining the homeostasis of our symbiosis with a large number of microorganisms, starting from the tightly coupled mitochondria that enable our large bodies. The intestine is one major center of microbial activity in the human body. At the same time, a vast number of nerves regulates its movement, involving 90% of the serotonine produced in the human body. The connection with psychological symtoms should be obvious.

References

Gominak, S. (2016). 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. Medical Hypotheses, 94103-107. doi:10.1016/j.mehy.2016.07.007

Said H. Intestinal absorption of water-soluble vitamins in health and disease.
Biochem J 2011;437:357–72.

Sheppard, S. K., Didelotc, X., Meric, G., Torralbo, A., Jolley, K. A., Kelly, D. J., Bentley, S.D., Maidena, M. C. J., Parkhill, J., Falush, D. (2013). Genome-wide association study identifies vitamin B5 biosynthesis as a host specificity factor in Campylobacter. PNAS, 29(110), 11923–11927. doi: 10.1073/pnas.1305559110