Hi Henry,
Since part of my terminal ileum is missing, and I have peripheral neuropathy (due to gluten damage), l take a multivitamin, and a prescription vitamin known as Metanx, that contains the active forms of vitamins B-12, B-9, and B-6. The Metanx has helped to reduce my peripheral neuropathy symptoms, but most people probably do not need to take it. I also take a capsule with 1,200 mg of fish oil, and another with 1,200 mg of flax seed oil, a magnesium supplement, and lutein (for my eyes — I have drusen).
Be careful with the vitamin A, unless it is in the form of beta-carotene. Beta-carotene is a natural source of vitamin A (the body uses beta-carotene to produce vitamin A, as needed), but most vitamin supplements use the synthetic substitute, retinol. Not only can too much retinol be toxic, but it can interfere with the absorption of vitamin D, and eventually lead to a vitamin D deficiency.
For anyone who has a celiac gene though, or one of the other genes that predisposes to non-celiac gluten sensitivity (which includes virtually everyone who has MC), there is another reason to be careful with vitamin A supplements. Rather than to take the time to rephrase it, I'll just quote a section from my book, where this is discussed:
Interleukin-15 may interact with vitamin A to promote the loss of tolerance for gluten
Recent research has shown that a metabolite of vitamin A, retinoic acid, together with interleukin-15 (IL-15) in the intestines of patients with celiac disease, may be responsible for generating the inflammation that results in celiac disease.7 Since the problem does not occur if IL-15 is absent, it has been proposed that developing ways to block IL-15 may be an effective approach for preventing and treating gluten sensitivity. Like retinoic acid, isotretinoin is a first-generation retinoid, and it is the active ingredient in the product Accutane and other medications used in the treatment in acne, that have been associated with the development of inflammatory bowel disease. Obviously, this may have implications for both the prevention and treatment of microscopic colitis, as well.
This also implies that until a safe and effective way to block IL-15 is developed, if we take a vitamin A supplement, we should minimize the retinol form that is found in many vitamins. Instead, our vitamin A supplementation should be limited to the beta-carotene form, whenever possible. It appears that the esters of retinol may also be a problem.
The main component of palm oil is retinyl palmitate, which is an ester of retinol. Also, the terms "Retinyl acetate", "retinol acetate", and "vitamin A acetate", are all names for the same thing. They refer to the acetate ester of retinol, which apparently is ultimately converted to retinoic acid by the body. This conversion tends to occur whether the product is applied topically (to the skin) or ingested. That suggests that for anyone sensitive to gluten, the retinol that results from the conversion could combine with IL-15 to generate enteritis, (intestinal inflammation).
And here is the reference cited in the first paragraph in that quote:
7. DePaolo, R. W., Abadie, V., Tang, F., Fehlner-Peach, H., Hall J. A., Wang, W., . . . Jabri, B. (2011). Co-adjuvant effects of retinoic acid and IL-15 induce inflammatory immunity to dietary antigens. Nature, 471(7337), 220–224. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/21307853
You can read the full article if you click on the "Free PMC Article" link below the abstract.
I've never tried L-glutamine or 5-htp, so I can't comment on those.
Tex
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