The other day as I was scouring the net for more vitiligo info (as I always do, it’s become somewhat of a hobby for me), I came across this post in the Paleo Hacks forum by someone with vitiligo:
Please talk to me about autoimmune flares
I have vitiligo. I’ve had it for about four years, and it gets a little worse each year. What’s on my body I can live with, but this year it’s really bad on my face, and it’s really, really getting me down. Generally, I start each summer with a few little patches that repigment. This year, it’s horrible. I think I was in the middle of some vit activity when I started paleo, about 3-4 months ago, just couldn’t tell because I had no tan. Now it’s just getting worse and worse. My face actually is repigmenting, because I’m using protopic and getting sunlight, but other places are going fast.
I was overdoing the dairy when I first started paleo (ish), have been egg/nightshade/grain/dairy free for about five weeks. Vitamin D is low, has been for a long time. (I’ve been bad about keeping up with supplements.) Right now, I’m waiting for the results of various lab tests, including celiac, thyroid, ANA, folic methylation, etc….
EDIT – Have gotten all my labwork back, and they’re all perfect. Except for one little thing — I have a polymorphism for the MTHFR gene, which means I don’t methylate folate acid properly. Some gets through, but not all. This actually could be the answer to a lot of my problems, and I wanted to update this in case anyone else is reading this.
Apparently, MTHFR variants are VERY VERY common–some say up to 44 percent of the population is heterozygous (that’s what I am) for this. So folate isn’t methylated, and among other things, that means homocysteine levels can build up. (Homocysteine is byproduct of methionine that is recycled back to methionine–and some other stuff–by folate byproducts. Sorry, am not chemist.)
I am finding this last point to be incredibly interesting, because I have gotten worse since going paleo. And it actually makes SENSE now, given this diagnosis. I’ve been eating way more protein. Methionine comes from protein. Therefore, I could possibly have elevated homocysteine levels, which is making the vitiligo worse (and there’s some other stuff going on too).
And if this is so common, then it might explain why so many people do better on limited protein, too.
This post caught my eye because I had recalled reading a couple of studies (here and here) that said that patients with vitiligo are shown to have elevated homocysteine levels. While some people are genetically predisposed to high homocysteine levels, there are some things that can actually cause it, such as:
- A diet that is high in animal protein, sugar, alcohol, coffee
- A B-12, B-6, folate deficiency caused by impaired methylation and/or malapsorbtion of vitamins due to issues such as leaky gut or poor diet
It’s a pretty well known fact that those with vitiligo are shown to be deficient in B-12 and folic acid.
Folate specifically, is VERY important to the body because it drives the entire methylation process. It combines with B-12 to facilitate an enormous amount of extremely important biochemical processes in the body.
Without folate, many things go haywire and don’t function properly – one of those things being the proper function of the immune system:
…defects in methylation lay the appropriate groundwork for the further assault of environmental and infectious agents resulting in a wide range of conditions including diabetes, cardiovascular disease, thyroid dysfunction, neurological inflammation, diabetes, chronic viral infection, neurotransmitter imbalances, atherosclerosis, cancer, aging, schizophrenia, decreased repair of tissue damage, improper immune function, neural tube defects, Down’s syndrome, Multiple Sclerosis, ADD, ADHD, Huntington’s disease, Parkinson’s disease, Alzheimer’s, and autism. Appropriate supplementation with vitamins and nutrients will bypass these mutations to allow for restored function of the pathway…(source)
The original post I mentioned above from the person over at the PaleoHacks.com forum, along with a podcast I listened to with Dr. Tim Jackson about neuro-immune syndromes, prompted me to get myself checked for the MTFHR mutation. I found out that I do, in fact, have a mutation that impairs my ability to methylate vitamin B-12.
You can read more about methylation here.
Do Elevated Homocysteine Levels Cause Vitiligo?
Elevated homocysteine in vitiligo patients may be a precipitating factor in the development of vitiligo (1). One study showed that patients with active vitiligo had significantly higher homocysteine levels than those with stable vitiligo, which would also indicate a B12, B6, and folate deficiency.
Homocysteine metabolism depends on folic acid and vitamin B12, both of which are lowered in patients with vitiligo. Elevated serum homocysteine levels are found in extensive vitiligo and may represent a severity marker. (source)
What’s even more interesting is that elevated homocysteine levels will stop catalase from being able to do its job – that is to break down hydrogen peroxide and protect melanin cells from oxidative stress. Vitiligo patients are shown to have an accumulation of hydrogen peroxide on the skin, or oxidative stress.
This explains why many people are able to repigment with pseudo-catalase cream, as this article from Science Daily points out:
In a new research report published online in The FASEB Journal, people who are going gray develop massive oxidative stress via accumulation of hydrogen peroxide in the hair follicle, which causes our hair to bleach itself from the inside out, and most importantly, the report shows that this massive accumulation of hydrogen peroxide can be remedied with a proprietary treatment developed by the researchers described as a topical, UVB-activated compound called PC-KUS (a modified pseudocatalase). What’s more, the study also shows that the same treatment works for the skin condition, vitiligo. (source)
One more interesting fact about elevated homocysteine is that it inhibits tyrosinase, which is vital for the production of melanin. (1)
So What Does All This Mean?
If you have active vitiligo, finding out if you have elevated homocysteine levels may be helpful in figuring out how to stop your vitiligo from spreading. It could be a good starting point (along with thyroid testing). Both can be done with a simple blood test.
I never got my homocysteine levels checked, but I did have genetic testing done to rule out a MTHFR mutation.
Remember, an elevated homocysteine level is really just an indicator of what is going on inside of your body…but I think it could be a really helpful indicator and another piece of the puzzle.
What do you think?