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Dear Dr Cannell: Acne, food allergy, and esophagitis

Posted on: December 19, 2012   by  John Cannell, MD


Dear Dr. Cannell:

My 19-year-old son has eosinophilic esophagitis. I started him on 5k per day. He reports feeling 90% better after less than one month. Maybe placebo but I am inclined to think it’s the vitamin D? He used to take Accutane when he was younger and it seemed to stunt his growth. Does Accutane affect vitamin D levels?

My other son got bad acne and I started him on 5k/day of vitamin D instead of Accutane and, no kidding, his acne has gotten much better. Thanks for your efforts. You have definitely helped my family.

Jan, New York

Dear Jan:

You are welcome; I hope all your family is taking adequate doses of vitamin D.

Eosinophilic esophagitis is an inflammatory condition of the esophagus, mainly in children, thought to be an immune phenomenon. Symptoms are difficulty swallowing, heartburn, and difficulty getting the food down. Food allergy plays a significant role in triggering the condition.

Ozdemir O, Mete E, Catal F, Ozol D. Food intolerances and eosinophilic esophagitis in childhood. Dig Dis Sci. 2009 Jan;54(1):8-14. Epub 2008 Jul 2. Review.

The entire epidemic of food allergies in children is a modern phenomenon that correlates well with the vitamin D deficiency epidemic, or the sunlight deprivation epidemic. Professor Carlos Camargo at Harvard first theorized the connection.

Vassallo MF, Camargo CA Jr.  Potential mechanisms for the hypothesized link between sunshine, vitamin D, and food allergy in children. J Allergy Clin Immunol. 2010 Aug;126(2):217-22. Epub 2010 Jul 10. Review.

I suspect that vitamin D levels of many toddlers are especially low, as parents wean them on fruit juice and not milk, keep them out of the sun, lather them in sunblock, seldom feed them salmon, and do not give them vitamin D supplements. Many older children are also inside all day playing video games, an activity which was common before the food allergy epidemic. Again, it is important to remind ourselves that we are suffering an epidemic of sunshine deficiency, not just an epidemic of vitamin D deficiency.

As far as acne is concerned, Dr Maynard reported that vitamin D was effective in 1938 but, to the best of my knowledge, no one has studied it since. The doses used in 1938 were between 5,000 and 14,000 IU/day. Dr Maynard went out of his way to report that many teenagers felt much better on vitamin D, not just that it helped their acne.

Maynard MT. Vitamin D in Acne: A Comparison with X-Ray Treatment. Cal West Med. 1938 Aug;49(2):127-32

Accutane does lower vitamin D levels and does so substantially. That may be the reason children on Accutane can have premature closure of the growth plates in their bones.

Ertugrul DT, Karadag AS, Tutal E, Akin KO. Therapeutic hotline. Does isotretinoin have effect on vitamin D physiology and bone metabolism in acne patients? Dermatol Ther. 2011 Mar-Apr;24(2):291-5.

I’m glad your son is doing better on 5,000 IU/day. Have him stay on that dose the rest of his life, unless he becomes a lifeguard.

1 Response to Dear Dr Cannell: Acne, food allergy, and esophagitis

  1. pf

    Re: vitamin D & acne
    Research increasingly shows that insulin resistance is associated with low vitamin D and may improve with supplementation. Perhaps improved insulin resistance is the reason that vitamin D can help in acne:

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