What Lurks in Your Fat Cells ?

[Snowpuppy]

This is probably a question for Gabriel or another scientific mind here! I have suffered from Sarcoidosis for the last 2 years and my body is slowly recovering. I decided to return to PP as I felt the best on this woe.

My new dr requested Vit D testing so I will do that shortly. I have read that Vit D is held in fat cells so releasing the excess amounts of Vit D (if I have any) during fat loss will increase my Sarc symptoms, at least initially.

There is some thinking that Sarc as well as other diseases such as RA and Fibro is caused by hidden bacteria in the body. If true, are these bacteria held in fat cells also?

Any input on what type of potential toxins that lurk in our fat cells?

[Billie]

Snow puppy I will make sure that Gabe sees this post. I think he is going to be around the computer alot to me working on a project for work so I will tell him to look in!

[Gabriel Guzman]

As far as I know, it is the exogenous Vitamin D what causes problems to people with active sarcoidiosis, and sometimes they are adviced against VitD supplementation, and overexposure to sunlight.

The problem with sarcoidiosis is that is a disease of unknown cause in which inflammation occurs in the lymph nodes, lungs, liver, eyes, skin, or other tissues. There have been observations of 'gram-negative' bacteria present in the granulomas but I'm not sure that cause-effect has been established. Nevertheless, the bacteria observed in those instances are 'Rikettsia'. In fact, some people believe that sarcoidosis is triggered by one or more microbes behaving in a non-infectious fashion in a genetically predisposed individual. Here, however, there seems to be a necessity for a genetic predisposition.

Since the disease is an inflammatory disease in nature, is possible that anything that can exacerbate an immune reaction can also worsen the condition for a person already with sarcoidiosis. There are also genetic factors believed to predispose some people for the disease.

The apparent link with calcium levels is that a person with sarcoidiosis may show serum calcium levels higher than normal. If I understand it correctly, the problem resides in the excessive conversion of VitD into the intermediate 25-hydroxyvitamin D (just call it 25(OH)VitD) in the liver. That intermediate is then converted into 1,25-hydroxyvitamin D ([just 1,25(OH)VitD) in the kidneys, which is the active form of VitD. In people with sarcoidiosis, specialized immune cells called macrophages produce a lot of 25(OH)VitD, which is then converted into the active form of VitD. The build up of 1,25(OH)VitD is believed to induce the formation of granulommas in people predisposed to sarcoidiosis. Hence the recommendation of limiting and even eliminating dietary sources of VitD. Since sunlinght also triggers the conversion of VitD into 25(OH)Vit and then into 1,25(OH)VitD, then people with sarcoidiosis are adviced to avoid direct sunlight until they achieve remission.

The idea that VitD is 'stored' in fat cells may derived from the fact that fat cells have a receptor for the active hormone (1,25(OH)VitD). Back in 2004, a group in Tennessee found that the hormone actually promotes weight gain by sending calories into storage. Interestingly, they found that while investigating the phenomenon of weight loss fostered by consumption of calcium-rich foods such as milk and other dairy products. But having receptor for something doesn't mean that cells actually accumulate it. In all likelyhood, once the hormone gets inside the cells, it will exert its function but doesn't hang around inside too long before it's degraded.

Note that calcium-rich doesn't mean VitD-rich. In fact, it's believed that calcium actually inhibits the production of 1,25(OH)VitD. The dynamics is something like this: when calcium concentrations in the body are low, the parathyroid gland in a person's neck senses it and secretes parathyroid hormone, which has a host of activities. One of them is to turn on the production of 1,25(OH)VitD in the kidneys. So, to keep that hormone at low to moderate concentrations, people must maintain adequate calcium intake. This type of regulation may have play a critical role for survival in ancestral times but that is for another discussion.

Your doctor may have requested a test for VitD to establish the ratio between the 25(OH)VitD and 1,25(OH)VitD ratio. In other words, he/she wants to know if you're making excess active form of the hormone which is what seems to worsen the condition in people with sarcoidiosis. I'm not sure of the actual values but some estimates suggest that a ratio of 4 and above indicate active sarcoidiosis, whereas a ratio of 2.5 indicates 'going in the right direction', to remission. A ratio of 1.25 seems to be considered 'normal'. That is something you will have to discuss with your doctor when the results are in.

Whether or not sarcoidiosis is produced by bacteria remains to be categorically shown, beyond just finding the presence of gram-negative bacteria near or inside granulommas. I suppose that a way to find out would be to isolate the organism from the affected organ or tissue and then induce the same disease in an animal model. I admit that I have not looked into that so I have no idea if that has already been done. What does seem to be a common denominator in prople with sarcoidiosis is the presence of an exacerbated inflammatory response that can initiate the formation of granulommas and that excess production of 1,25(OH)VitD worsens the condition.

If dietary sources of VitD are limited, I don't see why losing weight through fat loss should necessarily worsen your condition, particularly if enough dietary calcium is taken, which is what keeps the production of the active form of the hormone in check. As we've learned in PP, it's better to get calcium from calcium-rich (not VitD rich) foods rather than supplements.

I hope this was of some help and remember that I'm not an MD, so anything I write here is for information/discussion purposes only. In a way, so you have enough food for thought and perhaps some more information you can then discuss with your physician.