As I wrote in the post about the histamine content of foods, beer has a higher histamine content than wine, but the question remains whether that also correlates with more rosacea symptoms if you drink exclusively beer vs. wine.

This summer when the weather was so hot, on a few occasions, I chose to have a beer instead of wine. Up until that point, I did not have a beer for over a year, but a day or so after I drank some beer, I noticed that my rosacea symptoms had worsened. I admit that this observation isn’t totally scientific, but I thought this was quite remarkable in itself.

Although alcohol has a (temporary) calming effect on the brain through its interaction with GABA receptors, alcohol has been suggested to be responsible for increased anxiety in people and can therefore be considered one of the trigger factors for rosacea.

The fact that beer may be worse for rosacea than wine could also be caused by other factors such as a high gluten content. Whatever it may be, I thought that it may be interesting to hear if some of my readers have similar observations.

Nevertheless, many people with rosacea still choose to consume alcohol occasionally and therefore it would be helpful to know what is worse for rosacea, beer or wine? For me it’s beer, what is it for you?

Zhou, R., Wang, S., Zhu, X. (2010) Prenatal ethanol exposure attenuates GABAergic inhibition in basolateral amygdala leading to neuronal hyperexcitability and anxiety-like behavior of adult rat offspring. Neuroscience 170: 749-57.

I would like to thank all of you who have made valuable comments lately. I want you to know that I read all of them. I haven’t posted much in the last 6 months, this is mainly because I was busy with many different things.

I will take some time in the next few weeks to respond to some of you comments. Many of your comments contribute to this blog and everyone with rosacea can benefit from them.

I wish everybody a great summer and I’ll talk to you soon.

These radicals can attack cell membranes, proteins and DNA. An iron overload inside cells can amplify the damaging effects of ROS in chronic inflammation. Most iron is usually bound to a specific protein called ferritin. Ferritin is therefore important to limit the effect of oxidative reactions, by sequestering iron.

Ultraviolet light (and UV-A in particular) is one of the most important contributors to the skin’s oxidative stress. Studies have shown that UVA radiation leads to an immediate release of iron from ferritin. It has been found that skin that is exposed to UV-A light has approximately 3 times more iron content than unexposed skin. Excess iron can also be found in skin affected by certain skin disorders such as psoriasis and atopic eczema (2).

The study I mentioned above, looked at rosacea skin in particular. The study involved 60 rosacea patients and 11 control subjects. Skin biopsies from the face were studied for iron and ferritin content and serum was collected for determination of total peroxide levels (to get an idea of how much oxidative stress each person was under).

It was found that the more severe cases of rosacea had higher levels of ferritin and iron in their skin compared to the control groups. This could possibly also explain why the more advanced cases of rosacea are more sensitive to UV(A) exposure. Additionally, rosacea patients overall were found to have higher peroxide levels in their serum and a lower anti-oxidant potential.

The authors of this study suggested that the higher frequency of rosacea seen in women can be attributed to women having a thinner skin than men and the fact that iron supplementation is more common in women.

Limiting UV exposure and reducing stress in combination with a diet that is high in antioxidants may be helpful in reducing the severity of rosacea sysmptoms.

1. Tisma, VS, Basta-Juzbasic, A, Jaganjac, M et al (2009) Oxidative stress and ferritin expression in the skin of patients with rosacea. J Am Acad Dermatol 60: 270-6.

2. Bissett, DL, Chatterjee, R, Hannon, DP. (1991) Chronic ultraviolet radiation-induced increase in skin iron and the photoprotective effect of topically applied iron chelators. Photochem Photobiol 54:215-23.

What is your experience with iron? Have you ever been on iron supplementation for extended periods and have you seen an effect on rosacea symptoms?

Intestinal alkaline phosphatase (IAP) is a membrane-bound enzyme found in the intestines, which function is to take away phosphate groups from a large number of molecules. For example, the absorption of the B6 vitamins pyridoxal phosphate and pyridoxamine phosphate is dependent on their dephosphorylation by intestinal alkaline phosphatase. IAP is also responsible for removing the phosphate from lipopolysaccharide (LPS), an endotoxin found on gram-negative bacteria that normally induces the fever response. A properly functioning intestinal alkaline phosphatase is important to prevent an immune response against the (good) gram-negative bacteria living in our gut.

Crohn’s disease and colitis are believed to be caused by an abnormal immune response to gram-negative bacteria in the intestine, a feature which may be shared with rosacea. Both Crohn’s disease and colitis are associated with reduced levels of intestinal alkaline phosphatase and the pathology of these diseases have been suggested to be triggered by LPS. Taking oral antibiotics for rosacea is believed to help eradicate these bacteria, resulting in a decreased immune response and subsequent improvement in rosacea symptoms.

Many people with rosacea are advised to modify their diet as many dietary triggers exist for rosacea. However, these dietary trigger factors vary from individual to individual and thus far no clinical evidence for a so-called anti-rosacea diet exists. The author of the paper further suggests that the typical Western diet (which is high in processed foods and low in fresh fruits and vegetables) results in a more acidic environment in the intestines. As its name implies, intestinal alkaline phosphatase works best in a more alkaline (or basic) environment with a pH in the range of 9-10.

Foods that lower IAP activity
IAP enzyme is inhibited by phytates, a substance found in grains and legumes. The only way to properly get rid of phytates is to cook grains and legumes well. In addition, the amino acid phenylalanine (found in some artificial sweeteners) also inhibits intestinal alkaline phosphatase.

Foods that stimulate IAP activity
Here are a number of foods that increase intestinal alkaline phosphatase activity:

• Short chain fatty acids such as butyrate, derived from butter or from fermentation of dietary fiber in the gut
• Fish oils (Omega 3, 6 and 9, either as a supplement or from fresh sea food)
• Dietary Zinc (found in oysters or as a supplement)
• Vitamin A (as found in carrots, sweet potatoes, pumpkins)

It is further suggested to increase the gut’s alkalinity by eating a variety of fresh fruits and vegetables and stay away from hard and processed cheeses and processed meat. Finally, adding probiotics to your diet may further decrease rosacea symptoms by the colonization of the g.i. tract with beneficial gram-positive bacteria while reducing the growth of LPS containing gram-negative bacteria.

Intestinal alkaline phosphatase is also stimulated by estrogen and inhibited by progesterone. For this reason, rosacea symptoms could appear during pregnancy and in women who use birth control pills.

Whitehead J. (2009) Intestinal alkaline phosphatase: The molecular link between rosacea and gastrointestinal disease? Med Hypotheses [Epub ahead of print Jun 30] doi:10.1016/j.mehy.2009.02.049

Vitamin B6 plays a major role in hundreds of enzymatic reactions in the body, including the synthesis of amino acids, nucleic acids (DNA/RNA), phospholipids (which are part of cell membranes), histamine, certain neurotransmitters (such as serotonin, norepinephrin, GABA), heme (the center part of hemoglobin) and the processing of carbohydrates.

Vitamin B6 is believed to have a major impact on the skin as when vitamin B6 levels are insufficient, inflammation of the skin can develop, in particular seborrheic dermatitis. Vitamin B6 used to be called anti-dermatitis factor and is also one of the main ingredients in topical treatments for seborrheic dermatitis.

Vitamin B6 deficiency
Since vitamin B6 is involved in the production of the “building blocks” for every tissue in the body, tissues that regenerate frequently such as blood and skin, are affected most when vitamin B6 is deficient. Symptoms of a vitamin B6 deficiency include anemia, fatigue and skin conditions such as eczema and (seborrheic) dermatitis.

Vitamin B6 is absorbed from our food in the intestines via passive diffusion. The absorption of B6 vitamins pyridoxal phosphate and pyridoxamine phosphate involves the dephosphorylation catalyzed by intestinal alkaline phosphatase, which is a a membrane-bound enzyme. Vitamin B6 deficiencies are relatively rare, but people with inflammatory bowel conditions (such as Crohn’s disease and celiac disease), people who drink large quantities of alcohol and people taking certain drugs (corticosteroids, anticonvulsants) are at risk for developing a vitamin B6 deficiency.

Because vitamin B6 plays a major role in the healthy functioning of our nervous system and skin, a severe deficiency of B6 can result in seizures, convulsions and inflammatory skin conditions.

Vitamin B6 is also important for the synthesis of vitamin B3 and for the absorption of vitamin B12. Foods that contain high amounts of vitamin B6 are meats, fish (tuna) and vegetables such as spinach, broccolli, Brussels sprouts, cauliflower and more. Cooked and processed food however, have lost most of the active vitamin B6 and for that reason, supplementation with vitamin B6 may be beneficial to your health if you suspect a B6 deficiency. In addition, several studies have reported that vitamin B6 supplementation can be helpful for managing symptoms of autism.

Additional Reading

• Top 5 Most Nutritious Vegetables in The World : Perfect Shape Blog … – According to Dr. Everett Koop (former US Surgeon General) and to Health magazine, 10 of the most nutritious vegetables in the world are: Broccoli; Spinach; Brussels sprouts; Lima beans; Peas; Asparagus; Artichokes …
• 5 Power Fruits to Eat Everyday | A Splendid Life – Fruit is underused by so many people. It’s also misused. Some claim the sugar content is to high; others mistakenly believe that they’re getting all the benefits of fruit from the juice they drink. Wrong! There are so many great …