Linking Rare Conditions with Nutrition Support

What’s new in VHL biology (and why it matters for nutrition)

• VHL loss → HIF stabilization (esp. HIF-2α) drives angiogenesis, glycolysis, and tumorigenesis in clear-cell RCC , the commonest malignancy in VHL.
• Therapeutic update: Belzutifan (a HIF-2α inhibitor) now has expanding data in VHL-associated RCC with durable responses, changing the clinical baseline we’re supporting nutritionally.
• Inflammation/ROS angle: New work links VHL dysfunction with ROS accumulation and mitochondrial stress, relevant when we discuss antioxidant micronutrients and vitamin D’s immunomodulation.

Nutrition intersection: In VHL, kidneys, adrenals, pancreas, CNS, and retina can be involved; surgery, targeted therapy, and surveillance are common, so we prioritize bone–muscle preservation, immune resilience, and renal-appropriate choices rather than “anti-cancer diets.”

Vitamin D × VHL: what the evidence supports

• Cancer & mortality signal: Low 25(OH)D is repeatedly associated with higher overall cancer mortality; while not VHL-specific, it’s relevant for RCC-prone cohorts.
• RCC-specific epidemiology: Higher predicted 25(OH)D has been linked with lower RCC risk in large prospective analyses, suggesting a protective association.
• Mechanistic plausibility: Vitamin D (calcitriol) exerts anti-inflammatory and anti-proliferative actions beyond classical genomic effects, potentially meaningful alongside VHL/HIF-driven biology.

Actionable takeaways for VHL care teams

• Assess & correct deficiency: Aim for guideline-concordant 25(OH)D levels; coordinate dosing with oncology/urology/endo teams, especially if renal function fluctuates.
• Bone health guardrails: Repeated surgeries, mobility limits, or steroid exposure increase fracture risk, optimize vitamin D with adequate calcium/protein + resistance where feasible.
• Immune & recovery support: During surveillance or post-op phases, maintaining sufficient vitamin D may aid infection risk reduction and convalescence, though randomized VHL-specific data are lacking.

Vanadium: promise, pitfalls, and why caution is warranted in VHL

• What it is: Vanadium compounds show insulin-mimetic effects in preclinical and limited human studies, with growing medicinal-chemistry interest.
• But not essential: No established essentiality for humans; regulatory reviews emphasize potential renal, hepatic, and other organ toxicity at higher exposures.
• Kidney relevance: Animal data demonstrate renal histopathology with vanadium at certain doses; human occupational data are mixed but reinforce prudence. In a population predisposed to renal tumors/surgeries, avoid non-indicated vanadium supplements.

Bottom line on vanadium for VHL: There’s no role for routine vanadium supplementation in VHL. If a patient has diabetes, evidence-based therapies + nutrition are preferred; experimental vanadium compounds remain research-stage with toxicity concerns, particularly important given VHL kidney involvement.

Practical clinic notes you can use tomorrow

• Screen: 25(OH)D, calcium, renal profile; revisit when treatment plans change (e.g., belzutifan initiation, surgeries).
• Food first: Fatty fish, fortified milks/alternatives, egg yolks, sensible sunlight; supplement to correct deficiency per local guidelines.
• Don’t over-promise: Vitamin D supports bone/immune health and may correlate with better RCC outcomes, but it is adjunctive, not disease-modifying in VHL.
• Avoid vanadium products: Not essential; toxicity risk > benefit in this context.

Dietitian Hazel Pinto l Founder Pixienourish