Role of Vitamin D in the Natural History of Inflammatory Bowel Disease
Journal of Crohn's and Colitis, jjy025, https://doi.org/10.1093/ecco-jcc/jjy025
Ole Haagen Nielsen Lars Rejnmark Alan C Moss
- This overviews a variety of types of IBD and Vitamin D studies
- IBD Studies giving a fixed amount of vitamin D have not been consistently successful
- Small, short IBD studies which has the goal of getting Vitamin D in the range of 40 to 50 ng have been successful.
- Many non-IBD studies with similar goals have likewise been successful
- No mention appears to be made of the importance of a gut-friendly form of Vitamin D for IBD, Diabetes, Multiple Sclerosis and other health problems associated with poor guts
- There appears to be no mention of the variety of non-gut methods of increasing vitamin D levels (see chart below)
- IBS – 6 out of 7 studies shows Vitamin D helps, still want more studies – Jan 2018
- Crohn’s Disease risk increased 3 X if inadequate vitamin D level (another form is needed) – Oct 2017
- Gut-friendly forms of Vitamin D
- Getting Vitamin D into your body has the following chart
Overview Gut and vitamin D in VitaminDWiki contains the following summary__
- Gut problems result in reduced absorption of Vitamin D, Magnesium, etc.
- Celiac disease has a strong genetic component.
- Most, but not all, people with celiac disease have a gene variant.
- An adequate level vitamin D seems to decrease the probability of getting celiac disease.
- Celiac disease causes poor absorption of nutrients such as vitamin D.
- Bringing the blood level of vitamin D back to normal in patients with celiac disease decreases symptoms.
- The prevalence of celiac disease, not just its diagnosis, has increased 4X in the past 30 years, similar to the increase in Vitamin D deficiency.
- Review in Nov 2013 found that Vitamin D helped
- Many intervention clinical trials for vitamin D to prevent or treat Gut problems (93 trials listed as of Jan 2017)
- All items in category gut and vitamin D
Gut category listing in VitaminDWiki contains the following
113 items in GUT category - see also Overview Gut and vitamin D,
- "Ulcerative Colitis" OR UC 447 items Feb 2018
- "celiac disease" OR CD 1280 items Feb 2018
- "inflammatory bowel disease" OR "inflammatory bowel symptom" 504 as of Jan 2018
- Search VitaminDWiki for Crohn's 797 items as of Feb 2018
- Gut-Friendly forms of vitamin D
such as: bio-emulsion, topical, spray, sublingual, inhaled, injection . .
The Meta-analysis of Gut and Vitamin D
- Vitamin D changed microbiota in gut and airway, might reduce cystic fibrosis – RCT Nov 2017
- Crohn’s disease associated with vitamin D and latitude – meta-analysis Dec 2015
- Gut problems more likely if low vitamin D (IBD: 1.6, UC: 2.3) – meta-analysis Aug 2015
- Inflammatory bowel diseases treated with vitamin D – Review May 2014
Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease, is a chronic and unpredictable characterized by alternating periods of remission interspersed with relapses. In recent years accumulating support for an immunomodulating effect of vitamin D on both the innate and adaptive immune system has been presented. Through the vitamin D receptor, the active form of vitamin D, 1,25(OH)2D, induces antimicrobial peptide secretion, decrease dendritic cell activity, and promotes Th2 and regulatory T cell development and activity. In addition, vitamin D promotes an increased ratio of anti-inflammatory cytokines to pro-inflammatory cytokines. Studies in IBD point to a role for vitamin D in ameliorating disease outcome. Suboptimal circulating levels of 25-hydroxyvitamin D are common in IBD and appear to be associated with an increased risk of flares, IBD-related hospitalizations and surgeries, an inadequate response to TNF inhibitors, a deterioration in quality of life, as well as low bone mineral density. With only few available randomized double-blind, placebo-controlled studies investigating therapeutic effects of vitamin D related to IBD, further research is necessary to determine the true therapeutic potential of vitamin D, as well as defining its optimal range in serum to achieve and maintain quiescent disease. This review aims to summarize the latest knowledge on the extraskeletal effects of vitamin D in IBD, and outlines the potential deleterious consequences of vitamin D deficiency in this patient cohort.
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