September 29, 2020

New study demonstrates the effect of vitamin D on intestinal inflammation in IBD

Inflammatory bowel disease (IBD) is an autoimmune condition where in most cases there are multiple triggers chronically stimulating the immune system over a long period of time in multiple ways and the immune system gets into overloaded, overwhelmed state and loses its ability to function leading to chronic inflammation causes symptoms such as diarrhea, abdominal pain, and other debilitating symptoms and anemia.

Vitamin D deficiency has been linked to many autoimmune diseases, including type 1 diabetes, systemic lupus erythematosus, multiple sclerosis, and IBD, with studies finding a higher prevalence of these diseases in those who are deficient in vitamin D.

More and more data has demonstrated that Vitamin D supplementation may lengthen the remission in patients with IBD.

According to a study published earlier this month in the Journal of Crohn’s and Colitis, researchers investigated the impact if vitamin D on the gut microbiome and inflammation.

This was a small study including twenty five patients. Eight individuals had active ulcerative colitis, nine were in remission, and eight did not have IBD and were controls. Inflammatory markers and the gut microbiome were analyzed. All of the patients were prescribed 40,000 IUs of vitamin once a week for an 8 week period.

As a result, vitamin D levels increased from 13.6 ng/ml to 44.4 ng/ml. In patients with active IBD, fecal calprotectin levels reduced from median 275 to 111µg/g, platelet count reduced, and albumin increased. These biomarkers did not change in patients with inactive ulcerative colitis or in the control group. In addition, there were no changes in overall bacterial diversity, however, there was a significant increase in Enterobacteriaceae bacteria in patients with ulcerative colitis.

Overall vitamin D supplementation was associated with reduced intestinal inflammation in patients with active ulcerative colitis as well as increase in Enterobacteriaceae but no change in diversity of the gut microbiome.

Most patients I find need anywhere form 5,000-10,000 IUs/day of vitamin D. It is crucial to use a supplement that combines vitamin K or supplement with a separate vitamin K supplement. There are intricate relationships between fat-soluble vitamins and it is important take this into account with dosing vitamin D supraphysiologically.

According to a study in The Journal of Immunology, March 2012, researchers demonstrated that the highest levels of inflammatory inhibition occurred at 50 ng/ml. Therefore, there may have been a more significant outcome this study if vitamin D was dosed 10,000 IU daily or 50,000IU/week.

One must also investigate into the other potential environmental triggers that can cause inflammation such as, food sensitivities, toxins, and molds. Also, stool testing is essential as one can rule of bacterial infections and dysbiosis as well as assess inflammatory, immune, digestion, and absorption markers.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Garg M, Hendy P, et al. The effect of vitamin D on intestinal inflammation and faecal microbiota in patients with ulcerative colitis. J Crohns Colitis. 2018 May 3. doi: 10.1093/ecco-jcc/jjy052

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