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Manage your IBD better with Vitamin D

Living in Alaska, the Winter months wear on you, and even in the Summer, the sun never seems to be enough to make a difference. I discovered D10 and have been feeling as good as a 64 year old can. I quit smoking, changed my diet, and have been taking Synergy products for a year, and never felt better. Thanks Synergy

 

P.S. I have been taking Bioflora Plus and can eat dairy the way I used to, before I was diagnosed with a food allergy. 

 

Dicker Anderson - Anchorage, AK

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Narinder Duggal, MD, FRCPC

Inflammatory bowel diseases (IBD) such as Crohn’s disease or ulcerative colitis can have a devastating impact on quality of life. Besides taking recommended medications, maintaining optimal nutritional status - especially Vitamin D levels - may be the key to fighting this agonizing disease.

Crohn’s disease is an autoimmune disease, caused by a defect in the body’s innate immune response in which bacteria, foods, and other substances are mistaken for being foreign and are attacked by the immune system, causing inflammation, pain and diarrhea. In other words, Inflammatory Bowel Diseases occur because of  inappropriate immune mediated attacks  against self tissue.¹ Since Vitamin D helps maintain our immune homeostasis, its insufficiency/deficiency may trigger or aggravate auto-immune diseases like the Crohn’s disease.² Consequently, taking Vitamin D supplements should help restore better homeostasis-resulting in a balanced immune system.
 
Yes, Vitamin D has been reported to have a role in directly countering the immuno-pathologic effects of Crohn’s disease as well as indirectly maintaining good nutritional status; both of which help prevent relapse.  Animal studies  have consistently documented that vitamin D  improves IBD.³ Now human studies replicate similar findings. A recent study (2010) by Canadian researchers of McGill University Health Center found that vitamin D acts directly on two genes - beta defensin 2 and NOD2 - which are both linked to Crohn’s disease.⁴ These genes encode anti-microbial peptides (proteins having broad spectrum antimicrobial activity) and messengers which alert the immune system to the presence of invading microbes.⁵ These genes protect the intestines from inflammation, pain and diarrhea. The lead investigator, Dr. White also noted that vitamin D sufficiency can help prevent the development of disease in individuals who are genetically predisposed, for example siblings of an affected individual.

Malabsorption associated with IBD can significantly impair nutritional status and therefore your health. Since Vitamin D is a fat soluble vitamin, it requires dietary fat in the intestine for absorption. In patients with inflammatory bowel disease, fat is malabsorbed which consequently leads to vitamin D deficiency forming a vicious circle. See the findings of Dr. Pappa’s study from Children's Hospital, Boston. His team evaluated 130 subjects with inflammatory bowel disease (both Crohn’s and Ulcerative Colitis) who were between 8 and 22 years of age.⁶ Thirty-five percent of the children had vitamin D deficiency and 11 percent had severe deficiency. The rates of vitamin D deficiency were similar in patients with Crohn's disease and ulcerative colitis. The study concluded that vitamin D deficiency is highly prevalent among patients with inflammatory bowel disease.

Vitamin D deficiency further causes metabolic bone disease, and low bone mineral density.^7,8 In children afflicted with this disease, malnutrition not only contributes to their poor weight gain but also impaired growth, found a team of Australian researchers.⁹
 
It is imperative for all patients with IBD, whether Crohn’s or ulcerative colitis, to strive toward optimal   nutritional status. Treatment may include a nutritional consult, medication, and dietary restrictions. Ask your health care provider if vitamin D should be included in your treatment. Oral Vitamin D supplementation may assist in maintaining remission and preventing bone loss in IBD patients. Coordinate with your health care provider to get your Vitamin D levels measured and take appropriate supplements.

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References:

1.    Cantorna MT. Vitamin D and its role in immunology: multiple sclerosis, and inflammatory bowel disease. Prog Biophys Mol Biol 2006;92(1):60-4. (PUBMED Abstract)
2.    Szodoray P, Nakken B, Gaal J, et al. The complex role of vitamin D in autoimmune diseases. Scand J Immunol 2008;68(3):261-9. (PUBMED Abstract)
3.    Cantorna MT, Zhu Y, Froicu M, Wittke A. Vitamin D status, 1,25-dihydroxyvitamin D3, and the immune system. Am J Clin Nutr 2004;80(6 Suppl):1717S-20S. (PUBMED Abstract)
4.    Wang TT, Dabbas B, Laperriere D, et al. Direct and indirect induction by 1,25-dihydroxyvitamin D3 of the NOD2/CARD15-defensin beta2 innate immune pathway defective in Crohn disease. J Biol Chem;285(4):2227-31. (PUBMED Abstract)
5.    Izadpanah A, Gallo RL. Antimicrobial peptides. J Am Acad Dermatol 2005;52(3 Pt 1):381-90; quiz 91-2. (PUBMED Abstract)
6.    Pappa HM, Gordon CM, Saslowsky TM, et al. Vitamin D status in children and young adults with inflammatory bowel disease. Pediatrics 2006;118(5):1950-61. (PUBMED Abstract)
7.    Driscoll RH, Jr., Meredith SC, Sitrin M, Rosenberg IH. Vitamin D deficiency and bone disease in patients with Crohn's disease. Gastroenterology 1982;83(6):1252-8. (PUBMED Abstract)
8.    Leslie WD, Miller N, Rogala L, Bernstein CN. Body mass and composition affect bone density in recently diagnosed inflammatory bowel disease: the Manitoba IBD Cohort Study. Inflamm Bowel Dis 2009;15(1):39-46. (PUBMED Abstract)
9.    Pons R, Whitten KE, Woodhead H, et al. Dietary intakes of children with Crohn's disease. Br J Nutr 2009;102(7):1052-7. (PUBMED Abstract)