Active Crohn's disease is associated with low vitamin D levels.

[kiny]

http://www.ncbi.nlm.nih.gov/pubmed/23403039

Active Crohn's disease is associated with low vitamin D levels.

Jørgensen SP, Hvas CL, Agnholt J, Christensen LA, Heickendorff L, Dahlerup JF.

Department of Medicine V, Hepatology and Gastroenterology, Aarhus University Hospital, Denmark

2013 Feb 8

BACKGROUND AND AIMS:

Crohn's disease prevalence increases with increasing latitude. Because most vitamin D comes from sunlight exposure and murine models of intestinal inflammation have demonstrated beneficial effects of 1,25-(OH)(2) vitamin D treatment, we hypothesised that Crohn's disease activity is associated with low vitamin D levels.

METHODS:

In a cross-sectional study of 182 CD patients and 62 healthy controls, we measured serum 25-OH vitamin D. Stratified analysis was used to compare 25-OH vitamin D levels with Crohn's disease activity index, C-reactive protein, smoking status, intake of oral vitamin D supplements and seasonal variation in CD patients and healthy controls.

RESULTS:

Serum 25-OH vitamin D was inversely associated with disease activity: Median 25-OH vitamin D levels of Crohn's disease in remission, mildly, and moderately active diseases evaluated by Crohn's disease activity index were 64, 49, and 21nmol/l (p<0.01) and by CRP 68, 76, and 35nmol/l (p<0.05), respectively. Patients who took oral vitamin D supplementation had lower Crohn's disease activity index (p<0.05) and C-reactive protein (p=0.07) than non-users. Crohn's disease patients who smoked had lower vitamin D levels (51nmol/l) than patients who did not smoke (76nmol/l), p<0.01. Overall, Crohn's disease patients did not differ from healthy controls regarding 25-OH vitamin D levels

CONCLUSIONS:

Active Crohn's disease was associated with low serum 25-OH vitamin D. Patients who smoked had lower 25-OH vitamin D levels than patients who did not smoke, independently of disease activity.

 

[rollinstone]

Do you think taking vit d supplements would be sufficient for people who can't get enough vit d from the sun, I'm on imuran so avoiding sunlight

 

[kiny]

Not sure, but I think so. I use supplements.

It's great that you stay out of the sun btw when you're on Imuran, a lot of people don't know this and they never tell them, the DNA damage of Imuran is from exposure to sun.

 

[rollinstone]

Do you use a main vit d supp, or just with multi vitamin, I don't know how much vit d I should be using is all

 

[kiny]

A specific vitamin D3 supplement, it's an oil suspension, liquid you squirt in your mouth. It's 10.000 UI I take every 2 weeks or so, depends on my vitamin D status really. I sometimes take multivitamins but the vitamin D is really low in them and it's not in an oil suspension so they're not really good to raise your vitamin D, I think it's like 300 UI in the ones I have and I don't know how well it works if it's not suspended in oil.

Have you checked your vitamin D btw? A doctor will be able to give you the right dosage if it's too low.

David knows more about the formulations that are good etc, he'll probably be able to help when he's on.

 

[kiny]

It's pretty funny that this forum is way ahead of clinical practice in some ways. People have known about vitamin D association for a long time on this forum thanks to people pointing it out, and it is just barely being used in clinical practice right now even though studies are pointing out that GI need to be checking vitamin D status as part of routine. This forum has known this stuff for literally years.

 

[rollinstone]

I got some blood work back today, everything came back within normal range, but I didnt get my vit d levels checked... They were just checking my bloodwork after starting imuran

 

[David]

Joshuaa, as kiny alluded to, get your vitamin D level tested first. That's the first step. That way you're not supplementing if you don't need to (I bet you'll need to) but it also lets you track your levels over time so you can optimize your dose. I'll be posting an interview with Dr. Cannell of the Vitamin D Council at the end of this month which has a lot of great information as well. Most people with IBD need to be on around 5,000iu per day, especially if you're not in the sun. But getting tested is the best bet so you can find the dose that's right for you.

 

[David]

It's pretty funny that this forum is way ahead of clinical practice in some ways. People have known about vitamin D association for a long time on this forum thanks to people pointing it out, and it is just barely being used in clinical practice right now even though studies are pointing out that GI need to be checking vitamin D status as part of routine. This forum has known this stuff for literally years.

As you say, on this forum we've been screaming about this for years. I think the next big clinical finding is they're going to realize that almost everyone with Crohn's is deficient in the vitamin D cofactors, especially magnesium. Get sufficient cofactors and vitamin D and I bet it changes the disease state for a majority of people who don't have significant scarring/stricturing or resection.

 

[sid]

^^^The vit D supplement I have ben given comes in a sachet in a powdered form...do i need to take it with some oil like olive oil or mustard oil fo absorption ?

 

[David]

Yes Sid, I'd suggest some form of fat. Some people take it with peanut butter which no doubt tastes better than olive oil

 

[sid]

sorry if this questions seems silly..but how much olive oil or peanut butter should I take along with it ?? say for 10gm of powder ..may be 1 teaspoon/tablespoon of butter or oil ?

 

[David]

Not a silly question at all! I don't actually know and maybe someone has some science that can provide us with some good data. But if it was me, for peanut butter, I'd take a heaping teaspoon to a tablespoon. For olive oil, maybe 1/2 to 1 teaspoon. That's just me though and I'd correlate it with whether my vitamin D level started to increase or not. I know you've been having trouble getting yours up.

 

[sid]

Thanks david. yes that's one area am really struggling with. but I am determined now to get my Vit D level up and in a healthy range. Beacuse all these research reports cant lie..and I have started to belive that vit D definitely has a link..otherwise why would every crohn's patient have it low..including mine.

 

[wild_one353]

ill testify to this, vitamin d seems to help calms things down a bit,it makes a noticable difference but not a dramatic one.

i think my requirements during winter are somewhere around 1200-1500 iu a day. i take 1000 iu year round.

i just recently tried a full 2000iu and experinced good effects for about three days, then started to feel a bit toxic after that, so late in the winter here in wisconsin (feb) i might require a bit more then 1000iu, but not much more then that. And i don't lower my intake in the summer, as every thing extra Ill receive from the sun will be regulated by my skin and i will not experiance and over dose symptoms, but since taking vitamin d in a supplement bypasses all the body's regulatory systems, it very easy to quickly reach toxic levels.

i would advise not to take anything over 2000IU in a supplement form.
i do realize people quote the vitamin d councils claims that 10,000iu in a supplement may be safe, but when you actually try this amount you will see that it is wrong. one time i was taking 8000iu in a supplement and after a few weeks my kidneys really hurt, thats because vit will raise your calcium in yoru blood and calcify your internal organs, thats likely what was happening to me, buts its a reversible effect of course.

 

[Beach]

Thought this article had a nice quote about vitamin D toxicity (hypercalcemia) and what to be concerned about. It isn't the dose taken that should be the greatest concern, but the testing level. Everyone is different in how much vitamin D they need to take in order to reach optimal testing levels due to several factors, age, obesity, absorption abilities, etc.

"Vitamin D toxicity"

http://blog.trackyourplaque.com/2008/02/vitamin-d-toxicity-2.html

 

[David]

i would advise not to take anything over 2000IU in a supplement form.

i do realize people quote the vitamin d councils claims that 10,000iu in a supplement may be safe, but when you actually try this amount you will see that it is wrong. one time i was taking 8000iu in a supplement and after a few weeks my kidneys really hurt, thats because vit will raise your calcium in yoru blood and calcify your internal organs, thats likely what was happening to me, buts its a reversible effect of course.

Sounds like you may be low in vitamin K2 which is a cofactor of vitamin D and helps tell the calcium where to go.

As for you recommendation about no more than 2000iu, I don't agree with it for everyone. It sounds like it may be correct for you if more than that causes you to feel poorly, but less than 2000iu is nowhere near enough for many.