by Wayne Persky |
RSS Feed A recent article published in the Journal Medicine describes a research project that involved the investigation of the association between inflammation levels (and disease severity), and serum vitamin D levels among IBD patients , compared with the vitamin D levels of healthy controls (Topalova-Dimitrova, Dimitrov, and Nikolov, 2023).1 As most of us are already well aware, the researchers pointed out that vitamin D is a steroid hormone that plays a vital role in the performance of our immune system.
Low vitamin D levels are common among IBD patients.
The researchers noted that IBD patients are commonly found to have low vitamin D levels due to issues associated with IBD [such as nutrient malabsorption, bile acid malabsorption (BAM), and medications such as immunosuppressants and corticosteroids]. Low vitamin D levels in IBD patients are associated with an increased risk of disease relapse, a slower response to biological therapy, and an increased risk of the need for surgical intervention. Naturally, as is typically the case, MC patients were excluded from this study. Only Crohn's and ulcerative colitis patients were qualified to participate in the study.
IBD patients' vitamin D levels averaged 61.5% of the levels of controls.
The data showed that 32.6% of IBD patients were vitamin D deficient, and 66.3% were vitamin D insufficient, compared with healthy individuals. Normally, in the U.S., deficiency is considered to be 20 ng/mL or less, and insufficiency is considered to be 30 ng/mL, or less. In international units, deficiency is considered to be 50 nmol/L, or less, and insufficiency is considered to be 75 nmol/L, or less. Note that these percentages add up to 99%, showing that low vitamin D levels are almost a certainty for IBD patients. The data showed that IBD patients in the study had an average vitamin D serum level of 16 ng/mL (with actual levels ranging between 7.4 and 24.6 ng/mL). The controls in the study had an average vitamin D level of 26 ng/mL (with actual levels ranging between 16.27 and 35.73 ng/mL.).
In international units, the data showed that IBD patients in the study had an average vitamin D serum level of 40 mmol/L (with the actual levels ranging between 18.5 mmol/L and 61.5 mmol/L). The controls in the study had an average vitamin D level of 65 mmol/L (with actual levels ranging between 40.68 mmol/L and 89.33 mmol/L).
In international units, the data showed that IBD patients in the study had an average vitamin D serum level of 40 mmol/L (with the actual levels ranging between 18.5 mmol/L and 61.5 mmol/L). The controls in the study had an average vitamin D level of 65 mmol/L (with actual levels ranging between 40.68 mmol/L and 89.33 mmol/L).
Numerous inflammation markers were considered.
The researchers noted that lower vitamin D levels were associated with higher levels of inflammation (as would be expected). The inflammation markers considered included the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fecal calprotectin, leukocytes, and platelets, and the data confirm the association between vitamin D levels and inflammation.
IBD patients' vitamin D levels should be tested, or their intake supplemented.
In addition to the increased risk of relapse, or the need for surgical intervention, low vitamin D levels lead to the development of osteoporosis, calcium deficiency, and slower response to biologics. At lower latitudes, especially during the summer, increased sun exposure can be used to boost vitamin D levels in many cases, and depending on an individual's diet, vitamin D levels can sometimes be increased by proper diet selections. But oral supplementation of vitamin D should always work, in any situation. In severe cases, vitamin D injections can be used, but of course these require visits to a doctor's office, and a prescription
Surely this also applies to microscopic colitis (MC) patients.
Our own epidemiological evidence (in the shared experiences posted to our discussion and support forum, and stored in the archives) shows that MC patients are no exception to the association of the disease with low vitamin D levels. Consequently, most of us already knew most of the information that this research project "discovered", but at least, now gastroenterologists should be on the same page, regarding vitamin D and IBDs.
These findings contradict the conclusions of most recent vitamin D studies.
For the past few years, virtually every research project published, regarding the association of vitamin D and disease, has concluded that vitamin D supplementation is useless, for the prevention or treatment of disease. Perhaps this research conclusion will inspire a few researchers to disregard their biases, and design a few research projects that will reveal the truth about how helpful vitamin D tends to be for preventing and treating disease, particularly IBDs.
References
1. Topalova-Dimitrova, A., Dimitrov, I. V., and Nikolov, R. (2023). Lower vitamin D levels are associated with the pathogenesis of inflammatory bowel diseases. Medicine, 102(41), p e35505. Retrieved from https://journals.lww.com/md-journal/fulltext/2023/10130/lower_vitamin_d_levels_are_associated_with_the.74.aspx
