Managing vitamin D deficiency in inflammatory bowel disease.
Frontline Gastroenterol. 2019 Oct;10(4):394-400. doi: 10.1136/flgastro-2018-101055. Epub 2019 Jan 7.
Nielsen OH1 ohn at dadlnet.dk, Hansen TI1, Gubatan JM2, Jensen KB3,4, Rejnmark L5.
1 Department of Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
2 Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, USA.
3 Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark.
4 Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Stem Cell Research, University of Copenhagen, Copenhagen, Denmark.
5 Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
Even with malabsorption there are many great ways to supplement vitamin D
Overview Gut and vitamin D contains gut-friendly information
Getting Vitamin D into your body has the following chart
Getting Vitamin D into your body also has the following
If poorly functioning gut
Bio-D-Mulsion Forte – especially made for those with poorly functioning guts, or perhaps lacking gallbladder
Sublingual – goes directly into bloodstream
Oil: 1 drop typically contains 400 IU, 1,000 IU, or 4,000 IU, typically not taste good
Topical – goes directly into bloodstream. Put oil on your skin, Use Aloe vera cream with Vitamin D, or make your own
Vaginal – goes directly into bloodstream. Prescription only?
Bio-Tech might be useful – it is also water soluble
Vitamin D sprayed inside cheeks 2X more response (poor gut) – RCT Oct 2015
and, those people with malabsorption problems had a larger response to spray
Inject Vitamin D quarterly into muscle, into vein, or perhaps into body cavity if quickly needed
Nanoparticles could be used to increase vitamin D getting to the gut – Oct 2015
Poor guts need different forms of vitamin D has the following
Guesses of Vitamin D response if poor gut
| Bio | Form | Speed | Duration |
| 10 | Injection ($$$) or Calcidiol or Calcitriol | D - Slow C -Fast | Long |
| 10 | Sun/UVB | Slow | Long |
| 10 | Topical (skin patch/cream, vagina) | Slow Fast nano | Normal |
| 9 | Nanoemulsion -mucosal perhaps activates VDR | Fast | Normal |
| 9? | Inhaled (future) | Fast | Normal |
| 8 | Bio-D-Mulsion Forte | Normal | Normal |
| 6 | Water soluble (Bio-Tech) | Normal | Normal |
| 4 | Sublingual/spray (some goes into gut) | Fast | Normal |
| 3 | Coconut oil based | Slow | Normal |
| 2 | Food (salmon etc.) | Slow | Normal |
| 2 | Olive oil based (majority) | Slow | Normal |
10= best bioavailable, 0 = worst, guesses have a range of +-2
Speed: Fast ~2-6 hours, Slow ~10-30 hours
Duration: Long ~3-6 months, Normal = ~2 months
Overview Gut and vitamin D has 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 with vitamin D for Gut problems (101 trials listed as of Sept 2019) - All items in category gut and vitamin D
168 items See also Vitamin D Life
- Inflammatory bowel diseases are associated with Vitamin D etc. – meta-meta-analysis - April 2019
- IBS quality of life improved by vitamin D (50,000 IU every two weeks) – RCT May 2016
- IBS, like many other diseases, appears to be treated better by non-daily supplementation
- Topical Vitamin D provides more benefits than oral for some people
- Those with poor guts as an example
- Inflammatory Bowel Disease Inflammation and Vitamin D – scores of studies and trials – Aug 2019
- The Role of Vitamin D in the Pathogenesis of Inflammatory Bowel Disease – March 2019
The Meta-analysis of Gut and Vitamin D
- Inflammatory Bowel Disease 1.5 X more likely if low vitamin D – meta-analysis Dec 2019
- Crohn’s Disease associated with lower Vitamin D - meta-analysis Sept 2019
- Inflammatory bowel diseases are associated with Vitamin D etc. – meta-meta-analysis - April 2019
- IBD relapse rate reduced by low Vitamin D - meta-analysis Nov 2018
- 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
Download the PDF from Vitamin D Life
Management of inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease, is generally cumbersome for patients and is a massive health-economic burden. In recent years, the immunomodulating effects of vitamin D have gained a huge interest in its possible pathogenic influence on the pathophysiology of IBD. Vitamin D deficiency is frequent among patients with IBD. Several clinical studies have pointed to a critical role for vitamin D in ameliorating disease outcomes. Although causation versus correlation unfortunately remains an overwhelming issue in the illusive chicken versus egg debate regarding vitamin D and IBD, here we summarise the latest knowledge of the immunological effects of vitamin D in IBD and recommend from available evidence that physicians regularly monitor serum 25(OH)D levels in patients with IBD. Moreover, we propose an algorithm for optimising vitamin D status in patients with IBD in clinical practice. Awaiting well-powered controlled clinical trials, we consider vitamin D supplementation to be an affordable and widely accessible therapeutic strategy to ameliorate IBD clinical outcomes.
Inflammatory Bowel Disease – proposed Vitamin D protocol – Oct 2019Printer Friendly PDF this page! Follow this page for updates761 visitors, last modified 29 Oct, 2019, This page is in the following categories (# of items in each category)