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. With IBD, the immune system ends up in an overloaded, overwhelmed state and loses its ability to function, resulting in chronic inflammation. Symptoms of IBD include diarrhea and abdominal pain, as well as other debilitating issues.
Vitamin D deficiency has been linked to many autoimmune diseases, including type 1 diabetes, systemic lupus erythematosus, and multiple sclerosis, as well as IBD, and 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 of vitamin D on the gut microbiome and inflammation. This was a small study that involved 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 D once a week for an eight 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 who had active ulcerative colitis with an increase in Enterobacteriaceae but no change in diversity of the gut microbiome.
I find that most patients 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 separate vitamin K. There are intricate relationships between fat-soluble vitamins and it is important take this into account when recommending vitamin D.
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. With the new study we just looked at, it stands to reason that there may have been a more significant outcome in this 2012 study if vitamin D was dosed at 10,000 IU daily or 50,000IU/week.
In addition, we 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 you 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