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10-12-2011, 02:11 PM   #1
David
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Vitamin D and Crohn's Disease

ScienceDaily (Jan. 27, 2010) — A new study has found that Vitamin D, readily available in supplements or cod liver oil, can counter the effects of Crohn's disease. John White, an endocrinologist at the Research Institute of the McGill University Health Centre, led a team of scientists from McGill University and the Université de Montréal who present their findings about the inflammatory bowel disease in the Journal of Biological Chemistry.

"Our data suggests, for the first time, that Vitamin D deficiency can contribute to Crohn's disease," says Dr. White, a professor in McGill's Department of Physiology, noting that people from northern countries, which receive less sunlight that is necessary for the fabrication of Vitamin D by the human body, are particularly vulnerable to Crohn's disease.

Vitamin D, in its active form (1,25-dihydroxyvitamin D), is a hormone that binds to receptors in the body's cells. Dr. White's interest in Vitamin D was originally in its effects in mitigating cancer. Because his results kept pointing to Vitamin D's effects on the immune system, specifically the innate immune system that acts as the body's first defense against microbial invaders, he investigated Crohn's disease. "It's a defect in innate immune handling of intestinal bacteria that leads to an inflammatory response that may lead to an autoimmune condition," stresses Dr. White.

What Vitamin D does

Dr. White and his team found that Vitamin D acts directly on the beta defensin 2 gene, which encodes an antimicrobial peptide, and the NOD2 gene that alerts cells to the presence of invading microbes. Both Beta-defensin and NOD2 have been linked to Crohn's disease. If NOD2 is deficient or defective, it cannot combat invaders in the intestinal tract.

What's most promising about this genetic discovery, says Dr. White, is how it can be quickly put to the test. "Siblings of patients with Crohn's disease that haven't yet developed the disease might be well advised to make sure they're vitamin D sufficient. It's something that's easy to do, because they can simply go to a pharmacy and buy Vitamin D supplements. The vast majority of people would be candidates for Vitamin D treatment."

"This discovery is exciting, since it shows how an over-the-counter supplement such as Vitamin D could help people defend themselves against Crohn's disease," says Marc J. Servant, a professor at the Université de Montréal's Faculty of Pharmacy and study collaborator. "We have identified a new treatment avenue for people with Crohn's disease or other inflammatory bowel diseases."

This study was funded by a grant from McGill University.
Source

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.
Source

Additional Papers and Reading:
- http://www.crohnsforum.com/showthread.php?t=35151 Vitamin D and the NOD2 Gene.
- http://www.crohnsforum.com/showthread.php?t=47789 - Vitamin D helps macrophages target ecoli in Crohn's disease.
- http://www.crohnsforum.com/showthread.php?t=48140 - Interview with Dr. John Cannell of the Vitamin D Council.
- http://www.crohnsforum.com/showthread.php?t=48267 Track your vitamin D from the sun with your smart phone.

Anyone here supplementing vitamin D? If so, how much, and do you feel it has helped at all?
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10-12-2011, 02:45 PM   #2
Crohn's Mom
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I don't supplement with Vitamin D, but I do with a multivitamin that contains it. On the facts sheet it says "Vitamin D 1000IU (amount per serving) 250% (% daily value)".
Would this be what this article considers an equivalent to just a Vitamin D tablet alone? Or do you think it would have a better benefit if it were only D tablets alone?

I started taking the multi around a month a go hoping it would help with "something"/ anything actually. I haven't noticed a difference in any of my health issues or energy yet tho.
I'd be willing to give Vit D by itself a shot tho if that would make a difference!
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10-13-2011, 10:32 AM   #3
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The upper daily limit has been increased to 2000 IU per day. If you are deficient as up to 70% of people in North America are you may need even more than that. A blood test is a good place to start. I take 2000 IU per day plus the 400 IU in my multi. I used to take 5000 IU daily for a few months until my blood work showed my levels were good.

I give my 3 year old 1000 IU daily, plus whatever is in her multivitamin. I find it helps protect her during cold and flu season. I also give her 250 mg vitamin C during the cold and flu season.
10-13-2011, 11:30 AM   #4
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I have been so tired lately, I asked my GI to run blood tests for me.
I posted the results for my Crohn's friends to see and they mentioned that there was no check for vit D, and a lack can make you tired.
A friend of mine takes 5000 daily, but I hadn't had a chance to research it, so I just started taking 1 1000 IU pill on top of my multivitamin.

I am remission now, so I can't really say if it's helping my Crohn's symptoms. I thought it helped my triedness for the first few days, but I'm now thinking that was my imagination.

The ingredients are Safflower Oil, Gelatin, Purified Water USP, Glycerin, and Cholecalciferol, so I don't really know what the beneficial part is. The last one maybe, since that is unrecognizable to me?

I think I will have to look up and see what dose is safe for kids to have. If my kids could have some protection against Crohn's, that would be amazing.
10-13-2011, 11:32 AM   #5
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The ingredients are Safflower Oil, Gelatin, Purified Water USP, Glycerin, and Cholecalciferol, so I don't really know what the beneficial part is. The last one maybe, since that is unrecognizable to me?
The Cholecalciferol is the vitamin D3.
10-13-2011, 11:52 AM   #6
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I used to take a Nature Made vitamin D tablet made with D3. It was 1000 I.U.
I recently switched to Wellesse vitamin D3 fast absorbing liquid. It is 2000 I.U.
I definitely notice a difference on the days that I forget to drink it.

My dad was prescribed a 50,000 I.U. tablet twice a month for his MS. That's on top of his multi and an order to get outside in the sun for at least 20 minutes a day.

A recent study I watched on the news stated that of all the vitamin supplements, vitamin D is crucial for everyone to be supplementing with. It can prevent a whole world of autoimmune diseases.
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10-23-2011, 05:12 PM   #7
Beach
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Saw this neat testimonial about a Crohn's suffer from Australia taking vitamin D3 on Dr. Cannell's sight. He reports that his condition improved greatly after 6 months of supplementing with 3000ius a day.

"Mailbag: vitamin D and Crohn’s"

http://blog.vitamindcouncil.org/2011...ce=twitterfeed
10-23-2011, 08:17 PM   #8
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I tested at 33 ng/ml which is low normal range. I've been taking Carlson D3 drops 4,000 Kj a day and my depression went away. Chrohn's is in check. My gf tested at 17 g/ml and doc put her on 50,000 iu once a week till normalizes. An article the other week stated pregnant women need 4 ,000 iu a day. Ten times more than previously thought. Remember RDA's are bare minimums to avoid rickets and scurvy not optimum performance.
10-23-2011, 08:20 PM   #9
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I took 10,000 iu a day in the Winter, and 5,000 iu in the Summer.

When I slacked off taking it I got ill. May be coincidence, but I am taking it again.

Dan
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10-23-2011, 08:22 PM   #10
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Dan have you had your levels checked? I'm curious what the optimal range is. It cured moderate case of depression for me.
10-23-2011, 08:44 PM   #11
D Bergy
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I had a test recently and my level was 40. I had not been taking the D for a while.

40 is considered normal, but I shoot for 60 to 80 as the experts do not believe 40 is adequate.

I have never got above 40 even taking 10,000 iu, but I have not had very many tests.

The last thing I read on it was that the rule of thumb is 35 iu for each pound of body weight. Sound pretty close to me.

Life guards typically have ranges from 60 to 80 of D.

Omega 3 and quelling low grade inflammation using Ginger and Turmeric cured my depression. The D should not hurt either.

Dan
10-31-2011, 06:00 AM   #12
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Well Matt had his monthly bloods done last Thursday and since he hadn't been tested for Vit D in quite some while I asked that it be added to the path request. Lo and behold they were all normal except for Vit D, he is deficient...53 with a reference range of 60-160mmol/l.

So the question is which way to go...

The GP has already suggested tablets, Ostelin 2,000 ui a day for month and then check levels.
But since Vit D is a fat soluble vitamin and there is a degree of fat malabsorption due to the resection is it better absorbed as a liquid than a tablet?
Or is it better given as an injection? Perhaps one of those annual mega injections?

Any thoughts or suggestions?

Thanks,
Dusty. xxx
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10-31-2011, 06:59 AM   #13
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My suggestion would be to scrap the Ostelin altogether.

It is not the right form of D to begin with. Ostelin is (ergocalciferol with ergosterol) or vitamin D-2.

Vitamin D-3 (cholecalciferol)what is found in food and produced from sun exposure. It is what is in over the counter D-3 supplements, which I am sure are way cheaper than Ostelin.

Vitamin D-2 is not even naturally produced by vertebrates, and it simply makes no sense to substitute what we are lacking, with something else we are not.

Do a little research on it. I think you will agree that D-2 is not a good substitute for D-3 It is not absorbed well either, so the 2,000 iu is unlikely to even budge his levels.

I use a liquid form of D-3 and when I can, I take it with Coconut Oil or a meal with fat in it, which is nearly all of them.

Dan
10-31-2011, 07:26 AM   #14
Beach
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I agree with taking D3 in liquid form. That seems to be the better kind of vitamin D for use in the body. It has worked well for me. And recall this article from a cardiologist on what worked best for his patients when supplementing with vitamin D. He had poor results when tablets where used.

"Getting vitamin D right"

http://www.trackyourplaque.com/blog/...n-d-right.html

Thought to add that I read Dr. Michael Hollick's book on vitamin D. Here in America he is one of the leading researchers on the vitamin. He mentioned that some crohns patients have had difficulty absorbing vitamin D supplements. So what he has done in those cases is arrange for the patients to sun bath, or use a D3 UVB lamp, for 20 minutes every other day. The nice thing about obtaining D3 naturally through sun light is that there are up to a dozen other substances created in the skin other than vitamin D. They are little understood, but undoubtably have a purpose.

His web sight is at:

http://vitamindhealth.org/
10-31-2011, 08:14 AM   #15
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Dusty, isn't summer heading your way fast? In addition to whatever is suggested above, how about suggesting he take 5 minute walks with his shirt off if he isn't on meds that preclude this. Then 7 minutes, then 10 minutes, and work up to 20 minute jogs? Exercise and sun
10-31-2011, 08:17 AM   #16
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In a past post a few years ago, there was findings that most people who got diagnosed had the bloods checked and was low. I agree with DAN that you need to up the doses in the winter. Now with hotter summers, most people stay indoors and their meds usually require to stay out of the sun with prolonged times. Where my husband works he is in the mines where there is not much sunlight in the winter and he is underground so I make him take the Vitamin D3 and Fish oil. I am sick enough for the both of us
10-31-2011, 08:19 AM   #17
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I take a multi (not sure how many IU's are in there) daily and one D3 with 5000 IU daily.
Not sure if it made a difference but I was told by my GP to do so after blood tests showed that I was low.
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10-31-2011, 08:23 AM   #18
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I don't go outside often enough so I take vitamin D every day. Hope it's doing some good.
10-31-2011, 08:25 AM   #19
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Believe it or not there was a study done and put in the that women to take multivitamins do not live as long as their counterparts. Didnt read is all but I dont take a multivitamin because I try to eat right.
10-31-2011, 09:09 AM   #20
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Believe it or not there was a study done and put in the that women to take multivitamins do not live as long as their counterparts. Didnt read is all but I dont take a multivitamin because I try to eat right.
It was an observational study and infinitely more properly controlled studies have shown the benefits of proper supplementation.
10-31-2011, 09:16 AM   #21
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That vitamin study was about as unscientific as they come. There was virtually no controls of any kind. It would never be accepted in any way by serious researchers.

It is one of those things the press ran with, without any investigation into the methods involved.

It certainly is better to get your nutrition from food, if that is possible. Vitamin D-3 is something that is not in many foods.
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10-31-2011, 11:34 AM   #22
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I agree with the Vitamin D3 I gotta start taking it now, darker longer. I just hate taking more pills than I need to. I dont have food problems at the moment. To make sure I am ok once in a while if I don't eat right I always have ensure on hand. Cause I like the taste.

Yeah my daughter is in research now and she says when the publicize stuff, you have to follow the money... her professors have taught her well
10-31-2011, 11:47 AM   #23
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Believe it or not there was a study done and put in the that women to take multivitamins do not live as long as their counterparts. Didnt read is all but I dont take a multivitamin because I try to eat right.
yeah because if you are vitamin deficient then you will be sicker and they can make more money treating you.

don't guess. have a medical doctor test you for vitamin deficiency and supplement accordingly.

if you eat a balanced diet (it's not as easy as it sounds) then you might be good but you would have to be a rare hyper vigilant individual who cookes most of their own food and makes amazing choices.
10-31-2011, 11:52 AM   #24
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to the Original Poster: Carlson D3 drops are top of the line in coconut oil. I'm not a salesperson i'm a poor documentary filmmaker with crohn's. just last week an article in mainstream media mentioned pregnant women need 10x than previously thought. that article said pregnant women need 4,000 iu a day. so if you take into consideration the RDA of Vitamin C, and how much Vitamin C we take when we get a cold, 1000's of mg more than RDA, come up with your own conclusion.

The funny thing is all the naysayers of supplemenation.. in the history of vitamins, how many have died from vitamins? 10 people? 20 people? Pharmaceuticals kill 100,000 people a year and how many of us are Humira junkies or take black label meds. Take some vitamins for a few months and see if you feel better. It won't kill you, but a lot of other things will. Just my opinion.
10-31-2011, 12:01 PM   #25
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yeah because if you are vitamin deficient then you will be sicker and they can make more money treating you.

don't guess. have a medical doctor test you for vitamin deficiency and supplement accordingly.

if you eat a balanced diet (it's not as easy as it sounds) then you might be good but you would have to be a rare hyper vigilant individual who cookes most of their own food and makes amazing choices.
I never said I agree with the statement , just that I try to get what I can for nutritional purposes rather than a pill. I get my bloods done regularly and never had a deficiency,only the B12 because I have a foot of intestine out.

Since I am getting picked on here, I think it is time for me to hibernate like the bears do...
10-31-2011, 12:11 PM   #26
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With the mention of taking a multi-vitamin, that reminds me of a problem that can develop between vitamin A and vitamin D. Activated vitamin A can override the helpful qualities of vitamin D. So if taking a multi, best that the A in the multi vitamin be in the form of beta carotene. If instead it is vitamin A retinol, best to avoid.

I've seen a few articles on this issue - one from Dr. Cannell that might be helpful.

"Proper vitamin D–vitamin A ratio"

http://www.vitamindcouncil.org/news-...tamin-a-ratio/
10-31-2011, 02:13 PM   #27
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With the mention of taking a multi-vitamin, that reminds me of a problem that can develop between vitamin A and vitamin D. Activated vitamin A can override the helpful qualities of vitamin D. So if taking a multi, best that the A in the multi vitamin be in the form of beta carotene. If instead it is vitamin A retinol, best to avoid.

I've seen a few articles on this issue - one from Dr. Cannell that might be helpful.

"Proper vitamin D–vitamin A ratio"

http://www.vitamindcouncil.org/news-...tamin-a-ratio/
I take 25k UI of vitamin D weekly irrc (haven't got the box with me) and avoid taking too many multivitamines, although it is an easy way to get zinc.

This reminds me, multivitamins / spullements sometimes have iron in them, iron, although most of us have a deficiency, it's important to note that many bacteria need iron to survive. But, this is important, common probiotics (which might help crohn's, only mucosa, a tiny bit) often have no use for them and are actually better off with lower iron levels. Iron levels increase during inflammation and active disease in crohn's patients (even if there is a general shortage of intake), but when you're in remission it's important not to overdo iron supplements either.
10-31-2011, 03:17 PM   #28
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Thank you all so much for your responses.

I will look into the available liquids and then discuss it with Matt. At the end of the day it will be his decision and whatever he is gong to be the most compliant with is the way we will go.

@Dan - Is it possible that Ostelin is different where you are? I wouldn't have thought so but here it is a cholecalciferol 25mcg gel cap (equivalent to Vitamin D3 1000 IU) and is available over the counter.

@David - Yes heading into Summer. Getting out into the sun the was the docs first suggestion and I will have him do that but I did explain to him about the Azathioprine so he suggested the tablets as an addition.

Dusty.
10-31-2011, 03:18 PM   #29
Beach
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I take 25k UI of vitamin D weekly irrc (haven't got the box with me) and avoid taking too many multivitamines, although it is an easy way to get zinc.

This reminds me, multivitamins / spullements sometimes have iron in them, iron, although most of us have a deficiency, it's important to note that many bacteria need iron to survive. But, this is important, common probiotics (which might help crohn's, only mucosa, a tiny bit) often have no use for them and are actually better off with lower iron levels. Iron levels increase during inflammation and active disease in crohn's patients (even if there is a general shortage of intake), but when you're in remission it's important not to overdo iron supplements either.
Interesting about iron, inflammation and probiotics. I know little about iron. This is years ago, but remember reading at one time that iron can cause constipation. So I had to give supplementing with it a try! Downed a few tablets for a few days and ....no relief. Recall though that it did dry out my skin pretty well for some reason.
10-31-2011, 03:41 PM   #30
steelek5
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My doctors have never spoken to me about my Vit. D levels... is it standard for them to check...?? Should I ask them to check this or would they check if there was a concern?
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