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Vitamin D

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About Vitamin D

Vitamin D is a fat soluble vitamin that is essential for efficient utilization of Calcium and Phosphorus and can be obtained via UV Rays / Sunlight (the skin synthesizes it) or dietary means. Vitamin D deficiency is common in people with Crohn's Disease and we at CrohnsForum.com implore everyone with IBD to get their Vitamin D levels checked.[1]

Uncontrolled proliferation of cells with certain mutations may lead to diseases like cancer and the active form of vitamin D, 1,25-dihydroxyvitamin D, inhibits proliferation and stimulates the differentiation of cells.[2].

Vitamin D has many beneficial effects on immune system function as it can affect aspects of both innate and adaptive immunity, including phagocytosis, cytokine production, lymphocyte differentiation, and antibody production. In addition, the active form of vitamin D stimulates the expression of antimicrobial peptides, which are synthesized by various immune cells and function as critical components of the innate immune system.[7][9][13]

Vitamin D and Relationship to Inflammatory Bowel Diseases

Crohn's Disease
Low sunlight (UV) exposure / Vitamin D Deficiency is correlated with an increased risk of developing Crohn's Disease (CD). This link may not be a primary cause of Crohn's but Vitamin D Deficiency exacerbates the condition. The authors state that further research on this topic is needed. [12] [13]
Ulcerative Colitis
There appears to be no increased incidence of Ulcerative Colitis with low sunlight exposure. [12]

Symptoms of Vitamin D Deficiency:

Bone pain, soft bones (osteomalacia), rickets, hyperparathyroidism, muscle weakness, muscle pain, joint pain, poor immune function (getting sick a lot).

Anatomy of Absorption:

You are at increased risk of vitamin D deficiency if you have trouble absorbing fats or have inflammation of large portions of the jejunum and/or ileum or you have had portions of the jejunum or ileum surgically removed.[4]. Vitamin D is one of the most important vitamins for people with IBD to supplement as it can make a world of difference. This thread is full of people with IBD who have benefited from supplementing with it.

Recommended Daily Intake:

US RDA for vitamin D is completely outdated and not pertinent to people with Crohn's Disease or other forms of IBD. A serum level of 60-80 ng/ml ("normal" range can be much lower, pay no attention to that) of 25-hydroxy vitamin D should be your target [5] which will likely require as much as 6,000iu per day to achieve. However, everyone is different and you may require more or less. Get your levels tested and begin supplementing under care of a doctor. Get your levels tested regularly so you can find the daily supplementation amount that works best for you.

100 IU (2.5 mcg) per day increases vitamin D blood levels 1 ng/ml (2.5 nmol/L).
200 IU (5 mcg) per day increases vitamin D blood levels 2 ng/ml (5 nmol/L).
400 IU (10 mcg) per day increases vitamin D blood levels 4 ng/ml (10 nmol/L).
500 IU (12.5 mcg) per day increases vitamin D blood levels 5 ng/ml (12.5 nmol/L).
800 IU (20 mcg) per day increases vitamin D blood levels 8 ng/ml (20 nmol/L).
1000 IU (25 mcg) per day increases vitamin D blood levels 10 ng/ml (25 nmol/L).
2000 IU (50 mcg) per day increases vitamin D blood levels 20 ng/ml (50 nmol/L).[8]

Only oil based forms (such as capsules) of vitamin D3 should be taken, NOT dry tablets as they are poorly absorbed (unless taken with a teaspoon of olive oil) [5]. According to a letter from Doctor John J Cannell MD of the Vitamin D Council written in November 2011 to Crohnsforum.com, "25(OH)D levels need to be 70-80 ng/ml, which requires 5,000 – 10,000 IU/day of vitamin D3, to treat Crohn’s disease.

Vitamin D needs cofactors to work properly. If I had Crohn’s, I would definitely pay the extra cost and buy a vitamin D with the expensive K2, and magnesium, zinc and boron. These are the cofactors vitamin D needs to work. For example, the vitamin D receptor is like a glove. At the base of the fingers of the glove is a zinc molecule. Most Americans are zinc deficient. The same is true for boron, magnesium and probably K2.

I recommend the new D-Plus from Bio-Tech Pharmacal. Make sure it is the new formula, not the old one. The dose is three pills per day for 5,000 IU, this is important as most people take only one or two and so are still vitamin D deficient. Take with largest meal of day."

Natural Sources of Vitamin D:

UltraViolet (UV) Light Therapy, usually through exposure of the skin to sunlight has been used as a therapy to normalize Hypovitamintosis D in patients that are not effectively able to take oral supplements. - If you are able to tolerate sunlight, spending enough time in the sun to turn your skin slightly pink (not burnt) is the best way to get vitamin D. Supplementation is the second best method. Avoid cod liver oil due to its high vitamin A content.

Food - While Vitamin D is not food naturally in too many foods, it can be obtained from salmon, sardines, milk and eggs. [6]

Non IBD Causes Of Deficiency

  • In countries with a high incidence of skin cancer, education to reduce exposure to the harmful effects of the sun has been very successful through the use of sun screen and sun protective clothing. Unfortunately this has also increased Vitamin D deficiency.
    It has been shown that wearing just SPF 8 sunscreen reduces Vitamin D synthesis via sunlight by 95%.[3]
  • The farther north you live of the equator the higher risk the risk of deficiency.
  • People with darker skin that live far from the equator.
  • If for religious or other reasons you wear concealed clothing.
  • Obese people are also at higher risk for vitamin D deficiency due to the low bioavailability of vitamin D in their system because it is stored in body fat.[45]

For those with IBD these may be other points to take into consideration when making a decision on Vitamin D supplementation.

For More Information on Vitamin D and Other Vitamins and Minerals

Excellent Vitamin D Resource

Check out the Vitamin D Council's Website (outside site) for an excellent resource of all things Vitamin D HERE
or
http://www.vitamindcouncil.org

References

[pos]1a[/pos][1] http://www.ncbi.nlm.nih.gov/pubmed/1...?dopt=Abstract
[pos]2a[/pos][2] http://lpi.oregonstate.edu/infocente...mins/vitaminD/
[pos]3a[/pos][3] http://www.ncbi.nlm.nih.gov/pubmed/1...?dopt=Abstract
[pos]4a[/pos][4] http://www.ucsfhealth.org/education/...bowel_disease/
[pos]5a[/pos][5] http://www.trackyourplaque.com/blog/...n-d-right.html
[pos]6a[/pos][6] http://whfoods.org/genpage.php?tname=nutrient&dbid=110
[pos]7a[/pos][7] http://lpi.oregonstate.edu/ss10/nutrition.html
[pos]8a[/pos][8] http://www.medscape.com/viewarticle/589256_8
[pos]9a[/pos][9] http://www.ncbi.nlm.nih.gov/pmc/arti...e0304_0220.pdf
[10]. http://www.vitaminddeficiencysite.com/
[11]. http://doc2doc.bmj.com/forums/open-c...d-screening_.2
[pos]12a[/pos][12] Nerich, V. V., Jantchou, P. P., Boutron-Ruault, M. C., Monnet, E. E., Weill, A. A., Vanbockstael, V. V., & ... Carbonnel, F. F. (2011). Low exposure to sunlight is a risk factor for Crohn's disease. Alimentary Pharmacology & Therapeutics, 33(8), 940-945. http://onlinelibrary.wiley.com/doi/1...601.x/abstract
[pos]13a[/pos][13]. Kamen DL and Tangpricha V. Vitamin D and molecular actions on the immune system: modulation of innate and autoimmunity. J Mol Med (Berl). 2010; 88(5): 441-450. http://www.ncbi.nlm.nih.gov/pmc/arti...ihms190355.pdf
[pos]45a[/pos][45]. http://jcem.endojournals.org/content/88/1/157.long
[pos]46a[/pos][46].http://www.vitamindcouncil.org

Popular Threads Discussing Vitamin D



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09-11-2010, 12:09 PM   #1
BulldozerKing
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All this research about Vit D being good for Chron's, Rhem etc.. HOW MUCH!! How much is to much? I am thinking of taking 5000 a day. Right now 3000. Maybe 10000? I hate articles that don't mention the important stuff!!
09-11-2010, 12:22 PM   #2
Rebecca85
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There is much debate on the recommended amounts of vitamin D. I am not a doctor, therefore would not wish to advise you on the correct amount to take.
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09-11-2010, 12:25 PM   #3
BulldozerKing
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Well, Doctor's know squat about nutrition. I have taken more University courses then they have!! Research is showing more is better.
09-11-2010, 12:45 PM   #4
Rebecca85
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It does appear that more is better, but please be aware that too much Vitamin D is toxic. 'Too much' will vary from person to person, and depends on things like how much sunlight you are getting, though a doctor may be able to test your blood to see if you are taking too much.

By the way, I see you are a new member. Welcome! Would you like to post your story in the story forum?

Last edited by Rebecca85; 09-11-2010 at 12:48 PM.
09-11-2010, 01:15 PM   #5
BulldozerKing
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That's not correct, in fact, no studies have ever proven Vitamin Toxicity :

Mt. Sinai researcher Dr. Reinhold Vieth. He's spent 30 years studying Vitamin D and thinks the cancer people are overreacting. "I'm afraid of having too little Vitamin D," he responds confidently. "I'm not afraid of having too much." How much does he take? "I stay steady at 4,000 units per day ... There is no risk involved."

In 1999, Vieth indirectly asked the medical community to produce any evidence 10,000 units of vitamin D a day was toxic, saying "Throughout my preparation of this review, I was amazed at the lack of evidence supporting statements about the toxicity of moderate doses of vitamin D." He added: "If there is published evidence of toxicity in adults from an intake of 250 ug (10,000 IU) per day, and that is verified by the 25(OH)D concentration, I have yet to find it."

Like most medication, cholecalciferol is certainly toxic in excess, and, like Coumadin, is used as a rodent poison for this purpose. Animal data indicates signs of toxicity can occur with ingestion of 0.5 mg/kg (20,000 IU/kg ), while the oral LD50 (the dose it takes to kill half the animals) for cholecalciferol in dogs is about 88 mg/kg, or 3,520,000 IU/kg. This would be equivalent to a 110-pound adult taking 176,000,000 IU or 440,000 of the 400 unit cholecalciferol capsules.

Vieth reports human toxicity probably begins to occur after chronic daily consumption of approximately 40,000 IU/day (100 of the 400 IU capsules). Heavy sun exposure when combined with excessive supplement use is a theoretical risk for vitamin D toxicity, but if such a case has been reported, I am not aware of it.

Physician ignorance about vitamin D toxicity is widespread. A case report of four patients appeared in the 1997 Annals of Internal Medicine, accompanied by an editorial warning about vitamin D toxicity. However, careful examination of the patients reveals that both papers are a testimony to the fact that incompetence about vitamin D toxicity can reach the highest levels of academia
09-11-2010, 01:40 PM   #6
Rebecca85
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So it would appear that up to 10,000 IU a day is safe.... except if you suffer from certain medical conditions (especially those that affect your kidneys). So I would still advise anyone thinking of taking large doses (more than is recommended on the pill bottle) to consult with their doctor, and get the blood tests.
02-23-2012, 07:31 AM   #7
mikeyarmo
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A local health food store told me there was no difference between the tablet forms of Vitamin D and the capsules (with oil). It seems like they might have been misinformed! I wonder if there will be any changes when I do switch from the tablets I currently take.
02-23-2012, 09:33 AM   #8
David
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Do you know what your levels are Mike?
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02-26-2012, 12:16 PM   #9
mikeyarmo
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I don't David.

I spoke with a local medical clinic as I wanted to test this a while ago and they will not do any blood work without a requisition form from a doctor. The clinics are paid by the provincial health care system, so even if I wanted to pay for my own private blood test I don't think I am able.

It is harder to get doctor's to check for Vitamin D as the public health insurance changed when this test can be performed due to the large increase in costs over the past few years due to the growth in having Vitamin D levels checked.

I have my annual appointment with my gastroenterologist next month and typically get blood work done then so I will see if I can get Vitamin D levels checked also and if I can obtain the results.
04-03-2012, 06:10 PM   #10
Laney1983
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All this research about Vit D being good for Chron's, Rhem etc.. HOW MUCH!! How much is to much? I am thinking of taking 5000 a day. Right now 3000. Maybe 10000? I hate articles that don't mention the important stuff!!


For what it's worth, I take one 5,000 IU capsule per day. It's a high-end brand of vitamin D3. From everything I've read, it seems that the quality of the supplement is every bit as important as the dose, and that lower quality supplement brands are not as well absorbed.

I was able to find some info on dosage. I guess it all depends on who or where you're getting the information. The FDA says one thing, the AJCN says another, and the individual health/nutrition experts who write and blog about the subject all seem to have their own ideas about what is the correct dose.

IMO, the right dose depends on the individual and her specific needs. My levels were very low when I had them tested, which is why I take 5,000 IU every night during the winter and 3-4 times per week during the summer.

I'm not a doctor though, so please don't take that as medical advice.

Anyway, here's what I was able to find from those who are more qualified to speak on the topic than I am:


"If you take Vitamin D supplements make sure it is Vitamin D3 and not D2. Take Vitamin D3 supplements with food. I usually recommend Vitamin D3 2000iu-5000iu/ day depending on lab levels." Source: http://www.pamelaegan.com/articles/vitamin-d3.htm

"... the safety data published by the American Journal of Clinical Nutrition (AJCN) Jan 2007; 85: 6 – 18, that concluded the safety profile of Vitamin D should safely permit raising the UL for vitamin D to 250ug (10,000iu) per day from the current UL of 50 ug (2,000iu) per day." Source: http://www.pamelaegan.com/articles/vitamind3.htm

"The recommended dosages for Vitamin D are 400 units a day if you are under 50 years old, 600 units a day for those 51-70, and 800 units a day for those over 71. When one is deficient, it is very difficult to replete levels with over the counter doses of Vitamin D. A prescription-strength dose is often required, and can be beneficial with a weekly dose." Source: http://vitamind3blog.com/2010/05/vit...hey-necessary/
06-03-2012, 06:53 AM   #11
hugh
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Clinical trial: vitamin D3 treatment in Crohn’s disease - a
randomised double-blind placebo-controlled study
http://www.google.com/url?sa=t&rct=j...JN_bWCUcrVKm1A
Conclusion: Oral supplementation with 1,200 IE vitamin D3 significantly increased serum
vitamin D levels and insignificantly reduced the risk of relapse from 29% to 13%, (p= 0.06).

Last edited by hugh; 06-03-2012 at 06:51 PM.
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