Written by Greg Arnold, DC, CSCS. Crohn’s disease participants who took 2000 IU of Vitamin D per day reduced their C reactive protein by 40% and anti-inflammatory protein by 31 % but only after their blood levels of Vitamin D reached 75 nanomoles per liter.
Crohn’s disease is a chronic disease that causes inflammation of the digestive tract, most commonly the small intestine and the beginning of the large intestine. Crohn’s disease is also called inflammatory bowel disease and also includes ulcerative colitis and microscopic colitis (1).
Complications from Crohn’s disease can be very severe and very debilitating if they occur for long periods of time. They include nutrition deficiencies due to absorption problems, a perforated bowel where the inflammation creates holes in the digestive tract, and what’s called a “toxic megacolon” where severe inflammation leads to rapid swelling of the colon (2). As a result, finding ways to help manage Crohn’s disease is extremely important.
Now a new study (3) suggests that vitamin D may help. The study involved 27 patients (13 men, 14 women) aged 25 to 47 who were diagnosed with Crohn’s disease for an average of 8.5 years but with their Crohn’s disease in remission. They were given either 2,000 IU per day of vitamin D (12 subjects) or a placebo (15 subjects) for 3 months. Blood samples were obtained before and after the study. The patients filled out a Crohn’s Disease Activity Index questionnaire (4) and a Quality of Life questionnaire. The researchers classified remission as a score less than 150 on the Crohn’s Disease Activity Index and blood levels below 5 milligrams/Liter of an inflammatory protein called C-reactive protein for at least 3 months before the study.
After 3 months, those in the vitamin D group as a whole did not see significant differences in the measurements taken compared to the placebo group. The researchers observed a threshold of vitamin D blood levels of 75 nanomoles per Liter before any significant benefits were seen in the patients, with 8 out of the 12 subjects in the vitamin D group achieving blood levels of at least 75 nmol/L.
Specifically, compared to those with vitamin D levels below 75 nmol/L (4/12 subjects), those with vitamin D levels of at least 75 nmol/Liter (8/12 subjects) had:
- 8.6% higher Quality of Life scores (190 vs.175, p = 0.038),
- 40% lower C-reactive protein levels (1.5 vs. 2.5 milligrams/deciliter (p = 0.019), and
- 31% higher levels of a protein called LL-37 (210 vs.160 ng/dL, p < 0.001), which promotes wound healing in intestinal cells (5) and reduces intestinal inflammation (6).
The researchers cited the 75 nmol/L threshold as a necessary level to reach for vitamin D benefits but admit that “different patients may require different dosages of vitamin D and different durations of supplementation in order to bring them over the study threshold.” Unfortunately, the researchers did not attempt to explain why 4 of the 12 patients did not reach the 75 nmol/L threshold and what would make patients “different” in deciding vitamin D dosage and duration.
The researchers concluded by suggesting that “future randomized controlled trials consider studies of longer duration to fully explore and capture the possible immune-modulatory and anti-inflammatory effects of vitamin D therapy in Crohn’s Disease.”
Source: Raftery, Tara, Adrian R. Martineau, Claire L. Greiller, Subrata Ghosh, Deirdre McNamara, Kathleen Bennett, Jon Meddings, and Maria O’Sullivan. “Effects of vitamin D supplementation on intestinal permeability, cathelicidin and disease markers in Crohn’s disease: results from a randomised double-blind placebo-controlled study.” United European gastroenterology journal 3, no. 3 (2015): 294-302.
© Author(s) 2015
Posted July 9, 2015.
Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY. You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com.
References:
- “Crohn’s disease” posted on the National Institute of Diabetic and Digestive and Kidney Diseases website
- Facts about Inflammatory Bowel Diseases” posted on the Crohn’s and Colitis Foundation of America
- Raftery T. Effects of vitamin D supplementation on intestinal permeability, cathelicidin and disease markers in Crohn’s disease: Results from a randomized double-blind placebo-controlled study. United European Gastroenterology Journal 2015; 3(3):294–302
- Best WR, Becktel JM, Singleton JW, Kern F jr. Development of a Crohn’s Disease Activity Index. National Co-operative Crohn’s disease study. Gastroenterology. 1976;70:439–44
- Otte JM, Zdebik AE, Brand S, et al. Effects of the cathelicidin LL-37 on intestinal epithelial barrier integrity. Regul Pept 2009; 156: 104–117
- Koon HW, Shih DQ, Chen J, et al. Cathelicidin signaling via the Toll-like receptor protects against colitis in mice. Gastroenterology 2011; 141: 1852–1863, e1851–e1853