Vitamin D3 Supplementation in Diarrhea-Predominant Irritable Bowel Syndrome Patients: The Effects on Symptoms Improvement, Serum Corticotropin-Releasing Hormone, and Interleukin-6 - A Randomized Clinical Trial
Complement Med Res, 1-8 2020 Mar 23, DOI: 10.1159/000506149
Masoumeh Khalighi Sikaroudi 1, Marjan Mokhtare 1, Leila Janani 2, Amir Hossein Faghihi Kashani 1, Mohsen Masoodi 1, Shahram Agah 1, Narjes Abbaspour 3, Afsaneh Dehnad 4, Farzad Shidfar 5
Study would probably have done even better if they had used a gut-friendly form of vitamin D
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
Overview Gut and vitamin D contains gut-friendly informationGut-friendly, Sublingual, injection, topical, UV, sunshine
Getting Vitamin D into your body has the following chart
Getting Vitamin D into your body also has the following
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
Long 10 Sun/UVB Slow Long 10 Topical
(skin patch/cream, vagina)
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
Gut category listing contains the following
167 items in GUT category - see also Overview Gut and vitamin D,
- "Ulcerative Colitis" OR UC 839 items Jan 2020
- "celiac disease" OR CD 1830 items July 2019
- "inflammatory bowel disease" OR "inflammatory bowel symptom" 1630 items as of Jan 2020
- Crohn's 1230 items as of Feb 2019
- Gut-Friendly forms of vitamin D
such as: bio-emulsion, topical, spray, sublingual, inhaled, injection . .
Items in both categories Gut and Intervention - non daily are listed here:
- Diverticular disease:12X reduction if low Vitamin D and given 100,000 IU monthly – RCT Aug 2020
- IBS diarrhea treated by weekly 50,000 IU of Vitamin D – RCT March 2020
- Irritable Bowel Syndrome treated by weekly 50,000 IU Vitamin D – RCT Feb 2019
- Ulcerative Colitis inflammation treated by weekly vitamin D (40,000 IU) – July 2018
- Gut bacteria of Crohn's disease patients improved by Vitamin D – March 2018
- Vitamin D changed microbiota in gut and airway, might reduce cystic fibrosis – RCT Nov 2017
- IBS quality of life improved by vitamin D (50,000 IU every two weeks) – RCT May 2016
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Objectives: This study aimed to evaluate whether vitamin D deficiency is associated with the severity of symptoms of irritable bowel syndrome (IBS) patients. Stress and gut inflammation can increase the serum level of corticotropin-releasing hormone (CRH) and interleukin-6 (IL-6), leading to a change in bowel movements. The aim of this study was to evaluate the anti-inflammatory and psychological effects of vitamin D3 supplementation on the symptom improvement of patients with a diarrhea-predominant form of IBS (IBS-D).
Methods: Eighty-eight IBS-D patients (age: 18-65 years) based on Rome IV criteria who suffered from vitamin D deficiency and/or insufficiency were enrolled in this randomized, placebo-controlled trial from February 2017 to May 2018 at Rasoul-e-Akram Hospital, Tehran, Iran. Participants were randomly divided into two groups. The intervention group received 50,000 IU vitamin D3 weekly and the control group received a placebo for 9 weeks. All patients received Mebeverine 135 mg twice a day besides supplementation. The IBS Severity Score System (IBS-SSS), serum 25(OH) vitamin D3, CRH, and IL-6 were measured before and after interventions.
Results: Seventy-four patients completed the study. The severity of IBS symptoms (p < 0.01) and IL-6 (p = 0.02) decreased significantly in the intervention group as compared to the control group, but there was no significant difference in the serum level of CRH. Also, in the treatment group, IBS-SSS and IL-6 were significantly reduced at the end of the study from baseline (p < 0.01 and p < 0.03, respectively).
Conclusion: Our findings indicate that vitamin D3 supplementation can modulate the serum level of CRH and IL-6 and can improve symptoms in IBS-D patients. Vitamin D3 supplementation should be considered in IBS-D patients who suffer from vitamin D deficiency and/or insufficiency.IBS diarrhea treated by weekly 50,000 IU of Vitamin D – RCT March 2020
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