Ulcerative Colitis significantly reduced by 480,000 IU loading dose of nano Vitamin D – RCT

Oral Nano Vitamin D Supplementation Reduces Disease Activity in Ulcerative Colitis: A Double-Blind Randomized Parallel Group Placebo-controlled Trial.

Letter to Editor on this study is at end of this page

J Clin Gastroenterol. 2019 Jul 26. doi: 10.1097/MCG.0000000000001233.

Ahamed Z R1, Dutta U1, Sharma V1, Prasad KK1, Popli P1, Kalsi D1, Vaishnavi C1, Arora S1,2, Kochhar R1.

1 Department of Gastroenterology.

2 Dept of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

RCT with unstated number of participants 60,000 IU per day of nano vitamin D for 8 days Then test 4 weeks later Average vitamin D level was 41 ng/ml 17 people (~half?) got > 40 ng     and more than 60% reduction in UC severity score --- * The exact form of the nano is not stated in the abstract, but it is probably similar to many nanoemulsions in being gut-friendly * Vitamin D Loading doses have worked well for > 1 million people over the past 50 years in raising Vitamin D levels in weeks instead of months) * Vitamin D loading is especially good for 50+ diseases. like UC, for which a Vitamin D Receptor can limit how much vitamin D actually gets to tissues They happened to:    1) Use a gut-friendly form to get Vitamin D into the blood    2) A method to get that Vit D into the tissue         Crohn's disease is another gut problem which should benefit from nano-loading 1. Ulcerative Colitis and Gut * Gut problems more likely if low vitamin D (IBD: 1.6, UC: 2.3) – meta-analysis Aug 2015 * Ulcerative Colitis inflammation treated by weekly vitamin D (40,000 IU) – July 2018 * Ulcerative colitis treated by injection of 300,000 IU of vitamin D – RCT July 2016 * Injection also avoids gut problem, but is much more expensive than nano * Turmeric stopped Ulcerative Colitis – RCT Feb 2019 1. Overview Gut and vitamin D has the following summary {include} 1. Gut category listing contains the following {include} 1. Loading Dose * Overview Loading of vitamin D * Healthy in Seven Days - Loading dose of Vitamin D – book 2014 * Similar to the 480,000 IU in the study on this page * 1. Nano forms of Vitamin D * Nanoemulsion Vitamin D may be a substantially better form * Inhaled vitamin D help lungs - many studies * Vitamin D nanoemulsion etc. for fortification, pills, injections, topical and cancer – July 2019 Types of UC

INTRODUCTION: Vitamin D possesses anti-inflammatory properties and could be beneficial in ulcerative colitis (UC).

METHODS:

We studied the effect of oral nano vitamin D3 supplementation on disease activity in active UC [ulcerative colitis disease activity index (UCDAI)≥3]. Patients with active UC and vitamin D <40 ng/mL were randomized to receive either oral nano vitamin D (60,000 IU/d×8 d) or placebo. They were evaluated for disease activity (UCDAI scores, C-reactive protein, erythrocyte sedimentation rate, and fecal calprotectin) at baseline and reassessed at 4 weeks. The response was defined as a 3-point reduction in UCDAI score at 4 weeks and reduction in inflammatory markers.

RESULTS:

The median vitamin D levels increased from 15.4 to 40.83 mg/dL in vitamin D group (P≤0.001) and marginally from 13.45 to 18.85 mg/dL (P=0.027) in controls.

The 3-point reduction in UCDAI was seen more often in vitamin D group as compared with the control (53% vs. 13%; P=0.001).

Increase in vitamin D levels correlated with reduction in UCDAI score (P≤0.001; ρ=-0.713), C-reactive protein (P≤0.001; ρ=-0.603), and calprotectin (P=0.004; ρ=-0.368).

Patients who achieved target vitamin D of >40 ng/mL (n=17) more often had a 3-point reduction in UCDAI (80% vs. 20%; P≤0.001) and reduction in grade of severity from 60% to 35% (P=0.038).

Vitamin D administration (odds ratio, 9.17; 95% confidence interval, 2.02-41.67) and baseline histologic activity (odds ratio, 1.92; 95% confidence intervals, 1.2-3.08) independently predicted response.

CONCLUSIONS:

Oral nano vitamin D supplementation in active UC is associated with a reduction in disease activity and severity grade and is seen more often in those who achieved a target vitamin D level of 40 ng/mL.

Oral Nano Vitamin D Supplementation and Disease Activity in Ulcerative Colitis

Journal of Clinical Gastroenterology: September 12, 2019 -doi: 10.1097/MCG.0000000000001263

Dai, Cong MD, PhD; Jiang, Min MD, PhD; Sun, Ming-Jun MD, PhD

Letter to the Editor: PDF Only

Image from the web