Crohn’s Disease reduced for a year by 7 weeks of high dose Vitamin D – RCT March 2021

Seven Weeks of High-Dose Vitamin D Treatment Reduces the Need for Infliximab Dose-Escalation and Decreases Inflammatory Markers in Crohn’s Disease during One-Year Follow-Up

Nutrients 2021, 13(4), 1083; https://doi.org/10.3390/nu13041083
by Mia Bendix 1,2,*,Anders Dige 1,Søren Peter Jørgensen 1,Jens Frederik Dahlerup 1,Bo Martin Bibby 3,Bent Deleuran 4,5OrcID andJørgen Agnholt 1OrcID

VitaminDWiki

200,000 IU the first day then 20,000 IU daily for 7 weeks

For most diseases the group with high dose of vitamin D would have similar levels to placebo group after 4-5 months   Perhaps the high-dose vitamin D reduced the Crohn's disease and improved gut bacteria enough that vitamin D absorption by the gut improved for the rest of the year

They would have probably had even better results if they had used a gut-friendly 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 203 items

Overview Gut and vitamin D contains gut-friendly information

Gut-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
If poorly functioning gut
Bio-D-Mulsion Forte – especially made for those with poorly functioning guts, or perhaps lacking gallbladder
Sublingual – goes directly into the bloodstream
Fat-soluble Vitamins go thru the slow lymph system
   you can make your own sublingual by dissolving Vitamin D in water or use nano form
Oil: 1 drop typically contains 400 IU, 1,000 IU, or 4,000 IU, typically not taste good
Topical – goes directly into the bloodstream. Put oil on your skin, Use Aloe vera cream with Vitamin D, or make your own
Vaginal – goes directly into the bloodstream. Prescription-only?
Bio-Tech might be useful – it is also water-soluble
Vitamin D sprayed inside cheeks (buccal spray) - several studies
    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 C -Fast	Long
10	Sun/UVB	Slow	Long
10	Topical (skin patch/cream, vagina)	Slow Fast nano	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

203 items in GUT category - see also Overview Gut and vitamin D,

• Ulcerative Colitis and Vitamin D - many studies 12+
• "celiac disease" OR CD 1830 items July 2019
• IBS or IBD or IRRITABLE BOWEL in title of 41 VitaminDWiki pages as of Aug 2022
• Gut-Friendly forms of vitamin D
  • such as: bio-emulsion, topical, spray, sublingual, inhaled, injection .

See also Microbiome category listing has 33 items along with related searches.

• Gut bacteria of Crohn's disease patients improved by Vitamin D – March 2018
• Strong interactions between Vitamin D and the gut microbiota via Butyrate and VDR – Dec 2019
• Crohn’s disease helped when vitamin D level raised above 30 ng – RCT Feb 2015

 Download the PDF from VitaminDWiki

Background: Seven weeks of high-dose vitamin D treatment decreases intestinal IL17A and IFN-γ mRNA expression in active Crohn’s disease (CD). In this follow-up study, we investigated whether seven-week vitamin D treatment affected the infliximab response in the following 45 weeks compared to placebo.

Methods: CD patients (n = 40) were initially randomised into four groups: infliximab + vitamin-D; infliximab + placebo-vitamin-D; placebo-infliximab + vitamin-D; and placebo-infliximab + placebo-vitamin-D. Infliximab (5 mg/kg) or placebo-infliximab was administered at weeks 0, 2 and 6. Vitamin D (5 mg bolus followed by 0.5 mg/day for 7 weeks) or placebo-vitamin D was handed out. After the 7-week vitamin D period, all patients received infliximab during follow-up. Results are reported for Group D+ (infliximab + vitamin-D and placebo-infliximab + vitamin-D) and Group D- (infliximab + placebo-vitamin-D and placebo-infliximab + placebo-vitamin-D).

Results: Group D- patients had greater needs for infliximab dose escalation during follow-up compared to group D+ (p = 0.05). Group D+ had lower median calprotectin levels week 15 (p = 0.02) and week 23 (p = 0.04) compared to group D-. Throughout follow-up, group D+ had 2.2 times (95% CI: 1.1–4.3) (p = 0.02) lower median CRP levels compared with group D-.

Conclusions: Seven weeks high-dose vitamin D treatment reduces the need for later infliximab dose-escalation and reduces inflammatory markers. EudraCT no. 2013-000971-34.