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)
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
- 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
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
Gut category listing contains the following
159 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 . .
- Overview Loading of vitamin D
- Healthy in Seven Days- Success through vitamin D treatment – book 2014
- Similar to the 480,000 IU in the study on this page
- Nanoemulsion Vitamin D may be a substantially better form
- The lungs can activate vitamin D locally – a Vitamin D inhaler may help lungs – Aug 2016
- Vitamin D nanoemulsion etc. for fortification, pills, injections, topical and cancer – July 2019
INTRODUCTION: Vitamin D possesses anti-inflammatory properties and could be beneficial in ulcerative colitis (UC).
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.
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.
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.
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
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