Low levels of vitamin D are common in patients with ileal pouches irrespective of pouch inflammation.
J Crohns Colitis. 2013 Aug;7(7):525-33. doi: 10.1016/j.crohns.2012.08.006
Khanna R, Wu X, Shen B.
Department of Gastroenterology, Digestive Disease Institute, the Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
BACKGROUND: Vitamin D (25(OH) D3) levels in pouch patients are not well defined.
AIM: To evaluate the frequency and factors associated with low 25(OH) D3 levels in pouch patients with underlying inflammatory bowel disease (IBD).
METHODS: A consecutive of 157 pouch patients was identified from our Pouchitis Registry. A sample of 155 ulcerative colitis (UC) patients without IPAA served as controls.
RESULTS: The mean age of the cohort was 37.5 ± 14.2 years, with 86 (54.8%) being female. Low 25(OH)D3 levels (<31 ng/mL) were detected in 69.4% of patients (N=109). 34 (21.7%) of the 157 patients examined were 25(OH)D3 deficient (<20 ng/mL). This was higher than the frequency of vitamin D insufficiency or deficiency in a sample of UC patients without IPAA. Between patients with and without normal 25(OH) D3 levels (>31 ng/mL), no differences were identified in terms of demographic, pouch, and medication variables.
A low hemoglobin level was found to be associated with low 25(OH) D3 levels in both univariate (p=0.02) and multivariate analyses (odds ratio [OR]=3.37; 95% confidence interval [CI]: 1.41-8.06; p=0.01).
Low levels of 25(OH)D3 was not related to markers of pouch inflammation, in particular there was no relation to pouchitis (OR=1.20; 95% CI: 0.41-3.52; p=0.74).
CONCLUSION:Low 25(OH)D3 level was common in this cohort, irrespective of inflammation of the pouch, possibly suggesting a strategy of routine testing in this population. Anemia was found to be associated with a low 25(OH)D3 level.
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Overview Gut and vitamin D contains 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.
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- 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.
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Many intervention clinical trials with vitamin D for Gut problems (101 trials listed as of Sept 2019)
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