Vitamin D deficiency is commonly seen in patients with Crohn’s and Ulcerative Colitis. So much so in fact, that an estimated 80% of those with CD and 75% with UC suffer from vitamin D insufficiency and 50% of those meet the markers to be deficient. To be considered Vitamin D insufficient your levels are between 20-30 ng/mL, with 30 ng/mL and above being considered normal. To be classified as deficient your level must be under 20 ng/mL. Where you suffer from insufficiency or deficiency of Vitamin D there are several side effects that come with it. These include; fatigue, hair loss, bone loss, back pain, depression, and slowed wound healing. Many of these symptoms can overlap with IBD, not always making it obvious.
Vitamin D is processed more like a hormone than a vitamin, and every single cell has a receptor for it. If that doesn’t tell you how important it is, I don’t know what does! Vitamin D is also special because it comes from sunlight as well as foods. When your skin absorbs Vitamin D through the sun’s rays it synthesizes it using cholesterol converting it to be used. Similarly, the small intestine is where absorption from food or supplementation occurs allowing it to be freely sent throughout the body. Vitamin D is responsible for many important functions like immunity, tissue healing, bone growth and maintenance, and energy levels.
There are several reasons why IBD patients have such low levels of Vitamin D. Use of corticosteroids, lack of sunlight, poor fat absorption due to active disease, bowel surgery, and having darker skin therefore requiring more sun time to get the same amount of Vitamin D all factor in. This has led researchers to ask does Vitamin D deficiency correlate with the development of IBD? While there does seem to be a connection, just having a vitamin D deficiency does not mean you will get IBD. For now, it is believed to be a bidirectional relationship meaning the flow of data is mutual between the two.
A large body of growing research is mounting on how Vitamin D, or lack thereof, can affect disease severity in IBD. In a recent study of 3,000 IBD patients, outcomes found risk was associated with low Vitamin D levels. Those with insufficiency and deficiency had higher risk of relapse, hospitalization, and surgery. Low Vitamin D levels have also been linked with C. Diff, colon cancer, and poor response to pathogens in IBD patients. So, if low levels make disease worse, do higher levels prevent active disease? Well, in one Scandinavian study those with Crohn’s were given placebo or Vitamin D. Those on placebo had a relapse rate of 29% compared to 13% for those given the Vitamin D. It may be even more important for those going on anti–tumor necrosis factor (TNF) therapy. Those that are deficient in Vitamin D had less success with positive response to these therapies, suggesting Vitamin D aids in the absorption of such medications.
So, know that you know how important Vitamin D is, where can you find it? Well, we already discussed the most common place, the sun! Make it a goal to get at least 30 minutes of sunlight each day to help. As far as food and supplementation go, you can find good amounts of Vitamin D in fatty fish, eggs, butter, milk, fish oil, and pill supplements. You may want to stay away from milk though as it is not SCD compliant and many people with IBD have lactose intolerance which can exacerbate symptoms. For those who are insufficient 1000-2000 units a day is good, but for those with more deficiency 3000-4000+ units will be enough. These are of course in general, follow whatever your physician suggests, as it will be right for you. Remember to consult your specialist before adding any supplements, and get your lab work done to show if you need supplementation in the first place. Calcium is often needed as well to help with absorption of Vitamin D, so I recommend taking it with Vitamin D supplements. Those with IBD are also at higher risk of osteoporosis because of curtain medication. While you’re at it and getting a blood draw, go ahead request to get your B12, Iron, and Zinc tested as well since those with IBD tend to have low values of these too. Getting your Vitamin D, Iron, and B12 all at normal levels can really help with fatigue and improve quality of life. So, get out there and get some sunshine, and remember to get your Vitamin D levels checked on a regular basis.
Want to check out my sources? Click HERE, HERE, & HERE!
Note: * This is NOT an affiliate post. I do not receive anything for promoting or recommending things. *