Crohn's Awareness Project

Sunshine is a key source of Vitamin D ©2012 BWD PHOTO www.bwdphoto.com

Weeks have passed since we started this series and we’ve all hopefully learned a little more about the B vitamin group. We now turn our focus to another letter in the alphabet and one that is a hotly debated topic in the world of GI medicine. With out getting into the boxing ring on the subject, let’s just focus on the facts.  To help us understand a bit more about vitamin D, we once again have the lovely Karen Langston here to explain the information we should know. This week we look at why vitamin D is important to our bodies and why IBD sufferers could use a little more than normal folk.

CAP: Vitamin D is such a hot button topic lately, I was wondering what your take on it is? Do you believe that most CD cases result in a lack of the vitamin?

Karen:
I am not sure exactly who discovered Vitamin D. Resources indicate Vitamin D was first recorded in detail by F. Glisson in 1650, and another claim of discovery in 1922, by Edward Mellanby while researching rickets disease. However Adolf Windaus was awarded the Nobel prize for chemistry in 1928 for his studies on the constitution of sterols and their connection with vitamins. In the past 10 years or so the medical profession has become interested in the functions of vitamin D and connection of deficiency in disease and illness   before that it was mostly concentrated upon the toxicity (which probably relates to the synthetic form ergocalciferol-more of a guess than fact).

I wouldn’t say that the lack of sufficient vitamin D alone is responsible for Crohn’s Disease manifestation rather it is one component of many nutrient deficiencies. Given the fact that most with Crohn’s disease do not eat a well-balanced diet and deal with a compromised digestive system, it is a nutrient I would have tested to ensure there are adequate amounts. What is really interesting and I think those with Crohn’s disease should pay attention to is the fact that vitamin D has the ability to prevent and reduce Inflammation because vitamin D up-regulates apoptotic mechanisms in pro-inflammatory cells to stop and prevent on-going inflammation that damages tissue.

CAP: Why is vitamin D important to not just IBD patients but people who generally don’t get as much sunlight as others?

Karen:
Vitamin D plays a major role in stimulation, absorption and metabolism of calcium and this all starts in the gut; 1,25-dihydroxycholecalciferol acts in the intestines to promote absorption of calcium and phosphorus.

I hope this is the biggest “Aha” for anyone who is dealing with Crohn’s disease because many of the medications used for Crohn’s disease deplete or increase the need for calcium such as Corticosteroids, Ophthalmic; Corticosteroid; Parenteral: Betamethasone, Celestone, Budesonide Entocort EC, Cortisone Cortone, Dexamethasone, Decadron, Hydrocortisone Cortef, Methylprednisolone, Medro Prednisone Methylprednisolone, Novo-Prednisolone which also depeltes or increases the needs for vitamin D. Immune modifiers or immunomodulators Azathioprine; Imuran®, Azasan, 6-MP; Purinethol®, and methotrexate; Amethopterin MTX; Rheumatrex Trexallare, Folex® PFS class of immunosuppressant agents, Tetracyclines: Chlortetracyline, demeclocycline, doxycycline, minocycline, oxytetracycline, tetracycline, Aminoglycosides: Neomycin, Amikacin, gentamicin, tobramycin also deplete or increase the need for calcium which will require adequate amounts of vitamin D for this job.
I know we are talking about vitamin D, however given the role calcium plays in regulating phosphorus, integrity of bones and other roles, calcium cannot work properly if vitamin D is not sufficient. Sufficient vitamin D prohibits thin, brittle, or misshapen bones as well as modulation of cell growth, neuromuscular and immune function, and reduction of inflammation (something any one with Crohn’s could benefit from), as well as many genes encoding proteins that regulate cell proliferation, differentiation, and apoptosis are modulated in part by vitamin D. One of the biggest concerns with those taking drugs, especially corticosteroids is the loss of bone density.

 Did you miss The B-Team? Don’t worry, we have a handy link right HERE for you!