Inflammatory bowl diseaseVitamin D levels

Those with Crohn's disease (CD) often have low serum 25(OH)D levels1 2 3 4 5 6 7 8 9 10. Such a finding generally indicates that lower serum 25(OH)D levels contribute to the incidence or severity of the disease. However, in some cases, the existence of the disease results in lower serum 25(OH)D levels.

In CD, absorption of all nutrients is impaired. It was demonstrated that for those with CD, UVB from a tanning bed is a useful way to raise serum 25(OH)D levels11.

Those with CD and low serum 25(OH)D levels are at increased risk for metabolic bone disease12 5 13.

Metabolic bone disease (MBD) is an umbrella term that covers a number of disorders related to the weakening of the bone or impaired systems function caused by an imbalance in vitamin D3, calcium and phosphorus. This imbalance may be caused by a lack of or too much of one of these three essential elements or the failure to provide one or more of them in a bioavailable form.

Common forms of MBD include osteopenia and osteoporosis. People with these conditions should consider taking vitamin D supplements14 15, along with calcium. However, since absorption of all nutrients is impaired for those with CD16, they should either take higher doses of vitamin D than others or obtain vitamin D from solar17 or artificial UVB11

A study in Japan found that those who had Ulcerative colitis (UC) who subsequently developed colorectal cancer had much lower fraction of vitamin D receptors in their the colorectal mucosal lining compared to normal mucosa (3.4% vs. 58.8%)18.

There is some risk of hypercalcemia for those with CD19.

“Inappropriately high levels of serum 1,25(OH)(2)D (>60 pg/ml) were observed in 42% of patients with CD” in a study in Los Angeles20.

“Crohn's disease is a granulomatous disorder that is more commonly associated with hypocalcemia caused by poor calcium intake and decreased intestinal calcium absorption related to vitamin D deficiency as a consequence of malabsorption21.”

Thus, those with CD should make themselves aware of the symptoms of hypercalcemia and, if increasing vitamin D intake or production, increase gradually, perhaps by 1000 IU/day for a month at a time until reaching 4000 IU/day.

Page last edited: 06 May 2011


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