A new study led by researchers from Boston’s Beth Israel Deaconess Medical Center has concluded that lower levels of vitamin D in the blood increase the risk of flare-ups in patients with ulcerative colitis. The study was published in the February 2017 issue of the journal Clinical Gastroenterology and Hepatology.
Through blood tests and biopsies, the researchers took “baseline” measurements of study participants’ vitamin D levels and levels of inflammation while they were in remission (not having a flare-up). The researchers then followed the participants for 12 months, and compared data from those who remained well and those who experienced flare-ups. The researchers found that people who had higher vitamin D levels when their disease was in remission were less likely to experience a flare-up in the future.
UC, a type of inflammatory bowel disorder in which the innermost lining of the large intestine becomes inflamed, causes symptoms including abdominal pain, fever, weight loss and fatigue. It’s an often miserable condition for its 700,000 American sufferers, having a significant impact on their quality of life. UC is believed to result from an interplay between environmental and genetic factors that affect the body’s immune system.
Dr. Gregory MacKay, a gastroenterologist associated with the Indian River Medical Center, says ulcerative colitis is a very complex condition, and is not well understood. “We’re learning more all of the time. We do believe an imbalance in the immune system is the primary culprit. This imbalance might result in the gut bacteria – the good kind – being attacked, when the immune system should be ignoring it.”
The minimum level of blood vitamin D found to protect against UC flare-ups is at least 35 nanograms per milliliter (ng/mL). Patients with UC should be closely monitored for levels of vitamin D as part of their maintenance therapy; deficiencies will likely result in their doctor recommending a supplement, as there aren’t many foods which have enough vitamin D to make a difference.
Dr. MacKay says that people with UC or Crohn’s disease (another type of inflammatory bowel disorder) are at a higher risk for a vitamin D deficiency, and he will often suggest they take a supplement of 800 milligrams a day. (While patients should check with their doctor or pharmacist, that level is generally considered very safe.)
In other advice for UC sufferers, Dr. MacKay says, “It’s important to maintain a balanced diet, with fruits, vegetables and a good source of protein. And unnecessary antibiotics should be avoided, as those drugs disrupt the good bacteria in our gut.”
It’s also known that stress can affect the immune system, so reducing stress levels to whatever degree possible can be helpful: Getting plenty of high-quality sleep, exercising regularly, and meditating and engaging in breathing exercises are other protective factors.
There are a number of medications designed to treat UC – including anti-inflammatory drugs such as corticosteroids, immune system suppressors, and biologics – medications derived from living organisms rather than chemicals. Dr. McKay says it’s critical that patients are diligent in taking their prescribed medication. “We can get the condition under control for the vast majority of patients,” he says, “and improve their quality of life.”
He adds that additional studies are needed to clarify the cause-and-effect connection between vitamin D levels and UC flare-ups.
Dr. MacKay’s practice is in the IRMC Health and Wellness Center, located at 3450 11th Court, Suite 206. The office phone number is 772-299-3511.
