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Ulcerative Colitis significantly reduced by 480,000 IU loading dose of nano Vitamin D – RCT July 2019

Oral Nano Vitamin D Supplementation Reduces Disease Activity in Ulcerative Colitis: A Double-Blind Randomized Parallel Group Placebo-controlled Trial.

Letter to Editor on this study is at end of this page
J Clin Gastroenterol. 2019 Jul 26. doi: 10.1097/MCG.0000000000001233.
Ahamed Z R1, Dutta U1, Sharma V1, Prasad KK1, Popli P1, Kalsi D1, Vaishnavi C1, Arora S1,2, Kochhar R1.
1 Department of Gastroenterology.
2 Dept of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Vitamin D Life

RCT with unstated number of participants
60,000 IU per day of nano vitamin D for 8 days
Then test 4 weeks later
Average vitamin D level was 41 ng/ml
17 people (~half?) got > 40 ng
   and more than 60% reduction in UC severity score


  • The exact form of the nano is not stated in the abstract, but it is probably similar to many nanoemulsions in being gut-friendly
  • Vitamin D Loading doses have worked well for > 1 million people over the past 50 years in raising Vitamin D levels in weeks instead of months)
    • Vitamin D loading is especially good for 50+ diseases. like UC, for which a Vitamin D Receptor can limit how much vitamin D actually gets to tissues

They happened to:
  1) Use a gut-friendly form to get Vitamin D into the blood
  2) A method to get that Vit D into the tissue
     Crohn's disease is another gut problem which should benefit from nano-loading

Ulcerative Colitis and Gut

Overview Gut and vitamin D has 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.
    • An adequate level vitamin D seems to decrease the probability of getting celiac disease.
    • 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.
  • Review in Nov 2013 found that Vitamin D helped
    Many intervention clinical trials with vitamin D for Gut problems (101 trials listed as of Sept 2019)
  • All items in category gut and vitamin D 168 items

Gut category listing contains the following

168 items in GUT category - see also Overview Gut and vitamin D,

Loading Dose

Nano forms of Vitamin D


INTRODUCTION: Vitamin D possesses anti-inflammatory properties and could be beneficial in ulcerative colitis (UC).

METHODS:
We studied the effect of oral nano vitamin D3 supplementation on disease activity in active UC [ulcerative colitis disease activity index (UCDAI)≥3]. Patients with active UC and vitamin D <40 ng/mL were randomized to receive either oral nano vitamin D (60,000 IU/d×8 d) or placebo. They were evaluated for disease activity (UCDAI scores, C-reactive protein, erythrocyte sedimentation rate, and fecal calprotectin) at baseline and reassessed at 4 weeks. The response was defined as a 3-point reduction in UCDAI score at 4 weeks and reduction in inflammatory markers.

RESULTS:
The median vitamin D levels increased from 15.4 to 40.83 mg/dL in vitamin D group (P≤0.001) and marginally from 13.45 to 18.85 mg/dL (P=0.027) in controls.
The 3-point reduction in UCDAI was seen more often in vitamin D group as compared with the control (53% vs. 13%; P=0.001).
Increase in vitamin D levels correlated with reduction in UCDAI score (P≤0.001; ρ=-0.713), C-reactive protein (P≤0.001; ρ=-0.603), and calprotectin (P=0.004; ρ=-0.368).

Patients who achieved target vitamin D of >40 ng/mL (n=17) more often had a 3-point reduction in UCDAI (80% vs. 20%; P≤0.001) and reduction in grade of severity from 60% to 35% (P=0.038).
Vitamin D administration (odds ratio, 9.17; 95% confidence interval, 2.02-41.67) and baseline histologic activity (odds ratio, 1.92; 95% confidence intervals, 1.2-3.08) independently predicted response.

CONCLUSIONS:
Oral nano vitamin D supplementation in active UC is associated with a reduction in disease activity and severity grade and is seen more often in those who achieved a target vitamin D level of 40 ng/mL.


Oral Nano Vitamin D Supplementation and Disease Activity in Ulcerative Colitis

Journal of Clinical Gastroenterology: September 12, 2019 -doi: 10.1097/MCG.0000000000001263
Dai, Cong MD, PhD; Jiang, Min MD, PhD; Sun, Ming-Jun MD, PhD
Letter to the Editor: PDF Only
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