A new open label carried out by Professor Linlin Yang and colleagues reports that vitamin D may be of help to people with Crohn’s disease.
Crohn’s disease is an inflammatory bowel disease that affects the gastrointestinal tract. Symptoms are unpleasant, including abdominal pain, diarrhea, vomiting, or weight loss, so management of these symptoms is important. The incidence of inflammatory bowel disease in general has risen the past 50 years, making many believe their might be some environmental factor causing the increase. Past research has shown that people with Crohn’s are deficient in vitamin D, and since vitamin D plays a beneficial role in other auto-immune diseases by way of reducing inflammation and smartening the immune system, researchers want to know if vitamin D can help people with Crohn’s.
In this study, the researchers enrolled 18 participants with Crohn’s into the study. They administered vitamin D for 24 weeks in a step-wise approach, starting all participants on 1,000 IU of vitamin D/day. Every two weeks, vitamin D levels were assessed. If participants’ levels were lower than 40 ng/ml, their dose was increased by 1,000 IU up to a maximum of 5,000 IU/day. After 24 weeks, all participants were either taking 5,000 IU/day or had a vitamin D level over 40 ng/ml. There was no placebo group in this trial.
The researchers assessed disease activity at baseline, 2 weeks, 12 weeks, and 24 weeks. To assess activity, researchers gave participants a diary to record daily bowel function, abdominal pain, sense of general well-being, and anti-diarrhea medication for 7 days before office visits to calculate what is called a CDAI score. A CDAI score of greater than 220 indicates active disease and a score of 150 or lower indicates remission. Also, a 70 point decline indicates favorable response, while a 100 point increase indicates a “flare-up.”
After the trial, here is what the researchers found:
- Mean vitamin D levels rose from 16 ng/ml to 45 ng/ml after 24 weeks.
- The mean CDAI score at baseline was 230. After 24 weeks, this fell to 118.
- After 24 weeks, 12 of 18 patients had their Crohn’s disease in remission (CDAI less than 150).
- 78% of patients had a favorable response, meaning their CDAI score dropped by 70 points. No participants had a flare-up.
The authors conclude,
“This small pilot study establishes that vitamin D3 supplementation of patients with mild-to-moderate Crohn’s disease is effective at improving the quality of life and suppressing clinical symptoms to induce remission. An effective dose of vitamin D3 for improving vitamin D status in Crohn’s patients was identified as being 5,000 IU/day.”
Study limitations include lack of placebo to compare treatment group to, small number of participants, and the inability to raise all participants over 40 ng/ml. This was likely due to malabsorption issues.
At this time, it’s unclear how vitamin D might improve CDAI scores of Crohn’s patients. In the future, research should take a closer look at mechanisms and study larger groups in a randomized controlled trial. In the meantime, it appears that vitamin D may be of some benefit to people suffering from Crohn’s.