Tagged with 'vitamin-D'

Vitamin D is a must while pregnant and breastfeeding. All your questions answered here!

Men and women have slightly different nutritional needs, and here are the nutrients men want to focus on.

What's up with my strong cravings for all things dairy right now?? Well, I did some investigating and check this out:

The amount of calcium your intestines absorb during pregnancy doubles!   

Another fun fact…about 80% of the calcium present in the baby’s skeleton at the end of pregnancy crossed the placenta during the third trimester and is mostly derived from the calcium in mom’s diet during pregnancy. The calcium mom eats seems to be the main way our bodies adapt to meet those high calcium demands during pregnancy (1). Amazing! That definitely explains the cravings and my baby needs the calcium with only 6 weeks left to grow.

How Much Calcium Does A Pregnant Woman Need? 

A pregnant woman needs 1,000 mg calcium per day and pregnant teenagers need 1,300 mg calcium per day (4).

A prenatal supplement isn’t going to provide a lot of calcium, and if needed, additional calcium can be supplemented alongside the prenatal supplement, especially in the third trimester of pregnancy when calcium's needed most. Calcium can be obtained from foods naturally rich in calcium, calcium-fortified foods and beverages, supplements, or a combination of all. 

A comparison of calcium-containing foods per serving relative to milk is shown here:

*References 2 and 3.

Choosing A Calcium Supplement 

First things first, please examine the nutrition label. You are looking for the amount of "elemental calcium,” not the milligrams or grams of calcium compound. For example, a 600 mg calcium tablet can actually contain only 150 mg of elemental calcium. Most high-quality manufacturers will specify on the label the milligram content of the compound and also the milligram content of "elemental calcium." If the label does not present this information, it would be best to avoid that product.

Maximize Absorption Of Your Calcium Supplement

1.  Look for the highly absorbable forms of calcium…calcium citrate and calcium citrate-malate.

2. The percentage of calcium absorbed in your intestines decreases as the quantity of calcium consumed increases (5).  This means, to maximize absorption, divide your calcium intake into more doses throughout the day.

3. The time you take your calcium is important because calcium taken with a meal is usually better absorbed than calcium taken without a meal (6). 

4. Take a dose of calcium at bedtime. Adding calcium at night seems to result in less removal of calcium from our bones during the night (7).

5. Calcium combined with Vitamin D increases calcium absorption, so vitamin D added to your calcium supplement is a good thing. Get all your vitamin D and pregnancy tips here.

One Last Perk About Calcium

Much research shows calcium supplementation during pregnancy decreases the severity of complications brought on by preeclampsia and also decreases your risk of delivering a premature baby (8, 9), especially in teenagers.

If you would like to read more pregnancy blogs, check out Prenatal Vitamins During Pregnancy, Probiotics During Pregnancy, and Vitamin D Tips During Pregnancy.

Bottom Line: Get your calcium from your diet whenever possible, and if you need additional calcium, look for a highly absorbable form and spread your dosage throughout the day.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

1.  Cross NA, Hillman LS, Allen SH, Krause GF, Vieira NE. Calcium homeostasis and bone metabolism during pregnancy, lactation, and postweaning: a longitudinal study. Am J Clin Nutr 1995;61:514–23.  

2.  Pennington JAT. Bowes and Church’s food values of portions commonly used. 15th ed. New York: Harper & Row, 1989.

3.  US Department of Agriculture. Composition of foods: vegetables and vegetable products. Washington, DC: US Government Printing Office, 1989. (Agriculture Handbook no. 8-11)

4.  Institute of Medicine. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, DC:  National Academy Press, 1997.

5.  Wilkinson R. Absorption of calcium, phosphate and magnesium. In:  Nordin BEC, ed. Calcium, phosphate and magnesium metabolism.  New York: Churchill Livingstone, 1976:36-1 12.

6.  Heaney RP, Smith KT, Recker RR, Hinders SM. Meal effects on calcium absorption. Am I Clin Nutr 1989:49:372-6.

7.  Blumsohn A, Al-Dehaimi AW, Hemngton K, Shao P. Eyre DR.  Eastell R.  Effect of timing of calcium supplementation on the circadian rhythm of bone collagen degradation.  Bone Miner Res 1993;8(suppl):S 158(abstr).

8.  Imdad A, Bhutta ZA.  Effects of calcium supplementation during pregnancy on maternal, fetal and birth outcomes.  Paediatr Perinat Epidemiol.  2012 Jul;26 Suppl 1:138-52.

9.  Villar J et al.  World Health Organization randomized trial of calcium supplementation among low calcium intake pregnant women.  Am J Obstet Gynecol.  2006 Mar; 194(3):639-49.  

It seems like every week I come across a different article reporting the role nutrition plays in dementia and Alzheimer’s disease, and vitamin D is one that is talked about very frequently. There’s a chance Vitamin D may protect the aging brain against dementia and Alzheimer's disease, and on the flip-side, people with the highest levels of vitamin D show a decrease in incidences of degenerative diseases.

Vitamin D is synthesized by the body when exposed to sunlight, and it stimulates more than 900 genes in human physiology—most of which reside in the brain. These genes relate to activities like reducing inflammation, strengthening nerve cells, and helping the brain rid itself of viruses.

The link between Vitamin D, the Nervous System, and the Brain

Vitamin D is critical for normal functioning of the nervous system because of the variety of roles it plays. For example, vitamin D is important in the synthesis of a number of neurotransmitters, such as dopamine, serotonin, catecholamines and acetylcholine. It has also been proposed vitamin D protects against age-related inflammatory changes in a section of the brain called the hippocampus.

How Much Vitamin D?

It's not quite clear how much vitamin D is enough for good health (measured by blood levels). Most experts have concluded the minimum level is between 20 and 30 ng/mL. Checking your vitamin D is a routine blood test your health care provider can easily do.

Where does Vitamin D come from?

Very few foods in nature contain vitamin D. The flesh of fatty fish, such as salmon, tuna, and mackerel, and fish liver oils are among the best sources. Small amounts of vitamin D are found in beef liver, cheese, and egg yolks.

Older individuals are particularly at risk of vitamin D deficiency because they may eat a diet with less than adequate vitamin D, have a limited ability to metabolize the vitamin, and have limited exposure to sunlight. Talk to your health care provider if you're interested in having your vitamin D levels checked or taking a vitamin D supplement.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

The flu virus wreaks the most havoc in the winter and declines in the summer months.

Influenza risk factors

Influenza is most common in winter, a time when:

• Solar ultraviolet-B (UVB) doses are low.
• The weather is cold. This prevents white blood cells from reaching the lining of the respiratory tract and fighting the virus.
• The humidity is low. Dry air allows the virus to live longer outside of the body.

Vitamin D and influenza risk

Vitamin D3, the true form of vitamin D is a fat-soluble vitamin produced in the skin when skin is exposed to the sun's ultraviolet rays. Vitamin D is also found in food and dietary supplements. High levels of vitamin D may prevent or lower the risk of influenza. Vitamin D may also reduce symptoms of influenza and reduce the risk of developing pneumonia following influenza.

Two randomized controlled trials found reduced incidence of influenza for those taking higher doses of vitamin D. A study involving African-American postmenopausal women in New York found a 60% reduced risk of colds and influenza for those taking 800 international units IU/d vitamin D3 and 90% reduced risk for those taking 2000 IU/d.

Another study in Japan, involving school children taking 1200 IU/d vitamin D3 vs. 200 IU/d, found a 67% reduction in Type A influenza, but no effect for Type B influenza. Type A influenza includes H1N1 varieties, which was the type involved in the 2009 “swine flu” infections.

How vitamin D boosts the immune system

To enhance the body’s immune system, vitamin D:

• Produces cathelicidin and defensins—These proteins have antiviral effects to combat viruses.
• Reduces inflammation—As a result, body temperature does not rise as much, and the lining of the lungs is less disturbed. This makes it harder for bacteria to give rise to pneumonia.

Optimal Vitamin D level

Based on several studies, raising vitamin D blood levels to 40 ng/ml (100 nmol/l) may reduce the risk of influenza. For most people, this involves taking 1000–5000 IU per day of vitamin D during the influenza season. On average, 2000-5000 IU/day vitamin D3 may provide protection against influenza. 

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

William B. Grant, Ph.D. Sunlight, Nutrition, and Health Research Center (SUNARC) P.O. Box 641603 San Francisco, CA 94164-1603, USA www.sunarc.org

Vitamin D Council. Influenza. March 2014.

Fall and winter are prime-time for colds, influenza (flu), and other respiratory illnesses. We’re all vulnerable to contagious viruses due in large part to people spending more time indoors with others when the weather gets cold.

Check out these natural prevention tips to avoid catching a cold or the flu this year.

Homemade Chicken Soup

Seems mom may be right about chicken soup. A handful of studies show the ingredients in chicken soup (chicken stock, carrots, onion, and celery) really could have medicinal value. One researcher set out to determine why chicken soup might help colds. He found the soup stopped the movement of neutrophils, the most common type of white blood cell that defends against infection. Ultimately, chicken soup helps reduce upper respiratory cold symptoms.

Another study on chicken soup shows it helps increase the movement of mucus in the nose, and also improves the function of protective cilia, the tiny hair-like projections in the nose that prevent potential infections from entering the body.

Another tip is to add veggies to your soup because it’s known that a nutrient-rich diet builds your immune system and fights inflammation.

Vitamin D₃

The flu is a respiratory infection caused by a virus that infects the nose, throat, and lungs. The flu is most common during winter and can cause fever, chills, sore throat, cough, body aches, and fatigue. How does vitamin D play a role? Well, vitamin D is an important part of the immune system, and studies have shown people who have low vitamin D levels may have a higher chance of getting the flu.

How Does Vitamin D₃ Boost Your Immune System? Prepare to get nerdy and talk science…

There are vitamin D receptors found on cells in the immune system, and vitamin D can bind to these receptors. Vitamin D works in the immune system by reducing levels of inflammatory proteins called cytokines, as well as increasing amounts of antimicrobial proteins, which destroy invading germs and viruses. This combination of lowering inflammation and increasing antimicrobial defenses can help your immune system fight infections better.

Hot Liquids

Like chicken noodle soup, drinking hot liquids also helps briefly increase the movement of mucus in the nose, and this happens through the nasal inhalation of water vapor. Green tea is a good additions since it’s full of antioxidants, which will boost your immune system even when you're already sick. Consider drinking a cup of hot tea or water 2x/day.

Many studies show taking some echinacea products when cold symptoms are first noticed can modestly reduce symptoms of the common cold in adults. 

Neti Pot

Using a neti pot is a natural solution for gently washing away mucous, bacteria, pollen, allergens, and viruses from the sinuses. There’s one main sinus a neti pot flush can reach—the maxillary sinus, which is on either side of your nose—basically inside the “cheek bone.” When they fill with pus or mucous, it hurts. Not only does it hurt, it provides a further haven for more bacteria and viruses as the immune system cannot enter because it’s too plugged.

Check out this blog about how to use a neti pot. 

Monolaurin

Monolaurin is made from lauric acid, which is found in coconut milk and breastmilk. Monolaurin is thought to have antibacterial, antiviral, and other antimicrobial effects, that may help prevent and treat the common cold, flu, and other infections. 

The science behind how monolaurin works is by incorporating itself into the cell membrane of bacteria, blocking its replication, which makes it easier for your immune system to take care of. You can get monolaurin at most health food stores.

All-in-all, eat a healthy, balanced diet, wash your hands often, exercise regularly, and sleep well.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

Influenza. Vitamin D Council. 

Monolaurin Incorporates Into Gram Positive Bacteria Cell Membranes. Appl Environ Microbiol. Tokarskyy O, Marshall DL.  

“Back-to-School” is an exciting time of year. You’ve shopped for your children’s new school supplies, new shoes, and new clothes, and they’re looking forward to seeing old friends, and meeting their new classmates and teacher.

In the midst of all this school delight, it’s easy to take your child’s health for granted, but we all know how a sick kid can bring life to a halt. Prevention is key when it comes to keeping your child’s immune system functioning full speed. It goes without saying, a healthy child is a more capable learner, and doesn’t miss school or their favorite sport’s practice or game.

To fight off those germ-filled classrooms, ensure your children wash their hands frequently, eat lots of fruits and vegetables, and get enough sleep. Also, here are five immune boosting supplements to consider.

A Children’s Multi-Vitamin with Minerals

If you have a finicky eater, getting a child to eat desirable foods such as fruits and veggies may be a challenge. A multi-vitamin with minerals is a good option for filling in any nutritional gaps.

For example, zinc is found in yogurt, peas, beef, and shrimp, and it’s important for preventing infection, diarrhea, and pneumonia.

Vitamin D₃

The school year means more time indoors and less D-building sunshine. Studies show most children aren’t getting enough of this essential vitamin. Vitamin D helps ensure the body absorbs and retains calcium and phosphorus, both critical for building bone. Children should be getting 600 IU per day, and there are several options for getting this in supplement form. For kids who are too young or don't like taking capsules, vitamin D is conveniently available in spray form and liquid drops. The spray and drops are flavorless, so easy to put directly into a child's mouth, or even drop onto any food or into liquid. 

Omega-3 fatty acids

Omega-3 fatty acids are essential fats you must get from food or a supplement. EPA and DHA are two fatty acids that work together to provide the most benefits to your health. Experts believe omega-3’s help your body fight illness. One small study found omega-3’s cut the number of respiratory infections in kids. Fish are the best source of omega-3’s. Walnuts are also a good source and are easy to sprinkle into a snack mix, or on cereal or yogurt.

Probiotics

There are hundreds of different probiotic strains. Various probiotics can be found in fermented and active culture foods, such as yogurt, kefir and Kombucha. These beneficial bacteria can help prevent stomachaches, diarrhea, food allergies, eczema, and respiratory problems.

Homeopathic Remedy

Hyland’s Complete Flu Care 4 Kids and Hyland’s Tiny Cold Tablets

These are great! They’re homeopathic, gentle on the system and all-natural. Have these on hand just in case your little one starts to come down with something. They’ll help head off the flu or a cold early and provide temporary relief of symptoms.

Here’s to Healthy and Happy School Kids!

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Live Superfoods

Vitamin D deficiency is thought to be common among pregnant women, and has been found to be associated with an increased risk of pre-eclampsia, gestational diabetes, preterm birth, and other tissue-specific conditions.

In general, normal pregnancy is associated with insulin resistance. Insulin resistance is a condition in which muscle, fat, and liver cells do not respond properly to insulin, and therefore can’t easily absorb glucose from the bloodstream. As a result, the body needs higher levels of insulin to help glucose enter cells.

However, insulin resistance is much worse in pregnant women with gestational diabetes, a condition that affects 10% of pregnancies.  No one knows why pregnancy is associated with insulin resistance. Gestational diabetes usually, but not always, disappears after the pregnancy is over. 

How Much Is Enough?

Vitamin D recommendations for pregnant women vary vastly depending on which source you read. The vitamin D council recommends 4,000-6,000 international units (IU) per day for pregnant women. The Food and Drug Administration recommends 600 IU per day.

Please consult with your health care provider about taking vitamin D during pregnancy and how much is recommended.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

1. Maghbooli Z, at al. Correlation between vitamin D3 deficiency and insulin resistance in pregnancy. Diabetes Metab Res Rev. 2008 Jan-Feb;24(1):27-32. http://www.ncbi.nlm.nih.gov/pubmed/17607661

2. Soheilykhah S, et al. The effect of different doses of vitamin D supplementation on insulin resistance during pregnancy. Gynecol Endocrinol. 2013 Apr;29(4):396-9. http://www.ncbi.nlm.nih.gov/pubmed/23350644

My senior year in college, I was unable to compete in our conference finals track meet due to an injury, and what I would later find out was a stress fracture—my second one in four years. It doesn’t mean I didn’t try to run, because I did; but it hurt so bad I could barely walk, let alone run. I was so disappointed because this meet was what I trained for all season. The injury took weeks to heal and required crutches, lots of rest, and proper nutrition. Here’s some information about stress fractures and the nutrition involved in healing bone.

What Is a Stress Fracture?

A stress fracture is an overuse injury, and is one of the most common sports injuries. It occurs when muscles become fatigued and are unable to absorb added shock. Eventually, the fatigued muscle transfers the overload of stress to the bone causing a tiny crack in the bone, aka: a stress fracture.

What Causes a Stress Fracture?

Stress fractures are often the result of increasing the amount or intensity of an activity too rapidly. They also can be caused by the impact of an unfamiliar surface (soft court to a hard court), improper equipment (ie: shoes), and increased physical stress (ie: an athlete who has a substantial increase in playing time). The American Academy of Orthopaedic Surgeons says that more than 50% of all stress fractures occur in the lower leg or feet.

Are Women More Susceptible to Stress Fractures than Men?

Studies have shown female athletes seem to experience more stress fractures than males. Many orthopedic surgeons attribute this to a condition called “the female athlete triad,” which consists of disordered eating patterns, amenorrhea (infrequent menstrual cycle), and osteoporosis. As a female’s bone mass decreases, her chances of getting a stress fracture increases.

It isn’t uncommon for athletic women to consume a very low-calorie and low-protein diet. This drastic reduction in food intake can lead to amenorrhea. Research suggests amenorrheic athletes have a four and one-half times higher risk for suffering a stress fracture than do regularly menstruating athletes. Eating a balanced diet with adequate calories can enhance restarting menses, provide adequate protein for building and protecting muscles, and enhance overall health.

Nutrients Involved in Bone Rebuilding

Stress fractures need proper food and nutrition to optimize their healing ability. Consume adequate amounts of the following nutrients:

Vitamin D

In order to properly absorb the calcium you consume, you need enough vitamin D. Vitamin D plays a very large role in protecting and preventing you from getting a stress fracture. Every single cell in the human body has a vitamin D receptor on it. Vitamin D stimulates calcium absorption in the gut, and balances calcium and phosphate levels in the blood. Keeping calcium and phosphate levels balanced allows for healthy bone mineralization. Osteoblasts and Osteoclasts, the cells that build and remodel our bones, require vitamin D to function. Without proper amounts of vitamin D, bones will become brittle and thin.

Vitamin K

It’s an important part of the processes that bind calcium to bone and is required for proper formation of the osteocalcin bone protein.  

Anti-Inflammatory Nutrients

When a stress fracture occurs, there is inflammation so free radicals are generated. Antioxidants help your body fight damaging free radicals that hurt cells and damage tissue trying to repair the stress fracture. Anti-inflammatory nutrients include vitamin C, quercetin, and omega-3 fatty acids.

Magnesium

Sixty percent of the magnesium in your body is stored in bone tissue, and it has multiple key roles in bone health. Magnesium helps to change vitamin D₂ into vitamin D₃, its active form, which increases calcium absorption. Magnesium contributes to the structure of bones and regulates calcium transport into the bones. Magnesium also triggers the hormone calcitonin, which helps protect the bones when the body is imbalanced, by pulling calcium from the blood and tissues back into the bones.

Potassium

Potassium is associated with greater gains in hip and whole body bone mineral density among young female distance runners.

Calcium

Your body requires proper amounts of calcium to help repair your stress fracture. Under circumstances when you can’t get enough calcium from food, a calcium supplement may be warranted. Calcium supplements are also recommended for people who are lactose intolerant, dislike or are allergic to dairy products, or can’t meet calcium requirements through dietary means in general.

The Recommended Dietary Allowances for calcium are currently 1,300 mg/day for males and females age 9-18, 1000 mg/day for males and females age 19-30, and for females who are estrogen-deficient and not menstruating, it has been recommended they increase their calcium intake to total 1,500 mg/day.

Protein

A protein deficiency, along with an overall calorie-deficient diet, is associated with medical problems, specifically loss of regular menstrual cycles. A female’s estrogen levels decline when menstruation stops, and this drop in estrogen leaves your bones more prone to a stress fracture.

The nutrients listed hold the potential power to prevent and protect you from a stress fracture.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

American Academy of Orthopaedic Surgeons. Stress Fractures.

Nieves JW et al. Nutritional factors that influence change in bone density and stress fracture risk among young female cross-country runners. 2010 Aug;2(8):740-50.

Carbon, R., Sambrook, P.N., Deakin, V., Fricker, P., Eisman, J.A., Kelly, P., Maguire, K., Yeates, M.G. Bone density of elite female athletes with stress fractures. The Medical Journal of Australia. 153:373-376, 1990. 

New research suggests people with traumatic bone fractures often have low levels of vitamin D.

The research validates the current understanding of vitamin D, in that vitamin D is important in repairing bone damage.

Researchers from the University of Missouri looked at vitamin D levels in 900 adults who suffered traumatic bone fractures from incidents like falls and car crashes.

Seventy-nine percent of men and 76 percent of women had deficient vitamin D levels. Furthermore, 40 percent of the women and 38 percent of the men had severely low vitamin D levels.

The research was presented at the annual meeting of the American Academy of Orthopedic Surgeons. Based on the findings, the researchers have started prescribing vitamin D medication for nearly all patients with broken bones as a protective measure to reduce the risk of healing problems.

“More research is needed to demonstrate whether vitamin D medications can reduce the risk of bones not healing properly,” Brett Crist said, an associate professor of orthopedic surgery. “But we know vitamin D is required for repairing damage to bones, and for most people there is very little risk in taking vitamin D medications. At this point, we believe it’s a reasonable step for physicians to prescribe the medication as a protective measure.”

People should talk to their doctor before using vitamin D supplements.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

Reference:

1. US News. Vitamin D Deficiency Often Seen in Traumatic Bone Breaks. 2013.

2. Vitamin D Council. 

Researchers out of Austria have found vitamin D supplementation may lessen pain in patients with fibromyalgia.

What is Fibromyalgia syndrome?

Fibromyalgia syndrome (FMS) is a disease characterized mainly by widespread pain throughout the body. Additionally those with FMS experience fatigue, memory and mood issues. Researchers aren’t sure yet what causes FMS, but some think it is due to increased sensitivity to pain signals by the brain.

What's the Link Between Fibromyalgia and Vitamin D?

Few studies have looked at vitamin D and FMS. So far, the main link found is that those suffering from FMS often have low vitamin D levels. Additionally, studies have shown vitamin D can be beneficial to different types of pain in general, not specific to FMS.

“Low blood levels of calcifediol [25(OH)D] are especially common in patients with severe pain and fibromyalgia. But although the role of calcifediol in the perception of chronic pain is a widely discussed subject, we lack clear evidence of the role of vitamin D supplementation in fibromyalgia patients,” stated lead researcher Dr. Florian Wepner.

Can Vitamin D Supplementation Help With Pain In Those Suffering From FMS?

To answer this question, the research team looked at a group of 30 women with FMS who all had vitamin D levels below 32 ng/ml. They randomized the women to either receive vitamin D supplementation or a placebo. Their goal for the vitamin D group was to raise their levels to between 32 and 48 ng/ml over the course of 20 weeks.

Twenty-four weeks after vitamin D supplementation stopped, the researchers found a marked reduction in perceived pain among the treatment group. Compared to the placebo group, the treatment group significantly improved on physical role functioning and on morning fatigue. There were, however, no alterations in depression or anxiety symptoms.

“We believe that the data presented in the present study are promising. FMS is a very extensive symptom complex that cannot be explained by a vitamin D deficiency alone. However, vitamin D supplementation may be regarded as a relatively safe and economical treatment for FMS patients and an extremely cost-effective alternative or adjunct to expensive pharmacological treatment as well as physical, behavioral, and multimodal therapies,” said Dr. Wepner.

Bottom Line: Vitamin D levels should be monitored regularly in FMS patients, especially in the winter season, and raised appropriately.

Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

Reference:

Materese, T. Vitamin D supplements reduce pain in fibromyalgia sufferers. Elsevier Health Sciences, 2014.

http://www.vitamindcouncil.org/vitamin-d-news/new-trial-vitamin-d-helps-alleviate-pain-in-those-with-fibromyalgia/

If you live in the Northern Hemisphere, you’re in the midst of winter and your body more than likely can’t make enough vitamin D from the sun because the sun is at too low an angle in the sky. Along those lines, isn’t it interesting a vitamin D deficiency is common in people with Inflammatory Bowel Disease (IBD)? Inflammatory bowel disease encompasses two independent but related entities: ulcerative colitis and Crohn's disease. In the Northeastern part of the United States, known for their lengthy, overcast winters, rates of ulcerative colitis and Crohn’s disease are highest, with rates in the Midwest and West not far behind.

The Link Between Vitamin D and Autoimmune Disease

Inflammatory bowel diseases are chronic, inflammatory, autoimmune disorders of the GI tract. It is now proven vitamin D is an important regulator of the immune system which may have implications for the development, severity and management of immune related disorders such as IBD. Particularly if someone with IBD has any malabsorption of dietary vitamin D, and/or has less exposure to the sun due to living in a climate suboptimal for vitamin D synthesis in the skin.

Ulcerative Colitis vs. Crohn’s Disease

The symptoms of these two diseases are quite similar, but the areas affected in the gastrointestinal tract (GI tract) are different.

Crohn’s most commonly affects the end of the small bowel (the ileum) and the beginning of the colon, also called the large intestine, but it may affect any part of the gastrointestinal tract, from the mouth to the anus. Ulcerative colitis is limited to the large intestine.

Crohn’s disease can also affect the entire thickness of the bowel wall, while ulcerative colitis only involves the innermost lining of the colon. Another difference is in Crohn’s disease, the inflammation of the intestine can “skip”— leaving normal areas in between patches of diseased intestine. This does not occur in ulcerative colitis. For more details about Crohn’s disease, visit my blog here.

Absorption of Dietary Vitamin D

Absorption of dietary vitamin D occurs in the upper small intestine, so if a person has had an intestinal resection due to some form of inflammatory bowel disease, they should be considered at risk of malabsorption of vitamin D, thus a low vitamin D status.

Vitamin D, IBD, and Bone Health

Vitamin D deficiency has been linked to bone loss among people with IBD, and bone loss is a problem for up to 50% of people with IBD. As a result, people with IBD are at risk of developing osteoporosis. To prevent bone disease, there are clear guidelines that recommend vitamin D supplementation for people with IBD, especially when undergoing steroid treatment. However, despite these recommendations, vitamin D deficiency is still common with IBD.

How Much Vitamin D?

The Vitamin D Council recommends adults with ulcerative colitis keep their serum vitamin D levels in the high-natural range, about 70-80 ng/ml. Your primary care physician can perform a simple blood test to determine current levels. The Vitamin D Council also advises children with ulcerative colitis should be given 2,000 IU per 25 pounds of body weight per day.

For Crohn’s disease, one study gave patients 2,000 IU per day and after 3 months, they had significantly less fatigue, increased muscle strength and an overall improvement in their quality of life.

Bottom Line: Vitamin D seems to play in integral part in overall well-being for those with some form of irritable bowel disease. Consult with your gastroenterologist and have your vitamin D levels checked.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

1. Andreassen H, Rungby J, Dahlerup JF, Mosekilde L. Inflammatory bowel disease and osteoporosis. Scand J Gastroenterol 1997;32:1247–55.

2. Andreassen H, Rix M, Brot C, Eskildsen P. Regulators of calcium homeostasis and bone mineral density in patients with Crohn's disease. Scand J Gastroenterol 1998;33:1087–93.

3. Margherita T Cantorna, Yan Zhu, Monica Froicu, and Anja Wittke. Vitamin D status, 1,25-dihydroxyvitamin D₃, and the immune system. Am J Clin Nutr. December 2004; vol. 80, no. 6:1717S-1720S.

4. Crohn’s and Colitis Foundation of America.

5. Holick MF. Vitamin D. In: Shils ME, Olson JA, Shike M, Ross CA, eds. Modern nutrition in health and disease. Baltimore: Williams & Wilkins, 1999:329–99.

6. Compston J, Creamer B. Plasma levels and intestinal absorption of 25-hydroxyvitamin D in patients with small bowel resection. Gut 1977;18:171–5.

7. Vitamin D Council: Inflammatory Bowel Disease.

8. Blanck S, Aberra F. Vitamin D deficiency is associated with ulcerative colitis disease activity. Dig Dis Sci. 2013 Jun;58(6):1698-702.

9. Vitamin D Council: Does vitamin D deficiency contribute to inflammatory bowel disease?

10. Walsh N. Vitamin D boosts quality of life in Crohn’s. MedPage Today. Mar 20, 2013.