Vitamin D boost might reduce IBD symptoms

Supplementation with vitamin D may have a role as an adjunct maintenance therapy in children with inflammatory bowel disease (IBD).

Preliminary results from a small randomised study of 5-18 year olds with Crohn’s disease, found a significant difference in the Paediatric CD Activity Index (PCDAI) after six months of daily vitamin D supplementation compared to controls.

Dr Steven Leach, research fellow in the School of Women’s and Children’s Health at the University of NSW, said there was experimental evidence that vitamin D can modulate immune function.

There was also limited evidence from small studies in adults with IBD that vitamin D reduced disease activity.

He told Australian Gastroenterology Week that all the children in the study were vitamin D sufficient with serum 25-hydroxy-vitamin D levels greater than 50 nmol/L.

Children randomised to the active arm of the study received 2,000 IU oral vitamin D daily, resulting in a mean increase in vitamin D levels of 35 nmol/L.

There were no serious adverse events associated with supplementation.

Dr Leach said larger studies were needed to define precisely how supplementation could be used in the clinical setting.

“Supplementation, used to have an effect on disease activity, really needs to be done under clinical supervision. We don’t want people to self-medicate because there is toxicity associated with vitamin D supplementation.”

His colleague Dr Robert Lopez, a fellow in paediatric gastroenterology at Sydney Children’s Hospital, told the limbic the definition of vitamin D sufficiency was still up for debate.

“Guidelines relate to the prevention of bone sequelae rather than improvement of gut health. Hopefully studies like this will go some way to providing information on the optimal level of vitamin D.”

“I think it is really exciting preliminary data and the potential is remarkable if this can be borne out in bigger prospective studies.”

“Vitamin D is readily available and fairly cheap and for most patients the advice that taking a vitamin supplement will go some way to helping their disease stay in remission will be an easy sell.”

Further results from the study are expected in 2018.

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