Vitamin D levels can predict the risk of surgical removal in inflammatory bowel disease

Promising results have been seen with the use of vitamin D supplements in the treatment of inflammatory bowel diseases such as ulcerous colitis and Crohn’s disease. However, there is missing information about blood levels of vitamin D and the prognosis for these patients. A new study that is published in International Journal of Surgery reveals that blood levels of vitamin D are directly linked to the risk of surgical removal of morbid intestinal tissue.

Chronic inflammatory bowel disease (also known as IBD) sometimes requires surgical removal of intestinal tissue and may even require a colostomy. Over the past years there has been increasing focus on vitamin D as part of the prevention and treatment of IBD. This is because vitamin D affects gut health in a number of ways, and a lot of people lack vitamin D. A group of scientists wanted to study if blood levels could be used to predict the risk of surgical procedures and removal of intestinal tissue. They gathered data from the UK Biobank, which is a database with detailed information about the health and nutrition of around 500,000 people in Great Britain.
In their study, the researchers included 5,474 patients with inflammatory bowel diseases and information about their vitamin D status. Also, information about surgical procedures and removal of intestinal tissue was collected from national patient registries.
Over a follow-up period of a little more than 13 years, 513 of the patients underwent surgery. Those patients who were not vitamin D-deficient had a lower risk of surgical procedures, especially when it came to ulcerous colitis. The scientists therefore conclude that lack of vitamin D is a risk factor for surgical procedures in patients with inflammatory bowel diseases.
The new study supports earlier studies, and it generally appears that vitamin D deficiency increases the risk of inflammatory bowel diseases and other inflammatory diseases.

Chronic inflammatory bowel disease is primarily linked to

• A derailed immune defense
• Imbalances in the gut flora (also known as dysbiosis)
• Structural changes in the intestinal mucosa
• Genetic factors

Vitamin D’s role in the immune defense and gut flora

The lion’s share of our immune defense is located in our intestines, where it destroys harmful microbes and toxins from our food and helps control the enormous intestinal microflora.
Vitamin D plays a key role in our innate immune defense and also in our adaptive immune defense, which is specialized and is able to produce antibodies. The vitamin also helps control inflammatory processes and stabilizes the microbial balance in the intestine.

Why is vitamin D so widespread in inflammatory bowel diseases?

The strong summer sun is our primary source of vitamin D, which we synthesize in our skin. Inflammatory bowel diseases are most common at the northern latitudes where there is less sun. Spending too much time indoors, overuse of sun factor cream, ageing, having dark skin, various genetic factors, and obesity can also affect our vitamin D status negatively. Patients suffering from inflammatory bowel diseases may also have difficulty with absorbing vitamin D from oily fish, eggs, cod roe, and high-fat dairy products. In addition, therapies that involve the use of corticosteroids and cholesterol-lowering statins can inhibit the ability to utilize vitamin D.

Vitamin D recommendations and optimal blood levels of the nutrient

The official guidelines for vitamin D call for an intake of around 5-20 micrograms daily, which is quite low. What is more, this intake level does not in any way guarantee that blood levels of vitamin D reach their optimal level of around 75 nmol/L, much less 100-120 nmol/L which is the ideal level.
Multiple studies show that the need for vitamin D varies from person to person and depends on things like sun exposure, skin color, genes, and BMI. Most people are able to optimize their blood levels of the nutrient by taking 50 micrograms of vitamin D daily, but there are even preparations that contain up to 100 micrograms, which is the safe upper intake level of vitamin D.

References:

Lintao Dan et al. Circulating 25-hydroxyvitamin D concentration can predict bowel resection risk among individuals with inflammatory bowel disease in a longitudinal cohort with 13 years of follow-up. International Journal of Surgery. 2024

Antonia Topalova-Dimitrova et al. Lower vitamin D levels are associated with the pathogenesis of inflammatory bowel diseases. Medicine. 2023

Gominak SC. Vitamin D deficiency changes the intestinal microbiome reducing B Vitamin production in the gut. The resulting lack of pantothenic acid adversely affects the immune system, producing a “pro-inflammatory” state associated with atherosclerosis and autoimmunity. Med Hypotheses 2016