Archive for February, 2012

Does it work?

February 22, 2012 52 comments

The short answer is – Yes!

Although it’s an experiment of 1 and admittedly not at all scientific, I thought it would make sense to report on the recent results from my daughters blood work. It turns out that the strategy we are following – borrowed heavily from the Core Strategy I outline in this blog –  is working.  While no plan is perfect, its nice to know that this one is safe and effective.  We set a goal about 18 months ago…to find a way to provide some diet flexibility beyond the strict SCD program that we had successfully implemented in the past. It does appear that the addition of LDN and key supplements has made some diet flexibility possible. I’m sure we’ll have to make adjustments over time, but we’re pretty pleased with the results!

Here is the plan:

  • Wheat/Gluten grain and mostly dairy free diet – potato & rice are well tolerated. (I’m sure there is some cheating going on, but not that much.)
  • LDN – 4.5mg capsules each night
  • Monthly B12 injections
  • Daily supplements: Vitamin D3 10,000 iu, Boswellia/5Loxin 150mg, Curcumin/BCM95 500mg, Krill Oil 1,000mg & Bacillus Coagulans (DuraFlora – 2 capsules)

Here are the blood results:

  • Vitamin D level – 25(OH)D = 79 (I think we are in “theraputic level” territory)
  • C-reactive protein (CRP) = .56 (is a protein found in the blood, the levels of which rise in response to inflammation) anything under 1 is considered a low level of inflammation.
  • The erythrocyte sedimentation rate (ESR), = 18 also called a sedimentation rate (SED) , is a common blood test  that is a non-specific measure of inflammation.  For women, anything under 20 is considered in the normal range.

Vitamin D and Crohn’s Disease

February 2, 2012 10 comments
Target Vitamin D Levels 25(OH)D
Dr. Jaquelyn McCandless 65 – 90
Robb Wolf 60 – 80 50 – 80 40 – 60
Vitamin D IBD Study 30 – 60

There is alot of talk about Vitamin D and its relationship to autoimmune disease and cancer. It appears that those with these diseases have very low levels of Vitamin D. And although its hard to tell which came first, Vitamin D deficiency or the disease, we know it plays an important role on a number of dimensions.

Genetic ExpressionResearch shows that (NOD2) gene insufficiency contributes to the development of the disease. Vitamin D signalling is a direct inducer of NOD2 expression arguing strongly that vitamin D deficiency plays a causative role in Crohn’s Disease.

Vitamin D plays a critical role in preventing and healing leaky-gut –  maintenance of the epithelial barrier integrity of the large intestine by vitamin D is critical in preventing IBD.  The VDR (vitamin D receptor)  is required for mucosal repair andVDR expression suggesting that Vitamin D is involved in the regulation of epithelial wound healing.

Vitamin D controls Zonulin – the molecule that is the glue of tight junctions in the gut lining. If you are deficient in D, the gates will stay open.

Vitamin D acts as an anti-inflammatory immunomodulator in IBD -Vitamin D downregulated Th1 (acting as a natural TNF-a suppressor) and upregulated Th2 responses (increased IL-4 anti-inflammatory cytokines). Th17 responses – a primary driver of  inflammation – were also downregulated.

Those with IBD are also prone to vitamin D intestinal malabsorption so we know that it is difficult to get enough. And that is the key question? How much Vitamin D is enough to help with healing? There are no clear answers but there are some good guidelines available.

Vitamin D

Test Your Vitamin D 25(OH)D Levels

Just as you would test you blood levels for key inflammation markers like CRP & ESR, you should be testing for Vitamin D or 25(OH)D. And while there is no clear theraputic range to target, the above chart gives some good guidance. Dr. Jaquelyn McCandless is a pioneer in treating Autism using LDN and diet. She also treats patients with IBD and suggests the highest target of 65 – 90. The above chart from Mercola is in agreement with her. Robb Wolf and the Vitamin D Council are pretty close in the 60 – 80 range.

How Much Vitamin D Do You Need?

 How much vitamin D3  (and yes you want D3) you supplement with – to get up to the target levels – depends on your situation. Where do you live? How much time do you spend in the sun? How much damage do you have to your ileum? As a result, everyone has to determine their own dosage based on their actual blood level results. For some that may mean 1,000 iu/day. Others may need 5,000 or 10,000 iu/day. Preliminary studies show that  high-dose Vitamin D3 Improves Clinical Activity in Crohn’s Disease.

What kind should I take?

Vitamin D is best assimilated when it is taken with fat, so the D3 you take should be in either an MCT oil or olive oil base.

I know that I’ve just scratched the surface on Vitamin D here. In addition to the Vitamin D Council and Grass Roots Health, the Vitamin D wiki is also a great resource – for further research. There are also some interesting discussions on other supplements that support vitamin d such as magnesium, zinc and K2. Making sure you get your Vitamin D levels up to theraputic levels does not insure that you’ll be cured (I wish it was that easy), but it’s cheap, safe and easy to do. So don’t wait! Get your blood levels checked and catch some rays!

“Direct and indirect induction by 1,25-dihydroxyvitamin D3 of the NOD2/CARD15-beta defensin 2 innate pathway defective in Crohn’s disease” The Journal of Biological Chemistry, January, 2010 .

Vitamin D and gastrointestinal diseases: inflammatory bowel disease and colorectal cancerTheraputic Advances in Gastroenterol,  January, 2011

“US research confirms latitude variation in incidence of chronic digestive diseases.”  American College of Gastroenterology, October, 2011