After I broke my shoulder in an accident three years ago, my GP suggested a DEXA scan to measure bone density for osteoporosis. I was not surprised, at the age of 70 and more than 20 years after suffering from ulcerative colitis (an auto-immune disease), to be found positive. Evidently, other common conditions tied to osteoporosis are diabetes, breast cancer and Crohn’s Disease, among others.
By chance, a few days after my scan, I read an article by Oliver Gillie, a renowned writer and scientist, about vitamin D deficiency and how it could prevent “modern” diseases such as Crohn’s and UC. I decided to find out more.
As far as I can understand, two of the hallmarks of thinning of the bones are lack of calcium and particularly of vitamin D. But apart from normal growth and strengthening bones and teeth, vitamin D is also essential for improving the health of your intestines. It reduces inflammation, protects the lining and prevents harmful bacteria from entering the blood stream. Vitamin D deficiency is routinely found in patients with IBD (Inflammatory Bowel Disease) as UC blocks its absorption.
Since the 1930s, and especially in the last 20 years, Crohn’s and UC have been increasingly recorded in developed countries. So far, 18 auto-immune diseases (including 11 identified in a study published in BMC Medicine, Oxford, in 2013) have been associated with low levels of this key vitamin. **
Public Health England has recently published data that pointed out that more than one in five people has below the accepted levels of vitamin D. According to Dame Sally Davies, Chief Medical Officer, in her report of 2013, as many as 40% of young children are vitamin D deficient. She is “profoundly ashamed” to see the return of rickets in children, blamed on low levels of this vitamin. During World War II the government prescribed cod liver oil, one of the natural sources of vitamin D to all children. Since then, free supplies have gradually been restricted to a small percentage of pregnant and breast-feeding women and under-fives who are on state benefits. Mr Gillie believes that a great advance could be made by providing all pregnant women and babies with free vitamin D supplements.
I was interested to learn that vitamin D takes two to three months to get into general circulation of the body. So babies born in October/November have a higher level during the final months in the womb. As a March baby, after the English winter, I was more at risk.
So how do you get vitamin D into your body? Diet provides only 5-10% of our needs. The remainder comes from exposure to the sun – but advice from the cancer charities in particular has made us worried about sunbathing. Over the last few years reduced exposure to UVB rays (the part of sunlight that promotes vitamin D) together with a more indoor lifestyle has lowered people’s levels. The National Osteoporosis Society maintains that 15 to 20 minutes of sunlight per day on the face and arms during the summer months enables the body to store enough vitamin D to last the rest of the year. Recent guidelines suggest up to 20 minutes around midday, wearing little clothing and no sun screen, is the way to go. After all, it is sunburn itself that is dangerous.
If you can’t get out in the sun (or, typically, if the weather is too bad) vitamin D supplements can raise your levels and reduce symptoms of IBD. Mr Gillie has written about clinical trials that show that patients with Crohn’s Disease may do better or have fewer relapses when they take vitamin D supplements, so long as the condition is not too advanced. Another study at Massachusetts General Hospital, USA, described in the journal Inflammatory Bowel Disease in 2013, demonstrated that the risk of surgery was reduced in Crohn’s patients who took a supplement that increased their blood level to normal.
I had always thought of vitamin D as just the sunshine vitamin that helped bones and teeth. Now I know that its impact and effectiveness is much, much more. Have you had your sunshine ration today?
** Other auto-immune diseases that can be affected by inadequate levels of vitamin D include food Allergies, Asthma, Autism, some types of Cancer, type 1 Diabetes, Lupus, MS, Rheumatoid Arthritis and Schizophrenia.
The article by Sandy originally appeared in the IA Journal (The Ileostomy & Internal Pouch Support Group) Issue 225 Autumn 2014.