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    Can a Gluten-Free Diet Normalize Vitamin D Levels for Celiac Patients?


    Jefferson Adams
    • A new study study strongly suggests that people with celiac disease can recover normal vitamin D levels through a gluten-free diet, without requiring any supplementation.

    Can a Gluten-Free Diet Normalize Vitamin D Levels for Celiac Patients?
    Image Caption: Image: CC--NASA/Goddard/SDO

    Celiac.com 08/16/2018 - What is the significance of vitamin D serum levels in adult celiac patients? A pair of researchers recently set out to assess the value and significance of 25(OH) and 1,25(OH) vitamin D serum levels in adult celiac patients through a comprehensive review of medical literature.

    Researchers included F Zingone and C Ciacci are affiliated with the Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; and the Celiac Center, AOU San Giovanni di Dio e Ruggi di Aragona, University of Salerno, Department of Medicine and Surgery, Salerno, Italy. 

    Within the wide spectrum of symptoms and alteration of systems that characterizes celiac disease, several studies indicate a low-level of vitamin D, therefore recent guidelines suggest its evaluation at the time of diagnosis. This review examines the data from existing studies in which vitamin D has been assessed in celiac patients. 

    Our review indicates that most of the studies on vitamin D in adult celiac disease report a 25 (OH) vitamin D deficiency at diagnosis that disappears when the patient goes on a gluten-free diet, independently of any supplementation. Instead, the researchers found that levels of calcitriol, the active 1,25 (OH) form of vitamin D, fell within the normal range at the time of celiac diagnosis. 

    Basically, their study strongly suggests that people with celiac disease can recover normal vitamin D levels through a gluten-free diet, without requiring any supplementation.

    Source:

     

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    Guest AWOL

    Posted

    "...most of the studies on vitamin D in adult celiac disease report a 25 (OH) vitamin D deficiency at diagnosis that disappears when the patient goes on a gluten-free diet, independently of any supplementation."

    As long as they test for Celiac first. I was misdiagnosed IBS decades, Vitamin D deficient for 6 years before a Dr. tested me for Celiac.  While untreated I had to supplement as vitamin D would fall. However good to hear researchers found it disappear on gluten-free compliant Diet.

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  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, and science. He previously served as Health News Examiner for Examiner.com, and provided health and medical content for Sharecare.com.

    Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book Dangerous Grains by James Braly, MD and Ron Hoggan, MA.

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    Roy Jamron
    Celiac.com 11/02/2007 - Researchers at the University of Chicago using vitamin D receptor "knockout" mice demonstrated vitamin D may have a key role in maintaining the intestinal mucosal barrier and the integrity of tight junctions.  The "knockout" mice were genetically altered to produce mice lacking vitamin D receptors normally expressed by cells in most body tissues.  A dextran sulfate sodium solution was used to induce colitis in both normal control mice and "knockout" mice.  Normal mice resisted intestinal mucosal injury from the dextran sulfate sodium solution, but "knockout" mice "developed severe diarrhea, rectal bleeding and marked body weight loss, leading to death in 2 weeks" and displayed severe colonic ulceration, impaired wound-healing, and tight junction disruption.  Additional study in cell cultures found vitamin D markedly enhanced and preserved tight junction integrity in the presence of dextran sulfate sodium and also stimulated epithelial healing.  The study concluded vitamin D deficiency may compromise the mucosal barrier, increasing susceptibility to mucosal damage and the risk of bowel disorders.
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    A study just released by the National Cancer Institute examined the relationship between serum 25(OH)D levels and total cancer mortality in 16818 participants and concluded "results do not support an association between 25(OH)D and total cancer mortality."  However, the study did find "colorectal cancer mortality was inversely related to serum 25(OH)D level, with levels 80 nmol/L or higher associated with a 72% risk reduction compared with lower than 50 nmol/L."  The fact that vitamin D appears to lower colon cancer mortality risk is consistant with the preservation role vitamin D appears to play in maintaining the intestinal mucosal barrier.  Note that this study does not consider whether receiving daily doses of vitamin D supplements much higher than current recommendations would provide a cancer risk benefit.
    ---------
    Am J Physiol Gastrointest Liver Physiol. 2007 Oct 25.
    Novel Role of the Vitamin D Receptor in Maintaining the Integrity of the Intestinal Mucosal Barrier.
    Kong J, Zhang Z, Musch MW, Ning G, Sun J, Hart J, Bissonnette M, Li YC.
    Medicine, The University of Chicago, Chicago, Illinois, United States; Chicago, Illinois, United States.
    http://ajpgi.physiology.org/cgi/content/abstract/00398.2007v1 .
    ----------
    J Epidemiol Community Health. 2003 Jan;57(1):36-9.
    Children born in the summer have increased risk for coeliac disease.
    Ivarsson A, Hernell O, Nystrom L, Persson LA.
    Department of Public Health and Clinical Medicine, Epidemiology, Umea University, Umea, Sweden.
    http://jech.bmj.com/cgi/content/full/57/1/36 .
    ----------
    J Natl Cancer Inst. 2007 Oct 30.
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    D. Michal Freedman, Anne C. Looker, Shih-Chen Chang, Barry I. Graubard.
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    Jefferson Adams
    Celiac.com 11/07/2011 - Fat-soluble vitamin malabsorption, inflammation and/or under-nutrition put children with celiac disease at risk for decreased bone mineral density.
    A research team recently set out to determine how vitamin D and K might influence bone mineral density and bone growth in children and adolescents with celiac disease. The study team included D. R. Mager, J. Qiao, and J. Turner.
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    Also, twenty-five percent of the children showed suboptimal vitamin K status at diagnosis. All vitamin K deficiencies resolved after 1 year.
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    Source:

    European Journal of Clinical Nutrition, (5 October 2011) | doi:10.1038/ejcn.2011.176

    Jefferson Adams
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    Yvonne Vissing Ph.D.
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    Based on its review of data of vitamin D needs, a committee of the Institute of Medicine concluded that persons are at risk of vitamin D deficiency at serum 25(OH)D concentrations 125 nmol/L (>50 ng/mL) are associated with potential adverse effects [1] (Table 1).
    Table 1: Serum 25-Hydroxyvitamin D [25(OH)D] Concentrations and Health* [1]
    nmol/L**
    ng/mL*
    Health status
    <30
    <12
    Associated with vitamin D deficiency, leading to rickets
    in infants and children and osteomalacia in adults
    30 to <50
    12 to <20
    Generally considered inadequate for bone and overall health
    in healthy individuals
    ≥50
    ≥20
    Generally considered adequate for bone and overall health
    in healthy individuals
    >125
    >50
    Emerging evidence links potential adverse effects to such
    high levels, particularly >150 nmol/L (>60 ng/mL)
    * Serum concentrations of 25(OH)D are reported in both nanomoles
    per liter (nmol/L) and nanograms per milliliter (ng/mL).
    ** 1 nmol/L = 0.4 ng/mL
    Reference Intakes
    Intake reference values for vitamin D and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine of The National Academies (formerly National Academy of Sciences) [1]. DRI is the general term for a set of reference values used to plan and assess nutrient intakes of healthy people. These values, which vary by age and gender, include:
    30. Recommended Dietary Allowance (RDA): average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy people.
    31. Adequate Intake (AI): established when evidence is insufficient to develop an RDA and is set at a level assumed to ensure nutritional adequacy.
    32. Tolerable Upper Intake Level (UL): maximum daily intake unlikely to cause adverse health effects.
    The FNB established an RDA for vitamin D representing a daily intake that is sufficient to maintain bone health and normal calcium metabolism in healthy people. RDAs for vitamin D are listed in both International Units (IUs) and micrograms (mcg); the biological activity of 40 IU is equal to 1 mcg (Table 2). Even though sunlight may be a major source of vitamin D for some, the vitamin D RDAs are set on the basis of minimal sun exposure.
    Table 2: Recommended Dietary Allowances (RDAs) for Vitamin D
    Age
    Male
    Female
    Pregnancy
    Lactation
    0–12 months
    400 IU
    (10 mcg)
    400 IU
    (10 mcg)
        1–13 years
    600 IU
    (15 mcg)
    600 IU
    (15 mcg)
        14–18 years
    600 IU
    (15 mcg)
    600 IU
    (15 mcg)
    600 IU
    (15 mcg)
    600 IU
    (15 mcg)
    19–50 years
    600 IU
    (15 mcg)
    600 IU
    (15 mcg)
    600 IU
    (15 mcg)
    600 IU
    (15 mcg)
    51–70 years
    600 IU
    (15 mcg)
    600 IU
    (15 mcg)
        >70 years
    800 IU
    (20 mcg)
    800 IU
    (20 mcg)
       
     
    References:
    Gluten Free Society. Celiac disease linked to gall bladder and liver problems. https://www.glutenfreesociety.org/celiac-disease-linked-to-gall-bladder-and-liver-problems/ Holick MF. Vitamin D and Health: Evolution, Biologic Functions, and Recommended Dietary Intakes of Vitamin D. In Vitamin D: Physiology, Molecular Biology and Clinical Applications by Holick MF. Humana Press 2010. Middleton, Bert. Gout and Celiac Disease: What is the connection? http://www.selfgrowth.com/articles/gout-and-celiac-disease-what-is-the-connection National Institutes of Health. Office of Dietary Supplements. Vitamin D. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/ Reasoner, Jordan. Why everyone with celiac disease desperately needs vitamin D. http://scdlifestyle.com/2012/07/why-everyone-with-celiac-disease-needs-vitamin-d/ Rottman, Leon. Vitamin D revisited. http://www.csaceliacs.org/vitamin_d.jsp Tavakkoli, A. Analysis of Vitamin D Levels in Patients with Celiac Disease and Co-Existing Autoimmune Disorders. http://www.biomath.info/Protocols/PGY2/docs/AnnaTavakkoli.pdf Tavakkoli A, Digiacomo D, Green PH, Lebwohl B. Vitamin D Status and Concomitant Autoimmunity in Celiac Disease. J Clin Gastroenterol. 2013; Jan 16. Vitamin D Council. Am I deficient in Vitamin D? https://www.vitamindcouncil.org/about-vitamin-d/am-i-deficient-in-vitamin-d/ Watson, Lisa. Nutrient Deficiencies in Celiac Disease. http://drlisawatson.com/nutrient-deficiencies-celiac

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