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Review
Managing vitamin D deficiency in inflammatory bowel disease
  1. Ole Haagen Nielsen1,
  2. Thomas Irgens Hansen1,
  3. John Mark Gubatan2,
  4. Kim Bak Jensen3,4,
  5. Lars Rejnmark5
  1. 1Department of Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
  2. 2Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, USA
  3. 3Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
  4. 4Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Stem Cell Research, University of Copenhagen, Copenhagen, Denmark
  5. 5Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
  1. Correspondence to Professor Ole Haagen Nielsen, Department of Gastroenterology, Herlev Hospital, University of Copenhagen, Copenhagen 2730, Denmark; ohn{at}dadlnet.dk

Abstract

Management of inflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease, is generally cumbersome for patients and is a massive health-economic burden. In recent years, the immunomodulating effects of vitamin D have gained a huge interest in its possible pathogenic influence on the pathophysiology of IBD. Vitamin D deficiency is frequent among patients with IBD. Several clinical studies have pointed to a critical role for vitamin D in ameliorating disease outcomes. Although causation versus correlation unfortunately remains an overwhelming issue in the illusive chicken versus egg debate regarding vitamin D and IBD, here we summarise the latest knowledge of the immunological effects of vitamin D in IBD and recommend from available evidence that physicians regularly monitor serum 25(OH)D levels in patients with IBD. Moreover, we propose an algorithm for optimising vitamin D status in patients with IBD in clinical practice. Awaiting well-powered controlled clinical trials, we consider vitamin D supplementation to be an affordable and widely accessible therapeutic strategy to ameliorate IBD clinical outcomes.

  • biologics
  • clinical control
  • inflammatory bowel disease
  • therapy
  • vitamin D

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors The authors’ responsibilities were as follows: OHN wrote first draft of the manuscript; TIH, JMG, KBJ and LR subsequently added and revised the manuscript. All authors read and approved the final manuscript. None of the authors reported a conflict of interest related to the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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