As we discussed in my previous article in this series, the foundation of an effective Celiac Disease treatment plan starts with a real food diet that goes beyond gluten-free junk food.
Reversing Celiac Disease is a three-headed monster. We’re up against inflammation, leaky gut, and Gut Dysbiosis. To be brutally honest with you: slaying a three-headed monster takes everything we’ve got.
And supplements are a critical part of “everything we’ve got.”
A word of caution… to supplement literally means, “something added to complete a thing, supply a deficiency, or reinforce or extend a whole.”
Supplements are a “supplement” for a reason. They support the whole of a treatment plan. They plug holes and deficiencies to reinforce what we’re already doing.
So if you’re reading this and treating Celiac Disease with a gluten-free diet, the truth is supplements aren’t going to help much until you take your treatment plan seriously and stop eating processed foods.
If you’ve got diet handled and you’re ready to take your health to the next level, I’m going to share why everyone with Celiac Disease should take vitamin D.
Vitamin D is kind of a big deal…
Most vitamins in our body come from outside sources like food, but vitamin D is different. We humans make it ourselves. What’s even more interesting is that it’s not really a vitamin, it’s a secesteroid, a hormonal precursor similar to steroids like cortisol, testosterone, and cholesterol.
When UVB light from the sun hits out skin and interfaces with a form of cholesterol called 7-dehydrocholesterol, vitamin D3 (cholecalciferol) is born. But it still has to go through the liver and kidneys to become the activated form of vitamin D we can use, called calcitriol.
Once in the activated form, it can bind to docking stations located in just about every tissue in the body called vitamin D receptors (VDR). In fact, VDR’s are located in the brain, heart, skin, gonads, prostate, breast, and there’s even VDR activation in the intestine, bone, kidney, and parathyroid gland cells.
Why is that important?
It means vitamin D is involved in brain function, cardiovascular health, immune support, bone and joint health, and just about every process critical to keeping us alive.
It’s also considered essential due to a few of these more specific roles:
- Promoting the mineralization and growth of bones
- Activating killer T-cells for defense against infections and bacteria
- Reducing chronic inflammation
- Modulating the expression of genes that regulate cell proliferation, apoptosis, and differentiation, (suggesting a potential connection to cancer when deficient)
But vitamin D is even more important for people with Celiac Disease…
As it turns out, vitamin D deficiency is common in Celiac Disease[1] and occurs in both autoimmune conditions and IBD[2].
It’s even more important if you’ve been prescribed corticosteroids like Prednisone. Research shows they can interfere with your body’s utilization of vitamin D, contributing to bone loss and osteoporosis[3] [4].
Here’s why that’s a problem: vitamin D deficiency feeds two heads of the Celiac Disease monster, leaky gut and inflammation. Let’s start by looking at how vitamin D impacts a leaky gut.
Vitamin D can stop your intestines from leaking
Research is beginning to show that vitamin D Deficiency leads to a comprised mucosal barrier[5] and we know that reversing leaky gut is critical to reversing Celiac Disease.
What does vitamin D have to do with leaky gut?
The tight junctions in your small intestine contain an adhesion junction around them help regulate what gets in and what stays out. Dr. Tom O’Bryan describes it like a “rubber band” wrapped around the tight junctions that can get too stretched out and lose its elasticity (ability to snap back in place).
Vitamin D plays a critical role in the elasticity of those rubber bands and how well they keep the tight junctions operating normally[6].
So if you’re deficient in vitamin D, the elastic band holding your tight junctions together doesn’t work properly… allowing foreign material to leak into your body and promoting inflammation.
Vitamin D helps put the fire out
Vitamin D plays a critical role in modulatating the immune system and down-regulatating inflammation when the fire burning inside gets too hot[7].
Vitamin D can even inhibit the development of autoimmune diseases like IBD, RA, and MS[8] by down-regulating NF-B activity, increasing IL-10 production and decreasing IL-6, IL-12, IFN-, and TNF- production… creating a well tuned immune system that’s much less inflammatory.
The immune system relies heavily on vitamin D to calm it down by regulating T cells and cytokines. When you’re deficient, inflammation rages inside you like an out of control freight train.
The bottom line is: vitamin D deficiency in Celiacs could be making leaky gut and inflammation worse… that’s why I believe it’s the number one supplement for everyone with Celiac Disease.
How to supplement with Vitamin D
1. Get tested
The first step to supplementing with vitamin D is to see if you actually need it. Start by ordering a vitamin D, 25 Hydroxy blood test to check your serum levels. It’s a common test that most doctors can order, or you can order it yourself here.
What levels are recommended?
Mark Sisson recommends serum levels between 50-60 ng/mL.
Chris Kresser recommends serum levels between 35-50 ng/mL.
The Vitamin D Council recommends serum levels between 50-80 ng/mL.
If you’re low, it’s time to get some vitamin D in your life.
2. Get outside
The most natural way to get vitamin D is from the sun – so after you’re done reading this, get outside and get some vitamin D the natural, fun way.
Depending on many factors, like where you live, about 20-30 minutes of afternoon sun with your shirt off will produce 10,000 IU’s (this vitamin D Council article lists all the confounding factors). Or you can use this fancy calculator from the Norwegian institute for Air Research to estimate how many IU’s you’ll get from playing outdoors.
If that’s not ideal for your lifestyle to get outside every or testing shows an acute deficiency, supplementing with vitamin D3 is probably your best option.
3. Get supplementing with vitamin D3
The amount of vitamin D each person needs is very individual. It depends on how long you’re exposed to the sun each day, the time of year, and how well you’re absorbing nutrients from food.
One study found severe cases of Celiac Disease with acute vitamin D deficiency should supplement with 50,000 IU’s 1-3 times a week until their gut health improved and proper vitamin D levels were restored[9].
Mark Sisson recommends 4,000 IU’s daily to maintain serum levels between 50-60 ng/mL.
Chris Kresser recommends between 2,000 – 5,000 IU’s daily to maintain serum levels between 35-50 ng/mL.
The Vitamin D counsel recommends a minimum of 1000 IU per 25 pounds of body weight, and adults and adolescents take at least 5,000 IU’s a day in the absence of sun exposure.
No matter how much you decide to supplement with, it’s important to keep getting your serum blood levels tested regularly to fine tune the amount you’re taking. It will change based on the time of year, what you’re eating, stress level, how well you’re absorbing nutrients, etc.
What form of vitamin D is the best to take?
Research shows supplementing with vitamin D in the form of D2 is bioequivalent to D3 in maintaining 25-hydroxyvitamin D levels over a 6 week period[10]. However, vitamin D3 is the natural precursor that we produce in our skin, and it’s the form the Vitamin D Council recommends for supplementation.
That said, we both trust Life Extension’s D3 or NOW Foods Vitamin D3. If someone you know has Celiac Disease, please share this information with them to help prevent vitamin D deficiency. It could change the outcome of their treatment plan.
Do you test and track your vitamin D levels? Tell me about your experience supplementing.
- Jordan
____________________________
Citations:
1. Vitamin D deficiency is common in celiac disease, but the actual prevalence of osteomalacia in celiac disease is unknown (level B evidence).
http://www.gastrojournal.org/article/S0016-5085(02)15984-1/fulltext
2. Vitamin deficiencies in general and vitamin D deficiency in particular have been shown to occur among patients with inflammatory bowel disease (IBD)
http://www.ajcn.org/content/80/6/1717S.long
3. Osteoporosis is common in patients requiring long-term treatment with glucocorticoids. Careful attention to preventive management may minimize the severity of this serious complication.
http://www.ncbi.nlm.nih.gov/pubmed/2407167?dopt=Abstract
4. Calcium and vitamin D3 prevented loss of bone mineral density in the lumbar spine and trochanter in patients with rheumatoid arthritis who were treated with low-dose corticosteroids.
http://www.ncbi.nlm.nih.gov/pubmed/8967706?dopt=Abstract
5. Therefore, vitamin D deficiency may compromise the mucosal barrier, leading to increased susceptibility to mucosal damage and increased risk of IBD.
http://ajpgi.physiology.org/content/294/1/G208.full.pdf
6. 1,25-dihydroxy-vitamin D3 [1,25(OH)2D3] markedly enhanced tight junctions formed by Caco-2 monolayers by increasing junction protein expression and TER and preserved the structural integrity of tight junctions in the presence of DSS
http://ajpgi.physiology.org/content/294/1/G208.full.pdf
7. Vitamin D also down-regulates nuclear factor-B (NF-B) activity, increases IL-10 production and decreases IL-6, IL-12, IFN-, and TNF- production, leading to a cytokine profile which favors less inflammation
http://www.nature.com/ki/journal/v68/n5/full/4496342a.html
8. D-hormone [1,25(OH)2 D3] is an important immune system regulator that has been shown to inhibit development of autoimmune diseases including experimental inflammatory bowel disease (IBD), rheumatoid arthritis (RA), multiple sclerosis (MS), and type 1 diabetes.
http://www.jrheum.org/content/supplements/76/11.abstract
9. In patients with intestinal malabsorption, very large doses of vitamin D (i.e., 50,000 U 1–3 times weekly) may be needed in the early stages of a gluten-free diet until the malabsorptive process has resolved.
http://www.gastrojournal.org/article/S0016-5085(02)15984-1/fulltext
10. A 1000 IU dose of vitamin D2 daily was as effective as 1000 IU vitamin D3 in maintaining serum 25-hydroxyvitamin D levels and did not negatively influence serum 25-hydroxyvitamin D3 levels. Therefore, vitamin D2 is equally as effective as vitamin D3 in maintaining 25-hydroxyvitamin D status.
http://www.ncbi.nlm.nih.gov/pubmed/18089691
About the author
- More at
{ 20 comments… read them below or add one }
My three year old son has Celiac, and we think our 15 month old daughter does too. We make an effort to make sure they get some time in the sun everyday.
Since we control their diet, they are strictly gluten free. We probably won’t be giving them any kind of supplements but would like to make sure they’re getting enough. Any dietary recommendations for increasing D intake?
Hey Graham, great question. Our friend Chris Kresser said this about getting Vit D from food:
“Seafood is the only significant source of vitamin D, but you’d still have to eat a lot of it to get enough. 8-9 ounces of herring provides about 2,000 IU of vitamin D, which is a minimum daily requirement for most people to maintain adequate blood levels.”
http://chriskresser.com/9-steps-to-perfect-health-4-supplement-wisely
Also, in Robb Wolf’s book The Paleo Solution, he states that, “We can obtain Vit-D from certain animal products, such as liver or fortified dairy products, but liver offers several problems, including very high levels of Vit-A.”
I didn’t get into it with this post, but too much dietary Vit-A can inhibit Vit-D, which is why Robb mentioned that.
If they’re getting sun everyday, you can use the calculator I linked to in my post to see how many IU’s are possible based on where you live, time of year, etc. Alternatively, you could get their blood serum levels tested, but having kids of my own I know how hard it is to get them pricked with needles unless it’s really important.
Hope that helps,
Jordan
I tried supplementing with pills and developed vitamin d toxicity! On a very very low dose. Now I get in the sun every day and use a tanning bed fitted with the correct lights during the winter. I’ve managed to get a level up from 2 to 35
Hth
Ressy
Ressy how was it that you were low in vit d but when taking d orally, you got toxicity?
Thanks for any info…christopher:-)
Thanks for sharing. If a person is gluten intolerant would there be the same tendency to be low in Vit D? Testing is probably the key
That’s a great point. Vitamin D is really important for everyone, even those that don’t have digestive problems or autoimmune conditions. That will have to be another post, but yes, getting tested is the first place to start.
Jordan
Jordan,
Could you comment on the importance of getting all of the fat soluble Vitamins together. That is a Vit D toxicity may be because you do not have enough A. The Vit D is good for your bones, but only if you have enough Vit K2 to direct it to the bones. I think that it is becoming more clear in the literature that it is dangerous to supplement just one of the fat soluble Vits without supplementing all.
what a great post! this definitely reminds me that i need to restock my vit D supplement!
Thank you for your article. It is a good reminder of a very important factor in keeping healthy.
I have to say though, that 3-headed dragon is really, really yucky!!1
Ha-ha thanks Rose!
Jordan
Great article…need to supplement more I know…one question…be careful about the type you get…in most softgels/liquids…glycerin is an ingredient…..which according to your leaky gut article…can make leaky gut worse…a good source for vitamin D3 is ‘Source Naturals’…get the capsules…they do not contain glycerin
We use Quick D from Nutristart: http://nutristart.com/products/quick-d/
It’s in drop form: emulsified liquid.
Has 950+ drops per bottle (each drop is 1,000IU).
It’s D3 (from organic sunflower oil)
Contains no preservatives, colour, sweeteners, wheat, gluten, dairy or yeast.
We add it to our coffee (4 drops each), would never know it’s there.
I remember giving our son D3 as a baby (breastfed in Canada) from the drugstore — that stuff was nasty! Wish I knew about the Quick D then.
Thank you so much for the great information you are providing. I´d like to hear your take on a supplement question. I bought swansons boronchelate to try if it helps with my messed up joints. Unfortunately i didn´t pay enough attention to the ingredients.One major component is rice flour as a filler. Can i still take these? The amount of flour i would ingest is tiny. I´m on a budget so i don´t want to throw it away. What do you guys think?
Thank you very much
@Markus – I’ve never heard of the supplement your taking but yes fillers can hurt people who have badly damaged guts. You’d have to test it just like any other food or change using our 4-day rule.
Your message is incredibly helpful and I can’t thank you enough. I’ve had many swerves and painful turns on my gluten free journey, the past year. It’s a breath of fresh air to have someone talk some sense who happens to see the big picture!
Thanks for all the great info!
I’ve been gluten free for seven years now, and still have problems. Millions of intolerances, and I have to take a lot more of my vitamins than normal to have good levels, because obviously I am not absorbing nutrients very well.
I had celiac symptoms from the age of three, and finally figured it out myself when I was 52 (I will be 60 in May).
I have to take at least 60,000 IU of vitamin D3 a week to maintain optimal levels.
And despite NOT eating a lot, and rarely eating those ‘gluten free foods’, I keep gaining weight.
But as of this week, I’ve been eating nothing but protein (organic meat) and fat (lard and butter mostly), and a very few vegetables…. no fruit, as I don’t tolerate fruit very well. I am also obviously carbohydrate intolerant….. and starch at all makes me sick.
After reading through several of your previous posts, I realize that my gut must still be in terrible shape, and I have systemic inflammation.
Thanks so much for your excellent explanations, I am sure it will be very helpful in my journey toward health. You guys are awesome!
If you are really bad as you explain, may I suggest you just drink bone broth from beef or chicken bones, homemade with all the gelatin, for several days. Include some chicken or meet from the broth, made in a slow cooker for 24+ hours. When my mother and I (both Celiacs and crohns disease) were at our worst, this healed us and was very nourishing.
I would like to see discussion concerning adding organic virgin coconut oil (from Indonesia) to gluten-free and All processed foods-free diet, (salt and caffeine free for heart) that consisted of only extra virgin olive oil in glass and real unsalted butter consumed for years. I realized that gluten-free processed foods contain too much salt and often seemed to contain other irritants as well.
@Pam – Coconut oil is awesome stuff, eat up!
Hi Jordan and Steven! I have Celiac and started supplementing with Vitamin D. It’s been 2 weeks now. How long does it take before I can see the effects, especially about the leaky gut? Thank you for all your work, this website is amazing and has helped me a lot.