Why do you take Vitamin D supplements if they are antagonistic to Mesalamine/Prednisone?

IBDISTHEPITS said...
I thought mesalamines help to reduce inflammation in the colon only. I did not think it had a systemic affect in the
entire body?
To my knowledge it does not suppress the immune system. It is not labeled as an immuno-suppressant.

Prednisone definitely suppresses the immune system.

As far as Mesalamine / 5-ASA, it "interferes with the chemical mediators between the inflamed tissue and the body’s immune system. Whenever tissue is damaged, be it a cut, bruise, burn, etc, the tissue releases a chemical message into the bloodstream alerting the immune system to the location and severity of damage. Normally the immuno-factors would come in and clean up the damaged tissue, destroy invading organisms, and help make repairs. But with inflammatory diseases (it is believed that) the immuno-factors cause damage to the tissue. The damaged/inflammed tissue calls out for more troops which arrive and do more damage and a vicious cycle continues. By interfering with the mediators the response is reduced and thereby so is the inflammation. This class of drugs doesn’t suppress the production of immuno-factors, just their response to the tissue where the 5-ASA is delivered."

BabeintheWoods said...
Mesalamines are anti-inflammatory drugs

That work by directly suppressing the immune system response.

BabeintheWoods said...
Prednisone is a corticosteroid anti-inflammatory drug related to the body's natural cortisol

Cortisol, and thus Prednisone, weakens the activity of the immune system.

BabeintheWoods said...
Vitamin D is a natural anti-inflammatory

That strengthen the immune-system.

?

We know so little about IBD but this is from Wikipedia:

"Broadly speaking, the genetic data indicate that innate immune systems in patients with Crohn's disease malfunction, and direct assessment of patient immunity confirms this notion.[34] This had led to the notion that Crohn's disease should be viewed as innate immune deficiency, chronic inflammation being caused by adaptive immunity trying to compensate for the reduced function of the innate immune system."

Who knows? Also I think we should concentrate less on what stimulates or represses the immune system and look at what cools inflammation. The bottom line is that mesalamine, pred, and D are all anti-inflammatory.

We need people like Medz.

For nothing else if only to play the devils advocate.

A very long time ago, my dad told me to question EVERYTHING in school. It got me into a lot of schtuck especially in religion class. (I'm still waiting for the answers)

I was quite prepared (read my earlier post) to run off to the pharmacy and stock up on 3 trillion bottles of vit. D3 and live in remission happily ever after.

There is always a down side to most of the good news stories we read on this forum.

We tend to make knee-jerk reactions to every positive thing we hear. It's natural. For a lot of us because we're desperate. And we are not really sure our GI's are as good as we'd like them to be.

I'm still gonna increase my D3 intake. But not as much as I initially thought.

Let's see how it goes.

Regardless of the effect on immune response, vitamin D is crucial if you're on pred. Pred leaches calcium from bones, increasing risk for osteoporosis. Vit. D is required for the uptake of calcium to replace that being lost.

subdued said...
I've been taking vitamin D for years--way before I ever had my first flare.

Which means it didn't prevent your first flare.

The main study is only a few months old, March 2010: http://www.nature.com/ni/journal/v11/n4/abs/ni.1851.html

Scientific American said...
From http://www.scientificamerican.com/blog/post.cfm?id=another-reason-vitamin-d-is-importa-2010-03-07

"In order for T cells to become active members of the body's immune system, they must transition from so-called "naive" T cells into either killer cells or helper cells (which are charged with "remembering" specific invaders). And, if ample vitamin D is not around, the T cells do not make that crucial transition, a group of researchers led by Carsten Geisler, head of the Department of International Health, Immunology and Microbiology at the University of Copenhagen, found. They draw this conclusion based on their experiments with isolated naïve human T cells.

"When a T cell is exposed to a foreign pathogen, it extends a signaling device of 'antenna' known as a vitamin D receptor, with which it searches for vitamin D," Geisler said in a prepared statement. If there is an inadequate vitamin D level, he noted, "they won't even begin to mobilize."

Although this vitamin requirement might seem like a handicap to the immune system, the researchers proposed that the additional step involving the vitamin D receptor might actually serve an important evolutionary function: keeping T cells from ravaging healthy tissue. "Given that T cells are capable of explosive proliferation, the lag phase imposed by the vitamin D [receptor step] may diminish the risk of unwanted immunopathology," they noted in the study, which was published online March 7 in Nature Immunology (Scientific American is part of Nature Publishing Group)."

While that says vitamin D is beneficial for the average person because it activates T cells, it also implies (in bold) that vitamin D is harmful for someone with an autoimmune disease like Ulcerative Colitis, for the very same reason.

Medz said...
Aminosalicylates (Mesalamine and its Derivatives) Mesalamine is an aminosalicylate (the common name of the compound 5-aminosalicylic acid or 5-ASA). This compound inhibits factors in the immune system, importantly, the cytokines that cause inflammation

Please provide a reference to this statement. I can find nothing that states that mesalamine affects the immune system.

We can argue forever how many angels can dance on the head of a pin. But let the data speak for itself. Nobody doubts the studies show that vitamin D is helpful for a range of diseases from cancer to heart disease, including IBD. But apparently that is not good enough.

I guess we need a study with people on mesalamine and prednisone. IBDers who are on pred with vitamin D should be compared with IBDers who are on pred without vitamin D. I will be the ranch that the vitamin D helps. I bet there are studies like this already out there.

When your flaring you need D3 more than ever - yet you cannot absorb it.

Why fool around ?

I inject it from a company called Trim. That bypasses all Digestive Tract absorption issues.

Medz said...

subdued said...
I've been taking vitamin D for years--way before I ever had my first flare.

Which means it didn't prevent your first flare.

Yes. This is true. But then, I strongly believe my colon flares due to the effects of antibiotics. The thing about UC is that the colon will flare for different reasons. Thus, I can only relate my experience, not others. So I guess my conclusion would be that taking vitamin D supplements will not prevent getting UC for everyone.

tap - I like your post - thanks!

D3 makes me feel better - little more energy - able to deal with life in general.  My husband and I both take it because blood tests showed we are deficient - nothing to do with my UC.  It did not change a thing with UC. 

ElaineNY

I can tell you one reason I take D3-taking it has not had any effect thus far on my UC (I also take Asacol and just took my last dose of pred this morning, and I am on Remicade), but I have been given strong information that indicates that taking D3 can help keep me well on other fronts. I KNOW flares are brought on for me by illness (as well as antibiotics and stress), so it makes absolute sense to take whatever precautionary measures I can to keep myself healthy and away from regular illness such as colds, sinus infections (to which I am prone), various viruses my kids bring home, etc. Since it hasn't had a negative effect on my UC, I am not in the slightest bit concerned about it, even if there is evidence suggesting it activates T cells. I need to stay healthy and away from the everyday bugs and viruses that invade my house-for other people they are just a nuisance, but for me, they can be a heck of a lot more than that. In fact, my girls both recently had a stomach bug (weird, having it happen in June), and normally, I get some variation of their viruses as well. This was the first time I have dealt with one of their illnesses while on a good dose of D3 (and I mean, scraping throw up off of sheets and the like, so I was definitely well exposed to it), and I didn't so much as have an ounce of nausea or even one "off" BM, which generally always happens to me. I can't prove it is the D that is doing it, but most everything else I am on, I have been on before without this same effect.

Krissy, I am taking 5,000IU of D3 daily, and was taking 10,000IU of it when I first started, so I think you should feel free to up yours if you want/need to.