Vitamin D status and autoimmunity in celiac disease

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Posted on February 11, 2013 by Rebecca Oshiro

A new study from researchers out of Columbia University have found those suffering from celiac disease and vitamin D deficiency may be at higher risk for psoriasis.
A cross-sectional study in The Journal of Clinical Gastroenterology looked at vitamin D levels in patients with celiac disease (CD) to determine if there was a connection between having CD and being diagnosed with another autoimmune disease.
Tavakkoli A, Digiacomo D, Green PH, Lebwohl B. Vitamin D Status and Concomitant Autoimmunity in Celiac Disease. J Clin Gastroenterol. 2013; Jan 16.
CD is an autoimmune disease that most commonly affects the gastrointestinal tract. It is induced through the consumption of gluten, a protein found in wheat and related grains. CD can also cause iron-deficiency anemia, osteoporosis, and dermatitis herpetiformis, an itchy skin rash.
Recent research has shown that individuals with CD are anywhere from three to ten times more likely than non-CD sufferers to have another autoimmune disease, such as autoimmune thyroid disease, type 1 diabetes, and psoriasis.
Some, but not all, research has indicated that the longer a person with CD is exposed to gluten, the more likely he or she is to develop another autoimmune disease. Because vitamin D deficiency is associated with numerous other autoimmune disorders, researchers wanted to see if there was any relationship between having low vitamin D levels and developing other autoimmune diseases after a CD diagnosis.
They analyzed the blood work of 530 CD patients and divided them into three groups:

• Serum 25(OH)D levels >30 ng/mL
• Serum 25(OH)D levels >20 ng/mL but <29 ng/mL
• Serum 25(OHD) levels <20 ng/mL

The researchers found no difference in the overall prevalence of other autoimmune disorders between groups. However, there was an association between psoriasis and low vitamin D levels. Patients with CD whose vitamin D levels were less than 20 ng/mL were more than twice as likely to have psoriasis than those with vitamin D levels above 20 ng/mL.
There was also an association between iron deficiency anemia and low vitamin D levels, which prompted the authors of the study to recommend screening for vitamin D deficiency in anemic CD patients. Notably, 60% of patients in the study were either vitamin D deficient or insufficient.
Thus, it appears that CD patients are yet another group of people likely to have low vitamin D levels. Screening for and treatment of vitamin D deficiency and insufficiency is warranted for this group of patients.