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Vitamin D deficiency = Treatment failures?

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ankiwo72
Posts: 73
Joined: Fri May 17, 2019 2:45 am

Vitamin D deficiency = Treatment failures?

Post by ankiwo72 »

Dear Helico Expert,

Can you please weigh in on this article I have recently found:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6308038/

A couple of years ago I had low levels of Vitamin D, supplemented for a little while then stopped. There was no followup to ascertain levels after supplementation. I then found out that Rifabutin can also lower Vitamin D levels (https://supp.ai/i/vitamin-d-rifabutin/C0042866-C0140575), and I had been on eradication therapy with Rifabutin in early 2019 which failed. I have also had decreasing ferritin levels and finally became fully anemic around end of last year. I did notice that starting after the Rifabutin regimen I came down with more frequent infections and have suffered about a half dozen UTIs since then (amongst other things). I tried to do oral iron supplementation but had to stop taking them when I had an accident (fell and broke 2 vertebrae) at the very end of 2019, because the iron supplements were causing terrible "plumbing" problems and along with the H.Pylori, creating terrible abdominal distention that exacerbated pain from the spinal injury. So, I had to go on an extended course of laxatives to help ease the discomfort and "make room" for healing. [I have very recently read that laxatives can deplete Vitamin D levels too (ugh)!] After the fall I developed worsened joint pains all over, nerve pains in my extremities, itching with pustules, fatigue, more cognitive difficulties, irritability, and became depressed. On a whim I took a high-dose D3 supplement (10,000 IU) and my symptoms improved by at least 10% (whether a real improvement or a placebo effect, I don't know). I have no idea what my current blood levels are and hope to get a blood test to determine how badly a deficiency I might have at this point in order to know how to proceed.

My question is, to your knowledge is the article linking low Vitamin D levels to H. Pylori eradication failures accurate? If so, then why are these blood levels not routinely ascertained prior to eradication therapy, in order to have better chance at success? Could low Vitamin D levels have contributed to my 7 treatment failures? If I get Vitamin D levels up could that be the missing the link to finally eradicating this nasty bug?

I was supposed to get the endoscopy redone for sensitivity panel at the end of last year but the $&@*%%*! accident caused me to have to cancel the procedure. I want to get stronger before I board this merry-go-round again!

Thanks!

ankiwo72
Posts: 73
Joined: Fri May 17, 2019 2:45 am

Re: Vitamin D deficiency = Treatment failures?

Post by ankiwo72 »

Dear Helico expert,
I just got my Vit D lab result back and as suspected I am definitely deficient. My level was 15.2 (range 32-100) and this was after I had taken a 10,000 IU Vitamin D3 supplement the week before, so I suspect my level may have been even lower before that. I am awaiting to hear back from my GP on what to do to raise my levels.
Will the HPylori infection interfere with the Vitamin D treatment? Is the Vitamin D deficiency a contributing factor toward all my previous treatment failures, and will raising my level give a better chance of success to eradicating the bacteria?
Please let me know your thoughts, as I would like to convey your feedback to my GP and also to my gastroenterologist. Thanks so much!

Helico_expert
Site Admin
Posts: 3881
Joined: Wed Mar 02, 2011 7:20 am

Re: Vitamin D deficiency = Treatment failures?

Post by Helico_expert »

I am actually waiting for Prof. Marshall to respond to your question.

anyway, while waiting, there are quite a few scientific articles out there discussing the possibility of deficiency of Vit D and its association with poorer cure rate. However, this has not been a factor discussed in any guideline.

I am also not sure if taking Vit D supplement will actually increase the Vit D level. I believe it is more to do with absorption. If you cannot absorb the Vit D, then it doesnt matter how much you took.

So, to save me some time reading all your previous post, can you list down all the antibiotics that you had taken for your HP treatment?

ankiwo72
Posts: 73
Joined: Fri May 17, 2019 2:45 am

Re: Vitamin D deficiency = Treatment failures?

Post by ankiwo72 »

Helico_expert wrote:
Tue Feb 25, 2020 9:05 am
I am actually waiting for Prof. Marshall to respond to your question.

anyway, while waiting, there are quite a few scientific articles out there discussing the possibility of deficiency of Vit D and its association with poorer cure rate. However, this has not been a factor discussed in any guideline.

I am also not sure if taking Vit D supplement will actually increase the Vit D level. I believe it is more to do with absorption. If you cannot absorb the Vit D, then it doesnt matter how much you took.

So, to save me some time reading all your previous post, can you list down all the antibiotics that you had taken for your HP treatment?
Here is full abx history, below. 6 failed H. Pylori treatments (not 7, I lost count LOL)

{8/22/14 – Vancomycin 250mg x 7 days (C.Diff)}
**1. 12/24/15 — Doxycycline, Clarithromycin, Prevacid x 14 days (H.Pylori)
{3/23/16 - Levaquin – 500 mg x 10 days (sinus infection)}
**2. 5/25/18 — Doxycycline, Clarithromycin, Omeprazole x 14 days (H.Pylori)
**3. 8/6/18 — PYLERA (Metronidazole, Tetracycline, Bismuth & Omeprazole) x 14 days (H.Pylori)
~~~SENSITIVITY TEST PERFORMED (results below)
**4. 12/23/18 — Amoxicillin, Doxycycline, Omeprazole, Pepto x 14 days (H.Pylori)
**5. 3/13/19 — Amoxicillin, Rifabutin, Omeprazole/Pantaprazole x 14 days (H.Pylori)
{5/22/19 -- Macrobid (Nitrofurantoin) x 7 (E. Faecalis UTI)}
{6/21/19 -- Cipro 2x/day x 5 days (E. Coli UTI)}
{8/16/19 -- Cipro 2x/day x 7 days (Klebsiella UTI)}
**6. 9/17/19 -- Amoxicillin 1000mg 3x/day after meals x30 days; Omeprazole 40mg 3x/day before meals
{12/29/19 -- Cipro 2x/day x 5 days UTI}

2018 Sensitivity test result:
Amoxicillin <=0.008
Ciprofloxacin >2
Clarithromycin >0.5 (resistant)
Metronidazole 32
Tetracycline 1

And to answer your next question, Furazolidone is not available in the United States! :-)

ankiwo72
Posts: 73
Joined: Fri May 17, 2019 2:45 am

Re: Vitamin D deficiency = Treatment failures?

Post by ankiwo72 »

Helico_expert wrote:
Tue Feb 25, 2020 9:05 am
I am also not sure if taking Vit D supplement will actually increase the Vit D level. I believe it is more to do with absorption. If you cannot absorb the Vit D, then it doesnt matter how much you took.
Does H. Pylori interfere with Vitamin D absorption?

Helico_expert
Site Admin
Posts: 3881
Joined: Wed Mar 02, 2011 7:20 am

Re: Vitamin D deficiency = Treatment failures?

Post by Helico_expert »

looks like you have tried everything.

perhaps you want to wait for the launch of the new PPI, vonoprazan?

it's a very powerful PPI. There are some articles that showed great cure rate from Vonoprazan and Amoxicillin (dual drug therapy).

ankiwo72
Posts: 73
Joined: Fri May 17, 2019 2:45 am

Re: Vitamin D deficiency = Treatment failures?

Post by ankiwo72 »

Helico_expert wrote:
Tue Feb 25, 2020 12:37 pm
looks like you have tried everything.

perhaps you want to wait for the launch of the new PPI, vonoprazan?

it's a very powerful PPI. There are some articles that showed great cure rate from Vonoprazan and Amoxicillin (dual drug therapy).
I would love to try that - do you have any idea when it might be available in the US?
Please keep me posted on any feedback on the Vitamin D issue. I also have recently read several studies that Vit D deficiency can affect iron absorption as well, and vice versa:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4659411/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6471745/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5159690/
Could this be the reason that many H.Pylori sufferers also have anemia? Or is that moreso from H.Pylori itself? Is this why you mentioned the problem with Vitamin D absorption? How much of these deficiencies is actually attributable to the H.Pylori? So wouldn't it make sense as a matter of routine to check and try to correct *both* Vitamin D and iron deficiencies simultaneously before H. Pylori eradication treatments?

Helico_expert
Site Admin
Posts: 3881
Joined: Wed Mar 02, 2011 7:20 am

Re: Vitamin D deficiency = Treatment failures?

Post by Helico_expert »

hmm... you have asked a question that I do not have an answer.
However, from experience and literature, many iron deficient patients have their iron level restored after HP eradication.

ankiwo72
Posts: 73
Joined: Fri May 17, 2019 2:45 am

Re: Vitamin D deficiency = Treatment failures?

Post by ankiwo72 »

Helico_expert wrote:
Tue Feb 25, 2020 11:57 pm
hmm... you have asked a question that I do not have an answer.
However, from experience and literature, many iron deficient patients have their iron level restored after HP eradication.
It seems then the mechanism of H.Pylori affecting iron absorption in turn causing Vitamin D deficiency in turn causing treatment failures is a very smart adaptive mechanism that this bacteria is capable of! Can this really be its evolution in order to ensure its survival? That would be crazy!!

Also, since I have read that rifabutin also causes Vitamin D depletion, wouldn't it make sense for Vitamin D supplementation to begin before and during this treatment protocol to raise chance of treatment success?

http://pennstatehershey.adam.com/conten ... gid=000179
"Taking rifampin or isoniazid may deplete vitamin D."

Helico_expert
Site Admin
Posts: 3881
Joined: Wed Mar 02, 2011 7:20 am

Re: Vitamin D deficiency = Treatment failures?

Post by Helico_expert »

Good question. It is probably true that Rifabutin can lead to lower Vit D. But I think for most patients it's ok. probably 1% of our patients suffer from the side effect of Rifabutin. Vit D is deficiency is mostly not the focus. We are more focus on the lower white blood cells and platelet count.

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