What causes MC to become a chronic disease?

Microscopic colitis patients tend to either be deficient in vitamin D and magnesium or they soon become deficient once the disease becomes active. Published research shows that about two-thirds of magnesium absorption normally takes place in the ileum and the colon, precisely where the inflammation associated with MC is known to be the most severe (Albion Laboratories, n.d., Koskela, 2011).1, 2

Not only does the malabsorption problem associated with the disease cause vitamin D and magnesium deficiencies, but the most popular medical treatment prescribed to treat the disease (budesonide) depletes vitamin D. All corticosteroids deplete vitamin D. And since the diet changes required to gain remission from MC should also include a reduction in the amount of vegetables eaten, especially raw, green, leafy, vegetables, magnesium intake is likely to be restricted as a result of diet changes associated with treating MC. Dr. Norman Shealy, a well-known neurosurgeon and pioneer in the field of pain medicine, once pointed out that every known disease is associated with magnesium deficiency.

So what are the consequences of these deficiencies? Could vitamin D and/or magnesium deficiency possibly interfere with our ability to heal? Yes it could. One of the primary functions of the immune system is to control the various stages of healing. Published research verifies that certain vitamins and minerals are so important to the immune system that they can speed up the healing process. And conversely, a deficiency can slow down the healing process. If the deficiency is severe enough, healing might be so compromised that it is not even possible until the deficiency is corrected.

For example, Narula, Cooray, Anglin, & Marshall, (2016) demonstrated that taking relatively large doses of vitamin D can help to prevent a relapse of Crohn’s disease.3 Compared with taking 1,000 IU of vitamin D daily, they showed that taking 10,000 IU of vitamin D resulted in no relapses in this group of subjects. By contrast, those taking only 1,000 IU daily had a 38 % relapse rate during the 12 month trial period. No one has investigated whether or not large doses of vitamin D might have any effect on MC, but it’s very likely that since all IBDs involve intestinal inflammation and compromised healing ability, the effect of vitamin D might be similar for MC patients.

And this makes a lot of sense, because the reason that microscopic colitis exists in the first place is because the inflammation that causes it becomes chronic. If the intestines just healed, as they should, the disease could not become chronic, and the symptoms would fade away after a few days. But our immune system is unable to heal the damage caused by the inflammation. Why are the intestines unable to heal? That’s a good question. And unfortunately medical science doesn’t seem to know the answer.

The initial cause of the chronic state of inflammation is continued exposure to foods that cause our immune systems to produce antibodies. But we also know from past experience that even after the diet is changed to avoid all known food and drug sensitivities, recovery can take a very long time. Logic tells us that making diet changes to avoid all foods that cause the inflammation in the first place is the best way to stop the inflammation, (which will stop the symptoms) since using this technique can be done with or without medications. So there’s no question that it works for most people. Now we realize that the next step in planning a treatment program that will optimize recovery from MC is to make sure that we are not deficient of vitamin D and magnesium.


  1. Advantages of magnesium bisglycinate chelate buffered. (n.d.). Albion Laboratories, Inc. Retrieved from http://www.albionminerals.com/human-nutrition/magnesium-white-paper
  2. Koskela, R. (2011). Microscopic colitis: Clinical features and gastroduodenal and immunogenic findings. (Doctoral dissertation: University of Oulu). Retrieved from http://herkules.oulu.fi/isbn9789514294150/isbn9789514294150.pdf
  3. Narula, N., Cooray, M., Anglin, R., & Marshall, J. (2016). P-064 Impact of High Dose Vitamin D3 Supplementation in Treatment of Crohn’s Disease in Remission: A Randomized Double-Blind Controlled Study. Inflammatory Bowel Diseases: Official Journal of the Crohn’s & Colitis Foundation. Retrieved from http://journals.lww.com/ibdjournal/Abstract/2016/03001/P_064_Impact_of_High_Dose_Vitamin_D3.89.aspx