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

My next book

I’m currently working on Edition II of Microscopic Colitis.  A lot has happened since the first edition was published.  This edition will basically begin where the first one left off.  In other words, it will not include the information in the first book except in places where new or more detailed information has become available about topics that were included in the first edition.  I’ve already accumulated over 700 pages of notes, most of them related to new research data that have become available.

And because so much medical research these days is biased because of the fact that most research is sponsored by commercial interests that have a financial stake in the outcome of the research, one cannot simply take the conclusions reached in most medical research reports at face value.  Nor can one safely assume that all of the headlines in the medical press articles that are based on the press releases and the actual research articles are accurate and totally objective.  Often they are biased either by improper conclusions stated in the research articles, or by dissenting medical opinion (especially when the conclusions of the research reports contradict prevailing mainstream medical opinions or policies).

So sorting out all the data found in research reports, and weighing the various comments made about the research by other medical authorities who are often interviewed to get their thoughts on newly-published research, can often require a lot of careful reading and sometimes a bit of detective work.

Here is the current list of chapters.  Bear in mind that this list may change before publication.

Chapter 1 – Why Do Treatment Programs Fail?
Chapter 2 – Cross-Contamination and Other Dietary Issues
Chapter 3 – Nutritional Deficiencies
Chapter 4 – Methylenetetrahydrofolate Reductase (MTHFR) Gene Mutations
Chapter 5 – Magnesium Deficiency, Histamine, Gut Bacteria, Inflammation
Chapter 6 – BAM, SIBO, Low-Dose Naltrexone, GERD, Other Considerations
Chapter 7 – Depression, Inflammation, and Stress Associated with MC
Chapter 8 – Medical Diagnostic and Treatment Issues That Must Be Corrected
Chapter 9 – Recent Research

Projected completion time is Fall, 2017.  If you have any suggestions on topics that you would like to see addressed in the book, or any other comments, please feel free to post your thoughts.