Vitamin D for the Immune System in Cystic Fibrosis (DISC): a double-blind, multicenter, randomized, placebo-controlled clinical trial.
Am J Clin Nutr. 2019 Feb 22. pii: nqy291. doi: 10.1093/ajcn/nqy291
Tangpricha V1,2,3,4, Lukemire J5, Chen Y5, Binongo JNG5, Judd SE6, Michalski ES1,2, Lee MJ1, Walker S3, Ziegler TR1,2,3,4, Tirouvanziam R3,7, Zughaier SM8, Chesdachai S1, Hermes WA1, Chmiel JF9, Grossmann RE10, Gaggar A11, Joseph PM12, Alvarez JA1,2,3.
Many CF candidates were rejected from the trial, probably due to already taking Vitamin D
1.6X as many were rejected due to Vitamin D than were accepted (149 vs 91
Speculation: Those who were accepted tended to be those who had previously found that
standard Vitamin D without Magnesium did not help their CF
Cystic Fibrosis patients often have gut absorption problens,
so need higher doses or different forms of Vitamin D, such as:
- 50,000 IU weekly (or more frequent)
- Note: Founder of VitaminDWiki is taking 50,000 IU every 2 days (Feb 2019)
- 100,000 IU monthly (see below with CF)
- Gut-friendly (see below)
- Topical (see below)
- Have Vitamin D with evening meal (in gut longer increases response ~30%)
- Also take Magnesium (increases response ~30%)
- Perhaps also use inhaled form of Vitamin D
- Cystic Fibrosis category listing has
- Cystic Fibrosis probably treated by Vitamin D (if use enough of the right type ) – Oct 2019
Overview Gut and vitamin D contains gut-friendly informationGut-friendly, Sublingual, injection, topical, UV, sunshine
Getting Vitamin D into your body has the following chart
Getting Vitamin D into your body also has the following
Bio-D-Mulsion Forte – especially made for those with poorly functioning guts, or perhaps lacking gallbladder
Sublingual – goes directly into bloodstream
Oil: 1 drop typically contains 400 IU, 1,000 IU, or 4,000 IU, typically not taste good
Topical – goes directly into bloodstream. Put oil on your skin, Use Aloe vera cream with Vitamin D, or make your own
Vaginal – goes directly into bloodstream. Prescription only?
Bio-Tech might be useful – it is also water soluble
Vitamin D sprayed inside cheeks 2X more response (poor gut) – RCT Oct 2015
and, those people with malabsorption problems had a larger response to spray
Inject Vitamin D quarterly into muscle, into vein, or perhaps into body cavity if quickly needed
Nanoparticles could be used to increase vitamin D getting to the gut – Oct 2015
Poor guts need different forms of vitamin D has the following
Guesses of Vitamin D response if poor gut
Bio Form Speed Duration 10 Injection: Vitamin D,
or Calcidiol or Calcitriol
D - Slow
Long 10 Sun/UV Slow Long 10 Topical
(skin patch/cream, vagina)
Slow Normal 9? Inhaled (future) Fast Normal 8 Bio-D-Mulsion Forte Normal Normal 6 Water soluble (Bio-Tech) Normal Normal 5 Nanoemulsion
perhaps activates VDR
Normal Normal 4 Sublingual/spray
(some goes into gut)
Fast Normal 3 Coconut oil based Slow Normal 2 Food (salmon etc.) Slow Normal 2 Olive oil based (majority) Slow Normal
10= best bioavailable, 0 = worst, guesses have a range of +-2
Speed: Fast ~2-6 hours, Slow ~10-30 hours
Duration: Long ~3-6 months, Normal = ~2 months
Download the PDF from Sci-Hub via VitaminDWiki
Left Chart: Poor response to 250,000 IU Loading Dose
CFers are known to have poor absorption of fat-soluable Vitamins (D, K, etc)
Most people with good guts would have ((Large dose of vitamin D (200,000 IU) lasts for about 100 days – Feb 2015
The effect of a single, large bolus of vitamin D in healthy adults over the winter and following year|>40 ng response to such a loading dose))
Right Chart: Poor response to 50,000 IU every 2 weeks Maintenance Dose
This would typically result in 40 ng/ml blood response
CFers clearly have far lower bio-availability to this oral vitamin D
Patients with cystic fibrosis (CF) have increased risk of vitamin D deficiency owing to fat malabsorption and other factors. Vitamin D deficiency has been associated with increased risk of pulmonary exacerbations of CF.
The primary objective of this study was to examine the impact of a single high-dose bolus of vitamin D3 followed by maintenance treatment given to adults with CF during an acute pulmonary exacerbation on future recurrence of pulmonary exacerbations.
This was a multicenter, double-blind, placebo-controlled, intent-to-treat clinical trial. Subjects with CF were randomly assigned to oral vitamin D3 given as a single dose of 250,000 International Units (IU) or to placebo within 72 h of hospital admission for an acute pulmonary exacerbation, followed by 50,000 IU of vitamin D3 or an identically matched placebo pill taken orally every other week starting at 3 mo after random assignment. The primary outcome was the composite endpoint of the time to next pulmonary exacerbation or death within 1 y. The secondary outcomes included circulating concentrations of the antimicrobial peptide cathelicidin and recovery of lung function as assessed by the percentage of predicted forced expiratory volume in 1 s (FEV1%).
A total of 91 subjects were enrolled in the study. There were no differences between the vitamin D3 and placebo groups in time to next pulmonary exacerbation or death at 1 y. In addition, there were no differences in serial recovery of lung function after pulmonary exacerbation by FEV1% or in serial concentrations of plasma cathelicidin.
Vitamin D3 initially given at the time of pulmonary exacerbation of CF did not alter the time to the next pulmonary exacerbation, 12-mo mortality, serial lung function, or serial plasma cathelicidin concentrations. This trial was registered at clinicaltrials.gov as NCT01426256.
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