Vitamin D Status in Pediatric and Young Adult Cystic Fibrosis Patients. Are the New Recommendations Effective?
Nutrients 2021, 13(12), 4413; https://doi.org/10.3390/nu13124413
by Carmen Mangas-Sánchez 1,María Garriga-García 2,María Juliana Serrano-Nieto 3,Ruth García-Romero 4,Marina Álvarez-Beltrán 5,Elena Crehuá-Gaudiza 6ORCID,Rosana Muñoz-Codoceo 7,Lucrecia Suárez-Cortina 2,Saioa Vicente-Santamaría 2,Cecilia Martínez-Costa 6,Juan José Díaz-Martin 1,*,Carlos Bousoño-García 1 andDavid González-Jiménez 1ORCID
Introduction: In recent years, guidelines for vitamin D supplementation have been updated and prophylactic recommended doses have been increased in patients with cystic fibrosis (CF).
Objective: To evaluate safety and efficacy of these new recommendations.
Results: Two cohorts of pancreatic insufficient CF patients were compared before (cohort 1: 179 patients) and after (cohort 2: 71 patients) American CF Foundation and European CF Society recommendations were published. Cohort 2 patients received higher Vitamin D doses: 1509 (1306–1711 95% CI) vs 1084 (983–1184 95% CI) IU/Day (p < 0.001), had higher 25 OH vitamin D levels: 30.6 (27.9–33.26 95% CI) vs. 27.4 (25.9–28.8 95% CI) ng/mL (p = 0.028), and had a lower prevalence of insufficient vitamin D levels (<30 ng/mL): 48% vs 65% (p = 0.011). Adjusted by confounding factors, patients in cohort 1 had a higher risk of vitamin D insufficiency: OR 2.23 (1.09–4.57 95% CI) (p = 0.028).
Conclusion: After the implementation of new guidelines, CF patients received higher doses of vitamin D and a risk of vitamin D insufficiency decreased. Despite this, almost a third of CF patients still do not reach sufficient serum calcidiol levels.
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Cystic Fibrosis patients need different Vitamin D dosing – Nov 2021 includes the following
The daily dosing of oral Vitamin D does not help much if the person has
a poor gut (e.g. cystic fibrosis), no gallbladder, poor liver, etc.
There are many gut-friendly forms of vitamin D that can be taken orally
A nanoemulsion form of vitamin D can avoid the gut by being swished in the mouth
Topical forms of vitamin D also avoid a poor gut
Non-daily dosing appears to get past gut restrictions by having a much higher concentration
- Reasons for low response to vitamin D ~40 reasons as of 2021
- Cystic Fibrosis got some benefit from 50,000 IU of vitamin D weekly (need gut-friendly form) – Feb 2018
- Powder-based Vitamin D may be gut-friendly (Cystic Fibrosis) – RCT Aug 2017
- Cystic Fibrosis probably treated by Vitamin D (if use enough of the right type ) – Oct 2019
- Inhaled Vitamin D looks like a possibility for CF
- Topical Vitamin D provides more benefits than oral sometimes - many studies - as of Oct 2019:: Preeclampsia. Food Allergy, PTSD, Ear infection, Infertility, MS, Colon Cancer, TB, Asthma, COPD, Epilepsy, Atrial Fibrillation. Liver, Also suspect for those people with poor guts: Cystic Fibrosis, Diabetes
Vitamin D could use some help - such as