Effect of monthly vitamin D on diverticular disease hospitalization: post-hoc analysis of a randomized controlled trial
Clinical Nutrition https://doi.org/10.1016/j.clnu.2020.08.030
Zhenqiang Wu ab JoannaBroadbJohnSluyteraDebbieWaayera Carlos A.Camargo Jr.c Robert Scragg a
Background & aims
Some studies have linked low vitamin D status and high risk of diverticular disease, but the causal relationship between vitamin D and diverticular disease remains unclear; clinical trial data are warranted. The objective was to assess the efficacy of vitamin D3 supplementation on diverticular disease hospitalization.
Post-hoc analysis of a community-based randomized double-blind placebo-controlled trial (RCT) with 5108 participants randomized to receive monthly 100,000 IU vitamin D (n=2558) or identical placebo (n=2550). The outcome was time to first diverticular disease hospitalization from randomization to the end of intervention (July 2015), including a prespecified subgroup analysis in participants with baseline deseasonalized 25-hydroxyvitamin D (25(OH)D) levels <50 nmol/L.
Over a median of 3.3 years follow-up, 74 participants had diverticular disease hospitalization. There was no difference in the risk of diverticular disease hospitalization between vitamin D supplementation (35/2558=1.4%) and placebo (39/2550=1.5%) groups (adjusted hazard ratio [HR]=0.90; p=0.65), although in participants with deseasonalized 25(OH)D <50 nmol/L (n=1272), the risk was significantly lower in the vitamin D group than placebo (HR=0.08, p=0.02).
Monthly 100,000 IU vitamin D3 does not reduce the risk of diverticular disease hospitalization in the general population. Further RCTs are required to investigate the effect of vitamin D supplementation on the diverticular disease in participants with low 25(OH)D levels.
- Higher Serum Levels of Vitamin D Are Associated With a Reduced Risk of Diverticulitis - Dec 2013
- Paradigm shift: the Copernican revolution in diverticular disease - Nov 2019
RCT with 100,000 IU monthly
- Across all 2550 patients - not statistically significant
- For those 1272 who have Vitamin D levels 20ng - 12X improvement
Results would probably have been even better if used a gut-friendly form of Vitamin D
Overview Gut and vitamin D contains gut-friendly information
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
or Calcidiol or Calcitriol
|D - Slow|
(skin patch/cream, vagina)
perhaps activates VDR
|6||Water soluble (Bio-Tech)||Normal||Normal|
(some goes into gut)
|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
Gut category listing contains the following
- "Ulcerative Colitis" OR UC 839 items Jan 2020
- "celiac disease" OR CD 1830 items July 2019
- "inflammatory bowel disease" OR "inflammatory bowel symptom" 1630 items as of Jan 2020
- Crohn's 1230 items as of Feb 2019
- Gut-Friendly forms of vitamin D
such as: bio-emulsion, topical, spray, sublingual, inhaled, injection . .
Overview Gut and vitamin D has the following summary
- Gut problems result in reduced absorption of Vitamin D, Magnesium, etc.
- Celiac disease has a strong genetic component.
- Most, but not all, people with celiac disease have a gene variant.
- An adequate level vitamin D seems to decrease the probability of getting celiac disease.
- Celiac disease causes poor absorption of nutrients such as vitamin D.
- Bringing the blood level of vitamin D back to normal in patients with celiac disease decreases symptoms.
- The prevalence of celiac disease, not just its diagnosis, has increased 4X in the past 30 years, similar to the increase in Vitamin D deficiency.
- Review in Nov 2013 found that Vitamin D helped
Many intervention clinical trials with vitamin D for Gut problems (101 trials listed as of Sept 2019)
- All items in category gut and vitamin D
167 itemsDiverticular disease:12X reduction if low Vitamin D and given 100,000 IU monthly – RCT Aug 2020 145 visitors, last modified 01 Sep, 2020,This page is in the following categories (# of items in each category)Gut 167 Intervention 636 Intervention - non daily 191
ID Name Comment Uploaded Size Downloads 14245 Paradigm shift.pdf PDF 2019 admin 01 Sep, 2020 17:05 527.39 Kb 17 14244 DD complications.jpg admin 01 Sep, 2020 17:03 77.05 Kb 43 14243 Higher Serum Levels of Vitamin D Are Associated With a Reduced Risk of Diverticulitis.pdf admin 01 Sep, 2020 16:52 43.81 Kb 16