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Inflammatory Bowel Disease in children is associated with low Vitamin D, Iron (also low Zinc for Crohn’s) – Aug 2018

A Systematic Review of Micronutrient Deficiencies in Pediatric Inflammatory Bowel Disease.

Inflamm Bowel Dis. 2018 Aug 21. doi: 10.1093/ibd/izy271
Fritz J1, Walia C2, Elkadri A3, Pipkorn R2, Dunn RK4, Sieracki R3, Goday PS3, Cabrera JM3.
1 Maine Medical Center.
2 Children's Hospital of Wisconsin.
3 Medical College of Wisconsin.
4 Peyton Manning Children's Hospital, Ascension Health.

VitaminDWiki

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 for vitamin D to prevent or treat Gut problems (93 trials listed as of Jan 2017)
  • All items in category gut and vitamin D 128 items

Overview Gut and vitamin D contains gut-friendly information

Gut-friendly, Sublingual, injection, topical, UV, sunshine

Getting Vitamin D into your body has the following chart
Image

Getting Vitamin D into your body also has the following

If poorly functioning gut

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 usefulit 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
Liposomal form on Amazon - Dec 2015
   $20 for 60 servings of 2500 IU - unsure why a very low-cost gut-friendly form should not be used instead
Poor guts need different forms of vitamin D has the following

Guesses of Vitamin D response if poor gut

Bio FormSpeedDuration
10Injection: Vitamin D,
or Calcidiol or Calcitriol
FastLong
10 Sun/UVSlowLong
10Topical
(skin patch/cream, vagina)
SlowNormal
9?Inhaled (future)FastNormal
8Bio-D-Mulsion ForteNormalNormal
6Water soluble (Bio-Tech)NormalNormal
5Nanoemulsion
perhaps activates VDR
NormalNormal
4Sublingual/spray
(some goes into gut)
FastNormal
3Coconut oil basedSlowNormal
2Food (salmon etc.)SlowNormal
2Olive oil based (majority)SlowNormal

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

128 items in GUT category - see also Overview Gut and vitamin D,

Items in both categories Gut and Infant-Child are listed here:


BACKGROUND:
This systematic review critically analyzes the current research on micronutrient deficiency in children with inflammatory bowel disease (IBD) and synthesizes these data to provide evidence-based guidelines for nutritional surveillance in this population.

METHODS:
We searched 5 databases (Ovid Medline, PubMed, Scopus, CINAHL, and Cochrane Library) for studies evaluating micronutrients in patients with IBD using the following inclusion criteria: 1) original research, 2) published 1996 or later; 3) published in English; 4) human subjects; and 5) containing pediatric data. Studies were reviewed and included based on the strength of research methods. Data on the prevalence of micronutrient deficiencies in pediatric patients with IBD and risk factors for micronutrient deficiency in these patients were extracted from included studies and compared and discussed in preparation of the proposed guidelines and manuscript.

RESULTS:
A total of 39 studies were included in the final review. The data presented in these studies show that iron deficiency and vitamin D deficiency are common in pediatric patients with IBD. Vitamin B12 and folate deficiency are rare. Zinc deficiency, while not common, occurs at a higher rate in patients with Crohn's disease than in healthy controls. There was limited data on vitamins A, E, and C, and selenium, but deficiency of these micronutrients seems rare.

CONCLUSIONS:
We recommend annual surveillance of iron and vitamin D in pediatric patients with IBD regardless of disease activity or phenotype. Zinc should be monitored annually in patients with Crohn's disease. There is insufficient evidence to support routine screening for other micronutrient deficiencies.

Created by admin. Last Modification: Tuesday August 28, 2018 00:38:58 GMT-0000 by admin. (Version 3)
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