A pilot-randomized, double-blind crossover trial to evaluate the pharmacokinetics of orally administered 25-hydroxyvitamin D3 and vitamin D3 in healthy adults with differing BMI and in adults with intestinal malabsorption
Am J Clin Nutr. 2021 May 19;nqab123. doi: 10.1093/ajcn/nqab123
Nipith Charoenngam 1 2, Tyler A Kalajian 1, Arash Shirvani 1, Grace H Yoon 1, Suveer Desai 1, Ashley McCarthy 3, Caroline M Apovian 3, Michael F Holick 1
Vitamin D takes about 4 hours longer than Calcidiol to respond
Note - different measures
3,600 IU daily
Note: Calcidiol about 3 X better but at perhaps 100X the cost.
3 X larger dose of vitamin D would probably result in similar response at far less cost
Note: There are many low-cost, gut-friendly forms 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
If poorly functioning gut
Bio-D-Mulsion Forte – especially made for those with poorly functioning guts, or perhaps lacking gallbladder
Sublingual – goes directly into the bloodstream
Fat-soluble Vitamins go thru the slow lymph system
you can make your own sublingual by dissolving Vitamin D in water or use nano form
Oil: 1 drop typically contains 400 IU, 1,000 IU, or 4,000 IU, typically not taste good
Topical – goes directly into the bloodstream. Put oil on your skin, Use Aloe vera cream with Vitamin D, or make your own
Vaginal – goes directly into the bloodstream. Prescription-only?
Bio-Tech might be useful – it is also water-soluble
Vitamin D sprayed inside cheeks (buccal spray) - several studies
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 ($$$) or Calcidiol or Calcitriol | D - Slow C -Fast | Long |
| 10 | Sun/UVB | Slow | Long |
| 10 | Topical (skin patch/cream, vagina) | Slow Fast nano | Normal |
| 9 | Nanoemulsion -mucosal perhaps activates VDR | Fast | Normal |
| 9? | Inhaled (future) | Fast | Normal |
| 8 | Bio-D-Mulsion Forte | Normal | Normal |
| 6 | Water soluble (Bio-Tech) | 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
Nanoemulsion
'Note: Vitamin D nanoemulsion (topical, swished in mouth, inhaled) may be much faster than both
VitaminDWiki had been testing various nanoemulsions since 2016%%%It appears that the initial response time for inhaled is 10 minutes and for topical is 2 hours
A pilot test of response times was planned for 2020, but COVID-19 happened
Nanoemulsion Vitamin D may be a substantially better form updated March 2019
Bought 6 kinds of Vitamin D Emulsion - March 2019
There are a variety of Vitamin D emulsions on Amazon (US) as of 2019
Bio Emulsion Forte is what I started buying in 2012.
I have given out 3 bottles (as of 2019) of it to friends with gut problems who were getting no benefit from standard vitamin D.
It worked well for them in each case
Since ~2017 I also have been purchasing Micro D3 Nanoemulsion for inhaled Vitamin D experiments
see further down this page details on nutrasal.com product
In March 2019 I also purchased PreventiX, Hi-Pro Emulsi-D3, Bio-Emulsion-D3, and Liquid Vitamin D3
They were added because
1) They had good Amazon reviews
2) Were likely to have a micro/nano size,
3) Seemed to have a > 1,000 IU per drop.
4) Were fairly low cost (per 5,000 IU)
I also have been getting some Vitamin D Nanoemulsion from Bio-Tech Pharmacal since ~2016.
They are making it for some Vitamin D clinical trials, and I have used it for inhaled tests.
Bio-Tech Pharmacal emulsion is not (as of 2019) being sold commercially.
Note: March 2019 Dried beans and peas in meal appear to decrease uptake of oil-based Vitamin D
If you often eat pulses when supplementing with Vitamin D, you might need to have a non-oil-based vitamin D, such as in the above picture
Bioavailability of nanoemulsion formulations of Vitamin D3 – Nov 2019
Vitamin D nanoemulsion, with comments on COVID-19 – June 2, 2020
Nanoemulsion Vitamin D may be a substantially better form has the following comparison
| 50,000 IU powder in capsule Example Biotech Pharmacal | Nanoemulsion Example micro D3 | ||
| Average Cost per day for 10,000 IU | 4 cents | 8 cents | |
| IU per serving | 50,000 IU = capsule | 2,000 IU = drop | |
| Servings if want average of 10,000 IU/day | 1 capsule per 5 days | 25 drops = 1 /4 teaspoon per 5 days | |
| Shelf life | 1 year? | 6 months? | |
| Add to food/drink | Yes (powder) | possiblly | |
| Apply to skin | No | Yes | |
| Swish in mouth for fast response | Yes if put powder in saliva or swish vitamin D water | Yes | |
| Gut-friendly | perhaps | probably | |
| Availability to cell - better than bio-availability | standard | perhaps 2X more - due to small size or activation of Vitamin D Receptor | |
Background: Obese and malabsorptive patients have difficulty increasing serum 25-hydroxyvitamin D [25(OH)D] after taking vitamin D supplementation. Since 25(OH)D is more hydrophilic than vitamin D, we hypothesized that oral 25(OH)D supplementation is more effective in increasing serum 25(OH)D concentrations in these patients.
Objectives: We aimed to investigate the pharmacokinetics of oral 25-hydroxyvitamin D3 [25(OH)D3] and oral vitamin D3 in healthy participants with differing BMI and malabsorptive patients.
Methods: A randomized, double-blind crossover trial was performed in 6 malabsorptive patients and 10 healthy participants who were given 900 µg of either vitamin D3 or 25(OH)D3 orally followed by a pharmacokinetic study (PKS). After ≥28 d from the first dosing, each participant returned to receive the other form of vitamin D and undergo another PKS. For each PKS, serum vitamin D3 and 25(OH)D3 were measured at baseline and at 2, 4, 6, 8, and 12 h and days 1, 2, 3, 7, and 14. Pharmacokinetic parameters were calculated.
Results: Data were expressed as means ± SEMs. The PKS of 900 µg vitamin D3 revealed that malabsorptive patients had 64% lower AUC than healthy participants (1177 ± 425 vs. 3258 ± 496 ng · h/mL; P < 0.05). AUCs of 900 µg 25(OH)D3 were not significantly different between the 2 groups (P = 0.540). The 10 healthy participants were ranked by BMI and categorized into higher/lower BMI groups (5/group). The PKS of 900 µg vitamin D3 showed that the higher BMI group had 53% lower AUC than the lower BMI group (2089 ± 490 vs. 4427 ± 313 ng · h/mL; P < 0.05), whereas AUCs of 900 µg 25(OH)D3 were not significantly different between the 2 groups (P = 0.500).
Conclusions: Oral 25(OH)D3 may be a good choice for managing vitamin D deficiency in malabsorption and obesity. This trial was registered at clinicaltrials.gov as (NCT03401541.