A feasibility study of perioperative vitamin D supplementation in patients undergoing colorectal cancer resection
Front. Nutr., 31 March 2023 Volume 10 - 2023 | https://doi.org/10.3389/fnut.2023.1106431
P. G. Vaughan-Shaw1,2, L. F. Buijs1,2, J. P. Blackmur1,2, A. Ewing1,2, H. Becher1, E. Theodoratou2,3, L. Y. Ooi1,2,4, F. V. N. Din2, S. M. Farrington2 and M. G. Dunlop1,2*
- 1MRC Human Genetics Unit, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, United Kingdom
- 2Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, United Kingdom
- 3Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, United Kingdom
- 4Department of Pathology, National University Hospital, Singapore, Singapore
Background: Vitamin D supplementation improves colorectal cancer (CRC) survival outcomes in randomized trials. The aim of this study was to test the feasibility, safety and efficacy of vitamin D supplementation in the pre- and perioperative period in patients undergoing CRC surgery.
Methods: Patients were given 3200IU oral cholecalciferol (D3) per day perioperatively. Serial serum 25-hydroxyvitamin (25OHD) was measured by liquid chromatography tandem mass spectrometry and compared to untreated CRC controls. 25OHD and C-reactive protein (CRP) levels were compared using adjusted generalized linear mixed-effects models.
Results: A total of 122 patients underwent serial perioperative sampling, including 41 patients given high-dose perioperative supplementation. Supplementation was well-tolerated with no adverse or serious adverse events related to supplementation reported. Pre-operative supplementation increased 25OHD levels on the day of surgery (103.9 vs. 42.5 nmol/l, P = 8.2E–12). Supplementation increased 25OHD levels at all post-operative timepoints (P < 0.001) and attenuated the post-operative drop in 25OHD (46 vs. 24% drop, P = 3.0E–4). Rate of vitamin D peri-operative insufficiency was significantly less in those on supplementation (e.g., day 3–5, 14 vs. 84%, P = 1.41E–08), with multivariate modeling across all timepoints indicating a ~59 nmol/l higher 25OHD compared to control patients (P = 3.7E–21). Post-operative CRP was lower in patients taking supplementation (e.g., day 3–5 timepoint; 129 vs. 81 mg/l, P = 0.04).
Conclusion: High dose pre-operative vitamin D supplementation is associated with higher perioperative 25OHD levels, lower rates of vitamin D insufficiency and reduced early post-operative CRP. Alongside published evidence for a beneficial effect of vitamin D on CRC survival outcomes, these novel findings provide strong rationale for early initiation of vitamin D supplementation after a diagnosis of CRC.
3,200 IU was the largest avaiable: Study should have used at least 3 capsules daily for several months
Or study could have gotten ahold of 50,000 IU that could be used as a loading dose: 6 capsules in the 6 days before surgery
- Can get 50,000 IU Vitamin D anywhere on the globe
- 3 bottles would have providing a loading dose for 50 people
See VitaminDWiki Improve your health BEFORE surgery (prehabilitation) helps your recovery - 2018
6+ VitaminDWiki Surgery pages with CANCER in the title
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VitaminDWiki – Loading Dose of Vitamin D category contains
see also Overview Loading of vitamin D Overview Toxicity of vitamin D
Better than Daily 1: Fewer chances to forget, 2) Gets past receptor barrier
Injection category has
It appears that over 1 million Vitamin D loading doses have been taken
Doses ranged from 100,000 to 600,000 IU over a period of a day to a month
No reports of serious adverse reactions
Many studies report on the benefits resulting from loading doses
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