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.
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
Overview Gut and vitamin D contains gut-friendly informationGut-friendly, Sublingual, injection, topical, UV, sunshine
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
Bio Form Speed Duration 10 Injection: Vitamin D,
or Calcidiol or Calcitriol
D - Slow
Long 10 Sun/UV Slow Long 10 Topical
(skin patch/cream, vagina)
Slow Normal 9? Inhaled (future) Fast Normal 8 Bio-D-Mulsion Forte Normal Normal 6 Water soluble (Bio-Tech) Normal Normal 5 Nanoemulsion
perhaps activates VDR
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
Gut category listing contains the following
139 items in GUT category - see also Overview Gut and vitamin D,
- "Ulcerative Colitis" OR UC 689 items March 2019
- "celiac disease" OR CD 1280 items Feb 2018
- "inflammatory bowel disease" OR "inflammatory bowel symptom" 1010 items as of March 2019
- Crohn's 1230 items as of Feb 2019
- Gut-Friendly forms of vitamin D
such as: bio-emulsion, topical, spray, sublingual, inhaled, injection . .
Items in both categories Gut and Infant-Child are listed here:
- IBD in children might be associated with low sun exposure – Aug 2018
- Inflammatory Bowel Disease in children is associated with low Vitamin D, Iron (also low Zinc for Crohn’s) – Aug 2018
- Crohn's disease in black children is worse in 6 ways – Dec 2015
- Obese children with celiac disease had lower levels of vitamin D – April 2012
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.
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.
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.
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.
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