People with poor guts getting nutrition via IV had poor oral Vitamin D bio-availability – May 2017

The Prevalence of Vitamin D Insufficiency and Deficiency and Their Relationship with Bone Mineral Density and Fracture Risk in Adults Receiving Long-Term Home Parenteral Nutrition

Nutrients 2017, 9(5), 481; doi:10.3390/nu9050481

VitaminDWiki Summary

2,000 IU of vitamin D with Home Parenteral Nutrition (This includes initial 7,000 IU daily) Average of only 26 nanograms of Vitamin D

It is amazing that HPN does not use gut-friendly forms of Vitamin D
They know that the person cannot get nutrtion via the gut, yet they continue to give vitamin D orally!

With just 200 IU vitamin D in intravenous feeds, deficiency results
Vitamin D injection is far better than oral for diabetics (poor gut) – RCT March 2017
Getting Vitamin D into your body has the following chart

Overview Gut and vitamin D contains 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 203 items

Gut category listing contains the following

203 items in GUT category - see also Overview Gut and vitamin D, See also Microbiome category listing has 33 items along with related searches.

 Download the PDF from VitaminDWiki

Indications for HPN, %

Short bowel syndrome 61 %
- Crohn’s disease 53 %
- Bowel ischemia 29 %
- Bowel atresia 1 3%
- Other short bowel 16%
Mucosal defect 6 %
Motility disorder 11 %

Navaporn Napartivaumnuay 1,* and Leah Gramlich 1,2
1 Department of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada
2 Nutrition Services, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
(This article belongs to the Special Issue Parenteral Nutrition 2016)

It has been demonstrated that low bone mass and vitamin D deficiency occur in adult patients receiving home parenteral nutrition (HPN). The aim of this study is to determine the prevalence of vitamin D insufficiency and deficiency and its relationship with bone mineral density (BMD) and fracture risk in long-term HPN patients.

Methods: A retrospective chart review of all 186 patients in the HPN registry followed by the Northern Alberta Home Parenteral Nutrition Program receiving HPN therapy >6 months with a 25 (OH) D level and BMD reported were studied.

Results: The mean age at the initiation of HPN was 53.8 (20–79) years and 23 (37%) were male. The mean HPN duration was 56 (6–323) months and the most common diagnosis was short bowel syndrome. Based on a total of 186 patients, 62 patients were categorized based on serum vitamin D status as follows: 1 (24.2%) sufficient, 31 (50%) insufficient and 16 (25.8%) deficient. Despite an average of 1891 IU/day orally and 181 IU/day intravenously vitamin D, the mean vitamin D level was 25.6 ng/mL (insufficiency) and 26.2 ± 11.9 ng/mL in patients with the highest 10-year fracture risk.

Conclusion: Suboptimal vitamin D levels are common among patients on long-term HPN despite nutrient intake that should meet requirements.

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