cholecalciferol and Malabsorption-Syndromes

Topics: Animals; Bone Diseases, Metabolic; Calcium; Cholecalciferol; Gastrointestinal Diseases; Humans; Intestinal Absorption; Malabsorption Syndromes; Phosphates; Postgastrectomy Syndromes; Vitamin D

Topics: Avitaminosis; Biological Transport; Child; Cholecalciferol; Dietary Fats; Humans; Intestinal Absorption; Intestinal Mucosa; Intestines; Malabsorption Syndromes; Micelles; Structure-Activity Relationship; Vitamin A; Vitamin E; Vitamin K 1; Vitamins

Topics: Acute Disease; Adult; Animals; Calcitonin; Calcium; Calcium, Dietary; Cholecalciferol; Chronic Disease; Fatty Acids; Homeostasis; Humans; Hypocalcemia; Hypophysectomy; Malabsorption Syndromes; Pancreas; Pancreatic Diseases; Pancreatitis; Parathyroid Hormone; Pituitary Gland; Thyroxine

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.. 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.. 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.. 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).. 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.

Topics: Administration, Oral; Adult; Area Under Curve; Body Mass Index; Calcifediol; Calcium-Regulating Hormones and Agents; Cholecalciferol; Cross-Over Studies; Double-Blind Method; Female; Half-Life; Humans; Malabsorption Syndromes; Male; Middle Aged; Pilot Projects; Vitamins

Vitamin D deficiency has been proposed to contribute to the development of malabsorption diseases. Despite this, the vitamin D status of these patients is often neglected. The objective of the present work was to compare the absorption of vitamin D3 through the oral route by comparing a 1000 IU soft gelatin capsule and a 500 IU buccal spray (delivering 1000 IU in two spray shots) in healthy subjects and in patients with malabsorption disease.. An open label, randomized, two-periods, two-way cross over study was conducted, first in healthy subjects (n = 20) and then in patients with malabsorption syndrome (n = 20). The study participants were equally divided and received either of the treatments (buccal spray, n = 7; soft gelatin capsule, n = 7; control, n = 6) in Period I for 30 days. After washout of another 30 days, the treatments were changed in crossover fashion in Period II. Fasting blood samples were collected to measure baseline 25-hydroxyvitamin D [25(OH)D] levels in all participants at day 0 (Screening visit), day 30 (completion of period I), day 60 (end of wash out and initiation of period II) and day 90 (completion of period II). Safety was evaluated by hematology and biochemistry analyses. Statistical analyses was performed using differences of mean and percentage change from baseline of 25(OH)D levels between two formulation by two tailed Paired t-test with 95% confidence interval.. In healthy subjects, the mean increase in serum 25(OH)D concentration was 4.06 (95% CI 3.41, 4.71) ng/ml in soft gelatin capsule group and 8.0 (95% CI 6.86, 9.13) ng/ml in buccal spray group after 30 days treatment (p < 0.0001). In patients with malabsorption disease, the mean increase in serum 25(OH)D concentration was 3.96 (95% CI 2.37, 5.56) ng/ml in soft gelatin capsule group and 10.46 (95% CI 6.89, 14.03) ng/ml in buccal spray group (p < 0.0001).. It can be concluded from the results that the buccal spray produced a significantly higher mean serum 25(OH)D concentration as compared to the soft gelatin capsule, in both healthy subjects as well as in patients with malabsorption syndrome over a period of 30 days administration in a two way cross over study. Treatments were well tolerated by both subject groups. CTRI/2013/06/003770.

Topics: Administration, Buccal; Adult; Capsules; Cholecalciferol; Cross-Over Studies; Female; Gelatin; Humans; Intestinal Absorption; Malabsorption Syndromes; Male; Oral Mucosal Absorption; Treatment Outcome; Vitamins

The objective is to present an update on the diagnosis and treatment of hypovitaminosis D, based on the most recent scientific evidence.. The Department of Bone and Mineral Metabolism of the Brazilian Society of Endocrinology and Metabology (SBEM) was invited to generate a document following the rules of the Brazilian Medical Association (AMB) Guidelines Program. Data search was performed using PubMed, Lilacs and SciELO and the evidence was classified in recommendation levels, according to the scientific strength and study type.. A scientific update regarding hypovitaminosis D was presented to serve as the basis for the diagnosis and treatment of this condition in Brazil.

Topics: Bariatric Surgery; Brazil; Calcifediol; Calcium, Dietary; Cholecalciferol; Databases, Bibliographic; Ergocalciferols; Evidence-Based Medicine; Humans; Hyperparathyroidism; Malabsorption Syndromes; Osteoporosis; Osteoporotic Fractures; Parathyroid Hormone; Risk Factors; Vitamin D Deficiency

The objective was to develop evidence-based clinical care guidelines for the screening, diagnosis, management, and treatment of vitamin D deficiency in individuals with cystic fibrosis (CF).. The guidelines committee was comprised of physicians, registered dietitians, a pharmacist, a nurse, a parent of an individual with CF, and a health scientist, all with experience in CF.. Committee members developed questions specific to vitamin D health in individuals with CF. Systematic reviews were completed for each question. The committee reviewed and graded the available evidence and developed evidence-based recommendations and consensus recommendations when insufficient evidence was available. Each consensus recommendation was voted upon by an anonymous process.. Vitamin D deficiency is common in CF. Given the limited evidence specific to CF, the committee provided consensus recommendations for most of the recommendations. The committee recommends yearly screening for vitamin D status, preferably at the end of winter, using the serum 25-hydroxyvitamin D measurement, with a minimal 25-hydroxyvitamin D concentration of 30 ng/ml (75 nmol/liter) considered vitamin D sufficient in individuals with CF. Recommendations for age-specific vitamin D intake for all individuals with CF, form of vitamin D, and a stepwise approach to increase vitamin D intake when optimal vitamin D status is not achieved are delineated.

Topics: 25-Hydroxyvitamin D 2; Adolescent; Adult; Age Factors; Calcifediol; Child; Cholecalciferol; Cystic Fibrosis; Dietary Supplements; Ergocalciferols; Evidence-Based Practice; Humans; Infant; Malabsorption Syndromes; Mass Screening; Seasons; Vitamin D; Vitamin D Deficiency

A 56-year-old patient with postsurgical hypothyroidism and hypoparathyroidism associated with gastrointestinal malabsorption syndrome was prescribed with L: -thyroxine and 1alpha(OH)D(3) at a massive daily dosage of 600 and 39 mug, respectively. Although the patient became nearly euthyroid, she had been hypocalcemic, requiring frequent intravenous injection of calcium gluconate to prevent tetany. Because the serum level of 1,25(OH)(2)D hardly increased after an oral intake of 21 microg 1alpha(OH)D(3), vitamin D(3) was administered intramuscularly. After stoss therapy (600,000 IU), the patient has been receiving 300,000 IU vitamin D(3) at intervals of 2-4 months so that she remained slightly hypocalcemic (7-8 mg/dl). At 1.5 years later, serum levels of 25(OH)D and 1,25(OH)(2)D were maintained at about 60 ng/ml and 30-50 pg/ml, respectively, and renal function was maintained well. These data suggest that intramuscular injection of 300,000 IU vitamin D(3) at an interval of a few months to maintain a slightly increased serum level of 25(OH)D and a slightly decreased serum level of calcium is a safe and cost-effective treatment in such a parathyroid hormone-deficient hypoparathyroid patient with malabsorption syndrome.

Topics: Abdomen; Cholecalciferol; Female; Graves Disease; Humans; Hypocalcemia; Hypoparathyroidism; Hypothyroidism; Injections, Intramuscular; Malabsorption Syndromes; Middle Aged; Reoperation; Thyroidectomy; Treatment Outcome

Dietary modifications can partly compensate for the alterations in copper homeostasis caused by distal intestinal resection, by improving biliary function. We studied the effects of resecting 50% of the distal small intestine (DSI) on copper status in rats fed three semisynthetic diets (basal diet, and basal diet with cholecalciferol or ascorbic acid). Intestinal resection significantly decreased the digestive (apparent digestibility coefficient; ADC) and metabolic utilization (balance) of copper 1 month after surgery. However, the supplementation of the basal diet with cholecalciferol attenuated the negative impact of surgery, leading to small differences in Cu ADC and Cu balance between transected and resected rats. Ascorbic acid also enhanced copper retention. Copper status was not as markedly affected by intestinal resection as digestive utilization 1 month after the operation. The beneficial effects of cholecalciferol and ascorbic acid at the digestive and metabolic levels suggest ways to lessen the impact of intestinal resection, and to avoid possible long-term postabsorptive alterations in copper distribution.

Topics: Animals; Ascorbic Acid; Cholecalciferol; Copper; Diet; Feces; Intestine, Small; Malabsorption Syndromes; Male; Rats; Rats, Wistar; Tissue Distribution

The effects of intestinal resection and diet on the digestive and metabolic utilization of phosphorus were studied in adult rats from which 50% of the distal small intestine had been removed and in sham-operated controls. Metabolic parameters were measured both 1 and 3 months after surgery. The loss of half of the distal small intestine led to a decline in digestive utilization of phosphorus 1 month after surgery as reflected in bone mineral content. Digestive efficiency had improved by 3 months after surgery. One month's feeding with a diet in which fat was provided as equal parts of medium chain triglycerides, sunflower seed oil and olive oil instead of 100% olive oil enhanced phosphorus absorption and retention, although this improvement was less evident after 3 months. The negative effects of distal small intestine resection on the nutritive utilization of phosphorus were not only palliated but significantly enhanced by supplementing the diet with vitamin D3 at a rate of 0.08 mg/100 g diet. This dose is within physiological limits, and favors phosphorus deposition in bone tissue.

Topics: Animals; Bone Density; Cholecalciferol; Dietary Fats, Unsaturated; Female; Femur; Intestinal Absorption; Intestine, Small; Malabsorption Syndromes; Male; Nutritional Requirements; Olive Oil; Phosphorus; Plant Oils; Rats; Rats, Inbred Strains; Sunflower Oil; Triglycerides

1. A method for assessing cholecalciferol absorption in man is described. 2. The intestinal absorption of [3H]cholecalciferol was studied in 20 female geriatric patients, most of whom were vitamin D-depleted. 3. The plasma [3H]cholecalciferol response after oral ingestion was significantly lower than that of a group of younger female subjects. 4. The plasma response of labelled polar metabolites of cholecalciferol was also lower in the geriatric than in the younger group, suggesting that increased removal of label by conversion into more polar metabolites could not account for the reduced plasma [3H]cholecalciferol response. 5. There was no evidence that alteration in gastrointestinal motility could account for the different rate of appearance of the labelled vitamin in the plasma in the two groups. 6. It is suggested that there is a defect in intestinal absorption of cholecalciferol in the elderly.

Topics: Adult; Age Factors; Aged; Cholecalciferol; Dietary Fats; Eating; Female; Humans; Intestinal Absorption; Malabsorption Syndromes; Male; Middle Aged; Time Factors; Triglycerides

Topics: Adolescent; Adult; Animals; Bone and Bones; Bone Resorption; Calcium; Child; Cholecalciferol; Chronic Kidney Disease-Mineral and Bone Disorder; Humans; Hypoparathyroidism; Intestinal Mucosa; Kidney; Liver Cirrhosis, Biliary; Malabsorption Syndromes; Osteomalacia; Parathyroid Glands; Phosphorus; Rats; Renal Tubular Transport, Inborn Errors; Vitamin D

Topics: Benzothiadiazines; Calcium; Cholecalciferol; Cyclic AMP; Diuretics; Humans; Kidney Diseases; Kidney Tubules; Malabsorption Syndromes; Parathyroid Hormone; Phosphates; Sodium Chloride Symporter Inhibitors

Topics: Adolescent; Adult; Aged; Carbon Isotopes; Cholecalciferol; Chromatography; Female; Humans; Kidney Failure, Chronic; Malabsorption Syndromes; Male; Middle Aged; Osteomalacia; Silicon Dioxide; Tritium; Vitamin D; Vitamin D Deficiency

Topics: Adult; Alcoholic Intoxication; Anti-Bacterial Agents; Bile Acids and Salts; Blind Loop Syndrome; Celiac Disease; Cholecalciferol; Chronic Disease; Feces; Humans; Intestinal Absorption; Intestinal Diseases; Intubation, Gastrointestinal; Jejunum; Malabsorption Syndromes; Male; Osteomalacia; Pancreatic Extracts; Pancreatitis; Tritium; Vitamin D Deficiency

Topics: Adolescent; Adult; Aged; Celiac Disease; Cholecalciferol; Female; Gastrectomy; Humans; Intestinal Absorption; Lipid Metabolism; Liver Cirrhosis; Malabsorption Syndromes; Male; Middle Aged; Osteomalacia; Pancreatitis; Protein-Losing Enteropathies; Rickets; Tritium; Vitamin D Deficiency

Topics: Adolescent; Adult; Aged; Cholecalciferol; Female; Humans; Intestinal Absorption; Kidney Diseases; Liver Diseases; Malabsorption Syndromes; Male; Middle Aged; Osteomalacia; Tritium

Topics: Adult; Aged; Celiac Disease; Cholecalciferol; Cholestasis; Chromatography, Thin Layer; Feces; Humans; Intestinal Absorption; Malabsorption Syndromes; Middle Aged; Urine