Need 3X more Vitamin D (or take semi-activated vitamin D) if have poor gut – small RCT

Created May 2021

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 1. Overview Gut and vitamin D contains gut-friendly information {include} --- 1. 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 {include} 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 {include}

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.

Tags: Calcidiol Gut Obesity