ORIGINAL RESEARCH article
Front. Med.
Sec. Gastroenterology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1649677
This article is part of the Research TopicNutrition Management Puzzle in IBDView all articles
Improved Bioavailability of Buccal Nanoemulsion Vitamin D Compared to Conventional Oral Supplementation in Patients with Inflammatory Bowel Disease: A Randomized Controlled Trial
Provisionally accepted
- 1Department of Internal Medicine, Tomas Bata Hospital Zlín, Zlín, Czechia
- 22nd Department of Internal Medicine, St. Anne's Faculty Hospital, Brno and Faculty of Medicine, Masaryk University, Brno, Brno, Czechia
- 3Department of Clinical Pharmacy, Tomas Bata Hospital Zlín, Zlín, Czechia
- 4Internal Clinic, 3rd Medical Faculty, Charles University and University Thomayer Hospital, Prague, Czechia
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
The absorption of conventional cholecalciferol may be impaired in patients with inflammatory bowel disease (IBD). The bioavailability and optimal dosing of buccally absorbable nanoemulsion vitamin D in this population remain unclear. This study aimed to compare the effects of buccal nanoemulsion and conventional oral vitamin D supplementation on serum 25-hydroxyvitamin D (25OHD) levels in patients with IBD.This was an open-label randomized trial. Patients with IBD were assigned to receive cholecalciferol in an oil emulsion at a dose of 14 000 IU weekly (GTTS) and orally absorbed cholecalciferol at dose 4000 IU twice a week (SPRAY) for 12-16 weeks during the winter months. Plasma 25OHD levels were measured at baseline and after the supplementation period.Results: A total of 120 patients were analyzed. Among 75 subjects with CD and 45 with UC, 27% had active disease, and 24% of the Crohn's disease patients had undergone ileocecal resection. The initial mean 25OHD level was 65.9±21.0 nmol/l in the SPRAY group and 59.1±27.7 nmol/l in the GTTS group. A similar increase of 9.3±26.8 nmol/l (GTTS) and 9.2±27.7 nmol/l (SPRAY) in 25OHD levels occurred in both groups, with similar variations. The proportion of subjects with normal and subnormal levels following the substitution was comparable. The change in 25OHD level correlated negatively only with the baseline 25OHD level (p<0.02) among all monitored variables.In IBD patients, the sufficient supplementation dose of the orally absorbable cholecalciferol is half that of the conventional oil emulsion (1143 IU/day vs 2000 IU/day). Variable intestinal absorption is not a factor explaining inter-individual differences in 25OHD levels using a conventional vitamin D emulsion.
Keywords: inflammatory bowel disease, Vitamin D supplementation, vitamin D bioavailability, Oral absorption, nanoemulsion Clinical trial registration: clinicaltrials.gov NCT05733117
Received: 18 Jun 2025; Accepted: 31 Jul 2025.
Copyright: © 2025 Kojecký, Klhůfek, Kohout and Kianička. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Pavel Kohout, Internal Clinic, 3rd Medical Faculty, Charles University and University Thomayer Hospital, Prague, Czechia
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.