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Is Nano vitamin D better than conventional Vitamin D when bioavailability and absorption are concerned?
It has long been understood that vitamin D, which is synthesized under the skin when exposed to sunlight, is essential for bone health. It is well established that the association between vitamin D deficiency (VDD) increases the risk of developing rickets and osteomalacia, along with emerging as a potential risk factor for several chronic diseases across all age groups in India and most other countries. (1)
Vitamin D-reaching the optimal dose: Vitamin D deficiency is still a significant public health issue in India and has been found in more than 70–90% of the healthy population. With this background, a growing body of research spurred the formation of national recommendations to prevent Vitamin D deficiency, and they suggested a serum level of 25-hydroxyvitamin D > 30 ng/mL as the ideal checkpoint for optimal bone health. (1)
Nano Vitamin D for improving supplementation: (2)
Given the low availability of vitamin D3 in Indian foods, vitamin D supplementation plays a significant role in reducing the burden of vitamin D insufficiency among Indians. Because of its limited solubility in the aqueous fluids of the gastrointestinal tract, vitamin D is also known for its poor bioavailability.
Nanoemulsions have shown great promise in enhancing the oral bioavailability of several therapeutic agents. In vitro and in vivo animal investigations have revealed that vitamin D3 has a higher bioavailability than coarse emulsion preparation.
Comparing Nano Vitamin D Formulation with Conventional Vitamin D: Indian Experience
Pioneering the study in humans, a randomized controlled trial conducted by R. K Marwaha et al. investigated the efficacy of nanotechnology-based micellised vitamin D3 based on serum 25(OH)D, PTH, and other biochemical parameters. One hundred eighty adults were included in the trial. They were randomly assigned to receive either conventional or micellised vitamin D3 at a monthly dose of 60000 IU (1500 µg) for six months.
The results showed that micellised vitamin D3 had superior bioavailability than conventional vitamin D3 formulations for achieving the desired serum 25(OH)D levels. The patients in the micellised group achieved an additional rise in serum 25 (OH) D levels of 20.2 nmol/l (95% CI 14.0, 26.4, P<0.001) which was statistically highly significant. Even with the age and sex factors taken into account, the difference was still statistically significant (17.5 nmol/l; 95% CI 11.8, 23.1; P<0.001).
How is Nano Vitamin D enhancing bioavailability and absorption? (2)
It has been observed that when the size of the particles encasing nanoemulsion formulations reduces, which in turn increases their bioavailability. The lipase/colipase adsorption is prevented by the stearic barrier and the nano-small particle's size, shielding it from digestion. Even when exposed to different in vivo pH settings, the nanoparticle's particle size and trapping effectiveness are maintained. These nanoparticles show rapid, exponential gastric emptying. Micellised formulations' bioavailability is higher than that of traditional granular formulations due to the aforementioned features.
Absorption: The same study by R.K. Marwaha et al. also showed how vitamin D3 in nanoemulsion absorbs vitamin D3 more effectively than vitamin D3 in conventional form.
Nano Vitamin D Formulation: Added Practical Advantages
This will have a significant impact on the fact that the micellised form of vitamin D3 can be taken alone or with water, orange juice, or other liquids. In contrast, the typical fat-soluble form of vitamin D3 needs to be taken with milk, oil, or other fat-based items to promote its absorption.
The results of the current study, which show that nanoemulsions absorb nutrients more effectively than coarse emulsions, are consistent with findings of earlier research by Biesalski et al., which showed that patients who got vitamins in micellised form absorbed them 3–6 times better than those who received them in coarse emulsions. However, a formulation of micellised vitamin D3 is more effective.
Given the aforementioned, patients with malabsorption syndromes (caused by inflammatory bowel disease, coeliac disease, short bowel syndrome, hepato-biliary illness, pancreatic insufficiency, or bariatric surgery) who are deficient in vital fatty acids and fat-soluble vitamins, including vitamin D, may benefit significantly from the use of nanotechnology-based formulations of all fat-soluble vitamins.
The rates and the ramifications of vitamin D insufficiency around the world appear to have a wealth of lessons to teach us. With consistent data showing the better potential ability of the micellization technique to raise the serum 25 (OH) level in comparison to conventional vitamin D formulations, it may be a highly feasible and practically advantageous option for treating vitamin D insufficiency.
References
Adapted from
1. Marwaha RK, Yenamandra VK, Ganie MA, et al. Efficacy of micellized vs. fat-soluble vitamin D3 supplementation in healthy school children from Northern India. J Pediatr Endocrinol Metab. 2016;29(12):1373-1377. doi:10.1515/jpem-2016-0191
2. Marwaha RK, Dev T, Mittal A, et al. A randomized controlled trial comparing the Efficacy of micellised and fat-soluble vitamin D3 supplementation in healthy adults. Br J Nutr. 2019;121(8):859-865. doi:10.1017/S0007114518003215
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751