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Vitamin D status and delayed gastric emptying: An unknown relationship?

Posted on: September 27, 2012   by  John Cannell, MD


Gastroparesis, also called delayed gastric emptying, is where food stays in the stomach for a longer time than normal. The most common symptoms of gastroparesis are chronic nausea, abdominal fullness, bloating, vomiting of undigested food, and abdominal pain.

Diabetes is the most common identified cause of gastroparesis but two-thirds of cases are “idiopathic,” meaning no one knows what causes it. It can lead to early death from thrombosis or blood clot. Most cases are in women so an autoimmune phenomenon is possible.

Dr. Kedar and colleagues from the University of Mississippi Medical Center measured gastric emptying time in 59 patients with gastroparesis and at the same time drew blood to measure eight micronutrients, including vitamin D and vitamin B12.

Kedar A, Nikitina Y, Abell KB, Vedanarayanan V, Griswold ME, Subramony C, Abell TL. Gastric Dysmotility and Low Serum Vitamin D Levels in Patients with Gastroparesis. Horm Metab Res. 2012 Sep 6. [Epub ahead of print]

The researchers found that vitamin D levels in the two groups (diabetic gastroparesis, and idiopathic gastroparesis) had average levels above 30 ng/ml. Surprisingly, they found that some individuals had levels well above 50 ng/ml, using the LCMS technique to measure vitamin D levels. In fact the highest levels was about 120 ng/ml, with a number of levels in the 70s and 80s, allowing the researchers to see if high 25(OH)D levels had a relationship with gastric emptying time. Apparently, some patients were supplementing with physiological doses of vitamin D, although the researchers did not ask about supplement use.

They found no association in the diabetic cases of gastroparesis with 25(OH)D levels but did find an association in the idiopathic cases; the higher the vitamin D levels the better the stomach emptied. Interestingly, high B12 levels were associated with worse emptying times in the diabetics but slightly better times in the idiopathic cases.

They concluded,

“Our study findings indicate that an association between low 25(OH)D levels and impaired motility exists in gastroparesis. These finding further argue for an assessment of serum 25(OH)D levels in conjunction with gastric emptying times for all gastroparesis patients at baseline clinic visits. We would further suggest that all patients with gastroparesis and particularly those with chronic and medically refractory gastroparesis should receive a nutritional assessment followed by appropriate supplementation to ensure adequate micronutrient levels. Further studies assessing the effects of 25(OH)D on gastric smooth muscle contractility are urgently needed.”

However, they failed to comment on the most interesting aspect of their study and that was that the patient with a level 100 ng/ml had the best gastric emptying time, and close behind were patients with levels well above 50 ng/ml,. As more and more Americans take physiological doses of vitamin D, we should expect to see more studies that look at high normal levels in conjunction with various medical conditions.

2 Responses to Vitamin D status and delayed gastric emptying: An unknown relationship?

  1. dbarra

    The study conclusion is confusing to me. Patients with gastroparesis had higher average levels of serum vitamin D but those with the highest levels had less severe gastroparesis? Is that what this is implying?

    Please comment.



  2. John Cannell, MD

    yes, some patients with gastroparesis had high levels but those patients had less severe disease.

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