Endocrine Abstracts

Vitamin D deficiency has been estimated to affect one billion people world wide¹. It is especially prevalent in Coeliac disease which is estimated to affect one in a 100 people. The intolerance to absorb gluten reduces not only the absorption of calcium, but can also further induce secondary hyperparathyroidism, infertility and a small increased risk of bowel carcinoma and osteoporosis.

A joint nurse/dietetic Coeliac and Osteoporosis clinic was set up at Manchester Royal Infirmary in 2001 due to an increased demand of Coeliac patients which required specialist treatment. Patients are seen after confirmation of Coeliac disease through biopsy. The clinic operates every Friday morning with approximately we see approximately ten patients each week. The patients are seen by both specialists in clinic when then are reviewed.

A cohort of 50 Coeliac patients were tested for vitamin D deficiency at their routine appointment. Forty patients were found to be deficient in varying ranges. Twenty were treated with 40 000 IU colecalciferol daily for 10 days and the remainder where prescribed 20 000 IU to be taken weekly for 12 weeks.

The patients bloods were rechecked after 12 weeks, to ensure that they were vitamin D replete, the results suggested that there was no significant difference between loading the patients with the 10-day regime as opposed to the 12-week regime.

Incidentally most patients preferred the 40 000 IU over 10-day regime as they were less likely to forget to take it and reported a positive health benefit such as reduced bone pain and lethargy.

Reference: 1. Holick M 2007.