Vitamins and CF:

Due to fat malabsorption, vitamins A, D, E, and K are needed in higher amounts because they are fat soluble vitamins. If the fat is being malabsorbed (aka diarrhea), these vitamins are also being malabsorbed.

There are several brands of water-miscible CF-specific multivitamins which contain fat-soluble vitamins in greater amounts than what are in non CF-specific multivitamins. Most of them also contain some water soluble vitamins, such as B vitamins, and sometimes contain zinc. Almost all brands are available in liquid, chewable, and soft gel forms.

CF specific vitamins (and individual A, D, E, and K) are best absorbed if taken with meals and enzymes.

These vitamin labs are drawn yearly to assess need for additional supplementation or supplementation changes. If vitamin labs are drawn during a hospital admission, it is best to wait to draw vitamin A until pt is no longer acutely ill. This is because vitamin A is an acute phase reactant and the level can be altered.

  • Why do we care if these vitamins are low?
    • Vitamin A is an antioxidant, which means that it may help protect the body from free radicals. Vitamin A also plays a role in the immune system, bones, eyes, and skin. Deficiency is most noticeable in the form of night blindness, or difficulty seeing at night.
    • Vitamin D helps the body absorb calcium, which keeps bones healthy and strong. Vitamin D also supports the nervous and immune systems. Deficiency can cause thin or brittle bones and secondary hyperparathyroidism [a condition typically seen in chronic kidney failure where parathyroid hormone (PTH) is excreted in excessive amounts in response to hypocalcemia]
    • Vitamin E is another antioxidant. It supports the immune system and the creation of red blood cells. Deficiency can lead to problems with muscles and nerves.
    • Vitamin K helps bones and assists with blood clotting. Deficiency can cause the blood to take longer to clot, which can be dangerous.

Available vitamin options

MVW Complete Formulations