Low vitamin D levels are common in patients with epilepsy

Teagarden, Diane L.; Meador, Kimford J.; Loring, David W.

doi:10.1016/j.eplepsyres.2014.06.008

Cited by 89 publications

(54 citation statements)

References 29 publications

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“…First, subjects with SMID have various health problems including nutritional ones. However, reports on the vitamin status in subjects with SMID have been quite limited, except for the effect of anti-epileptic drugs, which are commonly administered to people with SMID, on the catabolism of vitamin D and folate deficiency (13,14). Studies on water-soluble vitamins including vitamin B12 have been scarce.…”

Section: Discussionmentioning

confidence: 99%

Gastric and Jejunal Enteral Feeding Differently Affect Vitamin B12 Status in Subjects with Severe Motor and Intellectual Disabilities

Mei

Nagae

Makino

et al. 2019

J Nutr Sci Vitaminol

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The absorption of vitamin B12 is a complex process involving gastric acid and intrinsic factor as the indispensable components. In this study, we have investigated the effects of the administration site in enteral feeding on vitamin B 12 status in subjects with severe motor and intellectual disabilities (SMID). This is a cross-sectional study conducted from January to June 2016. Blood concentrations of vitamin B12, folate, vitamin B6, and homocysteine (Hcy) were measured in a total of 82 subjects (38 men, 44 women). Also, nutrients intake was assessed. Subjects with enteral feeding (EF) had significantly higher intakes of vitamin B12, folate, and vitamin B6 than those with oral ingestion (OI). Serum folate and vitamin B6 concentrations in subjects with EF were significantly higher than those with OI. Among the EF subjects, serum vitamin B12 concentration was significantly higher in those fed with gastric tube than those fed with jejunal tube in spite of similar vitamin B12 intakes. No significant difference was observed between the two groups regarding the circulating concentrations of folate, vitamin B6, or Hcy. Although each administration route has its own benefit, gastric tube is advantageous in the absorption of vitamin B12.

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Section: Discussionmentioning

confidence: 99%

Gastric and Jejunal Enteral Feeding Differently Affect Vitamin B12 Status in Subjects with Severe Motor and Intellectual Disabilities

Mei

Nagae

Makino

et al. 2019

J Nutr Sci Vitaminol

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“…Furthermore, Borusiak et al [43] uniquely suggested the downregulation of vitamin D not only occur in epileptic but also in otherwise healthy children receiving AEDs. Some reports also proposed that vitamin D deficiency was significantly frequent in patients taking EIAEDs but still common in those taking non-EIAEDs [44][45][46][47] . On the other hand, VPA, a wide-spectrum AED, is commonly regarded as an inhibitor of cytochrome P450 system, but this belief was recently challenged, as VPA was reported to augment the expressions of CYP24 and CYP3A4 through in vitro experiments [48,49] .…”

Section: Discussionmentioning

confidence: 99%

Effect of Antiepileptic Therapy on Serum 25(OH)D3 and 24,25(OH)2D3 Levels in Epileptic Children

Jiang²,

Zhu³

et al. 2016

Ann Nutr Metab

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Background: Vitamin D deficiency is not only associated with the adverse effects of chronic treatment with antiepileptic drugs (AEDs), but also with epilepsy. Although emerging evidence suggests that AEDs can accelerate the vitamin D catabolism, resulting in suboptimal vitamin D status, there are a limited number of studies examining the vitamin D status in epileptic patients, especially in first-episode or AEDs-naïve children. Methods: Determined with high-performance liquid chromatography-tandem mass spectrometry, circulating 25(OH)D₃ and 24,25(OH)₂D₃ levels, and 24,25(OH)₂D₃:25(OH)D₃ ratio were compared between AEDs-treated epileptic (n = 363) and control (n = 159) children. To further figure out whether the patients were in a vitamin D deficient prone state even before treatment, epileptic children before their initiation of treatment (n = 51) were enrolled into a follow-up study. Results: A significant decrease of 25(OH)D₃ and 24,25(OH)₂D₃ levels, but a significant increase of 24,25(OH)₂D₃:25(OH)D₃ ratio was observed in epileptic children, compared with controls. Baseline 25(OH)D₃, 24,25(OH)₂D₃ and 24,25(OH)₂D₃:25(OH)D₃ ratio in the follow-up group were similar to those in controls, but significantly changed with 2 months of AED therapy. Conclusions: Disturbed vitamin D levels were possibly the consequence of AED therapy, rather than the contributing factor of epilepsy. Collectively, circulating vitamin D levels should be monitored and corrected in AEDs-treated epileptic children.

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“…Among the conventional AEDs, early reports have focused on inducers of cytochrome P450 (CYP) enzyme such as carbamazepine, phenobarbital, phenytoin and primidone that can activate the PXR, increasing vitamin D metabolism and eventually leading to hypocalcemia and secondary hyperparathyroidism (113). In a total of 600 patients receiving AEDs, 45% had 25(OH)D level <20 ng/mL while deficiency was present in 54% of enzyme-inducing and 37% of non-enzyme-inducing antiepileptic drug groups (114). Interestingly, Tombini et al found that patients taking multiple AEDs had lower levels of 25(OH)D than patients taking single therapy, with 25(OH)D levels depending on treatment duration (115).…”

Section: Antiepileptic Drugsmentioning

confidence: 99%

DIAGNOSIS OF ENDOCRINE DISEASE: Drug-induced endocrinopathies and diabetes: a combo-endocrinology overview

Diamanti-Kandarakis

Duntas

Kanakis

et al. 2019

European Journal of Endocrinology

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In the currently overwhelming era of polypharmacy, the balance of the dynamic and delicate endocrine system can easily be disturbed by interfering pharmaceutical agents like medications. Drugs can cause endocrine abnormalities via different mechanisms, including direct alteration of hormone production, changes in the regulation of the feedback axis, on hormonal transport, binding and signaling, as well as similar changes to counter-regulatory hormone systems. Furthermore, drugs can interfere with the hormonal assays, leading to erroneous laboratory results that disorientate clinicians from the right diagnosis. The purpose of this review is to cover a contemporary topic, the drug-induced endocrinopathies, which was presented in the monothematic annual Combo Endo Course 2018. This challenging part of endocrinology is constantly expanding particularly during the last decade, with the new oncological therapeutic agents, targeting novel molecular pathways in the process of malignancies. In this new context of drug-induced endocrine disease, clinicians should be aware that drugs can cause endocrine abnormalities via different mechanisms and mimic a variety of clinical scenarios. Therefore, it is extremely important for clinicians not only to promptly recognize drug-induced hormonal and metabolic abnormalities, but also to address the therapeutic issues for timely intervention.

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Low vitamin D levels are common in patients with epilepsy

Cited by 89 publications

References 29 publications

Gastric and Jejunal Enteral Feeding Differently Affect Vitamin B<sub>12</sub> Status in Subjects with Severe Motor and Intellectual Disabilities

Gastric and Jejunal Enteral Feeding Differently Affect Vitamin B<sub>12</sub> Status in Subjects with Severe Motor and Intellectual Disabilities

Effect of Antiepileptic Therapy on Serum 25(OH)D<sub>3</sub> and 24,25(OH)<sub>2</sub>D<sub>3</sub> Levels in Epileptic Children

DIAGNOSIS OF ENDOCRINE DISEASE: Drug-induced endocrinopathies and diabetes: a combo-endocrinology overview

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