Vitamin D sprayed inside cheeks (buccal spray) - several studies

Buccal and sublingual gets vitamin D into the body about day faster then oral
  and gets MORE vitamin D into the blood for those with poor guts

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Vitamin D3 Buccal Spray review of RCTs (not help much) - March 2020

Efficacy of Vitamin D3 Buccal Spray Supplementation Compared to Other Delivery Methods: A Systematic Review of Superiority Randomized Controlled Trials

Tested everyone, not just those with poor guts

Nutrients 2020, 12(3), 691; https://doi.org/10.3390/nu12030691

Background: Vitamin D deficiency is an important public health concern and supplementation is common for this deficiency. Many different modes of delivering supplementation have been proposed in order to enhance absorption and utilization. The present review compared the efficacy of vitamin D3 buccal spray against other forms of supplementation delivery.

Methods: The protocol was registered at PROSPERO (CRD42019136146). Medline/PubMed, CENTRAL and clinicaltrials.gov were searched from their inception until September 2019, for randomized controlled trials (RCTs) that compare vitamin D3 delivery via sublingual spray against other delivery methods. Eligible RCTs involved humans, of any age and health status, published in any language that evaluated changes in plasma 25(OH)D concentrations. Three reviewers independently extracted data, assessed risk of bias (RoB) and the quality of the trials.

Results: Out of 9759 RCTs, four matched the predefined criteria. Intervention duration ranged from 30 days to 3 months whereas vitamin D3 dosage ranged between 800 and 3000 IU/day. One RCT advocated for the superiority of buccal spray in increasing plasma 25(OH)D concentrations, although several limitations were recorded in that trial. The rest failed to report differences in post-intervention 25(OH)D concentrations between delivery methods. Considerable clinical heterogeneity was observed due to study design, intervention duration and dosage, assays and labs used to perform the assays, population age and health status, not allowing for synthesis of the results.

Conclusions: Based on the available evidence, delivery of vitamin D3 via buccal spray does not appear superior to the other modes of delivery. Future RCTs avoiding the existing methodological shortcomings are warranted.
 Download the PDF from VitaminDWiki

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RCT buccal spray for poor gut - Oct 2015

Radomized two way cross over study for comparison of absorption of vitamin D3 buccal spray and soft gelatin capsule formulation in healthy subjects and in patients with intestinal malabsorption
Nutrition Journal 2015, 14:114 doi:10.1186/s12937-015-0105-1
MC Satia1 milansatia at ethicare-cro.com, AG Mukim2, KD Tibrewala3 and MS Bhavsar4
1 Ethicare Clinical Trial Services, Ahmedabad, India
2 Mukim Medical And Nursing Homes, Ahmedabad, India
3 Tibrewala’s Clinic, Ahmedabad, India
4 Bhavsar’s Clinic, Ahmedabad, India

This was a crossover study

 Download the PDF from VitaminDWiki

Background
Vitamin D deficiency has been proposed to contribute to the development of malabsorption diseases. Despite this, the vitamin D status of these patients is often neglected. The objective of the present work was to compare the absorption of vitamin D 3 through the oral route by comparing a 1000 IU soft gelatin capsule and a 500 IU buccal spray (delivering 1000 IU in two spray shots) in healthy subjects and in patients with malabsorption disease.

Methods
An open label, randomized, two-periods, two-way cross over study was conducted, first in healthy subjects (n = 20) and then in patients with malabsorption syndrome (n = 20). The study participants were equally divided and received either of the treatments (buccal spray, n = 7; soft gelatin capsule, n = 7; control, n = 6) in Period I for 30 days. After washout of another 30 days, the treatments were changed in crossover fashion in Period II. Fasting blood samples were collected to measure baseline 25-hydroxyvitamin D [25(OH)D] levels in all participants at day 0 (Screening visit), day 30 (completion of period I), day 60 (end of wash out and initiation of period II) and day 90 (completion of period II). Safety was evaluated by hematology and biochemistry analyses. Statistical analyses was performed using differences of mean and percentage change from baseline of 25(OH)D levels between two formulation by two tailed Paired t-test with 95 % confidence interval.

Results
In healthy subjects, the mean increase in serum 25(OH)D concentration was 4.06 (95 % CI 3.41, 4.71) ng/ml in soft gelatin capsule group and 8.0 (95 % CI 6.86, 9.13) ng/ml in buccal spray group after 30 days treatment (p < 0.0001). In patients with malabsorption disease, the mean increase in serum 25(OH)D concentration was 3.96 (95 % CI 2.37, 5.56) ng/ml in soft gelatin capsule group and 10.46 (95 % CI 6.89, 14.03) ng/ml in buccal spray group (p < 0.0001).

Conclusion
It can be concluded from the results that the buccal spray produced a significantly higher mean serum 25(OH)D concentration as compared to the soft gelatin capsule, in both healthy subjects as well as in patients with malabsorption syndrome over a period of 30 days administration in a two way cross over study. Treatments were well tolerated by both subject groups

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New buccal spray review proposed Dec 2018

Comparative effectiveness of vitamin D supplementation via buccal spray versus oral supplements on serum 25-hydroxyvitamin D concentrations in humans: a systematic review protocol.
JBI Database System Rev Implement Rep. 2018 Dec 3. doi: 10.11124/JBISRIR-2017-003907Pritchard L1,2, Lewis S3, Hickson M2.

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Vitamin D sprays and alternatives

http://smile.amazon.com/s/ref=sr_nr_i_1?rh=k%3A%22vitamin+d%22+spray+-liquid%2Ci%3Ahpc&keywords=%22vitamin+d%22+spray+-liquid&ie=UTF8&qid=1354821043&sa-no-redirect=1|Amazon sells 100 Vitamin D sprays as of Dec 2018]
Possible alternatives to spray:
Drops, water-soluable powder (Bio-Tech)
Which may provide as much response and as fast response as spray at much lower cost

See also VitaminDWiki

• Sublingual vitamin D
• Sublingual vitamin D gave similar response as oral for most, and better for some – RCT Sept 2019
• Spray vitamin D inside cheek in case of emergency - Nov 2012
  Time to reach half of the response to oral vitamin D is about 32 hours
  Vs Time for spray on the cheek is about 4 hours, perhaps 8X faster!
• Topical vitamin D might be more bio-available than oral – Oct 2015
• Gut-Friendly Vitamin D
• Alternatives if not swallow pills or not absorb vitamin D
• Topical vitamin D raised blood level to 38 ng (used Aloe Vera gel) – RCT March 2014
• Pill taking is not a problem with vitamin D
• Vitamin D bioavailability: State of the art – Oct 2014
• How you might double your response to vitamin D
• Oil-based Vitamin D3 has the worst bioavailability – April 2014
• Getting Vitamin D into your body
• 200 IU needed to increase vitamin D levels by 1 ng (not 100 IU) – summary of 25 studies – Feb 2014 which has the following chart

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