People with CF and their Carers

Why do people with CF need vitamin supplements?

For people with CF, eating a nutritious and balanced diet is not easy. This is because most people with CF have pancreatic insufficiency, and don’t produce enough pancreatic enzymes to breakdown, digest or absorb nutrients from the food they eat. This is a particular issue for fat-soluble vitamins A, D, E and K, and without supplementation, these nutrients can become depleted leading to nutrient deficiencies.

This is where Paravit®-CF can support you. Paravit®-CF is specifically designed to supplement fat-soluble vitamins A, D, E and K in the right dosages, appropriate for people with Cystic Fibrosis, based on CF Trust guidance on the Nutritional Management of Cystic Fibrosis1.

Traditionally, people with Cystic Fibrosis may have had to take multiple tablets or liquid products each day to supplement their fat-soluble vitamins. With Paravit®-CF Liquid or Capsule, the four fat-soluble vitamins can now be taken in just one convenient daily dose.

Why are fat-soluble vitamins important in maintaining health?

Fat soluble vitamins A, D, E and K perform a variety of critical functions in the human body, and are essential in maintaining good health. This section describes their important roles, also highlighting good dietary sources of each vitamin.

Vitamin A plays an important role in many parts of the body. It is essential for the normal function of our immune system (our body’s natural defence against illness and infection), and the health of our skin, eyes, and mucous membranes (for example, it can help maintain / repair the lining inside our lungs).

When our bodies don’t get enough Vitamin A, we can develop dry skin, dry eyes, night blindness, poor wound healing, stunted growth (in childhood), and an increased risk of throat and chest infections.

To help prevent deficiency, good dietary sources of Vitamin A can be found in:

  • Dairy products, such as dairy milk, yogurts, and cheese
  • Oily fish, such as salmon, mackerel, sardines, herring, pilchards
  • Liver*
  • Egg yolk
  • Carrots and other brightly coloured orange, yellow and green vegetables

*You should avoid eating liver if you are pregnant, as liver contains exceptionally high levels of Vitamin A, which could harm your unborn baby.

Vitamin D has attracted a lot of attention in recent years, as more research uncovers how important this vitamin really is. Firstly, it’s critical in helping our bodies absorb Calcium from food, to develop strong bones and teeth as we grow and age. Vitamin D also helps manage inflammation, and plays an important role in maintaining our body’s immune system. It has also been linked to improved lung and muscle function, which is especially important for people living with CF.

In the UK, we are all at risk of Vitamin D deficiency. This is because the most efficient way for our bodies to produce Vitamin D is from sunlight exposure onto our skin (which is hard to come by in the winter months). Symptoms of Vitamin D deficiency include an increased risk of infections (especially chest infections), tiredness and fatigue, bone and/or muscle pain, poor wound healing, and low mood. In order to prevent Vitamin D deficiency, it’s really important to spend some time outdoors every day, for at least 20-30 minutes if at all possible.

Vitamin D is not widely available in foods, but it can be found in the following:

  • Oily fish, such as salmon, mackerel, sardines, herring, pilchards
  • Liver*
  • Fortified margarine
  • Egg yolks

*You should avoid eating liver if you are pregnant, as liver contains exceptionally high levels of Vitamin A, which could harm your unborn baby.

Vitamin E is a powerful antioxidant, which protects cells in the body from damage caused by compounds called free radicals. It helps strengthen our immune system, and is needed to maintain healthy skin, eyes, nerves and blood cells. Signs of vitamin E deficiency include muscle pain and weakness, problems with coordination, and problems with your vision.

The best food sources of Vitamin E include:

  • Vegetable oils and margarines e.g. rapeseed, olive, sunflower, soya, and corn-based oils/margarine
  • Eggs
  • Nuts and seeds

Vitamin K is essential for blood clotting, which is critical to stop wounds from bleeding, and to help them heal. It is also important for maintaining healthy bones, along with Calcium and Vitamin D.

The main symptom of Vitamin K deficiency is bleeding too much. This may be more obvious externally e.g. from a cut or sore, than internally e.g. from excessive bruising, or very dark poo (which can be a sign of blood in poo).

Good dietary sources of Vitamin K include:

  • Green leafy vegetables
  • Vegetable oils and margarines e.g. rapeseed, olive, sunflower, soya, and corn-based oils/margarine
  • Liver*

To help meet your fat-soluble vitamin needs, you could try and include the above food sources in your diet, at meal times when you are taking your pancreatic enzymes. If you have been advised by your healthcare professional to take fat-soluble vitamin supplements, such as Paravit®-CF, it is essential that you keep taking them as advised, even if you are eating good sources of Vitamins A, D, E and K.

*You should avoid eating liver if you are pregnant, as liver contains exceptionally high levels of Vitamin A, which could harm your unborn baby.

  1. Cystic Fibrosis Trust and Cystic Fibrosis Dietitians Group UK. Vitamin Supplements in Cystic Fibrosis. 2019. Available at Vitamin Supplements in Cystic Fibrosis. 2019.pdf