Frequent Report of Vitamin Deficiencies and Use of Supplements and Complementary/Alternative Treatment Approaches in Patients with Eosinophilic Gastrointestinal Diseases

Introduction: Eosinophilic gastrointestinal diseases (EGIDs) can impact food and nutrient intake. However, the frequency of vitamin deficiency, supplements, and other complementary/alternative medicine (CAM) treatments is unknown in EGIDs. We aimed to assess the frequency of vitamin deficiency, supplement use, and CAM use in EoE and non-EoE EGID patients. Methods: We performed a study based in EGID Partners (egidpartners.org), an online patient-centered research network designed and implemented by patient advocacy groups (PAGs) and EGID researchers. Subjects are recruited via informational emails, social media, webinars, medical record patient portals, and by physicians. Adults (≥18 years) and caregivers of children < 18 years of age can join. We surveyed patients about topics most of interest to them. Based on their responses, we developed and implemented a survey to document physician-diagnosed vitamin deficiencies, vitamin and supplement use, and use of CAM. We compared patients with EoE to those with non-EoE EGIDs. Results: We analyzed 81 EGID patients, 58 of whom had EoE alone and 23 of whom had a non-EoE EGID (13 had eosinophilic gastritis [EoG], 14 had eosinophilic enteritis [EoN], 7 had eosinophilic colitis [EoC], and 14 had overlapping disease). The mean (SD) age was 35.1 (19.0) years; 64% female; 95% White. The proportion of patients reporting vitamin deficiencies was numerically higher in non-EoE EGIDs compared to EoE (61% vs 50%, respectively; P=0.38) (Figure 1A). Across EGIDs, frequencies of deficiencies were numerically highest for Vitamin D, iron, and B12 (86%, 60%, and 33%, respectively). The majority of patients (77%) reported taking vitamins or supplements, with a numerically higher proportion in non-EoE EGID cases (87% vs 72%; P=0.16). Use of >30 different supplements or vitamins were reported, Most commonly multivitamins, Vitamin D, B12, C, iron, calcium, and probiotics (Figure 1). For CAM, herbal approaches were more frequent in non-EoE EGIDs compared to EoE (26% vs 5%; P=0.008). Yoga, massage therapy, chiropractice, and cognitive behavioral therapy were used by ≥15% of EGID patients (Figure 1B). Conclusion: Vitamin deficiencies are reported by >50% of EGID patients and may be more common in non-EoE EGIDs. Vitamin and supplement use was very common, with frequent CAM utilization as well. The frequent use of vitamins, supplements, and CAM highlight the large unmet need for rigorously evaluated treatments in EGIDs.Figure 1.: EGID patients and analyses.