Vitamins
& Nutrition

The intestinal absorption of vitamins A, D, E, and K is strongly dependent on the liver’s ability to secrete bile acids into the intestine because these vitamins are fat soluble. In PFIC and many other cholestatic diseases, fat malabsorption occurs along with fat-soluble vitamin deficiencies. Therefore, supplementation is needed for the fat-soluble vitamins. Water soluble vitamins are not affected. Vitamin levels of A, D, E, and K may be routinely checked, and supplementation started if levels return low. In addition, certain fats (such as medium chain triglycerides, MCT’s) have been shown to be more easily absorbed, even with poor bile flow, and diets may be adjusted to maximize MCT consumption.