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What causes vitamin D deficiency?

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Posted on Mon, 14 Jul 2014
Question: Hi there,

My children have been diagnosed with Vit D deficiency. My 110 lob, 5 foot 2 inch 11 year old girl scored 15, my 89 pound 4 foot 9 12 year old scored 17 and my 9 year old was 19. I did not get my 5 year old tested. We Iive in a highly urbanized environment, they do not go outside much to play. They are all type 1 skin, so they have to cover up outside anyway. My doctor said just give them fortified milk which is ridiculous -- they need D3, not D2, and on the Vitamin D site they actually recommend 1000 IU per 50 pounds per children. How much can I safely give them to quickly bring their levels up to a healthy one? I will get them bloodtested again in August, but I want to know how much I can give them. The registrar at the doctor's said he would actually give them 4000 a day for three months and then get them tested. What should I do?
Thank you!
XXXX
doctor
Answered by Dr. Binu Parameswaran Pillai (2 hours later)
Brief Answer:
Hello

Detailed Answer:
Hello,
Good day.
The most common cause of vitamin D deficiency is sun avoidance. Other cause include malabsorption, celiac disease etc. There are no much other natural sources of vitamin D except oily fish and egg yolk ( very little). Now a days milk and bread are fortified with vitamin D, but the dose is too small and is insufficient to treat a deficiency state.

Being fat soluble, Vitamin D will sit tightly bound to fat and that is one of the cause of vitamin d deficiency in obesity.

In your children, you have mentioned that the levels are low. I gusee the units are ng/dl. In that case it is low.

You need to give them a loading dose first. This is to saturate the storing sites of vitamin D ( fat).

Usual loading dose is 50000 to 60000 IU weekly for six weeks followed by 2000 IU daily for atleast 5-6 months. Once you start the treatment, re check the levels after 4 months. ( this dose may vary from place to place). I give 60000 IU tablets or satchet weekly once for 6 weeks as loading dose and then 2000 IU daily for 5-6 months.

The optimum level is above 30 ng/dl.

Apart from this, they also need some form of sun exposure.

Regards
Binu


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (43 minutes later)
Thank you so much. What should I do for the five year old who has not been tested, but has the same diet and lifestyle?

And what signs should I look out for for vitamin d overload?

Thankyou!
XXXX
doctor
Answered by Dr. Binu Parameswaran Pillai (5 minutes later)
Brief Answer:
hi

Detailed Answer:
You could surely check the 5 year old's vitaminn D levels as well. We often treat very young children with vitamin d deficiency, but the dose required would be lower ( loading dose would be half the previously mentioned dose). To be XXXXXXX It is reare to have vitamiin D toxicity in this dose.

The main signs are excess passage of calcium in urine ( hypercalciuria) and high calcium levels. Nausea and vomiting are common visible signs. Advisable to check serum calcium around 3 months after starting the treatment.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (3 hours later)
Dear Dr XXXXXXX

Thank you for your advice. Do you think I could begin the dosage suggested for all of them (five year old too, with the lesser dose) and then get them all tested in three months' time?

Thanks!
XXXX
doctor
Answered by Dr. Binu Parameswaran Pillai (6 hours later)
Brief Answer:
Hi

Detailed Answer:
Hello,
Yes, I would think that will be good idea. However, you may get a prescription from local pediatrician or GP as the local practices may vary.

Usually, a five year old can be treated with 30000 IU as tablet or satchet ( if it comes in that dose in your area. We do have it) weekly once for 6 weeks, followed by 1000 units daily for 5-6 months.

I presume your 5 yr old also has vitamin d deficiency because all siblings have it. However, it is better to check it at baseline so that we can compare the levels after the treatment.

The aim of the forum is to guide patients and not to prescribe medicines and it is not legal to do that. For the prescription , you may meet a local pediatrician or GP who can do it for as per the local recommendations.

" Please remember to advice them about sun exposure which is very important , however to avoid sun burn and prolonged exposure at peak times.

You are welcome to ask more questions. Otherwise, you may please close the query.
I wish your children good health.
Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1435 Questions

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What causes vitamin D deficiency?

Brief Answer: Hello Detailed Answer: Hello, Good day. The most common cause of vitamin D deficiency is sun avoidance. Other cause include malabsorption, celiac disease etc. There are no much other natural sources of vitamin D except oily fish and egg yolk ( very little). Now a days milk and bread are fortified with vitamin D, but the dose is too small and is insufficient to treat a deficiency state. Being fat soluble, Vitamin D will sit tightly bound to fat and that is one of the cause of vitamin d deficiency in obesity. In your children, you have mentioned that the levels are low. I gusee the units are ng/dl. In that case it is low. You need to give them a loading dose first. This is to saturate the storing sites of vitamin D ( fat). Usual loading dose is 50000 to 60000 IU weekly for six weeks followed by 2000 IU daily for atleast 5-6 months. Once you start the treatment, re check the levels after 4 months. ( this dose may vary from place to place). I give 60000 IU tablets or satchet weekly once for 6 weeks as loading dose and then 2000 IU daily for 5-6 months. The optimum level is above 30 ng/dl. Apart from this, they also need some form of sun exposure. Regards Binu