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Children's Cancer hospital now testing vitamin D frequently and supplementing weekly – July 2021

Improving Vitamin D testing and supplementation in children with newly-diagnosed cancer: A Quality Improvement Initiative at Rady Children’s Hospital San Diego

Ksenya Shliakhtsitsava,Erin Stucky Fisher,Erin Trovillion,Kelly Bush,Dennis Kuo,Ron Newfield,Courtney Thornburg,William Roberts,Paula Aristizabal


Unfortunately, they aim for only >30 ng
   More vitamin D is needed for treatment than prevention

Study ignored the importance of activation of the Vitamin D Receptor for Cancers

The risk of 44 diseases at least double with poor Vitamin D Receptor as of Oct 2019
Vitamin D Receptor activation can be increased by any of: Resveratrol,  Omega-3,  MagnesiumZinc,   Quercetin,   non-daily Vit D,  Curcumin, intense exercise,   Ginger,   Essential oils, etc  Note: The founder of VitaminDWiki uses 10 of the 13 known VDR activators

They wait months for the Vitamin D levels to respond
Loading doses could achieve the same levels within a week
   Note: Loading doses have been used on over 1 million childen during the past 70 years

Would have been much better if they had increased Vitamin D levels before the surgery

Even better - Have high vitamin D levels and not get Cancer in the first place

derived from Grassroots 2013

Items in both categories Cancer and Infant-Child :

I will not be surprised if in the future they stop pushing Vitamin D
They are given too little vitamin D, too late to make much of a difference 

 Download the PDF from VitaminDWiki
Note:Most are weekly supplementations
Amazingly, they do not increase dose size with age: An 18 year-old needs much more than a 2 year-old

Increased testing

Increased supplementation


Background: Vitamin D deficiency and insufficiency have been associated with poorer health outcomes. Children with cancer are at high risk for Vitamin D deficiency and insufficiency. At our institution, we identified high variability in Vitamin D testing and supplementation in this population. Of those tested, 65% were Vitamin D deficient/insufficient. We conducted a quality improvement (QI) initiative with aim to improve Vitamin D testing and supplementation among children aged 2-18 years old with newly-diagnosed cancer to ≥ 80% over 6 months.

Methods: An inter-professional team reviewed baseline data, then developed and implemented interventions using Plan-Do-Study-Act (PDSA) cycles. Barriers were identified using QI tools, including lack of automated triggers for testing and inconsistent supplementation criteria and follow-up testing post-supplementation. Interventions included an institutional Vitamin D guideline, clinical decision-making tree for Vitamin D deficiency, insufficiency and sufficiency, electronic medical record triggers, and automated testing options.

Results: Pre-intervention: N=26 patients, four (15%) had baseline Vitamin D testing; two (8%) received appropriate supplementation. Post-intervention: N=33 patients; 32 (97%) had baseline Vitamin D testing; 33 (100%) received appropriate supplementation and completed follow-up testing timely (6-8 weeks post-supplementation). Change was sustained over 24 months.

Conclusions: We achieved and sustained our aim for Vitamin D testing and supplementation in children with newly-diagnosed cancer through inter-professional collaboration of hematology/oncology, endocrinology, hospital medicine, pharmacy, nursing, and information technology. Future PDSA cycles will address patient compliance with Vitamin D supplementation and impact on patients’ Vitamin D levels.

Created by admin. Last Modification: Thursday July 22, 2021 21:07:45 GMT-0000 by admin. (Version 15)

Attached files

ID Name Comment Uploaded Size Downloads
15949 Rady Change.jpg admin 21 Jul, 2021 21:39 111.56 Kb 333
15948 Rady supplementation.jpg admin 21 Jul, 2021 21:38 42.26 Kb 365
15947 Rady testing.jpg admin 21 Jul, 2021 21:38 41.69 Kb 317
15946 Rady.jpg admin 21 Jul, 2021 21:36 103.37 Kb 368
15945 Rady Children's Hospital.pdf PDF 2021 admin 21 Jul, 2021 21:36 852.11 Kb 333