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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 111.56 Kb 369
15948 Rady supplementation.jpg admin 21 Jul, 2021 42.26 Kb 445
15947 Rady testing.jpg admin 21 Jul, 2021 41.69 Kb 357
15946 Rady.jpg admin 21 Jul, 2021 103.37 Kb 447
15945 Rady Children's Hospital.pdf admin 21 Jul, 2021 852.11 Kb 392