Clinical features of vitamin D deficiency in children: A retrospective analysis.
J Steroid Biochem Mol Biol. 2019 Oct 3:105491. doi: 10.1016/j.jsbmb.2019.105491.
Zhang X1, Liu Z2, Xia L3, Gao J4, Xu F5, Chen H6, Du Y7, Wang W8.
VitaminDWiki
All children with Vitamin D deficiency (< 15ng) were given Calcium then injected with Vitamin D 3 days later
Amazingly, the study does not seem to indicate how much Vitamin D nor Calcium was given
No mention was made of ongoing vitamin D
Injection (expensive) is generally not required
- Vitamin D deficiency in China – only 1 in 18 have even 30 ng, fewer if young or female – Feb 2015
- 2000 IU vitamin D not enough to get most Chinese to 20 ng level – RCT Feb 2015
- Beijing extremely vitamin D deficient even in the fall: 10 ng – April 2013
Items in both categories Intervention - non daily and Infant-Child are listed here:
- Children had a better response to Vitamin D given every 2 weeks than daily – RCT Aug 2024
- Monthly vitamin D dosing better for children than daily (again) - Oct 2023
- Bone fractures of children not reduced if given little vitamin D, no Calcium etc. – RCT May 2023
- Chronic tonsillitis virtually eliminated in children by Vitamin D (50,000 IU weekly) – RCT May 2023
- Response to infant 2,000 IU Vitamin D daily was in 194 ng, monthly dosing was 20% less – RCT May 2023
- Monthly 120,000 IU of Vitamin D while breastfeeding was good – RCT Jan 2022
- Vitamin D for infants – 100,000 IU monthly is better than 400 IU daily – RCT Oct 2020
- Vitamin D levels in children optimized with six Vitamin D biscuits – RCT Nov 2018
- Attention-Deficit Hyperactivity Disorder treated by weekly 50,000 IU of vitamin D – RCT Nov 2018
- Breastfeeding mothers and Vitamin D: supplement only themselves usually, 4 out of 10 used monthly rather than daily – Jan 2017
- Vitamin D required for breastfed infants – daily or monthly, infant or mother – Jan 2017
- Mother got 100,000 IU of vitamin D monthly, breastfeeding infant got a little – RCT Aug 2016
- Infant infection reduced by half with vitamin D supplementation – RCT May 2016
- Children getting 60,000 IU monthly got to vitamin D level of 33 ng – Sept 2015
- Type 1 diabetes helped with 50,000 IU of vitamin D every two weeks – Nov 2014
- Growing pains reduced 60 percent by monthly Vitamin D – March 2014
- Breast milk resulted in 20 ng of vitamin D for infant if mother had taken 5,000 IU daily – RCT Dec 2013
Items in both categories Loading Dose and Infant-Child are listed here:
- Growing pains reduced in 91% of children with a single dose of Vitamin D – July 2024
- High-dose Vitamin D safe for children (10,000 IU daily, 600,000 IU bolus) – meta-analysis April 2022
- Childhood cancers – give Vitamin D loading dose if low – Oct 2021
- Vitamin D loading dose was as effective as daily dosing (rickets in this case) – RCT July 2021
- 3X less Septic Shock in children with sepsis getting 150,000 IU of Vitamin D - RCT June 2020
- Child soccer players who were deficient were helped by a single 200,000 IU vitamin D dose – RCT May 2020
- Infant Vitamin D doubles 6 months after birth (can double in 2 weeks)– Oct 2019
- Vitamin D levels in children optimized with six Vitamin D biscuits – RCT Nov 2018
- 2X improved development by severely malnourished children with 2 loading doses of vitamin D – RCT May 2018
- 100,000 IU Vitamin D weekly for 4 weeks is safe and effective for children – May 2019
- Vitamin D loading dose of 300,000 IU for children – 3 weeks with capsules, biscuits, injection – RCT Aug 2018
- Critically ill children – randomized clinical trial to give single doses of up to 400,000 IU of vitamin D – 2019
- Childhood asthma problems eliminated for months by 600,000 IU of Vitamin D injection – June 2017
- Quick restoration of vitamin D in children – 10,000 IU per kg loading dose was not enough – Jan 2017
- Takes a year to restore children and youths to good levels of vitamin D without loading dose - RCT Dec 2016
- Children in Intensive Care need Vitamin D loading dose of 10000 IU per kg (nearing a consensus) - Oct 2016
- Newborn Vitamin D - single 50,000 IU is better than daily – RCT Sept 2016
- Pediatric trials of high dose vitamin D -163 are in a single online database – Feb 2016
- Rapid Normalization of Vitamin D in Critically Ill Children (10,000 IU per kg) – clinical trial
- Vitamin D loading doses of up to 400,000 IU OK for adolescents – meta-analysis Dec 2014
- Neonate loading dose of 30,000 IU vitamin D helped a lot – May 2014
- Recurrence of child pneumonia delayed by 100000 IU of vitamin D – RCT Oct 2010
- 600,000 IU of vitamin D2 every 4 months for decades in East Germany – 1987
Infant-Child category has
- No consensus on MINIMUM International Units (IU) for healthy infant of normal weight
- 400 IU Vitamin D is no longer enough
Was OK in the past century, but D levels have been dropping for a great many reasons.
FDA doubles the amount of vitamin D permitted in milk – July 2016 - No consensus: range is 600 to 1600 IU – based on many randomized controlled trials
- Review of 400 IU to 2000 IU daily and higher if non-daily
- Fewer pre-infants were vitamin D deficient when they got 800 IU – RCT Feb 2014
- 1600 IU was the conclusion of three JAMA studies
1000 IU recommended in France and Finland – 2013 - appears to be a good level - 5X less mite allergy after add vitamin D
- Child bone fractures with low vitamin D were 55X more likely to need surgery
- 75 % of SIDS had low vitamin D
- Children stayed in ICU 3.5 days longer if low vitamin D – Dec 2015
- 5 out of 6 children who died in pediatric critical care unit had low vitamin D – May 2014
- Infants have gotten free 400 IU of vitamin D in Turkey since 2005, More for longer would be even better – Feb 2022
- Preemies should have vitamin D supplements – reaching an agreement – April 2021
- Vitamin D loading dose was as effective as daily dosing (rickets in this case) – RCT July 2021
Having a good level of vitamin D cuts in half the amount of:
- Asthma, Chronic illness, Doctor visits, Allergies, infection
Respiratory Tract Infection, Growing pains, Bed wetting
Need even more IUs of vitamin D to get a good level if;
- Have little vitamin D: premie, twin, mother did not get much sun access
- Get little vitamin D: dark skin, little access to sun
- Vitamin D is consumed faster than normal due to sickness
- Older (need at least 100 IU/kilogram, far more if obese)
- Not get any vitamin D from formula (breast fed) or (fortified) milk
Note – formula does not even provide 400 IU of vitamin D daily
Infants-Children need Vitamin D
- Sun is great – well known for 1,000’s of years.
US govt (1934) even said infants should be out in the sun - One country recommended 2,000 IU daily for decades – with no known problems
- As with adults, infants and children can have loading doses and rarely need tests
- Daily dose appears to be best, but monthly seems OK
- Vitamin D is typically given to infants in the form of drops
big difference in taste between brands
can also use water-soluable form of vitamin D in milk, food, juice, - Infants have evolved to get a big boost of vitamin D immediately after birth
Colostrum has 3X more vitamin D than breast milk - provided the mother has any vitamin D to spare - 100 IU per kg of infant July 2011, Poland etc.
More than 100 IU/kg is probably better
851 items in the category Infant/Child See also - 34 pages in VitaminDWiki had BREASTFE*in title as of Jan 2022
- "BIRTH DEFECTS" 172 items as of July 2016
- Stunting OR “low birth weight” OR LBW OR preemie OR preemies OR preterm 1940 items as of Oct 2018
- 96 VitaminDWiki pages contained PRETERM or PREEMIE in title as of Aug 2021
- "SUDDEN INFANT DEATH" OR SIDS 214 items as of Dec 2020
- Overview of Rickets and Vitamin D
- Youth category listing has
174 items along with related searches - Down's syndrome and low vitamin D - several studies
- Rett syndrome associated with low vitamin D, treated by Omega-3
Download the PDF from VitaminDWiki
Most children improved in 1 week
Most children had 12 to 28 ng 1 month after injection
Vitamin D is very important for children's health. Previous studies have shown that vitamin D deficiency leads to a series of diseases in adults. However, pediatricians are mostly aware of rickets caused by vitamin D deficiency in children and poorly aware of other symptoms. This study aimed to retrospectively analyze the different clinical features of vitamin D deficiency to enhance identification by pediatricians, thus minimizing misdiagnosis. In this study, we retrospectively analyzed the clinical features of vitamin D deficiency in 268 children aged 0-14 years from June 2016 to May 2018 in the Third Affiliated Hospital of Zhengzhou University. Serum 25-hydroxy vitamin D [25(OH)D] levels were determined using the chemiluminescence method.
Of the 268 cases,- 101 cases showed movement disorder (37.7 %) and
- 167 nervous system abnormalities (62.3%).
Among all cases, 6 were misdiagnosed as febrile seizures (2.23%), 5 as epilepsy (1.86 %), 2 as Tourette syndrome (0.74%), and 2 as developmental retardation (0.74%).
There were significant differences in patients with clinical characteristics of movement disorder and nervous system abnormalities partly between Pre-and post-vitamin D treatment. This analysis revealed that vitamin D deficiency occurs not only in children but also in adolescents, with diverse clinical features. Therefore, pediatricians should pay more attention to clinical different signs and symptoms, and future studies should be conducted to confirm the mechanisms of these processes.
References
- K. A. Kennel, M. T. Drake, D. L. Hurley. Vitamin D Deficiency in Adults: When to Test and How to Treat. Mayo Clinic Proceedings, 2010, 85(8): 752-758
- Rathish Nair, Arun Maseeh. Vitamin D: The "sunshine" vitamin. Journal of pharmacology & pharmacotherapeutics, 2012, 3(2): 118-126
- S. Meeker, A. Seamons, L. Maggio-Price, et al. Protective links between vitamin D, inflammatory bowel disease and colon cancer. World J Gastroenterol, 2016, 22(3): 933-948
- M. J. Berridge. Vitamin D deficiency accelerates ageing and age-related diseases: a novel hypothesis. J Physiol, 2017, 595(22): 6825-6836
- M. F. Holick. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord, 2017, 18(2): 153-165
- E. Angellotti, D. D’Alessio, B. Dawson-Hughes, et al. Vitamin D Supplementation in Patients With Type 2 Diabetes: The Vitamin D for Established Type 2 Diabetes (DDM2) Study, J Endocr Soc, 2018, 2(4): 310-321
- U. Sethuraman, M. A. Zidan, L. Hanks, et al. Impact of vitamin D treatment on 25 hydroxy vitamin D levels and insulin homeostasis in obese African American adolescents in a randomized trial. J Clin Trans1 Endocrinol, 2018, 12: 13-19
- K. N. Bae, H. K. Nam, Y. J. Rhie, et al. Low levels of 25-hydroxyvitamin D in children and adolescents with type 1 diabetes mellitus: a single center experience. Ann Pediatr Endocrinol Metab, 2018, 23(1): 21-27
- L. Bertoccini, D. Bailetti, Summer Study in Diabetes Group, et al. Variability in genes regulating vitamin D metabolism is associated with vitamin D levels in type 2 diabetes. Oncotarget, 2018, 9(79): 34911-34918
- T. M. Ananda Kesavan, N. Thuruthiyath, E. P. Thomas. Subclinical Vitamin D Deficiency in Children from Thrissur, Kerala. Indian Pediatr, 2018, 55(5): 434-435
- J. M. Fernandez Bustillo, A. Fernandez Pombo, R. Gomez Bahamonde, et al. Vitamin D levels in a pediatric population of a primary care centre: a public health problem?, BMC Res Notes, 2018, 11(1): 801
- F. Wei, Z. Wang, J. Wang, et al. Serum vitamin D levels among children aged 0-12 years in the First Affiliated Hospital of Harbin Medical University, China. J Public Health (Oxf), 2018:
- P. Gazerani, R. Fuglsang, J. G. Pedersen, et al. A randomized, double-blinded, placebo-controlled, parallel trial of vitamin D3 supplementation in adult patients with migraine. Curr Med Res Opin, 2018: 1-9
- J. Dai, C. Jiang, H. Chen, et al. Vitamin D and diabetic foot ulcer: a systematic review and meta-analysis. Nutr Diabetes, 2019, 9(1): 8
- J. Welsh. Vitamin D and breast cancer: Past and present. J. Steroid Biochem. Mol. Biol., 2018, 177: 15-20
- Y. Cesur, S. A. Yuca, A. Kaya, et al. Vitamin D deficiency rickets in infants presenting with hypocalcaemic convulsions. West Indian Med J, 2013, 62(3): 201- 204
- M. A. Bellazzini, D. S. Howes. Pediatric hypocalcémie seizures: a case of rickets. J Emerg Med, 2005, 28(2): 161-164
- M. L. Gross, M. Tenenbein, E. A. Sellers. Severe vitamin D deficiency in 6 Canadian First Nation formula-fed infants. Int J Circumpolar Health, 2013, 72: 20244
- K. M. Bhimji, H. Naburi, S. Aboud, et al. Vitamin D Status and Associated Factors in Neonates in a Resource Constrained Setting. Int J Pediatr, 2018, 2018: 9614975
- D. W. Lowe, B. W. Hollis, C. L. Wagner, et al. Vitamin D insufficiency in neonatal hypoxic-ischemic encephalopathy. Pediatr Res, 2017, 82(1): 55-62
- G. Saggese, F. Vierucci, F. Prodam, et al. Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians. Ital J Pediatr, 2018, 44(1): 51
- A. C. F. Almeida, F. J. A. de Paula, J. P. Monteiro, et al. Do all infants need vitamin D supplementation?. PLoS One, 2018, 13(4): e0195368
- M. Z. Chi, L. Zhu, Z. L. Zhang, et al. The Relationship between Maternal Serum Vitamin D Levels and Infant Neurodevelopment and Anthropometry: A Prospective Observational Study. J Nutr Sci Vitaminol (Tokyo), 2018, 64(2): 161-167
- Y. Wang, H. Li, M. Zheng, et al. Maternal vitamin D deficiency increases the risk of adverse neonatal outcomes in the Chinese population: A prospective cohort study. PLoS One, 2018, 13(4): e0195700
- P. Singh. Treatment of Vitamin D Deficiency and Comorbidities: A Review. J Assoc Physicians India, 2018, 66(1): 75-82
- Z. A. Bhutta. Vitamin D reduces respiratory tract infections frequency. J Pediatr, 2017, 186: 209-212
- N. Masoudi Alavi, M. Madani, Z. Sadat, et al. Fatigue and Vitamin D Status in Iranian Female Nurses, Glob J Health Sci, 2015, 8(6): 196-202
- K. Johnson, M. Sattari. Vitamin D deficiency and fatigue: an unusual presentation. Springerplus, 2015, 4: 584
- R. Yilmaz, A. Salli, H. T. Cingoz, et al. Efficacy of vitamin D replacement therapy on patients with chronic nonspecific widespread musculoskeletal pain with vitamin D deficiency. International Journal Of Rheumatic Diseases, 2016, 19(12): 1255-1262
- R. A. Khalifah, A. Hudairi, D. A. Homyani, et al. Vitamin D supplementation to prevent vitamin D deficiency for children with epilepsy: Randomized pragmatic trial protocol. Medicine (Baltimore), 2018, 97(40): el2734
- R. A1 Khalifah, A. Hudairi, D. A1 Homyani, et al. Vitamin D supplementation to prevent vitamin D deficiency for children with epilepsy Randomized pragmatic trial protocol . Medicine, 2018, 97(40): 5
- T. J. Song, M. K. Chu, J. H. Sohn, et al. Effect of Vitamin D Deficiency on the Frequency of Headaches in Migraine. Journal Of Clinical Neurology, 2018, 14(3): 366-373
- T. J. Song, M. K. Chu, J. H. Sohn, et al. Effect of Vitamin D Deficiency on the Frequency of Headaches in Migraine. J Clin Neurol, 2018, 14(3): 366-373
- Elspeth E. Shipton, Edward A. Shipton. Vitamin D Deficiency and Pain: Clinical Evidence of Low Levels of Vitamin D and Supplementation in Chronic Pain States. Pain and therapy, 2015, 4(1): 67-87
- S. Prakash, M. Kumar, P. Belani, et al. Interrelationships between chronic tension-type headache, musculoskeletal pain, and vitamin D deficiency: Is osteomalacia responsible for both headache and musculoskeletal pain?. Annals Of Indian Academy Of Neurology, 2013, 16(4): 650-658
- H. S. Talaat, A. M. H. Kabel, L. H. Khaliel, et al. Reduction of recurrence rate of benign paroxysmal positional vertigo by treatment of severe vitamin D deficiency. Auris Nasus Larynx, 2016, 43(3): 237-241
- N. Altunsoy, R. N. Yuksel, M. Cingi Yirun, et al. Exploring the relationship between vitamin D and mania: correlations between serum vitamin D levels and disease activity. Nord J Psychiatry, 2018, 72(3): 221-225
- A. Rusinska, P. Pludowski, M. ffalczak, et al. Vitamin D Supplementation Guidelines for General Population and Groups at Risk of Vitamin D Deficiency in Poland- Recommendations of the Polish Society of Pediatric Endocrinology and Diabetes and the Expert Panel With Participation of National Specialist Consultants and Representatives of Scientific Societies-2018 Update . Front Endocrinol (Lausanne), 2018, 9: 246
- A. Haq, J. Svobodova, NY. Sofi, et al. Vitamin D status among the juvenile population: A retrospective study . J. Steroid Biochem. Mol. Biol., 2018, 175: 49-54
- L. Calderon-Garciduenas, M. Franco-Lira, A. D’Angiulli, et al. Mexico City normal weight children exposed to high concentrations of ambient PM2. 5 show high blood leptin and endothelin-1, vitamin D deficiency, and food reward hormone dysregulation versus low pollution controls. Relevance for obesity and Alzheimer disease. Environ Res, 2015, 140: 579-592
- M. R. Esmaeili Dooki, L. Moslemi, A. A. Moghadamnia, et al. Vitamin D status in preschool children: should vitamin D supplementation, preventing vitamin D deficiency be continued in children over 2 years?. J Public Health (Oxf), 2018:
- D. A. Niculescu, C. A. M. Capatina, R. Dusceac, et al. Seasonal variation of serum vitamin D levels in Romania. Arch Osteoporos, 2017, 12(1): 113
- A. Bleizgys, J. Kurovskij. Vitamin D Levels of Out-Patients in Lithuania: Deficiency and Hypervitaminosis. Medicina (Kaunas), 2018, 54(2):
- D. Chlebna-Sokol, J. Konstantynowicz, P. Abramowicz, et al. Evidence of a significant vitamin D deficiency among 9-13-year-old Polish children: results of a multicentre study. Eur J Nutr, 2018:
Printer Friendly Follow this page for updates6599 visitors, last modified 19 Jul, 2020,