Vitamin D in a child

[joannqn]

DS9 is struggling with a variety of issues revolving around depression, anger, being mean to his younger brother, and social stuff.

 

Two days ago, he had a follow up with our pediatrician that ended with upping his Zoloft dosage, getting a referral to the developmental pediatrician for asperger's evaluation, and checked his D levels.

 

So, his vitamin D level is 22. The lab says 30-100 is normal. The doctor is recommending otc vitamin D at 2,000iu a day for a week then 1,000iu a day for a month, and a recheck after that.

 

What do you think of that supplementation advice? I don't know anything about vitamin D levels in children. The amounts he's suggesting he takes seems kind of low to me.

[redsquirrel]

Well, on my calcium supplement it says that the upper intake levels of Vit D is 2000 IU daily. I know that adults who are low are told to take a higher level while under a doctors monitoring. Maybe, because this is a child, 2,000 IU is as high as the Dr is willing to go. I am sure there hasn't been a double blind study of the long term effects of very high dosing of Vit D and kids. 2,000 IU, the known upper limit, seems like a safer choice for kids.

 

My kids get a daily supplement at the suggestion of our doctor based on where we live and the fact that my kids are very, very pale and must wear sunscreen all summer. I keep it to 2,000 IU a day.

[daysaregifts]

I think the Vitamin D Council website has some great info. I bet Dr. Cannell has recs for kids on there somewhere. Sure hope upping his D helps him!

[Rod Everson]

So, his vitamin D level is 22. The lab says 30-100 is normal. The doctor is recommending otc vitamin D at 2,000iu a day for a week then 1,000iu a day for a month, and a recheck after that.

 

What do you think of that supplementation advice? I don't know anything about vitamin D levels in children. The amounts he's suggesting he takes seems kind of low to me.

 

Dr. Cannell of the vitamindcouncil.org recommends that children over age 1 take 1,000 IU for every 25 pounds of body weight, so if your son weighs, say, around 75 pounds, he should be taking 3,000 IU just to maintain his levels.

 

If you're trying to get them higher, he should take more. The problem is that you have to factor in summer sunshine, and most kids get a lot of summer sun. In the winter, unless you live far south and he spends time outdoors, he'll manufacture very little vitamin D3 from sunshine.

 

I would follow your doctor's orders for a couple of months but then make sure he retests your son's vitamin D to see whether the 22 ng/ml level increased. If it didn't, or only goes up a couple of points, and he weighs over 50 pounds, then you'll know that he needs more on a daily basis to get his level up. The problem you have is that he'll need to take some extra for a time to get his levels up, and then will have to reduce the dosage to maintain the levels. Figuring this out will take some testing.

 

You might also be interested to learn that Dr. Cannell authored a paper on vitamin D and autism, and that for people on the spectrum he recommends getting them toward the higher end of the 30-100 range to see if symptoms improve. He also has communicated with several parents who've done so and seen significant improvements in their children.

 

Long story short, if I were you this is an area I would study closely and work to get his levels up to where you were comfortable that he isn't deficient, and then make sure you're testing regularly enough to see that he a) stays high enough and b) doesn't get too high. (We store vitamin D so we can reach toxic levels. Plus, some people have health conditions that can be aggravated by too much.)

 

I spend a fair amount of time discussing this on my website at OnTrack Reading incidentally. See The Diet Piece of the Dyslexia Puzzle if you're interested.

 

Rod Everson

 

OnTrack Reading

[wapiti]

I'd supplement with D3, not just regular vitamin D.

 

You might like this chewable product.

[bnrmom]

We do sublingual (under the tongue) Vit D3 drops quite regularly. 1 drop is 2,000iu, and we probably do 2-3 drops at a time. Dh and I both know we are deficient, so I assume the kids are as well. I take it daily, and I give it to the kids when there is illness going around, or to up their immune system, or just whenever I think of it. I think it makes a huge difference.

 

Just a side note about your son's health issues - I recently found out that my cholesterol level is too low. Now, most doctors would think this is a really good thing, but my naturopath said that it means that I'm not absorbing enough fat, which can lead to depression. She wants me to up all the good fats, but also take a digestive enzyme when I eat. Also, I have issues with anxiety, and feel a huge difference when I take fish oils regularly.

 

Probiotics never hurt either, especially when any medication is being taken, as most medication seems to wreak havoc on your digestive system.

[KS_]

My two take 5,000IU a day.

[Rod Everson]

We do sublingual (under the tongue) Vit D3 drops quite regularly. 1 drop is 2,000iu, and we probably do 2-3 drops at a time.

 

 

This is a bit off-topic, and it's not directed at you, but at others who use drops. Dr. Cannell got a letter once from a mother who'd been administering one dropperful, instead of just one drop, to her child. The result was a massive overdosing of the child over time and some repercussions that I don't recall right now.

 

My daughter just had her first child and has been instructed to supplement with vitamin D3. (I think this is going to be an up and coming thing with pediatricians, by the way, because I doubt that my granddaughter even needs the supplement because her mom's high enough in vit D3 to pass it through in feedings.)

 

Anyway, I noticed that the instructions on her particular bottle of D3 were to administer a dose of one dropperful, so they've really diluted it down, possibly to prevent the sort of overdose occasioned by a poor reading of directions.

[TracyR]

This is a good question as I was wondering this myself for my children. Just be sure that what he is taking is Vitamin D3 and not the prescription D2 that doctors give out.

 

So would my oldest who is 14 be given doses as a child or an adult? She's a 14 yr old in an adult body. She's 5 '9 and probably about 145lbs.

[Tigger]

DS9 is struggling with a variety of issues revolving around depression, anger, being mean to his younger brother, and social stuff.

 

Two days ago, he had a follow up with our pediatrician that ended with upping his Zoloft dosage, getting a referral to the developmental pediatrician for asperger's evaluation, and checked his D levels.

 

So, his vitamin D level is 22. The lab says 30-100 is normal. The doctor is recommending otc vitamin D at 2,000iu a day for a week then 1,000iu a day for a month, and a recheck after that.

 

What do you think of that supplementation advice? I don't know anything about vitamin D levels in children. The amounts he's suggesting he takes seems kind of low to me.

 

For a child, it's sound.....I'd add that you should use a fish oil based vitamin D3 as it's best absorbed.

[LAS in LA]

Also, I have issues with anxiety, and feel a huge difference when I take fish oils regularly.

 

:iagree: Is there naturally vitamin D in fish oil, or only if it's added?

[Michelle in AL]

I would go with what your pediatrician recommended. Kids metabolize drugs differently and need different dosing than adults. Vit D also builds up in your body and levels can become too high if doses are too high.

[gardenmom5]

you live in a dark house.

 

3ds has also been put on 2000iu's by his DAN!, but we are not doing labs again for another 8 weeks.

 

If they are going to refer you to childrens or UWCHDD - call now and get on the list. there are huge intake packets to fill out first, and the wait was six months at UWCHDD (though they told me it was under three months - I think I only got an appointment because I called and left a VM - there is no direct line - and asked when we were going to be seen), and have been told children's was eight or nine.

 

eta: I looked at ds's paperwork - his D level was 34, and that was last summer when we also did school in a room that receives far more daylight than where we are schooling now, so it is probably lower now that it is winter.

Edited January 26, 2012 by gardenmom5

[HiddenJewel]

Those supplement amounts would be way too low for my thinking. But then my doctor's office likes to see D labs closer to 100.

 

If you are worried about overdosing, watch the blood calcium levels as well as the D.

Edited January 25, 2012 by HiddenJewel

[Rod Everson]

 

So would my oldest who is 14 be given doses as a child or an adult? She's a 14 yr old in an adult body. She's 5 '9 and probably about 145lbs.

 

As I said, Dr. Cannell recommends 1,000 IU's per 25 lbs of body weight. However, his normal recommendation for adults is 5,000 IU per day.

 

It really is important to get it measured a couple of times a year, especially in the beginning, to see how levels are changing relative to dosage, and summer sunshine as well.

 

Then there's the issue of kids who are really, really low, or where you might want to get it up near the top of the range over just a few months. In that case, someone like your daughter might have to take somewhat more than 5,000 IU's, say 6,000 to 8,000 for a few months before cutting back to a maintenance dosage.

 

Again, you can't really know unless you measure it from time to time. This definitely isn't one of those supplements where more is necessarily better, however. You can overdose, although it takes a lot and over a sustained period. Doctors routinely prescribe a single dose, for example, of 50,000 IU's as a one-time booster, then fall back to the 1,000-2,000 level daily.

 

The medical community is changing it's views rapidly on this, by the way. The tolerable upper limit recommendations were doubled (from 2,000 to 4,000) less than a year ago, and even then, the researchers who are leading the way on this topic think that's way too low for an upper tolerance level.

 

Rod

 

OnTrack Reading

[Rod Everson]

For those curious enough to want to learn a lot more about vitamin d3, I have a page on my site that links to some great videos of presentations by various D3 researchers. There's about five of them, and most are nearly an hour long and cover different diseases that have been associated with a vitamin D3 deficiency.

 

Here's the link: Vitamin D and Disease

 

I'm wondering if a vitamin D3 deficiency might be what triggers the pattern of delayed development that we see in so many struggling readers, whether it be visual development, auditory development, fine motor, gross motor, etc., and figured that if I could show people how many other diseases are being associated with it, maybe they'd figure that supplementation is a good idea even if my theory of it also causing dyslexia is just plain wrong. I have a feeling, however, that there's going to turn out to be something to it in time.

 

All the best...

 

Rod

[AdventureMoms]

I'd give at least 2000iu/day. When my DD was low (26) we had her on 2000-3000iu and she was 15 months old and weighed maybe 25-30lbs. I'd also look to get his levels up to more like 60+, not just 30. The thinking on the acceptable levels of vitamin D is changing in the medical community, and most doctors I've spoken to, including my kids' very mainstream pediatrician, feel that 30 is too low. When DD was diagnosed as deficient, I was tested as well (I was breastfeeding her) and my level was 30ish (can't remember exactly now). I took 10,000iu a day to get back up to decent levels. That was in the summer, with lots of natural sunshine exposure as well. Now I take at least 5000iu a day to maintain. More in the winter. My daughter now weighs 40lbs and is 3.5yo, and she takes 1000-2000iu a day. My sons are weaning off formula, and I'm starting them on 1000iu a day pre-emptively. The formula kept their levels decent through infancy, but without it I'm sure they will need supplementation as well. They are 14 months old and weigh 30lbs.

 

I don't know how big your 9yo is, but I'd be totally comfortable with a temporary dose of 3000iu/day for my 3.5yo if she was seriously deficient. It is hard to OD on vitamin D. Definitely make sure it is D3 though. If you live somewhere where it's currently warm, try to get lots of outside time too!

Edited January 26, 2012 by AdventureMoms

[Angjune]

I think when my son's was really low, he had to take 50,000 IU for several weeks and then take the 2,000 daily. Its just hard getting him to remember to take it every day.

[Rod Everson]

I think when my son's was really low, he had to take 50,000 IU for several weeks and then take the 2,000 daily. Its just hard getting him to remember to take it every day.

 

Just to be clear, he was probably taking a 50,000 IU dose once a week, right? A daily dose of that amount would be way too much if sustained for a few months.

 

Incidentally, the researchers seem to be in reasonable agreement with getting the blood level up to around 50-60 ng/ml. That's about the middle of the 30-100 range now recommended, and that range is higher than it used to be also.

 

Dr. Cannell is speculating that one should probably shoot for close to the high end of the range with an autistic, or autistic spectrum, child just to see if that level will have a treatment effect. According to some parents, it has.

[annlaura]

This is a bit off-topic, and it's not directed at you, but at others who use drops. Dr. Cannell got a letter once from a mother who'd been administering one dropperful, instead of just one drop, to her child. The result was a massive overdosing of the child over time and some repercussions that I don't recall right now.

 

My daughter just had her first child and has been instructed to supplement with vitamin D3. (I think this is going to be an up and coming thing with pediatricians, by the way, because I doubt that my granddaughter even needs the supplement because her mom's high enough in vit D3 to pass it through in feedings.)

 

Anyway, I noticed that the instructions on her particular bottle of D3 were to administer a dose of one dropperful, so they've really diluted it down, possibly to prevent the sort of overdose occasioned by a poor reading of directions.

 

Also OT a bit, but it was my understanding that D doesn't pass through the mother to the baby well, hence the D3 drops across the board for those babies.

[Alphabetika]

My dd was found to be very low in vitamin D and she took a prescription of 50,000 IU for about 6-8 weeks, then take a maintenance dose of 2,000 a day. But she was 16 at the time, and a girl, so I think that may make a difference in what is recommended. It did help a lot.

[HiddenJewel]

Just to be clear, he was probably taking a 50,000 IU dose once a week, right? A daily dose of that amount would be way too much if sustained for a few months.

 

 

For an adult 50,000iu a day for at least a month was good for me, dropping to 50,000 twice a week after that. Don't know on a younger child.

[Rod Everson]

Also OT a bit, but it was my understanding that D doesn't pass through the mother to the baby well, hence the D3 drops across the board for those babies.

 

I believe there's some research out there that indicates mother's milk will contain vitamin D once the mother's blood level is above about 50 ng/ml. In fact, that's one reason some of the researchers feel we should set that level as a floor.

 

Then there's the issue of how high the mother's level needs to be while she's pregnant. Vitamin D3 is important during gestation too, and the only source is the mother's blood supply.

[Rod Everson]

For an adult 50,000iu a day for at least a month was good for me, dropping to 50,000 twice a week after that. Don't know on a younger child.

 

Wow, that's a lot. Did you have testing done so you know where you ended up, and what level you're maintaining?

 

Most people would not require anywhere near that amount, either initially to get their level up, or on an ongoing maintenance basis. In fact, some would probably become vitamin D toxic over time with those levels and start to experience related health issues.

[HiddenJewel]

Wow, that's a lot. Did you have testing done so you know where you ended up, and what level you're maintaining?

 

Most people would not require anywhere near that amount, either initially to get their level up, or on an ongoing maintenance basis. In fact, some would probably become vitamin D toxic over time with those levels and start to experience related health issues.

 

I was on the 50,000 for month and then dropped down to 50,000 twice a week for 3 months. My level after that was 138 with good calcium levels. My doctor's office was very happy with that. But then they also feel that 50 is a very low minimum.

Edited January 26, 2012 by HiddenJewel

[Rod Everson]

I was on the 50,000 for month and then dropped down to 50,000 twice a week for 3 months. My level after that was 138 with good calcium levels. My doctor's office was very happy with that. But then they also feel that 50 is a very low minimum.

 

Makes me feel a lot better that you were keeping on top of it. Some people just "wing it" with supplementation.

 

As you found, though, that level of supplementation got you up pretty high, and quite quickly. 138 is well above the recommended 100 maximum so I'm surprised you found a physician who would want you that high. Problems start at levels not much higher than that, say as you approach 200 ng/ml, and if you weren't keeping on top of it, you could have easily reached those levels.

 

In fact, I'd be curious whether you might still be going up from the 138 if you're taking that much yet every week. It appears that you're not though from what you said above. What maintenance dose did they recommend, assuming they wanted you to stay that high?

 

As for 50 being quite low, that's probably not accurate, though your physician might view it as a minimum he/she would want you at. Personally, I aim for 60-80, but I view 80 as a level that I don't want to get much above, certainly not above 100.

 

Dr. Cannell summarizes a lot of research at his website, and people who spend a lot of time in the sun stabilize somewhere between 50 and 80 ng/ml. Lifeguards, for instance, as well as a recent study of two equatorial populations. Lifeguards tended to range 50-80, and the two small black populations near the equator right around 50, with some 10-15 points below that and some about that much higher. These studies are important, because vitamin D3 production from sunshine is self-regulating. After sufficient sunshine is received, production shuts down. So those studies indicate naturally occurring levels under intense sun are well under 100 ng/ml.

[HiddenJewel]

Makes me feel a lot better that you were keeping on top of it. Some people just "wing it" with supplementation.

 

As you found, though, that level of supplementation got you up pretty high, and quite quickly. 138 is well above the recommended 100 maximum so I'm surprised you found a physician who would want you that high. Problems start at levels not much higher than that, say as you approach 200 ng/ml, and if you weren't keeping on top of it, you could have easily reached those levels.

 

In fact, I'd be curious whether you might still be going up from the 138 if you're taking that much yet every week. It appears that you're not though from what you said above. What maintenance dose did they recommend, assuming they wanted you to stay that high?

 

As for 50 being quite low, that's probably not accurate, though your physician might view it as a minimum he/she would want you at. Personally, I aim for 60-80, but I view 80 as a level that I don't want to get much above, certainly not above 100.

 

Dr. Cannell summarizes a lot of research at his website, and people who spend a lot of time in the sun stabilize somewhere between 50 and 80 ng/ml. Lifeguards, for instance, as well as a recent study of two equatorial populations. Lifeguards tended to range 50-80, and the two small black populations near the equator right around 50, with some 10-15 points below that and some about that much higher. These studies are important, because vitamin D3 production from sunshine is self-regulating. After sufficient sunshine is received, production shuts down. So those studies indicate naturally occurring levels under intense sun are well under 100 ng/ml.

 

I am very glad to have a doctor's office that tries to stay up on current research as I prefer individualized treatment vs. checking off boxes that supposedly fit the masses. My understanding is that if you are going toxic with vitamin D, other levels (like calcium) will also be elevated. So thus you need to watch at least both those lab levels.

 

I like the lifeguard illustration as that makes sense to me.

Edited January 26, 2012 by HiddenJewel

[Angjune]

Yes, he was taking it once a week. Incidentally, my daughter also had low vitamin D but not nearly as low as my son's. The doctor she was going to recommended a similar dose but twice a week for about three months. My dd was younger, very petite, and I thought the dose might be too high for her. I asked her pediatrician about it since I was concerned and he said that she didn't need that high of a dose since her levels weren't that low.

[Rod Everson]

My level after that was 138 with good calcium levels. My doctor's office was very happy with that. But then they also feel that 50 is a very low minimum.

 

I got to thinking some more about your comment that your doctor thought 50 was a "very low minimum."

 

Is there a chance you're from Canada, or another country that uses the nanomoles/Liter (nmoh/L) rather than the U.S. method of nanograms/milliliter (ng/ml)?

 

This is important because 50 nmoh/L is the equivalent of 20 ng/ml in the U.S., and both of those levels are indeed low levels. To get to 50 ng/ml, you'd have to be at 125 nmoh/L.

 

You multiply the U.S. measurement by 2.5 to get the equivalent in the Canadian system.

 

Just wondered if that was the case with your numbers, because I really can't imagine a U.S. physician thinking 50 ng/ml is a "very low minimum."

[HiddenJewel]

I got to thinking some more about your comment that your doctor thought 50 was a "very low minimum."

 

Is there a chance you're from Canada, or another country that uses the nanomoles/Liter (nmoh/L) rather than the U.S. method of nanograms/milliliter (ng/ml)?

 

This is important because 50 nmoh/L is the equivalent of 20 ng/ml in the U.S., and both of those levels are indeed low levels. To get to 50 ng/ml, you'd have to be at 125 nmoh/L.

 

You multiply the U.S. measurement by 2.5 to get the equivalent in the Canadian system.

 

Just wondered if that was the case with your numbers, because I really can't imagine a U.S. physician thinking 50 ng/ml is a "very low minimum."

 

No. I'm in the US. Like I said earlier, it is an MD office that is willing to step outside the bounds of "normal" and go with what makes sense for the health of the patient.

Edited January 31, 2012 by HiddenJewel

[AdventureMoms]

I got to thinking some more about your comment that your doctor thought 50 was a "very low minimum."

 

Is there a chance you're from Canada, or another country that uses the nanomoles/Liter (nmoh/L) rather than the U.S. method of nanograms/milliliter (ng/ml)?

 

This is important because 50 nmoh/L is the equivalent of 20 ng/ml in the U.S., and both of those levels are indeed low levels. To get to 50 ng/ml, you'd have to be at 125 nmoh/L.

 

You multiply the U.S. measurement by 2.5 to get the equivalent in the Canadian system.

 

Just wondered if that was the case with your numbers, because I really can't imagine a U.S. physician thinking 50 ng/ml is a "very low minimum."

 

My DD's ped. considers 50ng/ml to be "iffy" and "supposedly ok, but on the low side". He's an otherwise very mainstream MD in a small town.

[Rod Everson]

No. I'm in the US. Like I said earlier, it is an MD office that is willing to step outside the bounds of "normal" and go with what makes sense for the health of the patient.

 

Yes, I'd prefer to keep mine above 50 ng/ml also, but not above 100. The amount of vitamin D3 that naturally occurs when getting a lot of sun exposure tends to peak out below 100 (probably more like 80) and that's because the body has a self-regulating system that reverses the process once too much sunlight is being received.

 

That self-regulatory process isn't effective, however, when we supplement, and it doesn't seem to make much sense to get levels above 100. The real problem is that many people are running around at less than 20 and suffering some serious health effects as a result.

 

Anyway, I just wanted to make sure we were talking the same numbers. It was the 138 that you mentioned earlier that bothered me, and made me wonder if we were comparing apples and oranges here, especially when you implied that your doctor was had no problem with the 138 level.

[Rod Everson]

My DD's ped. considers 50ng/ml to be "iffy" and "supposedly ok, but on the low side". He's an otherwise very mainstream MD in a small town.

 

Yes, I agree that we should shoot for higher numbers with 50 as a "floor", but to me higher is 60-80, not 60-140 or so. I suspect that your doctor would be uncomfortable with a number much over 100, but I could be wrong.

 

Having said that, if everyone was right at 50 we'd probably have a lot healthier population than we do today. Even 50 might be enough. We really don't know for sure.

[AdventureMoms]

Vitamin D is necessary for all children.it can be gain by the sunlight.

 

Not if you live in northern lattitudes. Most of the US does not get enough usable vitamin D via sunshine for most of the year, even if we were outside naked all day long. And most people who do live in sunny enough climates spend too much time indoors to get enough D.