There are a few different ways to get vitamin D. Vitamin D may come from foods or vitamin supplements; vitamin D can also be made by the skin when it is exposed to ultraviolet rays (UV light).
Vitamin D deficiency is often missed because there are no real symptoms associated with it. Rickets and osteomalacia (softening of the bones) are the most common signs of vitamin D deficiency but there is no way for parents to tell if their child is suffering from these illnesses. The only way to prove that your child is vitamin D deficient is by completing a blood test which screens for a particular form of vitamin D, called 25-hydroxyvitamin D (25(OH)D).
Think that name sounds complicated? Unfortunately, many doctors do too. In fact, doctors often order the wrong blood test when assessing vitamin D levels. Be sure to ask for 25(OH) D blood test not 1, 25-dihydroxy-vitamin D (aka calcitriol). With such complicated names, it is no wonder that such mistakes are made!
Vitamin D deficiency exists when 25(OH) D levels fall below 25 ng/mL. Levels may vary depending on time of year, direct sunlight exposure, skin color and vitamin D consumption. Levels should be between 50 - 80 ng/mL year-round for both children and adults.
As a doctor, I am finding more and more children with low levels of vitamin D, mainly because kids are spending less time in the sun. These days, toddlers are more often inside watching TV than playing outside. And if they are in the sun, they are lathered with sun block, which reflects the sun's rays and decreases vitamin D formation. Obviously, sunscreen is important and should not be avoided! But it does lead to lower levels of vitamin D. Also, many toddlers do not get enough vitamin D to meet their needs since there are limited food sources of high vitamin D content.
The current recommendation is 400 IU per day in the form on of vitamin D3 (cholecalciferol). New studies are showing that higher levels may be needed to prevent the diseases discussed above. Many are now recommending 1,000 IU per day in the form of vitamin D3 (cholecalciferol). If your child doesn't get this amount of vitamin D in his diet, you may want to consider a multivitamin that contains vitamin D.
What Should I do?
1. Get at least 10 minutes, 3 times per week of sun exposure.
Although this may sound easy to do, certain location like colder regions may not provided enough UV light and in warmer climate this may increase the risk of skin cancer.
2. Consume foods that contain vitamin D.
Foods that contain Vitamin D include fortified milk, fortified yogurt, fortified breakfast cereals, wild salmon, canned tuna, cod liver oil, sun-dried shitake mushrooms and egg yolks.
3. Take a supplement.
Taking a daily vitamin supplement is the most effective means of meeting vitamin D needs. Take one multi-vitamin that contains at least 1000 IU of vitamin D daily OR supplement with a calcium pill that contains at least 1000 IU of vitamin D per day.
Joanna Dolgoff MD is a Pediatrician, Creator of Dr. Dolgoff's Weigh: Online Child & Teen Weight Management and Mommy of two.
Dr. Dolgoff's Weigh has been featured on NBC, ABC, Fox 5, WPIX & My9 News & boasts a 96% success rate!
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