SAN FRANCISCO – Vitamin D deficiency is common among children and adolescents, particularly those with chronic disease, Catherine Gordon, MD, said at the annual meeting of the American Academy of Pediatrics.
Yet the precise definition of vitamin D deficiency and the healthy threshold for vitamin D levels lack universally agreed-upon standards. Generally speaking, levels of at least 30 ng/mL (75 nmol/L) appear safe and reasonable for children with chronic disease, and additional research is confirming whether this range is appropriate for other pediatric groups as well. Although too much vitamin D can lead to hypercalcemia, vitamin D intoxication is very rare, said Dr. Gordon, director of the division of adolescents and transition medicine at the University of Cincinnati.
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Those at the highest risk for vitamin D deficiency include people who eat an inadequate diet and/or get inadequate exposure to sunlight, including those who live in high latitudes or use sunscreen frequently. Obesity, malabsorption issues, taking anticonvulsants, and having a dark skin pigmentation are additional risk factors. Malabsorption can result from conditions such as celiac disease, cystic fibrosis, inflammatory bowel disease, or kidney problems.
Severe vitamin D deficiency can lead to rickets, when bones have insufficient calcium and phosphorus levels, resulting in bone softening and weakening before growth plates close. If not treated with vitamin D and calcium supplementation, rickets becomes osteomalacia after the growth plates close.
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