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Inappropriate supplementation of Vitamin D can result in toxicity: a crosssectional study of paediatrics population
Nazia Shamim1, Hafsa Majid2, Suneeta Khemani1
1Department of Paediatrics, and Child Health, Aga Khan University Hospital, Karachi, Pakistan.
Insights
Vitamin D toxicity in children is a growing concern. This study found that excessive vitamin D supplementation, especially mega-doses, can lead to serious health issues like abdominal pain and constipation.
Area of Science:
- Pediatrics
- Endocrinology
- Clinical Pharmacology
Background:
- Hypervitaminosis D, or vitamin D toxicity, is a condition resulting from excessive intake of vitamin D.
- While vitamin D is essential for bone health, elevated levels can lead to adverse effects.
Purpose of the Study:
- To investigate the prevalence, clinical features, and pharmacological aspects of hypervitaminosis D in children.
- To understand the patterns of vitamin D supplementation and associated toxicity in pediatric populations.
Main Methods:
- A retrospective cross-sectional study analyzing medical records of children (<18 years) with 25-hydroxyvitamin D levels >50ng/ml.
- Data collection included clinical and pharmacological information from January 1 to December 31, 2018.
- Statistical analysis was performed using SPSS 23.
Main Results:
- Out of 16,316 children tested, 602 (22%) had elevated 25-hydroxyvitamin D levels (>50ng/ml), with a median of 70.1ng/ml.
- Vitamin D supplementation was noted in 197 children, with 68 receiving mega-doses, often prescribed for pain, developmental delay, or deficiency.
- Reported symptoms of toxicity included abdominal pain (13.7%) and constipation (15.7%).
Conclusions:
- Vitamin D supplements should be administered cautiously in children.
- Prolonged supplementation and repeated mega-doses of vitamin D can result in toxicity with potentially serious consequences.
- Awareness of hypervitaminosis D symptoms and judicious prescribing practices are crucial.
Objective:
To evaluate children with suspected or definite hypervitaminosis D with respect to prevalence, clinical manifestations and pharmacological aspects.
Methods:
The retrospective cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, and comprised medical records from January 1 to December 31, 2018, of children aged <18 years with 25-hydroxyvitamin D levels >50ng/ml. Clinical and pharmacological data was retrieved. Data was analysed using SPSS 23.
Results:
Of the 118,149 subjects visiting the clinical laboratory during the study period, children tested for serum 25-hydroxyvitamin D levels were 16,316(13.8%) who had a median age of 9.78 years (interquartile range: 10.2 years). Children who registered for consultation were 2720(16.6%), and, out of them, 602(22%) had serum 25-hydroxyvitamin D >50ng/ml. The median 25-hydroxyvitamin D levels and age were 70.1ng/ml (interquartile range: 100ng/ml) and 3.1 years (interquartile range: 17.93 years), respectively, and 345(57.3%) of them were boys. Children supplemented with vitamin D were 197(33.1%) and 193(97.9%) of them were prescribed by physicians. Mega-doses were taken by 68(34.17%), while the remaining had used various combinations in syrup or tablet forms. Commonly prescribed mega-doses were 600,000IU 30((44.1%) and 200,000IU 31(45.5%) injections of vitamin D. The primary indications were pains/aches in 51(25.8%) cases, developmental delay 50(25.3%), and vitamin D deficiency 49(24.8%). The main symptoms of hypervitaminosis D or toxicity were abdominal pain 27(13.7%) and constipation 31(15.7%).
Conclusions:
Children should be given vitamin D supplements with caution as prolonged supplementation and repeated mega-doses can result in toxicity which may cause serious consequences.
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