The vitamin D toxicity in children It is rare, but real and potentially serious: an excessive dose, especially due to errors with drops or different concentrations, can cause hypercalcemia and significant damage to children’s health.
Vitamin D toxicity in children: an avoidable risk
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Vitamin D supplementation is safe and necessary in childhood, but errors in dosage can cause serious toxicity with renal and cardiac consequences.
The vitamin D It is essential for everyone, but especially for children: its chronic deficiency causes rickets. It is common for the pediatrician to prescribe vitamin D to supplement young children, it is effective and safe… as long as the stipulated doses are respected: an excess can cause serious toxicity problems. Pay close attention to the dosage of each product.
Why vitamin D can cause toxicity in children
The vitamin D it’s a vitamin essential in both childhood and adulthood. It is essential for the health of the bone system, teeth and immune system.
Among many other things, vitamin D allows intestinal absorption of the phosphorus and calcium that we ingest in the diet. And that is precisely where the risk of excess vitamin D lies, since having high levels of calcium in the blood (hypercalcemia) can be very dangerous.
Be careful with excess calcium
Depending on how serious it is, hypercalcemia can cause:
- Lack of appetite, vomiting, constipation.
- Lots of thirst and lots of urine.
- Weakness, drowsiness, irritability.
- In the long term, serious kidney damage.
- In extreme cases, serious heart problems.
Sources of vitamin D
Where do we get vitamin D? Well mainly, thanks to the effect of sunlight and From the cholesterol present in our skin, we synthesize it ourselves.
Y to a lesser extent also through diet well There are some foods that contain it: mainly fatty fish, mushrooms and mushrooms that have been exposed to the sun and, although in smaller quantities, we also find it in eggs and full-fat dairy products.
Haysome population groups that are less exposed to sunlight and require more attention.
That is the case of the smallest children, babieswhich are not usually exposed to much sunlight. Additionally, breast milk is not rich in vitamin D, which is why The recommendation of pediatricians is to supplement the diet of healthy children under one year of age with 400 IU (international units) per day of vitamin D.even if they drink adapted formula milk (unless they drink at least one liter daily, which would already provide the necessary amount of vitamin D).
In children over one year old, recommendations change and supplementation must be individualized, assessing whether there is a vitamin D deficiency and whether there are risk factors, such as little exposure to light, obesity, diseases that reduce intestinal absorption of the vitamin present in the diet (intestinal malabsorption, celiac disease, Crohn’s disease, etc.) or the use of certain medications that negatively affect vitamin D.
Vitamin D-based medications
Most vitamin D medications contain cholecalciferol, which is the natural form of vitamin D from animal sources. which in our body is transformed, through several steps, into calcitriol, which is the active form of the vitamin. There are also medications that contain some of the intermediate forms, for example calcifediol.
Regarding its presentation, there are a multitude of pharmaceutical forms: tablets, capsules, oral drops, sachets, oral ampoules… and at different concentrations and in different administration patterns (daily, once a week, once a month, etc.). In the case of medicines for children, these are usually in liquid form and are taken daily.
1. Oral solutions with cholecalciferol
In this table you will see the oral solutions based on cholecalciferol that are sold in Spain for children, which are commonly used.
| Mark | Concentration | IU per drop | Number of drops equivalent to 400 IU |
| Cholecalciferol Standard oral drops solution (10 ml) | 10,000 IU/ml | 200 UI | 2 drops |
| Delcrin oral drops solution (10 ml) | 10,000 IU/ml | 200 UI | 2 drops |
| Deltius oral drops solution with dropper (10 ml) | 10,000 IU/ml | 200 UI | 2 drops |
| Devik oral drops solution (10 ml) | 10,000 IU/ml | 200 UI | 2 drops |
| Vitamina D3 Fresenius Kabi oral drops solution (12.5 ml) | 14,400 IU/ml | 400 UI | 1 drop |
| Vitamina D3 Kern Pharma soral solution dropper (10 ml) | 2,000 IU/ml | 66 UI | 6 drops |
| Vitamina D3 Kern Pharma oral solution (30 ml) + 1 ml syringe | 2,000 IU/ml | n.p. | 0,2 ml |
2. Calcifediol
Along with these, which are the most common, in pediatrics a medicine based on calcifediolbut only for the treatment of rickets or diagnosed vitamin D deficiency. It is Hydroferol oral drops in solution (concentration 0.1 mg/ml), which is administered daily: the dose is 1 drop in children under 11 years of age, and 2 drops from 12 years of age.
Pay attention to doses
The cases of vitamin D overdose toxicity due to administration errors They are not frequent, but they occur with a certain periodicity. In fact, in Spain there have been dozens of overdose casessome serious, which have required hospital admission. Recurrent cases of problems caused by errors with drops have also been described in babies and children.
Es It is very important to always read the medication leaflet that they have dispensed to us since it explains well how much to take.
How to safely give vitamin D to a child
If the pediatrician has prescribed vitamin D for your child, these ideas can help you:
- Follow exactly the dosage that has been indicated to you. It arises “6 drops once a day“, that’s 6 drops total once a day, not 6 drops spread throughout the day. Do not change the dosage on your own.
- Always check the concentration of the container. Although the commercial name is similar, the amount of vitamin D per drop varies between some brands.
- If they change your medication at the pharmacy, ask them to explain how many drops equal to the prescribed dose.
- Do not use several products with vitamin D at the same time. Avoid giving vitamin D medications along with multivitamin food supplements and a milk of “adapted formula“, unless the pediatrician has evaluated it. Remember to comment in the reviews on all the products that the child takes (including “natural” supplements).
- Don’t give vitamin D on your own “just in case.” If your child is healthy, eats well and the pediatrician has not indicated it, it is not a vitamin to take lightly.
- Follow the doctor’s instructions, Don’t get carried away by what is said on social networks or forums.
- Keep it out of the reach of children. Like any medication, it should be stored in a safe place.
- Ask any questions. If you are not clear with the drops, syringe or dose, consult your pediatrician or pharmacist before giving them.
