Vitamin D-3

HELLO ALL
Has anyone here been prescribed vitamin D-3 (cholecalciferol). Hassan has been prescribed 10 drops at one go. Is the dosage too high since his calcium and phosphorus tests were ok? The bottle just says 1ml=4500IU, all other instructions are in german and I can`t make head or tail of it. When I checked on the net I landed on a site that said danger. Cholecalciferol over dosage has many undesirable side effects. Any feedback will be appreciated.
thankyou,
MAHA

Hi,

I am taking another form of Vitamin-D it is called Alfacalcidol. My calcium were on the lower margin of normal range. I am experiencing joint pains and can't walk for few minuets.

That's all I know about it. No one warned me about any ill effects and I've been using it for a month and my doctors say that it will take time.

Sajid,

Have you checked the possibility of Osteoprosis, Joint pains are not good at this age. Infact we have seen a case where the patients complained about joint pains and she was put to calcium and vitamin D dosage plus regular Gym sessions. She is improving now.

Regards

There are about 20 drops in a ml. That dosage would be about 2250 IU daily which does seem a bit high, although researchers are finding that we often need much higher doses of D than previously thought. Please ask the doctor about the dosage and make sure it is safe for a child.

ALL thals should be taking vitamin D along with calcium regardless of bone health. The long term picture for thals requires supplementation before bone weakening takes place.

Sajid, what dose of D are you taking?

Hi Again,
Vitamin D-3 is usually prescribed for children with rickets. Hassan is 15 months now and is a little short for his age. Moreover his skull bone has not joined completely as yet. (it has not started to seperate). His calcium is on the higher margin of the normal range and that`s the reason this dose is frightning me. More vitamin D means more calcium will be absorbed. The doc (THAL SPECIALLIST) herself recommended this dose but it was over the phone. Thats why I am so unsure.
thanks again
MAHA

Yes Canadian_Family, Osteoprosis is kicking in for me. I have been recomended exercise and I try to do as much I can tolerate since it is Summer.

Andy, I am taking 0.5µg (microgram) of Alfacalcidol daily

Sajid, .5 mcg of Alfacalcidol is a low dose, as the starting dose is usually 1 mcg. You may eventually be raised to a higher dose.

Maha, prescribing vitamin D for thals is routine and nothing to be alarmed about. Starting at a young age can prevent problems that will occur later on. A good article about D and thal can be found at

http://www.thalassemia.com/vit_d_2.html

For individuals who have thalassemia major standard recommendations may not be adequate. A Greek study revealed that individuals who had transfusion dependent thalassemia and who were using desferoxamine for iron overload (these subjects had average serum ferritins greater than 3000 ng/ml) had low levels of vitamin D metabolites... Osteoporosis is common in thalassemia major and can be modified by an adequate intake of calcium, vitamin D, and in hypogonadism hormone replacement. Individuals who have osteoporosis may require much higher doses of vitamin D to maintain or increase bone density, 800 to 1000 IU per day has been recommended by some experts. An Italian study of bone density in patients with thalassemia showed that only the most severe phenotype (bo/bo) had a decrease in bone density. However, a large daily intake of calcium and vitamin D could lead to hypercalciuria and hypercalcemia; supplementation at higher than recommended doses requires careful monitoring.

There is a great need for vtamin D supplementation in thals but I do question the apparent high dosage Hassan has been placed on. Please consult with your doctor and ask about this dose. Is it over 2000 IU daily and if so, is this a temporary measure? Recent research has shown that higher doses may be needed for some conditions, but is 2000 IU safe for a child?

Hi Andy,
I got the German instructions translated (thanks to the web). It states 1ml=45drops and 1drop=100IU.The doctor originally had prescribed 45 drops. I felt she meant 4-5 drops. She had asked me to call her once his ALK-P reports arrived, so that she could adjust the dose and that`s when she said 10 drops. I gave him 8 drops to start with (800IU),since all undesirable effects were recorded with doses above 1000IU.Hopefully those two drops doesn`t delay anything.
thankyou
MAHA

hi
No more vitamin D 3 for Hassan. His paediatrician said V D3 was prescribed only when the child had Rickets and according to him Hassan did not show any symptoms. He said if we wanted he would do an X-Ray, but better still it would be if we kept him in the sun for about 10 min. Since Hassan is fair skinned that much exposure would be enough to meet his D3 requirements. Why can`t all doc`s hold the same opinion??
Bye
MAHA

Hi Maha,

Vitamin-D is not only for Rickets. Like in my case it is prescribed for the Oesteoprosis to increase my calcium absorption.

Your child is pretty young and it is unlikely that Oesteoprosis has started but to be on the safe side, ask your doctor about it for Hassan. I think you should follow what the doctor says about Rickets. If it is evident that he is developing Rickets then you should give Vitamin D otherwise don't.

Hi Sajid
Vitamin D is available in many forms. Vitamin D2, Vitamin D3, D12 etc...The most common form being D2 which is usually found in multivitamins. D3 is obtained from sunlight and is administered only in case of Rickets(in children) and osteomalacia( in adults). I just found over the net that in Rickets the calcium level in children are down to 2-3. Alhamdulillah Hassan`s serum calcium is 10.2, so it is highly unlikely that he has rickets. I was worried as Hassan is still not walking.

Vitamin D is regularly prescribed for thals and it has nothing to do with rickets. Vitamin D is absolutely necessary for proper absorption of calcium, which is another supplement normally prescribed for thals. The two act together to help prevent the bone loss which occurs in thalassemia.

Sunlight is an excellent source of vitamin D. Daily exposure for 10-30 minutes will normally provide all the D one needs, although the requirements of thals may be greater, resulting in the need for supplementation. Dark skinned people need more sun than fair skinned, in order to create the same amount of D. It is always advised to avoid the mid-day sun.