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Reviewed by

Dr. S. Sivaraj

Consultant - Orthopaedic Spine Surgeon

Manipal Hospitals, Salem

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Early Signs And Symptoms Of Vitamin D And Calcium Deficiency In Children

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Strong bones are the cornerstone of optimal skeletal health, providing essential support and structure. In achieving a healthy body, two key nutrients play a major role: vitamin D and calcium. Vitamin D, functioning as a hormone, and calcium, as a mineral, are essential nutrients crucial for maintaining strong bones. This blog delves into the specifics of vitamin D and calcium, exploring their individual functions and how deficiency of Vitamin D and Calcium can impact bone health.

Synopsis

The Importance of Vitamin D and Calcium
How Much Vitamin D and Calcium Do You Need?
What are the Symptoms of Vitamin D Deficiency?
What are the Causes of Vitamin D Deficiency?
What are the Signs and Symptoms of Calcium Deficiency?
How Do You Get Vitamin D and Calcium?
Conclusion

The Importance of Vitamin D and Calcium

Vitamin D and calcium play vital roles in facilitating muscle movement, supporting nerve communication, promoting the absorption of calcium and phosphorus (vitamin D), and contributing to immune system responses (vitamin D). They also facilitate cell-to-cell signalling (calcium), aid in hormone secretion (calcium), and support blood vessel function (calcium).

Low levels of vitamin D or calcium can cause the parathyroid glands to overproduce their hormone, leading to hyperparathyroidism. This condition can result in bone weakening (osteoporosis) and an increased risk of fractures.

Additional issues related to deficiencies in calcium and vitamin D include:

Skeletal deformities like rickets in children aged 6-24 months.
Muscle weakness, particularly in children and the elderly (due to vitamin D deficiency).

How Much Vitamin D and Calcium Do You Need?

The table below outlines the recommended daily allowances (RDA) and maximum intake levels for calcium and vitamin D across various age groups and conditions:

Age	Calcium RDA (mg)	Calcium Max (mg)	Vitamin D RDA (IU)	Vitamin D Max (IU)
0-6 months	200	1000	400	1000
260	1,500	1500	400	1500
1-3 years	700	2,500	600	2500
4-8 years	1,000	2,500	600	3000
9-13 years	1,300	3,000	600	4000
14-18 years	1300	3,000	600	4000
18 or younger, pregnant/lactating	1,300	3,000	600	4000
19-50, pregnant/lactating	1,300	2500	600	4000
19-30 years	1,000	2500	600	4000
31-50 years	1,000	2500	600	4000
51-70 years (male)	1,000	2000	600	4000
51-70 years (female)	1200	2000	600	4000
70+ years	1200	2000	800	4000

What are the Symptoms of Vitamin D Deficiency?

Knowing the vitamin deficiency symptoms in children helps identify potential health issues caused by low vitamin levels.

Children (Severe Deficiency - Rickets)

Pain in legs, ribs, or lower back
Muscle Weakness
Persistent tiredness or lack of energy
Discomfort or stiffness in joints
Mood Changes
Painful muscle contractions, often in the legs
Slower recovery from injuries or illnesses
Thinning or loss of hair
Increased susceptibility to infections
Weakened immune system response
Abnormal growth patterns with bowed or bent bones
Restless Sleep
Poor Concentration
Digestive Issues

What are the Causes of Vitamin D Deficiency?

The causes of someone being vitamin D deficient include the following:

General Causes

Not enough vitamin D in the diet or sunlight exposure.
Poor absorption or utilisation of vitamin D by the body.

Specific Causes

Medical conditions like cystic fibrosis, Crohn's disease, or celiac disease can impair vitamin D absorption
Weight loss surgeries
Certain medications
Biological factors such as older age and high melanin levels in the skin can increase risk

Medical Conditions Associated with Vitamin D Deficiency

Cystic fibrosis, Crohn's disease, and celiac disease affect vitamin D absorption
Obesity (BMI > 30) can trap vitamin D in fat cells, requiring higher supplement doses
Kidney and liver diseases reduce enzymes needed to activate vitamin D, leading to insufficient levels

What are the Signs and Symptoms of Calcium Deficiency?

A lack of calcium may not show symptoms immediately, but it can lead to conditions like osteoporosis without warning signs until a bone breaks. When calcium deficiency symptoms do appear, they can include:

Burning/tingling sensation in hands and feet
Muscle cramps
Excessive nervousness
Headaches
Numbness around the mouth, fingers & toes
Dry, rough skin
Patchy hair loss, such as thinning eyebrows
Muscle spasms in hands, feet, or arms
Fatigue and weakness
Irregular heart rhythm
Brittle Nails
Tooth Decay
Tingling Sensations
Delayed Puberty

Seek medical attention from our Orthopaedic Doctor in Salem if you experience these symptoms. Severe low blood calcium levels can lead to serious health issues like kidney damage, depression, seizures, or coma.

How Do You Get Vitamin D and Calcium?

Vitamin D is synthesised by your body when your skin is exposed to sunlight. However, several factors can limit its production:

Living above latitude 33 degrees (north of the top of Louisiana)
Using sunscreen to prevent melanoma
Having naturally dark skin
Aging, which reduces the skin's ability to absorb sunlight effectively

The amount of sun exposure needed to achieve normal blood levels of vitamin D is often more than what is considered safe for your skin. Therefore, most people may require supplements to maintain adequate vitamin D levels.

Both forms of vitamin D (D2 and D3) benefit the body, but only a few foods naturally contain this nutrient or are fortified with it. Hence, doctors commonly recommend supplements to bridge this gap.

Food Rich in Calcium and Vitamin D include:

Vitamin-D Foods	Calcium Rich Foods
Cod liver oil	Collard greens, frozen
Wild-caught salmon	Broccoli rabe or fresh, cooked
Farmed salmon	Kale, frozen
Canned salmon	Soy Beans, green, boiled
Canned sardines	Bok Choy, cooked, boiled
Canned mackerel	Figs, dried
Canned tuna	Oranges: 1 whole
Fresh shiitake mushrooms	Sardines, canned with bones
Egg yolk	Salmon, canned with bones
Sun-dried shiitake mushrooms	Shrimp, canned

Additionally, various foods such as milk, orange juice, infant formula, yoghurt, margarine, butter, cheese, and breakfast cereals are fortified with vitamin D.

Conclusion

Your child's bones need calcium and vitamin D to stay strong and healthy. Calcium comes from different foods, while vitamin D is found in some foods and from sun exposure. If your child is not getting enough calcium or vitamin D, or if a blood test shows their low levels, talk to their doctor about taking supplements. Visit our Orthopaedic Hospital in Salem to learn more about Vitamin D and Calcium deficiencies. Check our blog page for the latest medical updates.