Confusion about Vitamin D and Calcium for kids
February 21, 2013 12:50 PM   Subscribe

Kid BlahLaLa's pediatrician wants him to take a calcium supplement, because he's never been into milk and doesn't eat very many milk products. But Kid BlahLaLa, who is almost 10, refuses all children's calcium supplements as too gross-tasting. (He's not ready to swallow pills.) He will accept a particular adult supplement, but when I combine that with his usual daily multi-vitamin I'm worried that I'm overdosing him on Vitamin D. There's so much woo on teh internets that I can't seem to get a straight answer about how much is too much.

His daily (adult) calcium supplement provides 1000 IU of Vitamin D, 500mg of calcium and 200mg of phosphorus.

His daily (kids) multi-vitamin provides 80IU of Vitamin D + a bunch of other stuff, but no calcium or phosphorus.

Can anyone point me in the direction of non-woo, mainstream medicine facts re: these amounts and if I'm in a safe or danger zone?
posted by BlahLaLa to Health & Fitness (32 answers total)
Too much vitamin D is, indeed, bad. I have a daily multivitamin and I have to shop around like crazy to find *just* calcium, but it is possible to get just-calcium.

Adult calcium can be found in chewable form. It tastes like chalk.
posted by tel3path at 12:55 PM on February 21, 2013

I think the toxicity section of this Wikipedia article has you covered. It says 4,000 IU per day is the tolerable upper limit.
posted by jeffkramer at 12:56 PM on February 21, 2013 [1 favorite]

Can you get him a gummy calcium supplement instead of the pills?
posted by zizzle at 12:57 PM on February 21, 2013

Best answer: Or perhaps some tums?
posted by Ruthless Bunny at 12:59 PM on February 21, 2013 [8 favorites]

Best answer: I assume you've seen this?
posted by ook at 1:00 PM on February 21, 2013 [1 favorite]

Best answer: He may be willing to chew up one of the many varieties of Tums/tums generics.
They are high in calcium and not much else, and come in a lot of differents flavors and a few different textures.
posted by SLC Mom at 1:01 PM on February 21, 2013 [2 favorites]

Dammit, RB.
posted by SLC Mom at 1:01 PM on February 21, 2013 [1 favorite]

Calcium gummies! The kids ones only have 200 IU of Vitamin D in them.
posted by barnone at 1:06 PM on February 21, 2013

Best answer: Is the kid's multivitamin recommended by your pediatrician or is there some specific reason you think it's necessary? " middle childhood, supplements are rarely needed." If not, you could just switch to the adult calcium supplement.
posted by Mr.Know-it-some at 1:07 PM on February 21, 2013

The best source of the non-woo medicine facts may be a quick phone call to the pediatrician or nurse who sees the kiddo.
posted by *s at 1:10 PM on February 21, 2013

Have you tried alternative sources of calcium? Like white beans (I blend w/ spaghetti sauce and use in place of ricotta in pasta casseroles), kale (for a kid, try kale chips, or throw a handful into a berry smoothie to hide it), hide the milk in other things (I make my rice with milk instead of water, it's tastier and you get the nutrient boost), blackberries, oranges, etc.
posted by melissasaurus at 1:12 PM on February 21, 2013

Response by poster: Loving all the answers so far...just want to pop in and say that all of the kids' calcium supplements appear to come in two forms -- gummy-ish with stripes and coated with sugar, or solid & chewable with alleged vanilla flavor. (Though there are lots of different brands, I wonder if there are maybe only two actual manufacturers, 'cause they all seem to look alike.) Kid BlahLaLa hates both.
posted by BlahLaLa at 1:17 PM on February 21, 2013

For a few more months at least, serve hot chocolate that's made with milk. In the summer, substitute homemade ice cream. "And no leaving the table 'til you finish your calcium supplement!"

Dude hear me now I am all about the being healthy here.
posted by wenestvedt at 1:17 PM on February 21, 2013 [10 favorites]

Best answer: There are chewable chocolate calcium supplements with nothing else in them, that sounds like a good option as long as he likes chocolate.
posted by catatethebird at 1:19 PM on February 21, 2013 [1 favorite]

Milk chocolate or Viactiv? They have a bit more Vitamin D in them, but it's still way under the limit for kids. Double check the Vitamin D levels with his doctor.
posted by barnone at 1:24 PM on February 21, 2013 [1 favorite]

Does he drink juice? You can add this calcium supplement to any liquid and it's orange flavored... apparently you can't taste it when it's mixed with juice.
posted by barnone at 1:28 PM on February 21, 2013

I'm certain your pharmacist could advise you on this.
posted by FergieBelle at 1:29 PM on February 21, 2013

The chocolate calcium chews at Costco only have 200IU of D, but still have 500mg calcium. The taste about like tootsie rolls.
posted by agentmitten at 1:30 PM on February 21, 2013

The Dietary Reference Intakes are what you're looking for. That's your official non-woo source of information on vitamins, etc.

As jeffkramer says above, the Tolerable Upper Limit for Vitamin D in males aged 9-13 years is 4000 IU daily (or 100 μg.) It's a fat soluble vitamin, so yes, toxicity is possible.

You can buy orange juice, like Tropicana, with added calcium and no extra vitamin D.
posted by Ouisch at 1:34 PM on February 21, 2013

I can relate to your kid, because I am a grown adult, and I think all chewable calcium stuff is disgusting. It tastes like metal and sticks in your teeth! I use this stuff, which I LOVE. It has 400IU of Vitamin D. I drink it plain from the spoon, but you can add it to a drink as barone said.

Another note, my son's ped simply recommended calcium fortified orange juice, as long as he isn't drinking a lot of other sugary drinks. Apparently a very absorbable form of calcium is used in OJ.
posted by peep at 1:38 PM on February 21, 2013 [2 favorites]

I like the Adora dark chocolates with calcium, which have 500 mg of calcium, 250 IU Vitamin D and 40 mg magnesium. Great tasting and doesn't stick like the calcium chews.
posted by Soliloquy at 1:43 PM on February 21, 2013 [1 favorite]

Best answer: Just popping in to advise *against* gummy vitamins of all kinds -- my pediatric dentist says that they seem to stick around and/or collect other kinds of food, such that even the sugar-free varieties lead to big increases in cavaties among kids who use them. So, try the orange juice, or find an alternative milk (almond, soy, etc.) that he likes, or feed him a lot of cheese.... but no gummies!
posted by acm at 2:03 PM on February 21, 2013 [1 favorite]

> ... apparently you can't taste it when it's mixed with juice.

We accidentally bought OJ with calcium a few years back, and ms scruss still reminds me of the "Calvin at the dinner table" aacckk-ing and grimacing I made over it. You can't taste it only if you have no tastebuds.
posted by scruss at 2:27 PM on February 21, 2013 [4 favorites]

Best answer: The Linus Pauling Institute at Oregon State is a wonderful resource for info on vitamins and minerals and micronutrients.

Here's the entry on vitamin D.

Here're the key bits:
  • Recommended Intake: Children 9-13 years: 15 mcg (600 IU)
  • Intake Upper Level: Children 9-13 years: 100 mcg (4,000 IU)
You'd really have to work hard to give your child more than 4,000 IU of vitamin D per day.

Note that the Institute suggests that the recommended intakes may be low:
While the recommended intake was increased from the adequate intake level (AI) set in 1997, some experts feel that this level is still too low to result in sufficient 25-hydroxyvitamin D levels (40-43).


Infants should have a daily intake of 400 to 1,000 IU (10 to 25 mcg) of vitamin D, and children and adolescents should have a daily intake of 600 to 1,000 IU (15 to 25 mcg) of vitamin D, consistent with the recommendations of The Endocrine Society (99). Given the average vitamin D content of breast milk, infant formula, and the diets of children and adolescents, supplementation may be necessary to meet these recommendations. The American Academy of Pediatrics currently suggests that all infants, children, and adolescents receive 400 IU of supplemental vitamin D daily (19)."
The link also includes some food sources, but there aren't many to choose from. Does your kid like canned salmon (530 IU per 3 oz serving!)? Otherwise, maybe six glasses of fortified orange juice or soymilk?

Here's the entry on calcium, just in case you're interested.
posted by notyou at 2:43 PM on February 21, 2013 [2 favorites]

I think almond milk (sugar and non-sugar types) comes calcium fortified and is, frankly, completely delicious
posted by jbenben at 2:53 PM on February 21, 2013

You didn't ask this but I know 10 year olds who swallow pillows just fine as I did before that age. Maybe a choice between a pill and a chewable?

If that doesn't work then I agree with previous answers on the chewable chocolate calcium supplements that cost much more.
posted by RoadScholar at 3:53 PM on February 21, 2013

Read what ook linked extra 80IU of vitamin D is less than 10% more...
upper doses for his age group: 4000IU and 'overdose' ranging from 77,000-600,000IU per day
...he is more than likely fine with what he's already taking...
posted by sexyrobot at 5:30 PM on February 21, 2013

I really don't think this is too much Vitamin D at all unless your kid is out in the sun a lot. If he is out in the sun a lot, finding another way for him to get calcium is probably a good idea, but in the winter this seems like a good dose. Even Wikipedia notes that the upper limit for kids over 9 is 4000IU.
posted by ch1x0r at 7:23 PM on February 21, 2013

I coincidentally just bought some Adora Dark Chocolates today and I have to second Soliloquy's suggestion of it. As someone who rarely consumes dairy, Adora makes it not only easy but tasty to get your calcium. Plus they come individually wrapped in foil, so it really feels like a treat, not only for your palate but for your body! As Soliloquy noted, there is only 250 IU of Vit. D per chocolate piece, so I think the amounts of vitamin and minerals in the product in combination with the taste of it could be enjoyable to your child. I highly recommend it!
posted by timespacewheredoifit at 8:51 PM on February 21, 2013

I wouldn't worry about toxicity.

I recommend Sunny Gummies as a way to get the Vitamin D in.
posted by lollipopgomez at 10:33 PM on February 21, 2013

Echoing roadscholar a bit - 10 years old is more than old enough to learn to take pills.
posted by MillMan at 10:56 PM on February 21, 2013 [2 favorites]

~1100IU of vitamin D is nothing to worry about.

Your child likely makes 5x as much spending 1/2 hour outside on a sunny summer day around noon.

Reinhold Vieth is a recognized authority on the subject.
- Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety
- Critique of the Considerations for Establishing the Tolerable Upper Intake Level for Vitamin D
- Vitamin D Toxicity, Policy, and Science

Also, sub-optimal Vitamin D levels may impair your child's ability to regulate calcium absorption.
Dr. Robert Heaney outlines why in this pretty interesting talk.
posted by zentrification at 7:40 AM on February 22, 2013

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