Broken bone? Get vitamin D checked.

Several years ago, while watching a girls’ club soccer game, a player from our team was fighting for the ball with 3 opponents.  As the opponents ran off, she crumpled to the ground.  Her femur was broken.  Shattered.  How could such a thing happen?  The orthopedic surgeon was reportedly appalled that such a severe injury could happen from a garden-variety kids’ soccer game.  Fortunately, she recovered eventually, and went on to play for several more years.  This incident happened before our public consciousness about vitamin D was raised, so I doubt this child was tested for deficiency at the time.

Now, doctors are more conscious about the likelihood that someone may be deficient.  Deficiency makes bones more fragile and prone to breaking; bones won’t heal very well if deficiency isn’t addressed.   Any child or adult who breaks a bone, especially when circumstances didn’t seem that extreme, should be tested as part of evaluation and treatment.  Surgery, metal pins, casts and physical therapy do not fix vitamin D deficiency.

Strictly speaking, vitamin D is a hormone, made in human skin when a precise narrow band of UV rays hits the skin.  Lacking exposure to sufficient sunshine to activate this process, humans need to consume vitamin D from food or supplements.  Milk is fortified with a minimal amount of vitamin D, but when kids or adults don’t drink milk, they can become deficient if they don’t get vitamin D elsewhere.  If a pregnant woman is deficient, her newborn starts life deficient in vitamin D, just when bones really start growing.

Plenty of 21st Century lifestyle factors have conspired to create the Perfect Storm for vitamin D deficiency and weak bones.  In fact, doctors are now starting to see more cases of rickets, a vitamin D deficiency disease that affects growing children, causing permanent bone deformities.  Other doctors report more broken bones, some kids with multiple fractures, and find vitamin D deficiency in many of those children.  The risk factors for deficiency include:

  • living at more northern latitudes.  Generally, anyone north of Atlanta will have a hard time making much vitamin D in their skin, even if they are fair skinned.  The farther north you live, the shorter the summers and the less sunlight.  Throw in locations with gloomy, cloudy weather, and the situation is worse.
  • spending most of your time indoors, out of sunshine
  • having darker pigmented skin*
  • not consuming vitamin D fortified foods every single day in sufficient amounts (according to current recommendations, this would be 6 cups of milk daily, every single day)
  • using sunscreen every time you go outside.  Sunscreen blocks the key UV rays that make vitamin D.

These risk factors apply to kids and adults.

Summer is a great time for kids to be outside and active, riding bikes, skateboarding, playing on playgrounds, hiking, running around playing games, jumping off stuff, climbing up things and participating in summer camp activities.  Broken bones may happen.  If so, ask your doctor to check your child’s vitamin D status.  Or, if you break a bone, you should be checked.  Make sure all your ducks were in a row for treating a fracture.  If it were my child, and the doctor refused to do that, I’d find another doctor.

*Vitamin D isn’t just about bones, and a recent study indicates deficiency can explain some of the increased risk for hypertension common to African Americans. Vitamin D deficiency is a heart disease risk factor as well.  Again, both adults and kids with darker skin tones who live in northern locations need to pay attention to this.  Vitamin D deficit doesn’t have visible symptoms.  Even healthy and fit-appearing people can be affected.

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