Poppy Brett thought she would just have to accept that her son Jago didn’t have the energy to keep up with his friends, didn’t like playing football and always seemed tired.
Their GP could find nothing wrong with him: he slept 12 hours a night and had a healthy diet. It never occurred to his mother that the factor 25 sun cream she slathered on him in the summer might be to blame for his exhaustion.
But a year ago a blood test revealed that Jago, 11, was severely deficient in vitamin D — vital for maintaining healthy bones and a well-functioning nervous system. Our bodies must have direct sunlight to produce it.
Twelve months on, after taking supplements and having more exposure to the sun, Jago is a different boy. The lethargy has gone — he loves playing in the park with his friends.
Gone, too, are the pains in his legs that would often cause him to wake in the night in agony. They had been dismissed as growing pains.
‘I never thought in a million years that his tiredness could be down to a lack of sun,’ says Poppy, 41, a charity fundraiser from Bristol. ‘When camping in Cornwall, I’d cover Jago in sunscreen the moment the sun came out.’
Poppy first went to the GP about Jago’s leg pains when he was seven, but the doctor simply showed him some stretching exercises. When this failed to have any effect, she went back to the GP twice, but the only suggestion was that he should get more sleep.
‘It was utterly frustrating trying to get anyone to take me seriously,’ says Poppy. ‘Jago looked tired all the time, but they just told me to put him to bed earlier, which was crazy as he was sleeping 12 hours a night.
‘I suggested it might be related to his dust-mite allergy, so they suggested I vacuum the house more!’
In February last year, Jago burst into tears at the side of a swimming pool because he felt so unwell. Poppy marched back to the GP and demanded a blood test.
‘I said: ‘‘Look, there must be something wrong with him. Please can you test his blood?’’ It seemed a good place to start.’ And she was right.
The results showed Jago’s vitamin D level was a quarter of what it should have been — this result was so worrying that the GP arranged for his legs to be X-rayed to check he didn’t have the bone-softening disease, rickets. Fortunately, he didn’t.
Vitamin D plays a vital role in promoting the absorption of calcium into the gut, which is key for maintaining healthy bones and normal muscle and nerve activity.
It is measured by its concentration in the blood. A count of 70 to 150 means there is a good store of it. At 50 to 70, levels are insufficient; at 50 they are deficient; and at less than 25 severely deficient. Jago’s count was just 24.
Severe deficiency can cause rickets, convulsions and heart failure in young children and adolescents, says Dr Jeremy Allgrove, consultant paediatric endocrinologist at Barts and the London Children’s Hospital. He is one of Britain’s leading experts on vitamin D deficiency.
Dr Allgrove says there is increasing evidence to show that vitamin D has an important effect on children’s immune systems, protecting against TB, asthma and other viral infections.
In adults, a deficiency may cause an increased incidence of diabetes, coronary heart disease and some forms of cancer.
Despite its importance for our health, up to half of those with white, northern European skin and up to 90 per cent of Britons with Asian or Afro-Caribbean backgrounds may be deficient, mainly because we can’t make it from sunshine in this country between October and March. The darker your skin, the harder it is to make.
But there are still no formal government guidelines on the amount children should have.
‘Unspecific’ symptoms of deficiency include lethargy, leg pain, eating issues and mood swings, but these are often missed by GPs.
Every parent has had it drummed into them to apply high-factor sun screen on their children’s delicate skin in the spring and summer, but Dr Allgrove says this is worsening the problem of vitamin D deficiency.
‘This is the one vitamin you can’t get in adequate quantities from your diet,’ he says.
‘The problem is that even low-factor sunscreens will absorb all the ultraviolet light you are exposed to that you need to make vitamin D.
‘I am not suggesting that sunscreen shouldn’t be used. But in my view its use has gone too far.’
He recommends allowing a small amount of sun exposure — apply sun cream after 15 minutes in the sunshine for pale-skinned children and up to an hour for darker-skinned children.
Lucia Decermic, 40, from West London, is another mother whose child’s vitamin D deficiency were not recognised by her GP.
She had to dose her five-year-old daughter Senka with Calpol three times a week to cope with her leg pain. Senka also had eating problems, often managing only a mouthful of cereal for breakfast.
Like Poppy, Lucia feels let down by her GP because she had to take matters into her own hands. When a locum suggested Senka had her legs X-rayed at Hammersmith Hospital, Lucia instead queued up for a blood test.
She had heard about another child with vitamin D deficiency and wondered if this might be the case with Senka.
She was right. Senka was significantly deficient in vitamin D, with a level of 49. ‘It seems ludicrous that GPs are still not fully informed about something as simple as vitamin D deficiency,’ says Lucia, who runs her own events management business.
‘It’s unacceptable to be told your daughter has growing pains with no offer of a solution. I had to resort to medicating her with painkillers and then sit helplessly listening to her scream until the pain subsided.
‘How many parents are going through this?’
Senka has been taking a vitamin D supplement for just three weeks. Remarkably, her leg pain levels have subsided and she is eating well.
Dr Allgrove says eating problems are a common symptom of vitamin D deficiency, probably because children at such a low ebb can’t face food.
He says GPs are beginning to wake up to vitamin D deficiency. Guidelines about testing and medication have recently been issued to surgeries by Barts and the Royal London Hospital. Millie Barrett of Key Nutrition, a London-based clinical nutrition consultancy, says she is seeing an increased awareness of the issue.
‘Every patient whose vitamin D status I have tested has been insufficient or deficient. These are not isolated cases,’ she says.
She advises mothers to ask their GP for a blood test or see a registered nutritional therapist, who will arrange a test for £40.
‘If one member of your family has been diagnosed with low or insufficient levels of vitamin D, it is likely the rest of the family will also be deficient because they are subject to the same influences.’
Tested or not, in Dr Allgrove’s view everyone should take vitamin D supplements.
He ADVISES 400 ius (international units in which vitamin D is measured) a day for babies, 1,000 ius a day for children and adolescents, and 1,000 to 2000 ius a day for adults.
Vitamin D supplements are vital for women who are pregnant or breast-feeding, and those who cover up for religious reasons.
Dr Allgrove says it is almost impossible to take too much. When deficiency is detected, the doses prescribed are far higher: 3,000 ius for infants; 6,000 ius for children aged six months to 12 years; and 6,000 to 10,000 ius for adolescents and adults.
Treating Jago’s vitamin D deficiency has had a transforming effect on him, says Poppy.
‘Before, when we went to the park I felt as if I was pulling a tired boy along behind me who didn’t want to be there.
‘For years I just thought my son was just not a child who was full of energy and life. How wrong I was. He’s got so much buzz about him now. He is a new boy.’