Fat-soluble vitamin | How to monitor | Standard oral treatment recommendation | Signs and symptoms of deficiency | Recommended supplementation in setting of deficiency |
Vitamin A | Measure serum or plasma retinol and RBP Interpretation:
| Liquid vitamin A:
|
| Liquid vitamin A 5000 IU/day by mouth; recheck levels in 1 month OR 25,000 to 50,000 IU/day by mouth for 1 to 4 weeks; recheck levels weekly OR 50,000 IU intramuscularly once/month up to 2 months; recheck levels monthly |
Vitamin D | Measure serum 25-OH vitamin D Interpretation:
| Cholecalciferol or ergocalciferol – 2000 to 5000 IU/day (50 to 125 mcg/day) |
| Cholecalciferol or ergocalciferol 1200 to 4000 IU/day by mouth; recheck levels in 1 month If child remains deficient, give 4000 to 8000 IU/day; recheck levels in 1 month OR Give 1,25-OH2 vitamin D 0.05 to 0.2 mcg/kg/day; recheck serum 1,25-OH2 vitamin D levels in 1 month |
Vitamin E | Measure serum vitamin E and total lipids Interpretation:
| TPGS – 15 to 25 IU/kg/day (10 to 17 mg/kg/day) |
| If deficient, 50 IU/kg/day of TPGS; recheck levels in 1 month |
Vitamin K | Measure PT, INR, and PIVKA-II | Vitamin K1 2 to 5 mg daily |
| If INR >1.5 and ≤1.8, give 5 mg vitamin K1 daily by mouth and/or 2 to 5 mg vitamin K intramuscularly 1 time; recheck PT/INR in 1 to 2 days |
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