Can we give iron, vitamin B complex (Becompex), and vitamin D3 as a first-line treatment for growing pains?

Iron, B Complex, and Vitamin D3 for Growing Pains

Iron, vitamin B complex, and vitamin D3 supplementation is effective for treating growing pains, with vitamin D supplementation showing the strongest evidence for symptom resolution. 1

Evidence for Vitamin D in Growing Pains

• Vitamin D deficiency is highly prevalent in children with growing pains, with studies showing that up to 86.6% of children with growing pains have vitamin D insufficiency 1
• Supplementation with vitamin D has been shown to significantly reduce pain intensity in children with growing pains who have hypovitaminosis D, with mean pain scores decreasing from 6.8 to 2.9 on a visual analog scale 1
• Children with unexplained limb pains should be tested for vitamin D status and treated if necessary, as routine biochemical markers alone are not sufficient to detect all cases of hypovitaminosis D 2

Evidence for Iron Supplementation

• Iron supplementation along with vitamin D3 and calcium has been associated with faster resolution of growing pain symptoms 3
• In one study, 67.3% of children who received iron supplementation became symptom-free after 3 months, compared to only 28.8% of those who received only calcium and vitamin D3 3
• The difference in symptom resolution between children receiving iron supplementation and those not receiving it was statistically significant (p < 0.0001) 3

Recommended Approach for Growing Pains

1. First-line treatment:

   • Vitamin D supplementation for children with growing pains, particularly those with confirmed vitamin D deficiency 1, 2
   • Consider adding iron supplementation, especially in children with hemoglobin less than 11 g/dL 3
   • B complex vitamins may be included as part of a comprehensive approach, though specific evidence for B vitamins alone in growing pains is limited

2. Dosing considerations:

   • For vitamin D: A single oral dose has shown effectiveness in raising 25(OH)D levels from a mean of 13.4 ng/ml to 44.5 ng/ml 1
   • For iron: Consider 3 mg/kg supplementation in children with hemoglobin less than 11 g/dL 3

Clinical Monitoring

• Reassess symptoms after 3 months of supplementation 1, 3
• Monitor for improvement in pain intensity using age-appropriate pain scales 1
• Consider checking vitamin D levels before and after supplementation to ensure adequate correction of deficiency 1

Caveats and Considerations

• The etiology of growing pains remains poorly understood with multiple theories proposed, including vitamin D deficiency, reduced bone strength, and genetic factors 4
• Not all studies show consistent results with vitamin D supplementation for pain conditions, highlighting the need for more focused research involving large randomized controlled trials 5
• While supplementation appears beneficial, it's important to rule out other causes of limb pain in children before attributing symptoms solely to growing pains 2, 4