Takeaway
Low vitamin D levels were common in children examined in sub-Saharan Africa, but levels were significantly lower in children with epilepsy due to their anti-seizure medication (ASM).
Why this matters
ASMs induce cytochrome P450 enzymes (especially CPY3A4) that increase catabolism of vitamin D and reduce calcium absorption. Children with epilepsy taking an ASM, especially enzyme-inducers, have significantly lower levels of vitamin D and should be managed for any deficiencies by diet or longer sun exposure.