Vitamin D Newsletter

Newsletter

Vitamin D in Pediatrics

I decided to concentrate on children in this newsletter but before we start, you should know Oliver Gillie recently published a landmark work. Instead of concentrating on a group at risk for vitamin D deficiency, such as the aged, the dark-skinned, pregnant women, or young children, Oliver concentrated on a country—Scotland. His entire report is free for download: Scotland's Health Deficit: an Explanation and a Plan.

Infant Heart Failure

Jena from New York writes:

I just read about a study that found my baby may have died from untreated vitamin D deficiency.

Dr. Cannell: Two years ago in March, my five month old baby girl died from heart failure, called "idiopathic cardiomyopathy." She was my first child, I breast fed her, we did everything her pediatrician said to do; he told us not to let her into the sun and to always use sunblock if we went outside. He never mentioned vitamin D. The heart doctors did everything they could think of before she died but they never measured her vitamin D level. I just read about a study that found my baby may have died from untreated vitamin D deficiency. Do you know about that study?

Dr. Cannell replies:

I'm sorry to tell you that I do. It appears likely that infantile idiopathic cardiomyopathy may just be another word for undiagnosed and untreated vitamin D deficiency. English cardiologists recently concluded that "the heart failure associated with vitamin D deficiency in infants is surprising," but added "the outcome is good" in the children treated with vitamin D. They should have said the "outcome is good if the diagnosis is made." The outcome is often fatal when the diagnosis is missed. It appears to me that the major mistake is that unless the serum calcium is low, pediatric cardiologists never measure vitamin D levels. Of course, if they did measure vitamin D levels, would they order the right test? If they did order the right test, would they know how to interpret it or would they rely on the outdated and dangerous reference ranges of American labs, such as LabCorp and Quest? As you will see below, genetics plays a much bigger role in 25(OH)D levels than anyone suspected and we must assume the same is true of tissue levels of activated vitamin D. Thus these children should be given enough vitamin D to normalize the kinetics of 25(OH)D, enough to get their 25(OH)D levels into the upper part of the reference range, 60–80 ng/ml.

Vitamin D deficiency is probably a common (and equally important, easily treatable) cause of pediatric cardiomyopathy.  

Five years ago, the New England Journal of Medicine reported on 435 cases of pediatric cardiomyopathy in the United States and failed to make the diagnosis of vitamin D deficiency in even one of the children. 68% of the cases were idiopathic, that is, no known cause. However, if the authors or the editors would have just looked at their data a little closer they would have found that children in the north were more likely to get cardiomyopathy than children in the south and that the disease is more common in black children than white children. Those two facts should have alerted the authors and the NEJM editors that vitamin D deficiency is probably a common (and equally important, easily treatable) cause of pediatric cardiomyopathy.  

Jena, it appears quite possible that your baby girl died from lack of vitamin D. Just think, in the year 2008, infants in the United States are dying from the lack of a simple vitamin, from lack of sunshine. I hope Dr. Barbara Gilchrist and the dermatologists (or should I say cosmetologists) soon stop blaspheming the Sun God or the Sun God's wrath will take even more of our children.

Page last edited: 09 August 2010