Rickets and cardiac arrest in an infant:

Jacob Schor, ND, FABNO
July 28, 2011

The July 27, 2011 issue of the Journal of Clinical Endocrinology and Metabolism (JCEM) contained a disturbing case report. 
Hassib Chehade describes the case of a 16-month-old infant brought to their hospital in Switzerland who went into full cardiac arrest shortly after arriving.  The child was revived.  After a thorough workup the hospital staff realized that the child had calcium levels so low that the heart couldn’t function.  The calcium levels were low because the infant’s vitamin D levels were low.       
For those of you who pay attention to vitamin D numbers, this child’s 25(OH)D level was just 5.7 ng/ml.  The normal range is 30-100 ng/ml. 
The kid had all the classic clinical signs of rickets; frontal bossing of the skull, a rachitic rosary of bone beads along the rib, muscle flabbiness and enlarged wrists and ankles.  His bone density was that of an osteoporotic menopausal woman.
A daily dose of 5,000 IU of vitamin D-3 for three months brought the kid’s serum levels up to 65 ng/ml.  X-rays reproduced in the journal show a dramatic transformation of the bones over that time period.        After treatment they look normal. 
The child had been exclusively breast fed for the first 10 months of life. The breast milk had been supplemented with rice milk for the prior 4 months before the hospitalization.
Both mother and child had dark skin.  Neither could make adequate vitamin D in Switzerland.  The mother’s belief that breast milk was adequate and her own lack of vitamin D nearly killed her child.  When breast milk is tested, 95% has inadequate levels of vitamin D.  This should be no surprise as 95% of lactating women are vitamin D deficient. 
We are told by the government agencies responsible for setting standards of vitamin dosing that there is still inadequate data to recommend the doses of vitamin D that nutritional researchers suggest.  The government wants to wait to see the results of randomized-double-blinded-placebo-controlled-human trials.  It’s been fifty year since scientists realized that cigarette smoking caused lung cancer.  If the government had waited for the quality of data they are asking for to prove the benefits of vitamin D, we’d all still be smoking as there has yet to be a smoking study that will meet the current level of proof being asked of vitamin D.
But don’t get me started.  Suffice to say, there is one lucky Swiss kid still alive
Chehade et al. Acute Life-Threatening Presentation of Vitamin D Deficiency Rickets. J Clin Endo and Metab. July 27, 2011 Current Issue.
A thank you to John Cannell, MD who pointed out this abstract to me.