Cardiomyopathy is a rare but frequently fatal heart condition in infants and children. In many cases, doctors are unable to find the cause, and severe cases need to stay in the hospital while waiting for their last hope at life- a heart transplant. But whole teams of specialists at major medical centers across the nation may be overlooking vitamin D deficiency as a cause of cardiomyopathy, and children are dying because of it.
Cardiomyopathy is a rare condition where a child's heart becomes enlarged and too weak to pump blood properly. This impaired pumping eventually causes a build-up of fluid into the rest of the circulation leading to swelling in the face and extremities. If the condition worsens, this fluid can collect in the lungs and cause difficulty breathing, even to the point of needing life support. If the heart is very weak and medication fails to manage this condition, the child will need round-the-clock medical management and possibly even a heart transplant. In the vast majority of cases of cardiomyopathy in infants, the cause is labeled 'idiopathic', a medical term meaning that the cause is unknown. Idiopathic, however, can also mean that doctors have simply failed to look in the right place, and vitamin D deficiency is a cause of cardiomyopathy that is simply not looked for. But in the cases where the deficiency HAS been recognized, Vitamin D supplementation has induced a quick and many times complete recovery in these very sick children.
"Vitamin D deficiency and consequent hypocalcaemia are seen in association with severe and life-threatening infant heart failure"
'Hypocalcaemia and vitamin D deficiency: an important, but preventable, cause of life-threatening infant heart failure'
While on the surface it seems incredible, two of vitamin D's many effects explain why it is able to induce such apparently miraculous recovery in these children for whom all other medical treatment has failed.
The first is Vitamin D's well known ability to aid calcium absorption in the intestines.
If you don't have vitamin D then you will simply NOT absorb calcium, and proper calcium balance is vital for the contraction of heart muscle.
Calcium is so important that the body is very careful about maintaining proper blood calcium levels in a very tight range.
But if calcium is not available in the diet or if it simply can't be absorbed due to Vitamin D deficiency, the body will do whatever it takes to maintain blood levels, even if it needs to pull calcium out of cells and bones to accomplish this.
Unfortunately for these children, the 'standard of care' is to check for Vitamin D deficiency ONLY if blood calcium levels are outside of the normal range. But vitamin D deficiency can be severe and lead to altered calcium metabolism in Heart Cells long before calcium levels in the Blood become abnormal. However, even mild vitamin D deficiency could have profound implications for these children due to one of vitamin D's other actions. For reasons that are not well understood, vitamin D deficiency has been implicated in muscle weakness. While this effect is particularly marked in the elderly, even young girls with vitamin D deficiency have weaker muscular strength than their vitamin D sufficient peers. This muscle weakening effect of vitamin d deficiency may also be contributing to the weak HEART muscles of these children that are unable to create strong enough contractions to pump their own blood.
"Dilated cardiomyopathy caused by nutritional deficiencies seems to have a better prognosis than idiopathic dilated cardiomyopathy.
Appropriate treatment can lead to complete resolution. Thus, in an infant with cardiac failure, a nutritional cause deserves early consideration"
But until vitamin D levels become so low that calcium blood levels become abnormal, doctors feel that checking for vitamin D deficiency is 'not indicated' for these dying children. This is despite the fact that research continually points to the fact that moderate to severe vitamin D deficiency can exist WITHOUT changes in calcium. With a child's life at stake, adding on a test that costs less than $100 to a hospital bill that can run into the hundreds of thousands of dollars seems particularly 'indicated'. Unfortunately, until doctors become aware that low vitamin D levels do not always cause the blood calcium changes that they are trained to look for, children are going to be getting heart transplants instead of the vitamin D that could save their life.
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