Latest / Common Sense Health / The Flaw in Vitamin K Research You Need to Know
Transcript
- Stephen Thomas BSc. Hons: Hello. Today I'd like to talk to you about a needle, a very small needle in a very small thigh given to almost every baby born in the developed world within about an hour of birth. And I'd like to ask you a question about it that almost nobody asks. Why do we never question it? Because if you've had a baby, you know the drill. The baby arrives and of course everyone cries and then someone appears with a syringe and a very confident face. your newborn gets a vitamin K injection in the fire. And if you ask why, which is a completely reasonable thing to ask when someone is about to stick a needle into a human who was just moments ago inside another human, you get a look. Not so much a hostile look exactly, more like a look you'd get if you asked a fire brigade why they use water. Well, because babies are born with low vitamin K. It prevents bleeding, it's standard. And That's the end of the conversation, because it's standard. Which is a funny kind of answer when you actually think about it. Everybody does it. Isn't the same as it's right. It's just the same as, nobody's checked why lately. So let's check. There's one paper that sits underneath this entire ritual. It's entitled Vitamin K as a pro-prolactic in 13,000 infants by a Swedish doctor named Jörgen Laman, I think that's how you pronounce it, published in The Lancet in 1944. Yes, all those years ago. And this is the cornerstone. When people defend routine newborn vitamin K, this is the study quietly standing behind that. And let's open it up and see why they use it and what's actually in it. And I want to start with a thing that gets glossed over in every explanation you'll ever hear. Babies are not born with low vitamin K. Babies are born with newborn level vitamin K, which happens to be lower than adult levels. Lehmann's own reference range stated right there in the paper is 80 to 110 and he labels it clearly. Normal values for adults. By the way, the range is a clotting time for blood. It's a ratio, a percentage. So if you get a score of 100, that is your blood clots at exactly the same time as a normal blood. If you had a 50, then it's half the speed. It's just a percentage. So he then measures newborns against this adult standard, finds them wanting and calls it a deficiency. That's like measuring a five year old against an adult height chart and diagnosing the child with a growth disorder. And here's the part that makes it even worse. Lehmann himself calls the condition physiological hypo-pro-throm- Beniarium. Something like that anyway, it's physiological. His own word, he made it up. He's saying in the same paper, this is normal and this needs treating without apparently noticing that he said both. And then if we look at his own graph, treated babies plateau at around 70 to 75. Like I say, it's like a percentage of that hundred and the adult range. starts at 80. Not one treated infant ever reaches the level that defined them as broken in the first place. So the treatment doesn't restore normal anyway. It raises babies to a level that's still below that standard that justified the needle, which raises the obvious question. What was the actual target? Now, you might be thinking, surely someone noticed. Well, here we are in the future. still doing it and it gets better. This is my favourite one because it's the kind of thing that makes you put your coffee down. Vitamin K is given once within an hour of birth. So you'd expect its effect to be strongest early when the drug is actually in the baby and to fade as it clears. So let's look at the deaths by day, averaging the two control periods against the treatment period. On the second day, seven and a half deaths were down to four. On third day, three and a half down to one. And on days four to eight, six deaths down to one. That's a drop of 83%. The biggest drop is on days four to eight. Days four to eight. When a single injection given at hour one is long gone. If your drug produces its largest effect after it's left the building, you're not measuring the drug. You're measuring something else. Now, here's the one that should end the conversation and somehow never does. Lehmann's own conclusions in his own words. A single intramuscular dose of zero point five milligrams is as efficient as five milligrams. The same doses given by mouth are as effective as by injection. And finally, administration by mouth is preferable as all the vitamin then enters the liver. Now read that third one again. The paper that anchors routine newborn vitamin K injection said oral was preferable and his graph backs it up. The oral arm actually plateaus higher than the injection arm. So the modern protocol, one milligram intramuscular every baby is double the dose he found optimal given by a route he said was inferior when he explicitly recommended oral. The practice everyone defends today is not what the study supports. It's the opposite of what the study supports. One more beautiful example of how numbers can be made to say whatever you need. Lehmann had three tables and two of them count the same deaths, just grouped them differently. Table two splits the years into three periods and the first day deaths read 21, 20 and then 19. Table 3 merges the first two periods into one and the first 8 deaths read 41, then 19. Same babies, same deaths. But look at the difference. Split apart, 21, 20, 19. He calls this remarkably constant. Look, merge together, 41 down to 19. That's a 54 % collapse. He uses the constant version to argue that one day deaths are from birth trauma and can't be affected by vitamin K. And he lets table three quietly show those deaths falling by more than half, the largest drop in the entire data set. Well, you can't have both. Either day one deaths were constant, his word, or they collapsed by more than half, his table. And if something else was cutting day one deaths by half. better delivery of care, better resuscitation, whatever was changing at the hospital across a decade, then that something else will probably help the later deaths too. Which brings us to the thing nobody wants to say out loud. Lehman compared babies born between 1934 and 1940 with babies born between 1940 and 1943. A different era, different wartime conditions, different practice, different everything. No randomisation, no blinding, no placebo. Just two stretches of time at one hospital compared to each other. And the two groups aren't even measured over the same number of years. The control period is six years. The treatment period is three. Six years of deaths versus three years of deaths. And we're supposed to read the difference as a drug effect. If you doubled the treatment window to match, those six deaths would possibly be closer to 12. Half the effect. vanishes before you've even adjusted for anything. This isn't a trial. It's a before and after photo taken across a decade of change with the drug getting credit for the whole picture. And here's the detail that ties the whole thing together. Lehmann ran two completely separate studies and glued them into one paper. The measurement study, 90 infants tested daily for a week. That's where all the bleeding thresholds come from. The mortality study, 30,990 infants never tested at all. Just deaths counted. So the thresholds that define who's at risk come from 90 babies. The conclusion that treatment saves lives comes from 30,000 babies who were never measured. The two halves never touch. No infant in the mortality group had a prothrombin test. No infant in the test group died or bled. And here's the kicker about those 90 tested infants. In layman's own words, no infant showed signs of 90 infants tested daily, prothrombin indices down in the single digits for some, not one of them bled. So the bleeding threshold, the number that decides how many babies are at risk, was never observed causing anything. It's a prediction, basically a guess, a line drawn on a graph. So why is it sacred? Let me be clear about what I'm not saying. I'm not saying babies never bleed. Some do. And for some it's a catastrophe. And that's a real and terrible thing. I'm not saying vitamin K is poison. It's a vitamin. It's been given to millions of babies. What I'm saying is that the paper underneath the ritual doesn't support the ritual. It calls the condition physiological in one breath and treats it as a disease in the next. It never brings a single infant to the normal range that define them as deficient. effects is largest when the drug has cleared. It recommends oral, lower dose administration, the opposite of what we actually do. Its control group is twice as long as its treatment group. It compares two different eras with no controls and not one infant in the tested group ever bled. That's not a foundation. That's a house of cards with a very confident paint job. So here's what I'd love you to take away. Whether you're a parent, a health hobbyist or just someone who enjoys watching sacred cows get a suspicious look, the sacredness of a practice is not evidence of its soundness. It's evidence that nobody's checked lately. When something is just standard, ask, what's the study behind it? What did that study actually find? Does current practice match what the study recommended? And has anyone rechecked? arithmetic in 80 years. You'll be surprised how often the answer to the last one is no. None of this tells you what to do if you're holding a newborn. Some babies, a small subset, with genuine bleeding disorders or biliary problems may need intervention. That's a conversation for you and a clinician who knows your situation. But what this does mean is you're allowed to ask questions. You're allowed to notice that a practice described as settled science rests on a paper that contradicts current practice en route, overstates its effect tenfold and never once observe the thing it claims to prevent. You're allowed to notice that the Emperor's numbers don't add up, and if someone tells you not to worry your pretty little head about it because it's standard, well now you know what standard is standing on. Anyway, thanks for watching. This is informational analysis of a historical document, not medical advice, and I'm not a doctor. If you want to check any of this yourself, the paper is vitamin K as a propralactic in 13000 infants. It's in the last Lancet 1944. Tables one, two and three are the ones to look at, And if you enjoyed this, please consider subscribing because there are a lot more sacred cows out there and I've got a lot more reading to do. So hopefully you did like it. So let's have you subscribing or sharing. drop in a comment down below, that would be really handy. And if you didn't like it, well, I do thank you for at least getting to the end and I hope to see you on the next one. I'll be back.