A British man’s vitamin D overdose is a wake-up call for people considering adding supplements to their lives, according to an article published in the journal BMJ Case Reports.
After a consultation with a private nutritionist, the man began taking more than 20 over-the-counter supplements every day, including 50,000 (52.97 mg) international units (IU) of vitamin D three times a day. That’s a dose hundreds of times higher than the standard nutritional recommendations.
Within a month, the man began to suffer from nausea, abdominal pain, diarrhea and repeated bouts of vomiting, as well as leg cramps and ringing in his ears.
The man, whose name has not been released, heard about the supplements on a radio show and contacted the show’s nutritionist afterwards, said the doctor who treated the man.
Unlike water-soluble vitamins, which the body can easily eliminate, vitamin D and its “cousins” A, E and K are stored in the liver and fat cells of the body until they are needed. Consuming well above the recommended daily dose can reach toxic levels.
The man stopped taking the supplements when his symptoms started, but his condition did not improve. When he was taken to the hospital two months later, he had lost 12.7 kg and his kidneys were in trouble. Tests showed he overdosed on vitamin D, a condition called hypervitaminosis D.
Recommended daily levels
The body needs vitamin D. Its main function is to help the body absorb calcium from the intestines – in fact, the body cannot absorb calcium unless vitamin D is present. The vitamin also plays a role in immune health, brain cell activity, and muscle function.
In the United States, 600 IU of vitamin D a day is recommended for adults age 69 and younger, according to the National Institutes of Health. For adults 70 years and older, the dose is increased to 20 micrograms or 800 IU per day. The recommended amount for infants, children and teens was recently doubled by the American Academy of Pediatrics to 10 micrograms or 400 IU per day.
A 2017 study found that 3% of Americans took more than the tolerable upper limit of 4,000 IU per day for adults, putting themselves at risk for toxicity. About 18% took more than 1,000 IU (1.05 mg) daily.
Too much vitamin D in the blood leads to hypercalcemia, which occurs when the level of calcium in the blood is above normal. The man hospitalized in the UK was diagnosed with hypercalcemia, which can weaken his bones, create kidney stones and interfere with the functioning of his heart and brain.
The man was hospitalized for eight days and treated with drugs to lower blood calcium levels. A follow-up two months later found that her blood calcium levels had dropped to near normal. Although the man’s vitamin D level also improved significantly, it was still high, doctors said.
Signs of excess vitamin D can include drowsiness, mental confusion, lethargy, and depression, and in more severe cases, it can lead to stupor and coma. The heart may be affected: Blood pressure may rise and the heart may begin to beat irregularly. In severe cases, the kidneys can fail. Hearing and vision can be affected.
Where to get vitamin D
The body produces adequate vitamin D when the skin is exposed to the sun. However, getting into strong midday sunlight is not advisable due to the risk of skin cancer.
Vitamin D supplementation may not be necessary for many children and adolescents, as many foods such as milk, eggs, cereal, and orange juice are often fortified with vitamin D.
Breastfed babies should receive 400 IU of supplemental vitamin D daily, starting in the first few days of life and continuing until the baby is weaned to milk or vitamin D-fortified formula.
If vitamin D supplements are being considered, daily levels of vitamin D obtained from food should be factored into the decision, experts warn. In addition to fortified foods, eggs, cheese, shiitake mushrooms, salmon, swordfish, tuna, rainbow trout, and beef liver contain vitamin D, as does cod liver oil.
Anyone concerned about their vitamin D levels should have them evaluated by a doctor, experts say.
Source: CNN Brasil
