“Overdose” of Vitamin D: the hospitalization of 16 people at the Balearics highlights the risks that many underestimate

We know that the Vitamin D is an essential nutrient for the absorption of calciumfor the bone health and for a good functioning of the immune system. Studies have connected a shortage of it not only to bone diseases, but also to autoimmune pathologies and anticancer effects in melanoma, colorectal cancer and breast cancer.

80% of our needs could derive from the direct sun action on the skin (it is with exposure to UVB rays that the 7 -dehydrocolesterol, – derivative of cholesterol present on the epidermis – is transformed into vitamin D) and the power to cover the remaining 20%, if it were not that the naturalness of this process is today hindered by various factors, including the essential use of the protectors, which They also block the synthesis of vitamin D. This necessary measure, associated with latitude, the succession of the seasons, to the type of skin, the aging of the skin, as well as a lifestyle in urban contexts where exposure to UVB rays is very reduced, explains the fact that the global deficiency of vitamin D was recently so high and general that it is called “an epidemic”.

For this problem, two different solutions have been developed: «In countries like the United States and Australia it has opted for the free fortification of food: foods like milk are enriched with vitamin D, compensating the sun exposure deficit through a greater food income », he explains Andrea Giustispecialist of bone metabolic diseases and skeletal mineral metabolism, and director SC Internal Medicine 1 Villa Scassi Asl3 Hospital Genoa. «In other places such as Italy, where this does not happen, the supplementation of vitamin D prescribed by the doctor».

However, an aspect to consider concerns the right administration: «The recommended quantity is 1000 international units per day»Says Giusti. “If you take a supplement in drops, and it is reported that a drop contains 250 international units, it is possible to give a precise indication”. Many bench products, however, do not guarantee this precision in the dosage. “There may be an excess of hiring,” says the specialist. “It is important that all vitamins and all supplements are always taken under medical supervision and never freely, in total autonomy”.

Instead, the consumption of supplements in total autonomy, including those of vitamin D, appears increasingly widespread in Italy and also in Europe. A recent case that occurred in the Balearic Islands has even induced the Spanish Ministry of Health to issue A notice on the risks of the irrational intake of vitamin D supplements without indication or medical supervision.

What happened in the Balearic Islands

As reported on an article on the medical platform Univadis Spain16 people were hospitalized, in the Balearic Islands, for Vitamin D toxicity after taking a supplement with a incorrect formulationpurchased online without medical supervision.
The first identified patients presented abdominal pain, nausea And vomit. The clinical evaluation confirmed acute renal failure, hypercalcemia and high serum levels of vitamin D, which led to an investigation of public health that also detected other cases of poisoning in otherwise healthy individuals who had consumed multivitamin products purchased online without guidance or medical supervision.

Following the reports of adverse effects, the Spanish agency for food safety and nutrition (Aesan) therefore issued an ‘public health alert concerning a defective lot of vitamin D supplements. Although the initial distribution was limited to the Balearic islands, the authorities have in fact warned against a possible wider diffusion.

The risks of an unchanged integration

This situation highlights The risks of the integration of vitamin D not supervised. Already in 2019, the Spanish agency for medicines (Aemps) had documented cases of vitamin D toxicity that caused hypervitaminosis of both adults and children through its pharmacovigilance system, in particular with regard to high dosage products.

Although the cases of toxicity from vitamin D remain overall rare, in Spain, pediatric accidents have shown a worrying increase in recent years. This trend is mainly attributed to inappropriate self -medication practices rather than to the prescribed medical use. To prevent complications, it is appropriate to use vitamin D supplements in a rational and always under medical supervision, based on scientific evidence.

This includes the request for diagnostic tests and the prescription of supplements only when it is clinically indicatedalthough vitamin D is essential for bone metabolism and calcium regulation. Use without supervision, in particular when you overcome the recommended doses, can lead to adverse effects and is not recommended without a specific medical indication.