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“Overdosing” on vitamin D supplements is both possible and harmful, doctors warn in the journal BMJ Case Reports after treating a man who needed to be admitted to hospital because of his excessive vitamin D intake.
“Hypervitaminosis D,” as the condition was formerly known, is on the rise and is associated with a wide range of potentially serious health problems, they stress.
The case concerns a middle-aged man who was referred to hospital by his family doctor after complaining of repeated vomiting, nausea, abdominal pain, leg cramps, tinnitus (ringing in the ears), dry mouth, increased thirst , diarrhea and weight loss (28 lb or 12.7 kg).
These symptoms lasted nearly 3 months and began about 1 month after he began an intensive vitamin supplementation regimen on the advice of a dietary therapist.
The man had various health problems, including tuberculosis, an inner ear tumor (left vestibular schwannoma) that resulted in deafness in that ear, fluid on the brain (hydrocephalus), bacterial meningitis and chronic sinusitis.
He was taking high doses of more than 20 over-the-counter supplements each day containing: vitamin D 50,000 mg – the daily requirement is 600 mg or 400 IU; vitamin K2 100 mg (daily requirement 100–300 μg); vitamin C, vitamin B9 (folate) 1000 mg (daily requirement 400 μg); vitamin B2 (riboflavin), vitamin B6, omega-3 2000 mg twice daily (daily requirement 200–500 mg), plus several other vitamin, mineral, nutritional and probiotic supplements.
After the symptoms developed, he stopped taking his daily cocktail of supplements, but his symptoms did not go away.
The results of blood tests ordered by his family doctor revealed that he had very high calcium levels and slightly elevated magnesium levels. And the vitamin D level was 7 times the level needed for sufficient.
Tests also show that his kidneys are not working properly (acute kidney injury). The results of various X-rays and scans to check for cancer were normal.
The man remained in hospital for 8 days, during which time he was given intravenous fluids to flush his system and treated with bisphosphonates, drugs usually used to strengthen bones or lower excessive levels of calcium in the blood.
Two months after discharge from the hospital, his calcium level returned to normal, but his vitamin D level was still abnormally high.
“Globally, there is an increasing trend of hypervitaminosis D, a clinical condition characterized by elevated serum levels of vitamin D3,” with women, children and surgical patients most likely to be affected, the authors wrote.
Recommended levels of vitamin D can be obtained from diet (eg, wild mushrooms, oily fish), from exposure to sunlight, and from supplements.
“Given its slow turnover (half-life of approximately 2 months) during which vitamin D toxicity develops, symptoms may persist for several weeks,” the authors warn.
The symptoms of hypervitaminosis D are many and varied, they point out, and are mostly caused by excess calcium in the blood. These include drowsiness, confusion, apathy, psychosis, depression, stupor, coma, anorexia, abdominal pain, vomiting, constipation, peptic ulcers, pancreatitis, high blood pressure, abnormal heart rhythm, and renal abnormalities, including renal failure.
Other associated features, such as keratopathy (an inflammatory eye disease), joint stiffness (arthralgia), and hearing loss or deafness, have also been reported, they added.
This is just one case, and although hypervitaminosis D is on the rise, it is still relatively uncommon, the authors caution.
However, complementary therapy, including the use of dietary supplements, is popular, and people may not realize that it is possible to overdose on vitamin D or its potential consequences, they say.
“This report further highlights the potential toxicity of supplements that are largely considered safe until taken in unsafe amounts or in dangerous combinations,” they conclude.
Vitamin D supplements may offset diabetes drug-induced bone loss More information: Vitamin D intoxication and severe hypercalcemia complicating supplement abuse, BMJ Case Reports (2022). DOI: 10.1136/bcr-2022-250553 Provided by British Medical Journal
Citation: ‘Overdosing’ on Vitamin D Supplements Possible and Harmful, Doctors Warn (2022, July 5) Retrieved July 6, 2022, from
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