Man overdoses 7 times on vitamin D supplements; experts on how much is too much


A man was recently hospitalised after he overdosed more than seven times the recommended limit of vitamin D supplements, according to a case study published in the British Medical Journal. According to the study, the middle-aged man took the vitamin D supplement alongside 19 other supplements as part of a regimen recommended by a private nutritionist.

The man’s case was reported after he complained of recurrent vomiting, nausea, abdominal pain, leg cramps, tinnitus (ringing in the ear), dry mouth, increased thirst, diarrhoea, and weight loss (28 lbs or 12.7 kg), the report noted.

The report further mentioned, “These symptoms had been going on for nearly three months, and had started around one month after he began an intensive vitamin supplement regimen on the advice of a nutritional therapist.” He also had several other issues including tuberculosis, an inner ear tumour (left vestibular schwannoma), which had resulted in deafness in that ear, a build-up of fluid in the brain (hydrocephalus), bacterial meningitis, and chronic sinusitis, according to the report.

It was only after a blood test that it was detected that the man’s vitamin D levels were “seven times the recommended amount”, which is 600 mg or 400 IU every week. Since vitamin D regulates calcium in the body, the calcium levels were also high, putting his kidneys at risk of damage.

Vitamin D is quite important nutrient for better immune system. Though India is a subtropical country with adequate sunlight, vitamin D deficiency is prevalent. (representative) (Source : Getty Images / Thinkstock )

This “uncommon case” is of prominence in the backdrop of vitamin D supplements being “freely available” in the market as capsules or sachets or liquid solutions. “It is advisable to consult your doctor and get a blood test done,” said Dr Ashutosh Shukla, MD, FACP, medical advisor and senior director – Internal Medicine, Max Hospital, Gurugram.

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Also, it must be noted that vitamin D is actually not a vitamin but a prohormone. This means that whether vitamin D is taken in the diet or from sunlight, it needs to be first transformed by the liver and kidney into an active form. So, it is not ready to be used for consumption right away, like other vitamins and minerals.

Can vitamin D become toxic?

Hypervitaminosis D or overdose of vitamin D is a potentially serious condition. “This condition presents with nausea, loss of appetite, bone loss, elevated calcium levels, kidney failure risk, constipation, increased urination and increased thirst. It is important to check your blood levels of vitamin D if you notice any of these symptoms,” said Dr Shukla.

“Globally, there is a growing trend of hypervitaminosis D, a clinical condition characterised by elevated serum vitamin D3 levels,” with women, children and surgical patients most likely to be affected, wrote the study authors.

The US Endocrine Society‘s Practice Guideline recommends a maximum safe limit of 1,000 IU per day, said Dr Jayant Arora, director and unit head, Fortis Bone and Joint Institute, Fortis Memorial Research Institute, Gurugram.

“Given its slow turnover (half-life of approximately two months), during which vitamin D toxicity develops, symptoms can last for several weeks,” warn the authors of the study.

“Risk of overdose is particularly high with patients receiving injections of vitamin D as compared to oral vitamin D. We have seen patients being prescribed weekly injections of vitamin D for many months and these are at a very high risk of overdose. Taking large oral doses daily for many months can lead to overdose,” Dr Arora informed.

What can be done?

Recommended vitamin D levels can be obtained from the diet (for example, wild mushrooms, oily fish), exposure to sunlight, and supplements, the study prescribed.

According to Dr Arora, while taking vitamin D supplements for deficiency, it is wise to check blood levels before beginning and again after 8-12 weeks. “Also, stick to the dosage and duration as prescribed by your doctor. If in doubt, get a second opinion,” he said.

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