After a visit with a private nutritionist, the man began taking more than 20 over-the-counter supplements each day, including 50,000 international units (IU) of vitamin D three times a day. This is a dose hundreds of times higher than standard nutritional recommendations.
A month later, the man began to suffer from nausea, abdominal pain, diarrhea and repeated vomiting, along with cramps in his legs and buzzing in his ears.
The man, whose name was not disclosed, knew how to talk about supplements from a radio program and contacted the program’s nutritionist afterwards, said Dr. Alamin Alkundi, co-author of the report and endocrinologist at William Harvey Hospital in East Kent in the UK, who treated the man.
“Registration by the regulator is not mandatory for nutritionists in the UK and their title is not protected, so anyone can practice as a nutritionist,” Alkundi said in an email.
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 body fat cells until they are needed. Consuming well above the recommended daily dose can reach toxic levels.
The man in the case study was taking a daily dose of 150,000 IU of vitamin D, which was “375 times the recommended amount,” Alkundi said. The UK National Health Service typically recommends 400 IU of vitamin D per day for children over 1 year of age and adults.
The man stopped taking the supplements when his symptoms started, but his condition did not improve. When he was taken to hospital two months later, he had lost 28 pounds (12.7 kg) and his kidneys were in trouble. Tests showed he had consumed an overdose of vitamin D, a condition called hypervitaminosis D.
Recommended daily levels
The body needs vitamin D. The main function of the vitamin is to help the body absorb calcium from the intestines; in fact, the body cannot absorb calcium unless vitamin D is present. Vitamin also plays a role in immune health, brain cell activity, and muscle function.
In the United States, 15 micrograms, or 600 IU of vitamin D a day, is recommended for adults up to 69, according to the National Institutes of Health. For adults 70 years or older, the dose is increased to 20 micrograms or 800 IU each day. The recommended amount for infants, children, and teens was recently doubled by the American Academy of Pediatrics at 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 daily for adults, therefore. putting yourself at risk of toxicity. About 18% took more than 1,000 IU daily.
Excess vitamin D in the blood causes hypercalcemia, which occurs when the level of calcium in the blood is above normal. The man in the BMJ case study was diagnosed with hypercalcemia, which can weaken bones, create kidney stones and interfere with the functioning of the 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 his blood calcium levels had dropped almost to normal. Although the man’s vitamin D level had also improved significantly, it was still high, Alkundi said.
“A plan was established to periodically monitor both parameters in the clinic to monitor the levels of decrease to normal levels. We had contact with him and he reported (feels) much better, but has not yet returned to his self. normal, ”Alkundi said.
“He is eager for his story to be known to alert others,” Alkundi added.
Signs of excess vitamin D can include drowsiness, confusion, lethargy, and depression, and in more severe cases can cause 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 go into kidney failure. Hearing and vision may be affected.
Where to get vitamin D.
The body produces the proper vitamin D when the skin is exposed to the sun. In fact, going out in a swimsuit for 10 to 15 minutes during the summer “will generate between 10,000 and 20,000 IU of vitamin D3 in adults with light skin pigmentation,” according to the AAP.
However, it is not recommended to go in bright midday sunlight due to the risk of skin cancer, so dermatologists and the AAP say it is best to use sunscreen if you are exposed for a long period of time. . Sunscreens can reduce the body’s ability to process vitamin D.
Vitamin D supplementation may not be necessary for many children and teens, the AAP said, as many foods such as milk, eggs, cereals and orange juice are often fortified with vitamin D. Breastfed babies they should receive 400 IU of vitamin D supplementation daily. starting in the first few days of life and continuing until the baby is weaned on milk or vitamin D-fortified formula, the AAP advised.
If vitamin D supplements are considered, the daily levels of vitamin D obtained from food must be taken into account in 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 do cod liver oil. .
Anyone concerned about their vitamin D levels should have them evaluated by a doctor, experts say.
“Patients are encouraged to seek the opinion of their general practitioners about any alternative therapy or over-the-counter medications they may be taking or want to start,” Alkundi said.