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A British man's vitamin D overdose is a warning to people considering adding supplements to their lives, according to an article published Tuesday in the journal BMJ Case Reports.
According to the article, published in BMJ Case Reports, the general practitioner referred the middle-aged man to an emergency department. For nearly three months, he had been dealing with a variety of ongoing symptoms, including vomiting, diarrhoea, abdominal pain, dry mouth, tinnitus, and leg cramps; he had also lost almost 30 pounds.
Tests soon ruled out other possible causes of his illness, such as infection. But they revealed evidence of acute kidney injury, as well as much higher levels of vitamin D and calcium (a common sign of vitamin D overdose) in his system than normal.
After a visit to a private nutritionist, the man began taking more than 20 over-the-counter supplements every day, including 50,000 international units (IU) of vitamin D three times a day. That's a dose hundred times higher than standard nutritional recommendations.
Within a month, the man began experiencing nausea, abdominal pain, diarrhoea and repeated bouts of vomiting, as well as leg cramps and ringing in his ears.
The man, whose name was not released, learned about the supplements on a radio show and then contacted the show's nutritionist, said Dr. Alamin Alkundi, a co-author of the report and an endocrinologist at William Harvey Hospital in East Kent in the UK, who treated the man.
Vitamin D Recommended Daily Intake
| Life Stage | Recommended Amount |
|---|---|
| Birth to 12 months | 10 mcg (400 IU) |
| Children 1–13 years | 15 mcg (600 IU) |
| Teens 14–18 years | 15 mcg (600 IU) |
| Adults 19–70 years | 15 mcg (600 IU) |
| Adults 71 years and older | 20 mcg (800 IU) |
| Pregnant and breastfeeding teens and women | 15 mcg (600 IU) |
Eventually, he was given IV fluids and was hospitalized for eight days, with doctors checking his blood every day to make sure he was getting better. He also received counselling and medications known as bisphosphonates to control his high calcium levels during and after his hospital stay. Vitamin D is fat-soluble, which means that it is absorbed into the body's fatty tissues and does not dissipate quickly. Two months after his hospital stay, follow-up tests showed that his calcium levels had returned to near normal, but his vitamin D levels had not.
People naturally get vitamin D from food or from regular exposure to sunlight. And while there is some evidence that many people may have insufficient vitamin D levels, there is no evidence that taking megadoses of vitamin D or other supplements improves health.
On the other hand, vitamin D intoxication, or hypervitaminosis D, is almost always related to inadequate supplementation. Data on how often it occurs is scant, but a 2016 analysis of US poison control data found more than 25,000 documented reports involving vitamin D between 2000 and 2014. Reports of illness were mild to moderate, with no related deaths, but exposures appeared to decrease and become more common over time, a trend noted by the authors of the current study.
"Globally, there is a growing trend of hypervitaminosis D, a clinical condition characterized by elevated serum vitamin D3 levels," they wrote, adding that cases are more common in women, children, and surgical patients.
Supplements can be useful for certain groups, such as people with clear nutritional deficiencies or pregnant women who need an extra supply of folic acid. But many doctors remain skeptical about its use for the average person.
In fact, an influential panel of experts recently recommended against taking vitamin E or beta-carotene supplements to prevent cancer or heart disease, citing a lack of strong evidence of their benefits, as well as some evidence that they may actually be harmful. Vitamin D overdoses like this current case aren't common, but it's another example of why supplements aren't as helpful or harmless as is commonly believed.
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