“Hypervitamin D,” as the condition was formerly known, is on the rise and linked to a wide range of potentially serious health problems, they point out. The case concerns a middle-aged man who was referred to hospital by his family doctor after complaining of recurrent vomiting, nausea, abdominal pain, leg cramps, tinnitus (ringing in the ear), dry mouth, increased thirst, diarrhea and weight loss. (28 lbs or 12.7 kg). These symptoms had been ongoing for almost 3 months and had started about 1 month after he started an intensive vitamin supplement regimen on the advice of a nutritionist. The man had various health problems, including tuberculosis, a tumor in the inner ear (left vestibular schwannoma), which resulted in deafness in that ear, a build-up of 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 (folic acid) 1000 mg (daily requirement 400 µg). vitamin B2 (riboflavin), vitamin B6, omega-3 2000 mg twice daily (200–500 mg daily requirement), plus many other vitamin, mineral, nutrient and probiotic supplements. Once the symptoms appeared, 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 his vitamin D level was 7 times above the level required for sufficiency. Tests also showed that his kidneys were not working properly (acute kidney injury). The results of various x-rays and scans to check for cancer were normal. The man stayed in hospital for 8 days, during which he was given intravenous fluids to flush out his system and treated with bisphosphonates – drugs usually used to strengthen bones or reduce excessive calcium levels in the blood. Two months after leaving the hospital, his calcium levels had 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 vitamin D3 levels,” with women, children and surgical patients more likely to be affected, the authors write. 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 about 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 mainly caused by excess calcium in the blood. They include drowsiness, confusion, apathy, psychosis, depression, lethargy, coma, anorexia, abdominal pain, vomiting, constipation, peptic ulcers, pancreatitis, high blood pressure, abnormal heart rhythm, and kidney abnormalities, including kidney failure. Other associated features, such as keratopathy (inflammatory eye disease), joint stiffness (arthralgia), and hearing loss or deafness, have also been reported, they add. This is just one case, and while hypervitaminosis D is on the rise, it’s 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 the potential consequences of it, they say. “This case report further highlights the potential toxicity of supplements that are considered largely safe until they are taken in unsafe amounts or in unsafe combinations,” they conclude.
