Man in Hospital with Too Much Vitamin D from New Supplement Regimen

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Yes, it is possible to ingest Vitamin D. What a case report was published in BMJ Case Reports DescribedHe was a middle-aged man who had just started a new vitamin regimen that a private nutritionist recommended. The man was admitted to the hospital after he took a vitamin D excess dose.

This regimen contained 150,000 IU per day of vitamin D, which is more than 400 times the daily recommended intake of 400 IU. You heard it right: 400 times. Vitamin D can be a great supplement to your bone health and other health benefits. But just because something can help protect you doesn’t necessarily mean that using much, much more of it is better. That’s why even though wearing underwear is a good thing in general, it’s usually not recommended that you wear 400 pairs of underwear at the same time.

Vitamin D wasn’t the only thing in excess in this what-you-need regimen recommended by the private nutritionist. The nutritionist had also recommended 1,000 μg of vitamin B9 (folate) per day, much higher than the daily requirement of 400 μg, and 2,000 mg of omega-3 twice a day, also much higher than the daily requirement of 200 to 500 mg. Additionally, the regimen consisted of a mix of other vitamins, minerals, and probiotics, along with borax powder and sodium chloride. Borax powder, also known as sodium birate, sodium triborate, or diodium tetraborate is used to clean the house and boost laundry detergent. So unless you are a kitchen counter or a pair of soiled underwear, you shouldn’t be putting borax powder into yourself.

The case report by East Kent Hospitals University NHS Foundation Trust’s (Alamin Alkundi & Rabiu Momoh), as well as William Harvey Hospital’s (Abdelmajid Musa & Nkemjika Nwafor), described the next steps for this man. Surprise, surprise, the man began to experience a variety of symptoms one month after he started this regimen. And these symptoms weren’t happiness, vitality, stronger erections, or whatever peddlers of questionable supplement regimens may tell you about how you’ll feel. He experienced nausea, vomiting and leg cramps. These symptoms continued for almost three weeks. If you’re wondering, diarrhea that lasts for more than three months is not a good sign. You should never say, “my diarrhea is going really well. It’s about to reach the three months mark.” Having diarrhea so long probably means that you haven’t been absorbing enough food and nutrients. This will most likely cause weight loss, but not the good type of weight loss. The man lost around 12.7 kg, which is equivalent to 28 pounds. The symptoms remained even after the man quit taking the supplements.

Finally, the man saw a doctor. According to The case report, “On examination, [the man] appeared cachectic with mild diffuse abdominal tenderness.” Cachectic is not a compliment. You don’t typically tell your date, “you look particularly cachectic tonight,” and expect a second date. Instead, the Merriam Webster dictionary defines “cachectic” as “affected by cachexia,” and then defines “cachexia” as “general physical wasting and malnutrition usually associated with chronic disease.” In other words, the man did not look well.

In this case, appearances were not deceiving. The man’s blood tests were off the charts, again not in a good way. His blood level of calcium was elevated: 3.9 mmol/L, which was well above the normal range of 2.2 to 2.6 mmol/L. So was his blood level of magnesium: 1.04 mmol/L, which topped the normal range of 0.7–1.0 mmol/L. His serum vitamin D levels were greater than 400 nmol/L. As a reference, any vitamin-D level higher than 50 nmol/L will be considered adequate.

It wasn’t too surprising that the man’s calcium levels were elevated. Vitamin D is important for bone health. It helps to absorb and maintain sufficient levels of calcium, phosphorous, and other essential nutrients. These are generally very good things. However, while country music artist Alan Jackson may have sung, “too much of a good thing is a good thing,” this does not hold for vitamin D. Too much vitamin D can lead to too high levels of calcium in the blood.

And too high calcium levels in your blood ain’t good. This can lead to brain problems such as drowsiness and confusion, depression, stupor and psychosis. Your cardiovascular system can be affected by high calcium levels, which can lead to abnormal heart rhythms and blood pressure. Then there’s what hypercalcemia can do to your kidneys, such as causing kidney stones and kidney failure.

Blood tests showed that the man had sustained acute kidney injury. His serum creatinine, urea and other levels were both significantly elevated. This was a very serious finding. Your kidneys are your body’s sewage system. Your kidney function and ability to filter waste materials and toxins from your blood will be greatly diminished if your kidneys are removed.

These findings prompted the patient’s admission to the hospital where he received intravenous fluids and treatment with oral bisphosphonates. Oral bisphosphonates are a class of medications that’s got a bone to pick, so to speak, with osteoclasts. These medications can block osteoclast activity. Osteoclasts, which are cells found in bones, typically break down bone material to release calcium into the blood. This is in contrast to osteoblasts who use calcium and other materials for bone building. Osteoblasts and osteoclasts work together to build and break down bones. This keeps them healthy and current. In this case, though, doctors wanted to keep the osteoclasts in check so that the man’s calcium levels in the blood could drop below danger levels. The man was discharged from the hospital after eight days. He was diagnosed with vitamin D intoxication, or hypervitaminosisD.

All of this doesn’t mean that you should never, ever take vitamin D supplements. Sunlight exposure can cause your skin to naturally produce vitamin, or at the very least pre-cursors, to vitamin D. However, you should not spend too much time indoors screaming at people on Facebook and Clubhouse. You can get vitamin D from foods like cod liver oils, salmon, swordfish and fortified dairy. So if you do have low vitamin D levels, your doctor may recommend that you take vitamin D supplements such as vitamin D2, otherwise known as “ergocalciferol” or pre-vitamin D, and vitamin D3 otherwise known as “cholecalciferol.”

Be wary of anyone telling you to consume more vitamin D than recommended. Remember, you can eat D.

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