How an increasingly popular supplement got a man hospitalized - Egypt Independent

(CNN) – A British man’s vitamin D overdose is a cautionary tale for people considering adding supplements to their lives, according to a paper published Tuesday in the journal BMJ Case Reports.

After visiting a private nutritionist, the man began taking more than 20 over-the-counter supplements daily, including 50,000 international units (IU) of vitamin D three times a day. That’s a dose hundreds of times higher than standard nutritional recommendations.

Within a month, the man started suffering from nausea, stomach pain, diarrhea and repeated vomiting, along with leg cramps and ringing in the ears.

The man, whose name was not disclosed, heard about the supplement on a radio talk show and contacted a nutritionist on the show afterwards, said Dr. Alamin Alkundi, a co-author of the report and an endocrinologist at William Harvey hospital in East Kent in England, who treated the man.

“Registration by regulators is not mandatory for nutritionists in the UK and their degrees are not protected, so anyone can practice as a nutritionist,” Alkundi said in an email.

Unlike water-soluble vitamins, which can be easily eliminated by the body, vitamins D and its cousins ​​A, E and K are stored in the liver and fat cells of the body until needed. Consuming more than the recommended daily dose can increase the level of toxins.

The man in the case study took a daily dose of 150,000 IU of vitamin D, which is “375 times the recommended amount,” Alkundi said. The UK’s National Health Service usually recommends 400 IU of vitamin D a day for children over 1 year of age and adults.

The man stopped taking the supplement when his symptoms started, but his condition did not improve. By the time he was referred to the hospital two months later, he had lost 28 pounds (12.7 kg) and had kidney problems. Tests showed he had overdosed on vitamin D, a condition called hypervitaminosis D.

Daily recommended level

The body needs vitamin D. The main job of vitamins is to help the body absorb calcium from the intestines — in fact, the body cannot absorb calcium unless vitamin D is present. Vitamins also play a role in immune health, brain cell activity and how muscles function.

In the United States, 15 micrograms, or 600 IU of vitamin D a day, is recommended for adults up to age 69, according to the National Institutes of Health. For adults 70 years of age and older, the dose rises to 20 micrograms or 800 IU daily. The recommended amount for infants, children and adolescents was recently doubled by the American Academy of Pediatrics to 10 micrograms or 400 IU per day.

A 2017 study found 3% of Americans consume more than the tolerable upper limit of 4,000 IU daily for adults, putting themselves at risk for toxicity. About 18% consume more than 1,000 IU daily.

Too much vitamin D in the blood causes hypercalcemia, which occurs when the level of calcium in your blood is above normal. The man in the BMJ case study was diagnosed with hypercalcemia, which can weaken your bones, create kidney stones, and interfere with how your heart and brain work.

The man was hospitalized for eight days and treated with drugs to lower the calcium levels in his blood. A follow-up two months later found her blood calcium levels had dropped to nearly normal. While the man’s vitamin D level also increased significantly, it was still high, Alkundi said.

“Plans to monitor both parameters at the clinic periodically are made to track the rate of decline to normal levels. We have been in contact with him and he reports (he is feeling) much better, but still not back to his normal self,” Alkundi said.

“He really wanted his story to be known to remind others,” Alkundi added.
Signs of excess vitamin D can include drowsiness, confusion, lethargy and depression, and in more severe cases can lead to fainting and coma. The heart may be affected: Blood pressure may increase and the heart may start beating erratically. In severe cases, the kidneys can experience kidney failure. Hearing and vision can be affected.

Where to get vitamin D

The body makes sufficient vitamin D when the skin is exposed to sunlight. In fact, going out in a bathing suit for 10 to 15 minutes during the summer “will produce 10,000 to 20,000 IU of vitamin D3 in adults with mild skin pigmentation,” according to the AAP.

However, going out into strong midday sun isn’t recommended because of the risk of skin cancer, so dermatologists and the AAP say it’s best to use sunscreen if you’re going to be exposed for a long time. Sunscreen can reduce the body’s ability to process vitamin D.

Vitamin D supplementation may not be necessary for many children and adolescents, the AAP says, because many foods such as milk, eggs, cereal, and orange juice are often fortified with vitamin D. Breastfed infants should be given 400 IU of vitamin D supplements daily. begins in the first few days of life and continues until the baby is weaned on milk or formula fortified with vitamin D, the AAP advises.

If vitamin D supplements are considered, daily vitamin D levels obtained from food should be factored into 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 does cod liver oil.

Anyone concerned about their vitamin D levels should be evaluated by a doctor, experts say

“Patients are encouraged to seek advice from their GP regarding alternative or over-the-counter medications they may be taking or would like to start with,” says Alkundi.

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