What are the side effects of excessive vitamin D intake. How can vitamin D toxicity affect your health. What are the symptoms and treatments for vitamin D overdose. How to prevent vitamin D toxicity while maintaining optimal levels.

The Dangers of Vitamin D Overdose: Unraveling the Toxicity Puzzle

Vitamin D, often hailed as the “sunshine vitamin,” plays a crucial role in maintaining overall health. However, the adage “too much of a good thing” applies even to this essential nutrient. Vitamin D toxicity, also known as hypervitaminosis D, occurs when excessive amounts of vitamin D accumulate in the body, leading to potentially serious health complications.

Typically, vitamin D toxicity results from taking extremely high doses of vitamin D supplements over an extended period. To put this into perspective, it usually requires consuming 60 to 100 times the recommended daily allowance (RDA) for several months to reach toxic levels. This equates to taking 10,000 to 60,000 international units (IU) daily for adults, far exceeding the recommended 600-800 IU for most individuals.

The Mechanism Behind Vitamin D Toxicity

How does excessive vitamin D intake lead to toxicity? The primary issue stems from its impact on calcium metabolism. When vitamin D levels soar, it triggers a cascade of effects:

• Increased bone breakdown: The balance between bone formation and resorption shifts, releasing more calcium into the bloodstream.
• Enhanced intestinal calcium absorption: The body absorbs more calcium from food than it normally would.
• Reduced calcium excretion: The kidneys retain more calcium, further elevating blood calcium levels.

These combined effects result in hypercalcemia, or abnormally high blood calcium levels, which is the hallmark of vitamin D toxicity.

Recognizing the Signs: Symptoms of Vitamin D Toxicity

Identifying vitamin D toxicity early is crucial for preventing long-term health consequences. The symptoms often develop gradually and can be subtle at first. What are the early warning signs of vitamin D overdose?

• Loss of appetite
• Nausea and vomiting
• Weakness
• Nervousness
• High blood pressure

As the condition progresses, more severe symptoms may emerge:

• Dehydration
• Confusion
• Kidney problems
• Bone pain
• Calcium deposits in soft tissues

It’s important to note that these symptoms can mimic other conditions, making diagnosis challenging without proper medical evaluation.

The Hidden Dangers: Long-term Effects of Vitamin D Toxicity

While acute symptoms of vitamin D toxicity can be alarming, the long-term consequences pose even greater concerns. What potential complications can arise from prolonged vitamin D excess?

• Kidney damage: High calcium levels can lead to kidney stones and potentially permanent kidney dysfunction.
• Cardiovascular issues: Calcium deposits may form in blood vessels and the heart, increasing the risk of heart problems.
• Bone weakening: Paradoxically, excessive vitamin D can lead to bone loss over time.
• Neurological symptoms: In severe cases, hypercalcemia can cause confusion, depression, and even coma.

These long-term effects underscore the importance of maintaining appropriate vitamin D levels and seeking medical attention if toxicity is suspected.

Diagnosing the Overdose: Medical Approaches to Vitamin D Toxicity

Accurately diagnosing vitamin D toxicity requires a combination of clinical assessment and laboratory tests. How do healthcare providers confirm a case of vitamin D overdose?

1. Medical history: Doctors inquire about supplement use, dietary habits, and symptoms.
2. Physical examination: This helps identify signs of hypercalcemia and its effects on various organ systems.
3. Blood tests: The primary diagnostic tools include:
   • Serum calcium levels: Elevated in vitamin D toxicity
   • 25-hydroxyvitamin D levels: The best indicator of vitamin D status, with levels above 150 ng/mL suggesting toxicity
   • Parathyroid hormone (PTH) levels: Often suppressed in vitamin D toxicity
4. Imaging studies: In some cases, X-rays or other imaging techniques may be used to assess calcium deposits in tissues.

Early diagnosis is crucial for preventing complications and initiating appropriate treatment.

Treating the Excess: Management Strategies for Vitamin D Toxicity

Once diagnosed, the primary goal of treatment is to lower calcium levels and prevent further damage to organs. What are the key components of managing vitamin D toxicity?

1. Discontinuation of vitamin D supplements: This is the first and most crucial step in treatment.
2. Hydration: Intravenous fluids help flush excess calcium from the system.
3. Medications:
   • Corticosteroids: These drugs can help reduce calcium absorption and inflammation.
   • Bisphosphonates: They may be used to inhibit bone resorption and lower blood calcium levels.
   • Calcitonin: This hormone can help reduce blood calcium levels quickly in severe cases.
4. Dietary modifications: Limiting calcium-rich foods may be recommended temporarily.
5. Treatment of underlying conditions: If vitamin D toxicity results from a medical condition, addressing that issue is crucial.

The duration and intensity of treatment depend on the severity of toxicity and the patient’s overall health status.

Prevention is Key: Strategies to Avoid Vitamin D Toxicity

While treatment options exist, preventing vitamin D toxicity is far preferable. How can individuals ensure they maintain healthy vitamin D levels without risking toxicity?

• Consult healthcare providers: Before starting any supplement regimen, discuss appropriate dosage with a medical professional.
• Regular monitoring: For those on high-dose supplements, periodic blood tests can help ensure levels remain within a safe range.
• Be cautious with fortified foods: Keep track of vitamin D intake from fortified products to avoid unintentional excess.
• Consider natural sources: Sunlight exposure and vitamin D-rich foods can contribute to maintaining adequate levels without the risk of overdose.
• Educate yourself: Understanding the recommended daily allowances and upper limits for vitamin D intake is crucial.

By following these preventive measures, most individuals can safely maintain optimal vitamin D levels without risking toxicity.

Debunking Myths: Separating Fact from Fiction in Vitamin D Supplementation

As with many nutritional topics, misinformation about vitamin D abounds. What are some common misconceptions about vitamin D supplementation, and what does the science actually say?

Myth: More Vitamin D Always Equals Better Health

Reality: While vitamin D is essential for health, excessive intake does not provide additional benefits and can be harmful. The body has mechanisms to regulate vitamin D from sunlight exposure, but not from supplements, making it possible to overdose.

Myth: Vitamin D Toxicity is Impossible

Reality: Although rare, vitamin D toxicity is a real and potentially serious condition, typically resulting from excessive supplement use rather than dietary sources or sun exposure.

Myth: Vitamin D Cures or Prevents All Diseases

Reality: While vitamin D plays a role in many bodily functions, it’s not a panacea. Current evidence does not support claims that vitamin D supplementation prevents or treats conditions like depression, cardiovascular disease, or most cancers.

Myth: You Can’t Get Enough Vitamin D from Food and Sunlight

Reality: For many people, a combination of dietary sources, moderate sun exposure, and possibly low-dose supplementation is sufficient to maintain adequate vitamin D levels.

Understanding these myths and facts can help individuals make informed decisions about vitamin D supplementation and reduce the risk of toxicity.

The Balancing Act: Achieving Optimal Vitamin D Levels Safely

Finding the right balance with vitamin D intake is crucial for reaping its benefits while avoiding the risks of toxicity. How can one achieve and maintain optimal vitamin D levels safely?

1. Know your baseline: Start with a blood test to determine your current vitamin D status.
2. Understand individual needs: Factors like age, skin color, geographic location, and health conditions can affect vitamin D requirements.
3. Incorporate natural sources:
   • Sunlight exposure: 10-30 minutes of midday sun several times per week can help many people maintain adequate levels.
   • Dietary sources: Fatty fish, egg yolks, and fortified foods can contribute to vitamin D intake.
4. Supplement wisely: If supplements are necessary, start with a moderate dose and adjust based on blood test results.
5. Regular monitoring: Periodic blood tests can help ensure levels remain within the optimal range.
6. Consider seasonal adjustments: Vitamin D needs may change throughout the year, especially in regions with significant seasonal variations in sunlight.

By taking a thoughtful, individualized approach to vitamin D intake, it’s possible to maintain optimal levels while minimizing the risk of toxicity.

Special Considerations: Vitamin D in Vulnerable Populations

While vitamin D is important for everyone, certain groups may have unique considerations when it comes to supplementation and the risk of toxicity. How do factors like age, health conditions, and medications affect vitamin D metabolism and toxicity risk?

Elderly Individuals

Older adults are at higher risk of vitamin D deficiency due to reduced skin synthesis and dietary intake. However, they may also be more susceptible to toxicity due to decreased kidney function. Careful monitoring and moderate supplementation under medical supervision are often recommended.

Pregnant and Breastfeeding Women

Adequate vitamin D is crucial during pregnancy and lactation, but high doses can be harmful to both mother and child. Guidelines typically recommend slightly higher intake during these periods, but within safe limits.

Individuals with Certain Medical Conditions

• Kidney disease: Impaired kidney function can affect vitamin D metabolism, increasing the risk of toxicity.
• Sarcoidosis and other granulomatous disorders: These conditions can cause increased sensitivity to vitamin D, lowering the threshold for toxicity.
• Primary hyperparathyroidism: This condition can exacerbate the effects of vitamin D on calcium levels.

Medication Interactions

Certain medications can interact with vitamin D, either enhancing its effects or altering its metabolism:

• Statins: May increase vitamin D levels
• Thiazide diuretics: Can increase calcium retention, potentially exacerbating hypercalcemia
• Antiseizure medications: Can affect vitamin D metabolism

For individuals in these groups, close medical supervision and personalized vitamin D management plans are essential to balance the benefits and risks effectively.

Vitamin D Excess – Disorders of Nutrition

By

Larry E. Johnson

, MD, PhD, University of Arkansas for Medical Sciences

Reviewed/Revised Nov 2022

VIEW PROFESSIONAL VERSION

Taking very high doses of vitamin D supplements can cause vitamin D toxicity.

• Vitamin D toxicity causes high levels of calcium in the blood.

• People with vitamin D toxicity may lose their appetite, feel nauseated, vomit, and feel weak and nervous.

• Doctors diagnose the toxicity by measuring levels of calcium and vitamin D in the blood.

• Treatment involves stopping vitamin D supplements and giving the person fluids and sometimes drugs.

(See also Overview of Vitamins Overview of Vitamins Vitamins are a vital part of a healthy diet. The recommended dietary allowance (RDA)—the amount most healthy people need each day to remain healthy—has been determined for most vitamins. A safe… read more .)

Taking very high daily doses of vitamin D—for example, 60 to 100 or more times the recommended daily allowance (RDA)—over several months can cause toxicity and a high calcium level in the blood (hypercalcemia Hypercalcemia (High Level of Calcium in the Blood) In hypercalcemia, the level of calcium in blood is too high. A high calcium level may result from a problem with the parathyroid glands, as well as from diet, cancer, or disorders affecting… read more ). Levels of calcium become high because when levels of vitamin D are high, the following occur:

• More bone is broken down than is reformed. (Normally, bones are continuously broken down and reformed—in a process called remodeling—to adjust to the changing demands placed on them.) As a result, calcium is released from the bone into the bloodstream.

• More calcium is absorbed from food in the intestine.

Vitamin D may be used to treat psoriasis Psoriasis Psoriasis is a chronic, recurring disease that causes one or more raised, red patches that have silvery scales and a distinct border between the patch and normal skin. A problem with the immune… read more , hypoparathyroidism Hypoparathyroidism Hypoparathyroidism is a deficiency of parathyroid hormone (PTH) often caused by an autoimmune disorder, treatment-related damage to the parathyroid glands, or removal of the glands during surgery… read more , and renal osteodystrophy Chronic Kidney Disease Chronic kidney disease is a slowly progressive (months to years) decline in the kidneys’ ability to filter metabolic waste products from the blood. Major causes are diabetes and high blood pressure… read more . Vitamin D has not been proven to prevent leukemia and breast, prostate, colon, or other cancers. Vitamin D supplementation does not effectively treat or prevent depression or cardiovascular disease, nor does it prevent fractures or falls. Some evidence, however, suggests that taking the combined recommended daily allowance of both vitamin D and calcium reduces the risk of fractures in people who are vitamin D deficient.

Early symptoms of vitamin D toxicity are loss of appetite, nausea, and vomiting, followed by weakness, nervousness, and high blood pressure.

Because the calcium level is high, calcium may be deposited throughout the body, particularly in the kidneys, blood vessels, lungs, and heart. The kidneys may be permanently damaged and malfunction, resulting in kidney failure.

• Blood tests

Vitamin D excess is usually diagnosed when blood tests detect a high calcium level in a person who takes high doses of vitamin D. Doctors also measure the level of vitamin D in the blood.

Treatment of vitamin D toxicity involves stopping vitamin D supplements to offset the effects of a high calcium level in the blood. Fluids are given intravenously as needed.

Drugs, such as corticosteroids Corticosteroids: Uses and Side Effects or bisphosphonates Drugs Osteoporosis is a condition in which a decrease in the density of bones weakens the bones, making breaks (fractures) likely. Aging, estrogen deficiency, low vitamin D or calcium intake, and… read more , are given to suppress the release of calcium from the bones.

NOTE:


This is the Consumer Version.


DOCTORS:



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Copyright © 2023 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved.

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What to Know About a Vitamin D Overdose

Written by Evan Starkman

• What Causes Vitamin D Toxicity?
• What Are the Symptoms of Vitamin D Toxicity?
• How Do Doctors Diagnose Vitamin D Toxicity?
• What’s the Treatment for Vitamin D Toxicity?
• How Do You Prevent Vitamin D Toxicity?

Vitamin D is important for your bones, muscles, nerves, immune system, and more.

But if you get too much, it could lead to a rare and possibly serious condition called vitamin D toxicity. You may hear your doctor call it hypervitaminosis D.

The condition can bring symptoms like weakness and vomiting. It can also affect your kidneys or heart rhythm.

Here’s why it happens, what the possible warning signs are, how it’s treated, and what you can do to prevent it.

Taking large doses of vitamin D supplements is usually what causes the condition.

Foods with vitamin D have small amounts of it, so it’s very unlikely that you’d get too much from your diet. Your skin also makes D when you get sunshine, but that doesn’t cause toxicity.

The dose at which vitamin D supplements become toxic isn’t clear. But it would need to be very high — way above the amount most doctors usually prescribe. Research shows that taking 60,000 international units (IU) of vitamin D a day for several months can cause toxicity.

Your chances of getting this condition could go up if you’re on a fad diet that has you take megadoses of a D supplement.

It’s also possible to get the condition if you take the wrong amounts of high-dose vitamin D supplements that your doctor has prescribed for health issues like:

• Malabsorption (trouble getting nutrients from food)
• Renal osteodystrophy (skeletal problems due to end-stage kidney disease)
• Osteoporosis
• Psoriasis

Some reports have described cases of vitamin D toxicity that were due to mistakes in the way vitamin D products were made or prescribed, including milk that was accidentally fortified with too much D.

If your doctor has you take a vitamin D supplement, make sure you know the right dose to take and how often to take it. If you’re on a high dose, the doctor will probably keep an eye on the level of vitamin D in your body by giving you blood tests.

Most healthy people only need 400 to 800 IU of vitamin D a day, depending on your age and whether you’re breastfeeding or pregnant.

Getting too much vitamin D can cause calcium to build up in your blood and body. That can bring on symptoms like:

• Nausea or vomiting
• Muscle weakness
• Tiredness and confusion
• Irritability
• Constipation
• Pain
• Less appetite
• Dehydration
• Peeing a lot along with thirst
• Kidney stones

Extremely high levels of vitamin D can lead to:

• Kidney failure
• Irregular heartbeat
• Death

Your doctor will give you a physical exam and ask you about your symptoms.

They might have you take tests that check your:

• Vitamin D levels
• Calcium levels in your blood and urine
• The amount of phosphate in your blood (phosphate contains the mineral phosphorus, which helps build strong bones)

The doctor may also check your bones with an X-ray.

You’ll probably stop taking vitamin D supplements under your doctor’s care. They’ll also limit how much calcium you get from food.

The doctor might need to give you fluids through a vein (IV) and have you take medications like steroids and bisphosphonates, too.

If you have kidney failure, you may need a treatment called hemodialysis. This takes over your kidneys’ job of filtering water and waste from your blood.

Most people with vitamin D toxicity recover without serious health complications, and they usually don’t get it again.

If your doctor tells you to take a vitamin D supplement, make sure you take the dose they prescribed. And only buy supplements from a reliable, licensed source. Ask your doctor or pharmacist, or check the NSF’s List of Certified Dietary Supplements. 

Lots of supplements that are a combination of vitamins have vitamin D in them. If you take one of these combo supplements, check the label to see how much D you’re getting.

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Of course, vitamin D is an essential nutrient for the human body, with a deficiency of which occurs
many failures. But in addition to the lack, there is also an overabundance of solar vitamin D, which is called
hypervitaminosis D. Independently, such a condition under the influence of ultraviolet radiation rarely occurs and is
pathology. But with excessive intake of supplements with cholecalciferol, it is quite possible to get an overdose of vitamin D
really.

It is a known fact that vitamin D is produced in the body by exposure to sunlight on the skin.
Insolation – exposure to the sun – provides 80% of the body’s need for vitamin D. Another source of the nutrient
(20% of the daily requirement) – certain products in which it is. But, unfortunately, such products are not
a lot, and the stay of a modern person in the sun (let’s be honest) is not so frequent.

For example, in order to meet the daily requirement for vitamin D with food, an adult needs
eat 40 egg yolks a day, or 2 kg of hard cheese, or 500-800 g of farm salmon . .. Not everyone is
strength, right?

And the sun is generally a problem. Not only are there not so many sunny days in our latitude, but also
due to work, not everyone can afford daily walks during especially active sunny hours – from about 11.00 to
17.00. Yes, and in the summer, walking in the sun is too risky: you can get at least overheating, and in
in the worst case, sunstroke and skin burns.

This is confirmed by a Ukrainian study conducted by the Institute of Medicine and the
creation of practical guidelines in endocrinology (Endocrine Practice Guidelines Committee). According to the
According to scientists and doctors, in Ukraine, the vast majority of residents have vitamin D deficiency (81.8%), and
cholecalciferol deficiency was found in 14% of Ukrainians aged 20 to 95 years. Especially it concerns
people living in the central, northern and western parts of our country.

All of the above combined leads to the need to take vitamin D supplements. AND
here every specialist will note: uncontrolled intake of cholecalciferol leads to intoxication, that is
an excess of vitamin D.

What does an excess of vitamin D lead to?

Although an overdose of vitamin D is extremely rare, the consequences are still quite serious. Consequence of intoxication
this nutrient is a large accumulation of calcium in the blood, which doctors call hypercalcemia.

The fact is that the kidneys are trying to remove excess
nutrient from the body, but do not cope with this work. As a result, calcium salts begin to be deposited in the ureters.
and renal pelvis, forming stones. If nothing is done in time and stop the overdose of vitamin D, then
there is an accumulation of calcium on the walls of blood vessels, in the heart, kidneys, lungs, intestines, spleen, which is why they
increase in size and cease to perform their functions fully.

In order to prevent vitamin D intoxication, you should still know what symptoms may indicate it, because in
Symptoms may vary between children and adults.

Signs of vitamin D overdose in infants

For babies under one year old, any overdose is dangerous, and even more so – an overdose of drugs. The small body is very
assimilates everything quickly, because his fat deposits are still too small, where excesses could be “stored”
vitamin D. Because of this, the nutrient accumulates in the blood, which causes hypervitaminosis.

Usually this condition occurs due to an erroneous dosage of the “sunshine vitamin”, which is prescribed to infants
up to a year. The fact is that now many manufacturers add vitamin D to baby food as a healthy supplement for babies.
Cholecalciferol (the so-called vitamin D) is additionally saturated with children’s dairy products – mixtures, milk,
kefir, yogurt, cottage cheese. And if the child’s daily nutrient requirement is fully covered by the child’s
diet, breastfeeding, and sufficient exposure to the sun, vitamin D supplementation may
cause an overabundance.

The main problem is that children under one year old cannot
to tell or at least show what hurts them. Therefore, it is possible to navigate only by the aggregate
symptoms.

An overdose of vitamin D in infants is manifested by:

• poor sleep;
• causeless crying at night;
• refusal to eat;
• thirsty;
• profuse urination;
• sudden weight loss;
• problems in the gastrointestinal tract – bloating, alternating diarrhea and constipation, sudden regurgitation and vomiting.

If you do not pay attention to these symptoms in time in an infant with an acute stage of vitamin D overabundance,
hypervitaminosis can become chronic, leading to pyelonephritis, early closure of the fontanel, and
fusion of the sutures of the skull.

Symptoms of vitamin D overdose in children

Experts note 2 forms of vitamin D overdose
– acute and chronic, and they were mentioned above. The first phase of hypervitaminosis makes itself felt during the first
2-10 weeks of the body’s response to cholecalciferol intoxication. In addition to the listed symptoms, which can be
notice in infants in this phase, in babies from a year old and older children, signs such as lethargy,
skin pallor, headache and abdominal pain.

An overdose of vitamin D passes into the chronic stage within 2 or more months. The child may suffer
from insomnia, loss of appetite. He may begin to complain of pain in his back and limbs.

Read more about the benefits of vitamin D for children and teenagers here.

Signs of too much vitamin D in women and men

Adults can also suffer from cholecalciferol intoxication. Often this happens unconsciously. Eg,
long-term combination of taking different vitamin complexes without taking into account the presence of vitamin D in them. It can also
occur due to dosage errors in the manufacture of vitamin-rich foods. In medical literature
there are several reported cases where young people came to the doctors with hypercalcemia due to poisoning
non-certified sports protein supplements that have exceeded the daily value of vitamin D by a hundred
once. At the same time, the presence of the nutrient was not mentioned in the composition of the product itself.

This is why it is very important to regularly produce
a laboratory blood test for the content of vitamin D in it – 25 (OH) D. You can read more about this in our
publications: “Analysis on
vitamin D – 25 (OH) D: put it on the shelves.

In adults, the symptoms of vitamin D overdose do not differ much from those in children. It’s nausea, vomiting,
headaches, dizziness and confusion, joint pain, convulsions, shortness of breath, arrhythmia –
heart rhythm disturbance, swelling, fatigue, irritability, weakness.

If you experience these symptoms, you should immediately stop taking supplements and products that contain
vitamin D, and see a doctor.

How to avoid too much vitamin D?

In order to avoid an overdose of vitamin D and benefit from taking a supplement, it is necessary to
control the amount of daily intake of cholecalciferol. The norm recommended by experts is 600-800
ME. The maximum allowable intake level is 4000 IU per day for those who have a vitamin D deficiency. Should not
self-medicate and independently, without prior consultation with a specialist, take any
additives.

The doctor adjusts the dosage according to age, gender,
concomitant diseases, the way of life of each patient individually. However, the most informative
the process of prescribing an additional supplement is a blood test for the level of vitamin D – 25 (OH) D.

To keep your vitamin D levels normal, you should follow a healthy lifestyle, avoid stress,
eat, filling the menu with products containing this nutrient, regularly walk in sunny weather. But let’s be
frank – these recommendations are ideal, but not for Ukrainians, especially now. Therefore, without additional
Vitamin D supplements are indispensable. How to do it right, you can read in our blog.

How much vitamin D do children and adults need?

The recommended daily intake of cholecalciferol for adults is 600 IU, and for people of retirement age (from
70 years) – 800 IU. If there is a vitamin deficiency in the blood below 30 ng / ml, endocrinologists recommend daily
consume 1,500-2,000 IU.

The risk of vitamin D deficiency for children is not exaggerated. It is a proven fact that a lack of a nutrient leads to a delay
growth and development of the baby, the occurrence of such a disease as rickets. Unfortunately, despite modern
progress, access to information and doctors, according to statistics, from 12 to 14% of young children have
hypovitaminosis D.

To prevent the development of such conditions, the recommended dose for children is given in the table below.

The recommendations for overweight children also differ. Doctors offer them a dose of
1200-2000 IU. If a significant vitamin D deficiency is detected in a child, the doctor may increase the dosage.

Diagnosis and treatment of excess (hypervitaminosis) vitamin D

It has already been said above that it is impossible to ignore the symptoms of hypervitaminosis D, as this can lead
to serious problems in the work of internal organs. That is why you should immediately consult a doctor who
will conduct an examination. What does it represent? The doctor first conducts a general examination of the patient and prescribes
additional research. This is a blood and urine test, an X-ray of the bones.

If an excess of vitamin D is detected, a special diet is prescribed, which excludes products containing this
nutrient – dairy products, fatty fish, eggs. The intake of additional supplements with cholecalciferol is also canceled.
In severe cases, hormonal drugs and the introduction of special drugs with the help of droppers may be prescribed,
which remove excess calcium from the body.

Probably, you have already heard the famous quote of the medieval physician Paracelsus: “Everything is poison, everything is medicine; both
dose determines. Therefore, do not forget that the truth is in the middle, and engage in independent
drugs should never be prescribed.

Sources:

1. Risk of hypervitaminosis D from feeding of high vitamin D premature infant formula // Yasushi Nako,
   Takeshi Tomomasa, Akihiro Morikawa // 2004 Aug// https://pubmed.ncbi.nlm.nih.gov/15310310/
2. Effect of vitamin D supplementation on non-skeletal disorders: A systematic review of meta-analyses and
   randomized trials. // Autier P, Mullie P, Macacu A, et al: Manson JE, Cook NR, Lee IM, et al // Lancet Diabetes
   Endocrinol 5(12):986–1004, 2017 // https://pubmed.ncbi.nlm.nih.gov/29102433/
   https://pubmed.ncbi.nlm.nih.gov/30415629/
3. Vitamin D screening and supplementation in community-dwelling adults: Common questions and answers // Michael L
   LeFevre, Nicholas M LeFevre // 2018 Feb https://pubmed. ncbi.nlm.nih.gov/29671532/
4. Effect of Long-term Vitamin D3 Supplementation vs Placebo on Risk of Depression or Clinically Relevant
   Depressive Symptoms and on Change in Mood Scores: A Randomized Clinical Trial // Olivia I Okereke, Charles F
   Reynolds, David Mischoulon, Grace Chang, Chirag M Vyas, Nancy R Cook, Alison Weinberg, Vadim Bubes, Trisha
   Copeland, Georgina Friedenberg, I-Min Lee, Julie E Buring, JoAnn E Manson // 2020 Aug //
   https://pubmed.ncbi.nlm.nih.gov/32749491/
5. Vitamin D Supplementation and Cardiovascular Disease Risks in More Than 83,000 Individuals in 21 Randomized
   Clinical Trials: A Meta-analysis // Mahmoud Barbarawi, Babikir Kheiri, Yazan Zayed, Owais Barbarawi, Harsukh
   Dhillon, Bakr Swaid, Anitha Yelangi, Saira Sundus // 2019 Aug // https://pubmed.ncbi.nlm.nih.gov/31215980/
6. Vitamin D and calcium for the prevention of fracture: A systematic review and meta-analysis // Pang Yao, Derrick
   Bennett, Marion Mafham, Xu Lin, Zhengming Chen, Jane Armitage, Robert Clarke // 2019Dec //
   https://pubmed. ncbi.nlm.nih.gov/31860103/
7. Vitamin D toxicity from an unusual and unexpected source: a report of 2 cases // Carolina Silva, Angela W S
   Fung, Vanessa Masson, Katrina Assen // 2022 Aug // https://pubmed.ncbi.nlm.nih.gov/36030768/
8. Vitamin D deficiency in the population of Ukraine and risk factors for its development // Povoroznyuk V.V., Balatskaya N.I. //2013 //
   http://www.mif-ua.com/archive/article/34626

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Doctors: Patients with vitamin D deficiency have a harder time with COVID-19. What else is dangerous vitamin D deficiency and how to make up for it?

Vitamin D deficiency leads to more severe COVID-19, doctors from Imperial College London report in a study. “All Pharmacies” figured out what else a lack of vitamin D in the body can threaten, why this vitamin is so important for us and how to maintain its normal level.

What is vitamin D and why is it needed?

In scientific language, this substance is called “colcalciferol”. Most people know it as the sunshine vitamin: it is produced by the body in response to the ultraviolet radiation from the sun hitting the skin. Vitamin D is also found in fish and fish oil, egg yolk, fortified dairy and grain products.

Vitamin D helps the body absorb calcium, strengthen bones, maintain muscle tone and stimulate the immune system.

Why is vitamin D deficiency dangerous?

The first signs of vitamin D deficiency are aches, pains in the bones or muscles. If left unaddressed, vitamin deficiency in the blood can increase the risk of death from cardiovascular disease, cancer, cognitive impairment in older children, and severe asthma in children.

In addition, vitamin D deficiency is dangerous if you have type 1 and type 2 diabetes, hypertension, glucose intolerance, or multiple sclerosis, in which case a deficiency can aggravate the condition.

Why does vitamin D deficiency occur?

Vitamin D deficiency can occur for several reasons. The most popular of them:

1. The diet is low in foods containing vitamin D . This is especially likely if a person is following a vegan diet, as most natural sources of vitamin D are animal based (fish, fish oil, egg yolks, fortified milk, and beef liver).

2. Not enough sunlight . The body produces vitamin D when sunlight hits the skin. The risk of deficiency is higher if you often stay at home (and we have been in self-isolation and remoteness for a long time), live in northern latitudes (it brightens late in winter, darkens early), wear closed clothes or hats for religious reasons, or abuse means that prevent ultraviolet radiation from reaching the skin.

3. Obesity . Vitamin D is taken from the blood by fat cells, reducing its release into the bloodstream. People with a body mass index of 30 or higher often have low vitamin D levels.

How do I know if I’m deficient in vitamin D?

The most accurate way is to take a blood test for 25-hydroxy-vitamin D. The norm for healthy people is from 20 ng / ml (nanograms per milliliter) to 50 ng / ml. If the analysis shows 12 ng / ml or less, this is a severe vitamin D deficiency – it must be treated.

How to compensate for vitamin D deficiency?

Treat vitamin D deficiency with dietary adjustments (more fish, yolk, and milk) and nutritional supplements.

For additives, the key indicator is the number of International Units (IU). For adults aged 18 to 70 years, the norm of vitamin D intake is 600 IU per day, over 70 – 800 IU. The safe upper limit of daily intake is 4000 IU, but with severe vitamin deficiency, doctors may prescribe more than 4000 IU per day for correction.

Is vitamin D deficiency really that dangerous during a pandemic?

Vitamin D deficiency is always dangerous, but, indeed, during the pandemic, it became a possible complication factor in the course of COVID-19. Numerous studies throughout the year ended with the following conclusions: a full intake of vitamin D can improve the results of treatment of patients with coronavirus, vitamin D can reduce the severity of the disease and the risk of complications, and patients with normal levels of vitamin D in the body are less likely to experience dangerous complications of coronavirus (for example, difficulty breathing and loss of consciousness).

However, it is important to remember : large doses of vitamin D are not a panacea for coronavirus or any other diseases.