What are the common and serious side effects of vitamin D3. How can vitamin D toxicity occur. What are the long-term effects of excessive vitamin D intake. How to avoid and treat vitamin D side effects.

Understanding Vitamin D3: Functions and Importance

Vitamin D3, also known as cholecalciferol, is a crucial nutrient that plays a vital role in maintaining overall health. Its primary function is to facilitate calcium absorption and maintain adequate calcium levels in the body. This essential vitamin contributes to:

• Bone health and strength
• Proper nerve functioning
• Muscle strength
• A robust immune system

Typically, our bodies produce vitamin D3 when the skin is exposed to sunlight, specifically ultraviolet-B (UVB) radiation. However, it can also be obtained through certain foods and dietary supplements.

The prevalence of vitamin D deficiency

Vitamin D deficiency is a widespread issue affecting both children and adults. Factors contributing to this deficiency include:

• Limited sun exposure
• Obesity
• Pregnancy
• Excessive use of sunblock

Chronic vitamin D deficiency can lead to serious health problems, including weak bones, increased risk of fractures, and rickets in children. It is also a major cause of generalized bone and muscle pain.

Common Side Effects of Vitamin D3 Supplements

While vitamin D3 supplements are generally safe when taken as directed, some individuals may experience side effects. These effects are typically associated with excessive intake over an extended period. Common side effects of vitamin D3 supplements may include:

• Nausea and vomiting
• Headache
• Irritability
• Fatigue
• Increased thirst
• Frequent urination
• Loss of appetite and weight loss

Can these side effects be managed? In most cases, these mild side effects can be alleviated by adjusting the dosage or discontinuing the supplement under medical supervision. It’s essential to consult a healthcare provider if you experience persistent symptoms.

Serious Side Effects and Vitamin D Toxicity

While rare, excessive intake of vitamin D3 can lead to a condition known as vitamin D toxicity or hypervitaminosis D. This occurs when vitamin D levels in the blood become dangerously high, leading to elevated calcium levels (hypercalcemia) and potentially severe health complications.

Symptoms of vitamin D toxicity

How can you recognize vitamin D toxicity? The following symptoms may indicate vitamin D toxicity:

• Severe nausea and vomiting
• Intense headache
• Extreme irritability
• Significant weight loss
• Weakness
• Constipation
• Kidney dysfunction

Long-term effects of vitamin D toxicity

What are the potential long-term consequences of vitamin D toxicity? If left untreated, prolonged vitamin D toxicity can lead to serious health complications, including:

• Kidney damage or failure
• Acidosis (increased acidity in the blood)
• Anemia
• Calcification of soft tissues, blood vessels, and organs
• Osteoporosis
• Stunted growth in children

Is vitamin D toxicity reversible? In most cases, vitamin D toxicity can be reversed by discontinuing vitamin D supplements and reducing calcium intake. However, severe cases may require medical intervention, including intravenous fluids, diuretics, and corticosteroids.

Timeline of Vitamin D3 Side Effects

Understanding the timeline of vitamin D3 side effects is crucial for early detection and prevention of potential complications. How quickly do vitamin D3 side effects manifest?

The onset of vitamin D3 side effects can vary depending on the dosage and individual factors. In most cases, mild side effects such as nausea or increased urination may appear relatively quickly after starting high-dose supplementation. However, more severe side effects associated with vitamin D toxicity typically develop over months or even years of excessive intake.

Duration of side effects

How long do vitamin D3 side effects persist? The duration of side effects can vary:

• Mild side effects may resolve within a few days to weeks after adjusting or discontinuing supplementation.
• Effects of vitamin D toxicity can last for two months or more after restricting vitamin D and calcium intake.
• In severe cases, some side effects may persist longer and require medical intervention.

It’s important to note that the long-term effects of chronic vitamin D toxicity may take time to fully resolve, even after appropriate treatment has been initiated.

Contraindications and Warnings for Vitamin D3 Supplementation

While vitamin D3 supplements can be beneficial for many individuals, there are certain situations where caution is advised or supplementation may be contraindicated. Who should exercise caution when taking vitamin D3 supplements?

• Individuals with hypercalcemia or a history of hypercalcemia
• People with kidney stones or a history of kidney stones
• Those with certain medical conditions, such as sarcoidosis or hyperparathyroidism
• Individuals taking medications that may interact with vitamin D

Special considerations for specific populations

Are there specific groups that require special attention when it comes to vitamin D3 supplementation?

• Pregnant and breastfeeding women: Should consult their healthcare provider before starting supplementation
• Infants and children: Require careful dosing based on age and individual needs
• Elderly individuals: May have increased sensitivity to vitamin D and require closer monitoring
• People with malabsorption disorders: May need higher doses but should be monitored closely

It’s crucial to consult a healthcare professional before starting any vitamin D3 supplementation, especially if you belong to one of these groups or have any underlying health conditions.

Interactions Between Vitamin D3 and Other Substances

Vitamin D3 can interact with various medications and substances, potentially affecting their efficacy or increasing the risk of side effects. What are some important interactions to be aware of?

Medications that may interact with vitamin D3

• Calcium channel blockers: May reduce the effectiveness of these blood pressure medications
• Thiazide diuretics: Can increase the risk of hypercalcemia when combined with high-dose vitamin D
• Corticosteroids: May interfere with vitamin D metabolism
• Cholesterol-lowering statins: Some statins may increase vitamin D levels in the blood
• Antacids containing magnesium: Can interfere with vitamin D absorption

Dietary interactions

Can certain foods or dietary habits affect vitamin D3 absorption or metabolism?

• High-fiber diets: May reduce vitamin D absorption
• Alcohol consumption: Can interfere with vitamin D metabolism
• Grapefruit juice: May increase vitamin D absorption and potentially lead to elevated levels

It’s important to inform your healthcare provider about all medications, supplements, and dietary habits when discussing vitamin D3 supplementation to avoid potential interactions and optimize its benefits.

Strategies to Avoid Vitamin D3 Side Effects

Preventing vitamin D3 side effects is crucial for safe and effective supplementation. What steps can be taken to minimize the risk of adverse effects?

Proper dosing and monitoring

• Follow recommended dosages: Adhere to guidelines provided by healthcare professionals or reputable health organizations
• Regular blood tests: Monitor vitamin D levels periodically, especially when starting or adjusting supplementation
• Gradual increases: If higher doses are needed, increase gradually under medical supervision

Lifestyle considerations

• Balanced diet: Incorporate vitamin D-rich foods to reduce reliance on supplements
• Safe sun exposure: Spend short periods in sunlight to promote natural vitamin D production
• Maintain a healthy weight: Obesity can affect vitamin D metabolism and increase the risk of deficiency

Quality control

• Choose reputable brands: Select supplements from trusted manufacturers
• Check for third-party testing: Look for products that have been independently verified for purity and potency
• Store properly: Keep supplements in a cool, dry place to maintain their efficacy

By implementing these strategies, you can significantly reduce the risk of experiencing vitamin D3 side effects while reaping its health benefits.

Treatment Options for Vitamin D3 Side Effects

If you experience side effects from vitamin D3 supplementation, it’s important to address them promptly. What are the available treatment options for vitamin D3 side effects?

Mild side effects

For mild side effects such as nausea or headache:

• Dose adjustment: Reduce the dosage or frequency of supplementation
• Timing changes: Take the supplement with food or at a different time of day
• Temporary discontinuation: Stop supplementation for a short period and gradually reintroduce

Vitamin D toxicity

In cases of suspected vitamin D toxicity:

• Immediate discontinuation: Stop all vitamin D supplements
• Calcium restriction: Limit dietary calcium intake
• Increase fluid intake: Help flush excess vitamin D and calcium from the system
• Medical intervention: Seek professional medical care for severe cases

Medical treatments

For severe cases of vitamin D toxicity, medical treatments may include:

• Intravenous fluids: To promote calcium excretion
• Diuretics: To increase urine output and calcium excretion
• Corticosteroids: To reduce calcium absorption
• Bisphosphonates: To inhibit bone resorption in severe cases
• Dialysis: In cases of kidney failure or severe hypercalcemia

It’s crucial to consult a healthcare professional if you suspect vitamin D toxicity or experience persistent side effects. They can provide appropriate guidance and treatment based on your individual situation.

Long-term Considerations for Vitamin D3 Supplementation

While vitamin D3 supplementation can be beneficial, it’s important to consider the long-term implications. What factors should be taken into account for prolonged vitamin D3 use?

Monitoring and adjustment

• Regular check-ups: Schedule periodic visits with your healthcare provider to assess vitamin D levels
• Seasonal adjustments: Consider modifying dosage based on sun exposure and dietary changes throughout the year
• Age-related changes: Be aware that vitamin D requirements may change as you age

Potential long-term benefits

What are the potential long-term benefits of appropriate vitamin D3 supplementation?

• Improved bone health and reduced risk of osteoporosis
• Enhanced immune function
• Potential reduction in the risk of certain chronic diseases
• Improved muscle strength and reduced risk of falls in older adults

Balancing risks and benefits

How can one balance the potential risks and benefits of long-term vitamin D3 supplementation?

• Individualized approach: Work with your healthcare provider to determine the optimal dosage for your specific needs
• Holistic health assessment: Consider vitamin D3 supplementation as part of an overall health and wellness strategy
• Stay informed: Keep up-to-date with the latest research and recommendations regarding vitamin D3 supplementation

By taking a thoughtful and proactive approach to vitamin D3 supplementation, you can maximize its benefits while minimizing potential risks over the long term.

Vitamin D side effects and how to avoid them

Vitamin D side effects can include vitamin D toxicity from taking too high of a dosage over a sustained period

Common vitamin D side effects | Serious side effects | Vitamin D toxicity | Side effects timeline | Contraindications | Warnings | Interactions | How to avoid side effects | How to treat side effects

Vitamin D is an essential nutrient responsible for calcium absorption and maintaining adequate levels of calcium in the body. It’s important for bone health, bone strength, nerve functioning, muscle strength, and the immune system. Vitamin D is normally produced by the skin when it is exposed to the sun’s ultraviolet-B radiation (UVB) but it also can be found in certain vitamin supplements and some foods.  

Having low vitamin D in the body is both a serious and common problem. Many children have a vitamin D deficiency, and the problem is common in adults who are overweight, pregnant, use sunblock, or otherwise don’t get enough sun exposure. Chronic vitamin D deficiency can lead to weak bones, bone fractures, and rickets (in children), and it is the major cause of generalized bone pain and muscle pain complaints. People take vitamin D supplements to avoid or correct vitamin D deficiencies. These supplements—available as synthetic vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol)—come in both over-the-counter and prescription dose strengths. Higher-dose prescription vitamin D is usually given to people with vitamin D deficiency, low parathyroid function (hypoparathyroidism, a condition that causes low blood calcium), and bone softening (osteomalacia). Side effects from both over-the-counter and vitamin D supplements are generally only a problem if too much vitamin D is taken over a long period.

Common side effects of vitamin D

Common side effects of vitamin D supplements may include: 

• Nausea and vomiting
• Headache
• Irritability 
• Tiredness
• Excess thirst
• Frequent urination
• Appetite and weight loss

Some adverse effects are due to taking too much vitamin D. In those cases, vitamin D toxicity (hypervitaminosis D) can cause several problems:

• High levels of calcium in the blood (hypercalcemia)
• Vomiting
• Nausea
• Headache
• Irritability
• Loss of appetite
• Weight loss
• Weakness
• Constipation
• Kidney dysfunction including:
  • Excessive or frequent urination
  • Thirst
  • High blood pressure
  • High calcium in the urine
  • Kidney damage (which could cause death)
• Acidic blood (acidosis)
• Anemia
• Calcium deposits (calcification) in the blood vessels, heart, lungs, kidneys, and other soft tissues
• Osteoporosis (a condition where the bones become weak and brittle)
• Slow growth in children

Serious side effects of vitamin D

Many of the common side effects of vitamin D overdose are very serious and related to how long calcium remains at high levels in the body. These include:

• Kidney dysfunction
• Kidney damage
• Kidney failure
• Acidosis
• Anemia
• Calcification of soft tissues, blood vessels, and organs
• Osteoporosis
• Slow growth and dwarfism (in children)

Vitamin D toxicity (hypervitaminosis D)

Overdosing on vitamin D for months or years can cause a rare but serious condition called hypervitaminosis D. High vitamin D levels in the blood raises calcium levels to dangerous levels and also leeches calcium from the bones, producing the side effects listed above. Overdosing on vitamin D only happens when people take too many vitamin D supplements or are prescribed high doses of vitamin D. However, people prescribed high-dose vitamin D will have regular blood tests to measure vitamin D and calcium levels to avoid vitamin D toxicity. About 4,000 people a year in the United States are diagnosed with vitamin D toxicity. In some extremely rare cases, people can have hypersensitivity to vitamin D. In those cases, normal vitamin D intake could be an overdose and cause high blood calcium. In these cases, vitamin D intake will be restricted. 

How soon do vitamin D side effects start?

Vitamin D side effects usually take months or years of overdosing to become a problem, though some of the milder side effects such as vomiting or excessive urination may be some of the first symptoms to appear.

How long do vitamin D side effects last?

The side effects of vitamin D toxicity can last for two months or more after vitamin D and calcium intake have been restricted. In terms of treatment for vitamin D toxicity, some patients may need to limit dietary calcium and consume excess fluids. More severe cases require aggressive treatment with IV saline, diuretics (to help remove calcium from the body), and corticosteroids. Some patients need dialysis and/or other medications. 

What are the long-term side effects of vitamin D?

Many side effects of vitamin D supplements are long-term side effects due to taking too much vitamin D. What constitutes an overdose has not been determined, but the Institute of Medicine has set the upper safe limit at 4,000 International Units daily. Overdosing could take years before becoming a problem (if problems develop at all). There is a small window between where vitamin D is therapeutic and where it can be toxic. Prescription doses can be as high as 500,000 IU a day in certain cases, so healthcare providers will monitor blood levels of both vitamin D and calcium at least every two weeks in these patients. They will modify treatment if high blood calcium becomes a problem. Many patients only need to take a small daily dose or a larger weekly dose (for example, 50,000 IU per week) and will be monitored occasionally, but not as frequently as those who take higher doses. Your healthcare provider will tell you how much vitamin D to take and how often you will need blood work.

Vitamin D contraindications

Vitamin D supplements should never be taken by people with:

• Vitamin D toxicity
• High blood calcium
• Allergies to any of the ingredients in the supplement
• Renal osteodystrophy (a complication of kidney disease that affects the bones and soft tissues)

Pregnancy

High-dose vitamin D is not recommended in pregnant women, although taking the suggested daily allowance is not prohibited. Vitamin D toxicity can affect a fetus and cause heart defects and developmental disabilities.

Breastfeeding

High-dose vitamin D is not recommended in women who are breastfeeding. The infant is at risk of high blood calcium due to ingesting high vitamin D doses through breast milk. If you are breastfeeding, consult your healthcare provider before taking vitamin D.

Children

Children who need vitamin D supplementation will be prescribed or recommended an individualized dose and carefully monitored with regular blood tests to prevent vitamin D toxicity. 

Older adults

High-dose vitamin D is not well-studied in older patients. People aged 65 and older are less efficient at absorbing vitamin D from foods or supplements. If vitamin D supplementation is a concern, blood tests can help identify a vitamin D deficiency. A healthcare provider can then suggest a supplementation regimen. For prescription vitamin D, a healthcare provider will start at the lowest possible dose and regularly perform blood tests to monitor vitamin D and calcium levels.  

Vitamin D warnings

As a supplement widely available in over-the-counter vitamins and multivitamins, vitamin D has only a few warnings and cautions. The most important warning: Don’t overdo it. Either follow the suggested guidelines or take the prescribed dose, but no more than that.

Cautions

A few medical conditions may cause problems when taking vitamin D, particularly in high doses. These include:

• Kidney stones. Raising vitamin D levels in the body can increase calcium levels in urine, which can contribute to the growth of some types of kidney stones.

• Kidney dysfunction. People with kidney disease are more likely to experience high calcium when taking vitamin D. Higher calcium in the blood makes the kidneys work harder to filter blood, putting an added strain on the kidneys. 

• High phosphate levels. Vitamin D regulates the absorption of phosphate and calcium through the intestines. Higher levels of vitamin D will cause the digestive system to absorb more phosphate, worsening pre-existing high phosphate levels.

• Malabsorption syndrome. Some medical conditions such as Crohn’s disease, cystic fibrosis, liver disease, or gallbladder problems diminish the digestive system’s ability to absorb fat-soluble vitamins like vitamin D. In those cases, higher amounts of vitamin D may need to be given.

Abuse and dependence

Vitamin D has no risk of drug abuse or drug dependence. 

Overdose

A single overdose of vitamin D will not cause major problems, though there may be digestive system issues. If too much vitamin D is taken at once, call a poison control center for advice. If a child takes too much vitamin D, call poison control. Because vitamin D toxicity can be very serious, take the child to the emergency room. 

Daily and chronic overdosing, however, can result in vitamin D toxicity, a serious medical condition characterized by the side effects listed above. If any cluster of these symptoms is noticed, immediate medical help is needed.

Vitamin D interactions

Vitamin D supplements have few drug interactions. Most involve drugs that reduce the effectiveness of taking the supplement. 

• Vitamin D. To avoid vitamin D toxicity, don’t combine vitamin D supplements with other vitamin D supplements unless the total daily dose is within guidelines.

• Calcium. To avoid high calcium, be prudent in taking calcium supplements or medicines containing calcium such as some antacids.

• Mineral oil. Mineral oil can interfere with the body’s absorption of vitamin D through the intestines.

• Bile acid resins. Used to treat high cholesterol, bile acid resins interfere with the digestive system’s ability to absorb fat-soluble vitamins like vitamin D.

• Thiazide diuretics. Combining vitamin D2 with thiazide diuretics such as hydrochlorothiazide can cause high calcium in people with low parathyroid function.

How to avoid vitamin D side effects

Avoiding vitamin D side effects involves a simple rule: don’t take too much. Here’s how to do it.

1. Know the right amount of vitamin D to take each day

Don’t guess. Look this up. There are two major guidelines for vitamin D intake. The Endocrine Society recommends 1,500 to 2,000 IU of vitamin D daily for adults. Infants less than one-year-old should get 400 to 1,000 IU daily, and children and adolescents should get 600 to 1,000 IU each day. The Institute of Medicine suggests lower daily doses: 400 IU daily for children and adults, and up to 800 IU daily for adults 71 years and older. Both recommendations are well below the maximum safe daily dose of 4,000 IU. Either way, your best bet is to ask your healthcare provider or your child’s pediatrician for a dosage recommendation based on lab results and/or guidelines.  

2. Know how much vitamin D is being taken each day

Many foods are fortified with vitamin D including milk, breakfast cereals, bread, and children’s foods. It may be possible that there’s enough vitamin D already in the diet, particularly for kids with a fondness for these foods. Check all the foods being eaten each day. Check any dietary supplements, like fish oil, for vitamin D. Add up the daily vitamin D intake. This will determine how many vitamin D supplements need to be taken. 

3. Know how much calcium to take each day

Vitamin D toxicity is also related to calcium intake. The IOM recommends a daily calcium dose of:

• Children ages 1 to 3 years old: 500 mg per day
• Children ages 4 to 8 years old: 800 mg per day
• Children/teenagers ages 9 to 18 years old: 1,300 mg per day
• Women 19 to 50 years old: 800 mg per day
• Women > 50 years old: 1,000 mg per day
• Men up to 71 years old: 800 mg per day
• Men 71 years and older: 1,000 mg per day

Again, there may be enough calcium in the diet, so take a look at all the other foods, dietary supplements, and calcium-containing drugs that are being taken to decide how much calcium needs to be added in the form of supplements.

4. Tell the prescriber about all medical conditions

If vitamin D is being prescribed by a healthcare professional, make sure the prescriber knows about all medical conditions and any drugs or supplements being taken. The most important are:

• Kidney disease
• Kidney stones
• High phosphate in the blood
• Crohn’s disease
• Gallbladder disease
• Liver disease
• Cystic fibrosis
• Pregnancy or pregnancy plans
• Breastfeeding or breastfeeding plans

5. Keep all follow-up appointments

If prescribed high doses of vitamin D, keep all follow-up and lab appointments. Many of the doses prescribed are enough to produce vitamin D toxicity, so regular blood tests are required to spot high levels of vitamin D or calcium before kidneys or tissues are damaged.

How to treat side effects of vitamin D

If any cluster of symptoms associated with vitamin D toxicity is noticed, stop using vitamin D and calcium supplements. Get immediate medical attention.

Sources

• Drisdol prescribing information, U.S. National Library of Medicine
• Ergocalciferol, Epocrates
• Ergocalciferol drug summary, Prescriber’s Digital Reference
• IOM releases report on dietary reference intakes for calcium and vitamin D, American Family Physician
• Vitamin D, StatPearls
• Vitamin D toxicity—a clinical review, Frontiers in Endocrinology

Cholecalciferol (Vitamin D3): MedlinePlus Drug Information

pronounced as (koe” le kal sif’ er ol)

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Cholecalciferol (vitamin D₃) is used as a dietary supplement when the amount of vitamin D in the diet is not enough. People most at risk for vitamin D deficiency are older adults, breastfed infants, people with dark skin, obese people, and those with limited sun exposure, or gastrointestinal disease (GI; affecting the stomach or intestines) such as Crohn’s disease or celiac disease. Cholecalciferol (vitamin D₃) is also used along with calcium to prevent and treat bone diseases such as rickets (softening and weakening of bones in children caused by lack of vitamin D), osteomalacia (softening and weakening of bones in adults caused by lack of vitamin D), and osteoporosis (a condition in which the bones become thin and weak and break easily). Cholecalciferol (vitamin D₃) is in a class of medications called vitamin D analogs. Cholecalciferol is needed by the body for healthy bones, muscles, nerves, and to support the immune system. It works by helping the body to use more of the calcium found in foods or supplements.

Cholecalciferol (vitamin D₃) comes as a capsule, gel capsule, chewable gel (gummy), tablet, and liquid drops to take by mouth. It is usually taken once or twice daily depending on the preparation, your age, and your medical condition(s). Cholecalciferol is available without a prescription, but your doctor may prescribe cholecalciferol to treat certain conditions. Check with your doctor or pharmacist before taking a cholecalciferol (vitamin D) supplement. Take cholecalciferol at around the same time every day. Follow the directions on your product label or doctor’s instructions carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take cholecalciferol exactly as directed. Do not take more or less of it or take it more often than recommended by your doctor.

Cholecalciferol liquid drops may be added to your child’s food or drink.

Cholecalciferol supplements are available alone and in combination with vitamins, and in combination with medications.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking cholecalciferol,

• tell your doctor and pharmacist if you are allergic to cholecalciferol, any other medications, or any of the ingredients in cholecalciferol products. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: calcium supplements, carbamazepine (Equetro, Teril, others), cholestyramine (Prevalite), multivitamins, orlistat (Alli, Xenical), phenobarbital, phenytoin (Dilantin), prednisone (Rayos), thiazide diuretics (”water pills”), or other cholecalciferol (vitamin D) supplements and fortified foods. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had hyperparathyroidism (a condition in which the body produces too much parathyroid hormone [PTH; a natural substance needed to control the amount of calcium in the blood]), kidney disease, or have high blood levels of calcium.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking cholecalciferol (vitamin D₃), call your doctor.

When cholecalciferol (vitamin D₃) is used to treat and prevent bone diseases, you should eat and drink of foods and drinks that are rich in calcium. If you find it difficult to eat enough calcium-rich foods, tell your doctor. In that case, your doctor can prescribe or recommend a calcium supplement.

Unless your doctor tells you otherwise, continue your normal diet.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Cholecalciferol (vitamin D

₃) may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• loss of appetite
• weight loss
• nausea
• vomiting
• constipation

Cholecalciferol (vitamin D₃) may cause other side effects. Call your doctor if you have any unusual problems while taking this vitamin.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this vitamin in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• loss of appetite
• weight loss
• nausea
• vomiting
• constipation
• weakness

• Fosamax^® Plus D (containing alendronate, cholecalciferol)
• Tri-Vi-Sol^® (containing Vitamin A, Vitamin C, Vitamin D)
• Viactiv^® Calcium Plus Vitamin D (containing calcium, vitamin D)

Last Revised – 10/15/2020

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An excess of vitamin D: what is dangerous, symptoms and signs of an overdose, vitamin norms in the body

It has long been known that vitamin D is one of the most important biologically active substances that help both strengthen physical health and achieve a stable working psyche.

However, not everyone knows that an overdose of vitamin D causes no less harm than its lack – especially for young children. Moreover, up to a certain point, the body can successfully fight the intake of an excess amount of a substance, so the result from its intake is not immediately visible, and the toxic effect is usually delayed.

On average, it takes about 1-4 months for a child’s body to show symptoms of an overdose.

Overdose symptoms

There are two forms of vitamin D overdose – acute and chronic.

In the acute form, the reaction in children manifests itself after 2-10 weeks and is expressed in lethargy, thirst, vomiting, pallor of the skin, headache, stool disorders, itching of the skin, pain in the epigastric region.

In chronic overdose, symptoms develop gradually over several months. The child’s appetite decreases, sleep disturbance, irritability, and frequent urination are noted. There may be pain in the bones, in the lumbar and cardiac region.

What happens inside the body?

The most common side effect is an excess of calcium in the blood. This condition negatively affects the functioning of the digestive system – hence symptoms such as nausea, vomiting, and abdominal pain. Trying to remove excess calcium in the urine, the kidneys do not fully cope with this task. As a result, calcium salts are deposited in the renal pelvis and ureters, which leads to the formation of stones. Some of the salts also settle on the walls of blood vessels, in the heart, lungs, liver, and spleen. Organs begin to increase in size.

What about babies?

Overdose of any drug occurs much faster in infants than in older children. Indeed, in children of the first year of life, there is still not much adipose tissue, where all the excess can be deposited, and therefore the substance accumulates in large quantities in the blood.

Babies with signs of hypervitaminosis usually do not sleep well, cry at night, lose their appetite, lose weight dramatically. There may be frequent regurgitation, diarrhea, vomiting. When anxiety symptoms appear, parents should definitely show the child to the doctor.

How much vitamin do you need?

Although vitamin D is not a drug, dosage decisions should be made by a physician. It is necessary to take into account the individual characteristics of a small patient, such as age, skin pigment, the presence / absence of digestive problems, intolerance to any products, allergic reactions, etc.

Children are usually advised to have a blood test before taking. Based on the results of the analysis obtained, a prophylactic or therapeutic dose is prescribed.

If there is no opportunity to conduct such a study, most likely the child will be prescribed a prophylactic dose, which, depending on the region of residence, ranges from 500 (in the middle and southern latitudes) to 1000 (in the north) IU per day.

Thus, vitamin D refers to those substances that are beneficial only in a certain amount. In order to prevent an overdose, parents should follow three simple rules:0038

Overdose of vitamin D

Why vitamin D is needed, what is the optimal daily dose and why its excess in the body is dangerous to health – in the material “Kommersant”.

Photo: Mark Lennihan / AP

Photo: Mark Lennihan / AP

Vitamin D benefits and where to find it

Vitamin D, also known as the “sunshine vitamin”, contributes to the normal functioning of the immune system. It comes in two main forms: D2 (ergocalciferol) found in foods and D3 (cholecalciferol) produced by the body when exposed to sunlight. It can be used to regulate the absorption of calcium, phosphorus and other minerals in the body, which are necessary for the health of muscles and bones.

Vitamin D levels depend on several factors:

Place of residence. People living in northern latitudes are at higher risk of vitamin D deficiency due to lack of sun.

Age. According to statistics, people over 65 produce four times less vitamin D than 20-year-olds.

Food. Vitamin D is rich in salmon, tuna, milk, cod and beef liver, eggs, orange juice.

State of health. In some diseases, vitamin D is practically not absorbed.

Young fair-skinned people produce vitamin D from sunlight much better than dark-skinned people over 50 years of age.

Supplements are the easiest way to get the right amount of vitamin D on a regular basis. They increase the amount of vitamin D in the body in the same way as sunlight or food.

When taken in a controlled manner, vitamin D provides significant health benefits:

• strengthens bones and muscles;
• improves immunity;
• improves heart function;
• reduces inflammation;
• is uplifting.

The Dangers of Vitamin D

Although vitamin D strengthens bones, taking too much can have the opposite effect. Its too high concentration in the blood is harmful and toxic.

Too much vitamin D—hypervitaminosis—can cause a buildup of calcium in the blood (hypercalcemia) and a range of adverse effects, including calcium deposits in soft tissues, joint pain, and sometimes loss of bone density—osteoporosis.

Overdose is due to excessive intake of vitamin supplements and cannot be caused by natural causes.

Daria Rusakova, Ph.D. skin reaches equilibrium and any additional vitamin D that is produced is degraded. It is almost impossible to achieve an excess of vitamin D through diet, since this vitamin in the human diet only from food is usually not enough. Vitamin D can accumulate in adipose tissue, therefore, a prerequisite for the development of a toxic effect is created. An excess of vitamin D causes an abnormally high concentration of calcium in the blood, which can cause calcification not only of bones, but also of soft tissues, heart, kidneys, in addition, blood pressure may increase, dehydration due to vomiting and diarrhea, muscle weakness, irritability. Symptoms of vitamin D toxicity usually appear several months after overdose. The symptoms are non-specific, so patients do not associate their malaise with taking the vitamin and do not seek medical help.”

Signs of vitamin poisoning:

• weakness;
• dizziness;
• nausea;
• convulsions;
• vomiting;
• confusion;
• fatigue;
• irritability;
• joint pain;
• cardiac arrhythmias;
• difficult breathing;
• swelling of various parts of the body.

If you overdose on vitamin D, you should immediately stop taking supplements and limit the use of foods containing it, and you should also drink more water.

How to Avoid Too Much Vitamin D

To safely supplement, you need to control your daily vitamin D intake. The standard recommended serving by doctors is 600 to 800 IU. The upper allowable level is 4,000 IU per day, for people with severe deficiency – no more than 10,000 IU per day.