Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Overview

Vitamin D is an essential vitamin that helps regulate calcium and phosphorus in the body. It also plays a role in maintaining proper bone structure.

There are different forms of vitamin D, including ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). Vitamin D is found in fish, eggs, and fortified milk. It’s also made in the skin when exposed to sunlight. During periods of sunlight, vitamin D is stored in fat and then released when sunlight is not available.

Vitamin D supplements are commonly used to treat and prevent vitamin D deficiency. People who don’t get enough sun and people who are 65 years or older are at risk for deficiency. People also use vitamin D for weak and brittle bones, heart disease, asthma, hay fever, and many other conditions, but there’s no good scientific evidence to support many of these uses. There is also no strong evidence to support using vitamin D supplements for COVID-19. But it is important to maintain healthy levels of vitamin D. This can be done by taking 400-1000 IU of vitamin D daily or spending 15-30 minutes in the sun each day.

Uses & Effectiveness ?

Effective for

• A rare, inherited bone disorder marked by low levels of phosphate in the blood (familial hypophosphatemia). Taking specific forms of vitamin D, called calcitriol or dihydrotachysterol, by mouth along with phosphate supplements is effective for treating bone disorders in people with low levels of phosphate in the blood.
• Underactive parathyroid (hypoparathyroidism). Taking specific forms of vitamin D, called dihydrotachysterol, calcitriol, or ergocalciferol, by mouth is effective for increasing calcium blood levels in people with low parathyroid hormone levels.
• Softening of the bones (osteomalacia). Taking vitamin D3 by mouth is effective for treating this condition.
• A bone disorder that occurs in people with kidney disease (renal osteodystrophy). Taking a specific form of vitamin D, called calcitriol, by mouth helps to manage low calcium levels and prevent bone loss in people with kidney failure.
• Rickets. Taking vitamin D by mouth is effective for preventing and treating rickets. A specific form of vitamin D, called calcitriol, should be used in people with kidney failure.
• Vitamin D deficiency. Taking vitamin D by mouth is effective for preventing and treating vitamin D deficiency.

Likely Effective for

• Bone loss in people taking drugs called corticosteroids. Taking vitamin D by mouth prevents bone loss in people taking drugs called corticosteroids. Also, taking vitamin D alone or with calcium seems to improve bone density in people with existing bone loss caused by using corticosteroids.
• Weak and brittle bones (osteoporosis). Taking vitamin D3 by mouth along with calcium seems to help prevent bone loss and bone breaks in people with osteoporosis.
• Psoriasis. Applying vitamin D in the form of calcitriol, calcipotriene, maxacalcitol, or paricalcitol to the skin can help treat plaque-type psoriasis. Applying vitamin D along with corticosteroids seems to work better than applying vitamin D or corticosteroids alone. But taking vitamin D by mouth doesn’t seem to help.

Possibly Effective for

• Hay fever. Taking vitamin D by mouth seems to reduce symptoms of hay fever in adults and children. But it isn’t clear if taking vitamin D during pregnancy can help to prevent hay fever in the child after birth.
• Cavities. Taking vitamin D2 or D3 by mouth reduces the risk of cavities by 36% to 49% in infants, children, and adolescents.
• Heart failure. Taking vitamin D by mouth can help reduce the risk of developing heart failure in some people. But it doesn’t seem to help patients who already have heart failure.
• Bone loss in people with overactive parathyroid (hyperparathyroidism-related bone loss). Taking vitamin D3 by mouth seems to reduce parathyroid hormone levels and bone loss in people with a condition called hyperparathyroidism.
• Infection of the airways. Taking vitamin D by mouth helps prevent respiratory infections in children. But taking vitamin D by mouth during pregnancy doesn’t seem to reduce the risk of these infections in the child after birth. It also doesn’t help prevent infections in adults.
• Preventing tooth loss (tooth retention). Taking calcium and vitamin D3 by mouth appears to prevent tooth loss in elderly people.

Possibly Ineffective for

• Heart disease. Taking a vitamin D supplement by mouth doesn’t seem to prevent heart disease, heart attack, stroke, or other serious heart-related events in most people.
• Critical illness (trauma). Giving vitamin D to people with low vitamin D levels who are in the hospital with a critical illness doesn’t make them more likely to live.
• Fractures. Taking vitamin D by mouth doesn’t seem to prevent fractures in older people who do NOT have osteoporosis.
• High blood pressure. Taking vitamin D by mouth doesn’t seem to lower blood pressure in most people with high blood pressure. But it might help people who have very low blood levels of vitamin D.
• A mental disorder marked by hallucinations and delusion (psychosis). Taking vitamin D by mouth doesn’t seem to improve symptoms of psychosis in adults.
• Prostate cancer. Taking vitamin D by mouth doesn’t seem to reduce cancer progression or death from prostate cancer.
• Tuberculosis. Most research shows that taking vitamin D by mouth doesn’t help to cure tuberculosis or make it less severe.

There is interest in using vitamin D for a number of other purposes, but there isn’t enough reliable information to say whether it might be helpful.

Side Effects

When taken by mouth: Vitamin D is likely safe when taken in recommended amounts. Most people don’t experience side effects with vitamin D, unless too much is taken. Some side effects of taking too much vitamin D include weakness, dry mouth, nausea, vomiting, and others. Taking vitamin D for long periods of time in doses higher than 4000 IU (100 mcg) daily is possibly unsafe and may cause very high levels of calcium in the blood.

Special Precautions and Warnings

When taken by mouth: Vitamin D is likely safe when taken in recommended amounts. Most people don’t experience side effects with vitamin D, unless too much is taken. Some side effects of taking too much vitamin D include weakness, dry mouth, nausea, vomiting, and others. Taking vitamin D for long periods of time in doses higher than 4000 IU (100 mcg) daily is possibly unsafe and may cause very high levels of calcium in the blood. Pregnancy and breast-feeding: Vitamin D is likely safe during pregnancy and breast-feeding when used in daily amounts below 4000 IU (100 mcg). Do not use higher doses unless instructed by your healthcare provider. Vitamin D is possibly unsafe when used in higher amounts during pregnancy or while breast-feeding. Using higher doses might cause harm to the infant.

Children: Vitamin D is likely safe in children when taken by mouth in recommended amounts. But it is possibly unsafe to take vitamin D in higher doses, long-term. Infants from 0-6 months should not take more than 1000 IU (25 mcg) daily. Infants aged 6-12 months should not take more than 1500 IU (37.5 mcg) daily. Children aged 1-3 years should not take more than 2500 IU (62.5 mcg) daily. Children aged 4-8 years should not take more than 3000 IU (75 mcg) daily. Children aged 9 years and older should not take more than 4000 IU (100 mcg) daily.

Hardening of the arteries (atherosclerosis): Taking vitamin D could make this condition worse, especially in people with kidney disease.

A type of fungal infection called histoplasmosis: Vitamin D might increase calcium levels in people with histoplasmosis. This could lead to kidney stones and other problems. Use vitamin D cautiously.

High levels of calcium in the blood: Taking vitamin D could make this condition worse.

Over-active parathyroid gland (hyperparathyroidism): Vitamin D might increase calcium levels in people with hyperparathyroidism. Use vitamin D cautiously.

Lymphoma: Vitamin D might increase calcium levels in people with lymphoma. This could lead to kidney stones and other problems. Use vitamin D cautiously.

Kidney disease: Vitamin D might increase calcium levels and increase the risk of “hardening of the arteries” in people with serious kidney disease. Calcium levels should be monitored carefully in people with kidney disease.

A disease that causes swelling (inflammation) in body organs, usually the lungs or lymph nodes (sarcoidosis): Vitamin D might increase calcium levels in people with sarcoidosis. This could lead to kidney stones and other problems. Use vitamin D cautiously.

Tuberculosis: Vitamin D might increase calcium levels in people with tuberculosis. This could lead to kidney stones and other problems. Use vitamin D cautiously.

Interactions ?

Moderate Interaction

Be cautious with this combination

• Aluminum is found in most antacids. Vitamin D can increase how much aluminum the body absorbs. This interaction might be a problem for people with kidney disease. Take vitamin D two hours before, or four hours after antacids.

• Taking vitamin D along with calcipotriene might increase the effects and side effects of calcipotriene.

• Taking vitamin D along with digoxin might increase the effects and side effects of digoxin. If you are taking digoxin, talk to your doctor before taking vitamin D supplements.

• Vitamin D helps your body absorb calcium. Calcium can affect the heart. Diltiazem can also affect the heart. Taking large amounts of vitamin D along with diltiazem might decrease the effects of diltiazem.

• Vitamin D helps the body absorb calcium. Calcium can affect the heart. Verapamil can also affect the heart. Do not take large amounts of vitamin D if you are taking verapamil.

• Vitamin D helps the body absorb calcium. Some “water pills” increase the amount of calcium in the body. Taking large amounts of vitamin D along with some “water pills” might cause too much calcium in the body. This could cause serious side effects, including kidney problems.

• Vitamin D might decrease how much atorvastatin the body absorbs. Taking vitamin D with atorvastatin might decrease the effects of atorvastatin.

Minor Interaction

Be watchful with this combination

• Some medications are changed and broken down by the liver. Vitamin D might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Dosing

Vitamin D is an essential nutrient. Fish, eggs, and fortified milk are good sources of vitamin D. The amount that should be consumed on a daily basis is called the recommended dietary allowance (RDA). The RDA is 600 IU (15 mcg) daily for people 1-70 years of age and 800 IU (20 mcg) daily for those 71 years and older. While pregnant and breastfeeding, the RDA is 600 IU (15 mcg) daily. In children, the RDA depends on age. Vitamin D is also made in the skin after sun exposure. Spending 15-30 minutes in the sun each day should be enough to maintain normal vitamin D levels for most people.

Most people should not consume more than 4000 IU daily unless under the care of a healthcare provider. Speak with a healthcare provider to find out what dose might be best for a specific condition.

View References

CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version.
© Therapeutic Research Faculty 2020.

Signs, Symptoms, and Side Effects of Too Much Vitamin D

You may have too much vitamin D if you experience stomach discomfort, unusual mental symptoms, or kidney problems. Excessive vitamin D also shows up in a blood test.

Vitamin D plays an important role in maintaining health. It’s necessary for the growth and development of your muscle cells, proper functioning of the innate and adaptive immune system, maintenance of the health of your skeletal system, and more (1, 2).

Because vitamin D deficiency is more common, many people use vitamin D supplements to maintain healthy vitamin D levels. But too much vitamin D can also lead to health problems.

Signs of too much vitamin D include:

Elevated blood levels

In order for vitamin D to reach toxic or dangerous levels in the body, it needs to exceed 100 nanograms (ng) per milliliter (mL).

Hypervitaminosis D is defined as blood vitamin D levels over 100 ng/mL, while vitamin D intoxication is defined as serum levels over 150 ng/mL (3, 4).

Recommendations on optimal vitamin D levels vary, but research suggests that levels between 30–60 ng/mL are likely optimal and may help protect against illness and disease (4, 5).

Even when taking high dose vitamin D supplements, it’s unlikely that a healthy person’s blood vitamin D levels would come close to reaching excessive or toxic levels.

Most cases of vitamin D toxicity are caused by inappropriate supplement dosing and prescription errors.

For example, in a 2020 case report, a 73-year-old man developed vitamin D toxicity after taking 10,000 IU of vitamin D per day for many years (6).

In another 2020 case report, a 56-year-old woman who took an average of 130,000 IU of vitamin D per day for 20 months in hopes of improving symptoms of multiple sclerosis was hospitalized for symptoms including nausea, vomiting, and muscle weakness.

Her vitamin D levels were discovered to be 265 ng/mL, which equals 130,000 IU and is over 30 times the generally recommended safe upper limit of 4,000 IU per day (7).

Keep in mind that people who are low or deficient in vitamin D may need to take much higher levels than the safe upper limit to reach and maintain optimal vitamin D levels.

However, make sure to consult a healthcare professional on what dosage you should take. This will help you avoid potentially inappropriate or dangerous dosing.

Summary

Vitamin D levels greater than 100 ng/mL may be harmful. Toxicity symptoms have been reported at extremely high blood levels in cases where people took megadoses (very high doses) of vitamin D supplements for extended periods of time.

Elevated blood calcium levels

Vitamin D helps your body absorb calcium from the food you eat. In fact, this is one of its most important roles.

However, if your vitamin D intake is excessive, your blood calcium may reach levels that can cause unpleasant and potentially dangerous symptoms.

The symptoms of vitamin D toxicity are primarily related to hypercalcemia, which means excessively high blood calcium levels (8).

Symptoms of hypercalcemia include:

• digestive distress, such as vomiting, nausea, constipation, and stomach pain
• fatigue, dizziness, hallucinations, and confusion
• loss of appetite
• excessive urination
• kidney stones, kidney injury, and even kidney failure
• high blood pressure and heart abnormalities
• dehydration

The normal range of blood calcium is 8. 5–10.8 mg/dL (9, 10).

Hypercalcemia typically develops after people take megadoses of vitamin D for a prolonged period of time.

Research shows that adults taking more than 10,000 IU of vitamin D daily who exhibit symptoms should be evaluated for hypercalcemia (11).

In the 2020 case report mentioned earlier, the woman who took an average of 130,000 IU of vitamin D per day for 20 months was also hospitalized for symptoms related to hypercalcemia (12).

These included nausea, vomiting, muscle weakness, and kidney injury. Her blood calcium levels were 3.23 mmol/L (12.9 mg/dL) (12).

Hypercalcemia can be life threatening and requires immediate medical attention.

Summary

Taking too much vitamin D may result in excessive absorption of calcium, which can cause several potentially dangerous symptoms.

Gastrointestinal symptoms

The main side effects of excessive vitamin D levels are related to excessive calcium in the blood (13).

Some of the main symptoms of hypercalcemia include:

• nausea
• vomiting
• constipation
• diarrhea
• poor appetite

However, not all people with hypercalcemia experience the exact same symptoms.

One woman experienced nausea and weight loss after taking a supplement that was later found to contain 78 times more vitamin D than stated on the label (14).

Importantly, these symptoms occurred in response to extremely high doses of vitamin D3, which led to calcium levels greater than 12 mg/dL.

For example, an 18-month-old child who was given 50,000 IU of vitamin D3 for 3 months experienced diarrhea, stomach pain, and other symptoms. These symptoms resolved after the child stopped taking the supplements (15).

Summary

Taking vitamin D can increase levels of calcium in the blood, and too much calcium can cause side effects. If you take large doses of vitamin D, you may experience stomach pain, loss of appetite, constipation, or diarrhea as a result of elevated calcium levels.

Altered mental status

Hypercalcemia can lead to altered mental status in people with vitamin D toxicity.

People with vitamin D toxicity–induced hypercalcemia commonly have symptoms like confusion, depression, and psychosis. In extreme cases, coma has been reported (15).

In a 2021 case report, a 64-year-old man accidentally took 200,000 IU of vitamin D per day because he misunderstood medication instructions. He showed altered mental status and other serious symptoms related to hypercalcemia.

He remained agitated and confused for the first 10 days of his stay in the hospital, but his symptoms gradually improved as his calcium levels dropped. It took about 18 days for his calcium to return to the expected levels (16).

Summary

Vitamin D toxicity can cause symptoms like confusion, agitation, and unresponsiveness. This also appears to result from elevated calcium levels, which high doses of vitamin D can cause.

Kidney complications

In some cases, vitamin D toxicity can result in kidney injury and even kidney failure.

This is because having too much vitamin D in the body can lead to high levels of calcium, which can lead to water loss through too much urination and calcification of the kidneys (17).

Hypercalcemia can also cause the blood vessels of the kidneys to constrict, which leads to decreased kidney function (18).

Indeed, many studies have reported moderate-to-severe kidney injury in people who develop vitamin D toxicity (12, 19, 20).

Interestingly, a vitamin D deficiency can also harm the kidneys and lead to severe complications in those with kidney disease. That’s one reason why maintaining optimal blood levels of vitamin D is critical (21, 22).

Summary

Too much vitamin D may lead to kidney injury and can even lead to kidney failure in some cases.

Vitamin D supplements are considered very safe, and toxicity is uncommon. This is because a healthy person would need to take extremely large doses of vitamin D over time in order to reach toxic or dangerous levels in the body (15).

However, vitamin D toxicity is more common in people with certain medical conditions. These include (15):

• granulomatous disorders
• congenital disorders
• some lymphomas
• dysregulated vitamin D metabolism

Although uncommon, vitamin D toxicity can occur, especially in cases of:

• accidental overdose
• prescription errors
• misuse of high dose vitamin D supplements

Vitamin D toxicity goes by a few other names, including hypervitaminosis D and vitamin D intoxication.

Healthcare professionals may recommend people who are very low in vitamin D take very high weekly doses of 50,000 IU for 8 weeks, followed by a maintenance dose of 2,000 IU per day after their levels reach 30 ng/mL (15).

Your doctor will decide the most appropriate dose of vitamin D for you, depending on your vitamin D levels and your overall health.

Even though vitamin D toxicity isn’t common, you may be at risk if you misuse over-the-counter vitamin D supplements, prescription vitamin D supplements, or injections.

If you’re taking very high dose vitamin D supplements or are receiving vitamin D injections, your doctor will monitor your vitamin D levels to ensure they aren’t becoming potentially dangerous.

Avoid taking high dose vitamin D supplements unless your healthcare professional recommends them.

Summary

Vitamin D deficiency is quite common. For this reason, many people need to take vitamin D supplements. However, it’s important to avoid taking high dose vitamin D supplements, except with the guidance of a healthcare professional.

Toxicity is unlikely if you keep your daily intake levels below 10,000 IU per day and avoid excessively high intakes of vitamin D supplements (23).

Is 5000 IU of vitamin D too much?

Experts recommend that people with typical vitamin D levels do not exceed 4,000 IU of vitamin D per day (24).

Can too much vitamin D make you tired?

Fatigue can be a symptom of excess vitamin D, though it could also be a symptom of deficiency and other conditions (25).

Vitamin D is extremely important for your overall health. Even if you follow a healthy diet, you may require supplements to achieve optimal blood levels.

However, it’s also possible to have too much of a good thing. Make sure to avoid excessive doses of vitamin D. Generally, for people with adequate vitamin D levels, taking supplements of 4,000 IU or fewer per day is considered safe.

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Overdose of vitamin D (vitamin D). Symptoms of deficiency or overdose of vitamin D.

Without vitamin D, it is impossible to imagine the full functioning of the body and maintaining good health. Its beneficial properties are already manifested at the cellular level, and then they are transferred to the work of organs and their systems, ensuring the flow of all biochemical reactions.

Not all people receive the required amount of the nutrient, which has already become commonplace, but is fraught with side effects and deterioration in health. To make up for the lack, many resort to the use of supplements. But if such drugs are used incorrectly and do not follow the instructions, vitamin D can accumulate in the body and even reach the toxic limit. Vitamin D side effects are very unpleasant.

This is extremely dangerous and requires medical intervention to restore normal health to the body.

The following article discusses 6 dangerous side effects of overconsumption of the nutrient.

What is the danger of deficiency and excess of vitamin D

“Sunshine” vitamin takes part in calcium absorption reactions, increases the body’s immune function and strengthens the bone system, as well as muscle tissue and heart. The trace element enters our body with natural food or is produced in a certain amount on our own when we are under the sun – after the rays hit the skin, the vitamin is generated and enters our body.

In addition to being found in fatty fish, vitamin D3 is also found in other nutritious foods. Many people fail to consume the required amount of the nutrient, it is not always possible to walk or work in sunlight. All this provokes a lack of a microelement in the body and even leads to its acute form – deficiency.

According to statistics, approximately 1 billion people on the planet cannot get enough vitamin D.

The easiest way to fill the gap is to use nutritional supplements. Both forms of solar vitamin D3 and D2 can be obtained from special food preparations. D3 is a form of vitamin that is produced by the interaction of sunlight and human skin, and D2 is a form of a substance that is found in plant foods.

Scientists have found that vitamin D3 contributes much more to the saturation of the blood with the nutrient than its second form – D2. According to the results of studies, it was found that every 100 IU of D3 consumed by a person during the day increases the level of vitamin in the blood by about 1 ng / ml, 2. 5 nmol / l.

But when taking high doses of a substance for a long period, an accumulation effect occurs, which then acquires the character of toxicity and danger to the body. When its content in the blood rises to more than 150 ng / ml, or 375 nmol / l, intoxication occurs. The accumulation of the vitamin is concentrated in body fat, then there is a slow process of its release into the bloodstream. Thus, the toxic effects caused by an overdose of vitamin D can last for several months and even after you stop taking the supplement.

It is noteworthy that this effect is not common and is more common among people who take supplements for a long period, exceeding the doses indicated in the instructions, which does not allow you to control the level of the vitamin in the blood.

Inadvertently exceeding the daily allowance of a nutrient when supplements are used if the composition of the preparation contains much more of it than indicated on the label cannot be ruled out.

If you get the sunshine vitamin only naturally, that is, from exposure to the sun or through a balanced diet, there is no risk of excessive accumulation of the substance in the body.

6 side effects of vitamin D overdose and the features of each of them (vitamin D contraindications)

Increases the level of a substance in the blood new diseases and osteoporosis. However, there is no exact definition of the optimal range for vitamin doses.

30 ng/mL, or 75 nmol/L, of vitamin D is considered adequate. However, Council officials recommend maintaining levels of 40-80 ng/mL, or 100-200 nmol/L. Going beyond the norm of 100 ng / ml, or 250 nmol / l, is already harmful to health.

Now more and more people are starting to use vitamin supplements, and it is simply impossible to meet someone who has an excess of a nutrient in the blood.

A recent study was conducted on 20,000 people over a 10-year time period. It was found that in 37 subjects, the level was above 100 ng / ml, or 250 nmol / l. One participant was diagnosed with true toxicity at a dose of 364 ng/mL, or 899 nmol/L.

Another study calculated a woman’s blood volume of the vitamin at 476 ng/mL, or 1171 nmol/L, from supplementation at a dosage of 186900 IU per day for 60 days. This is 47 times the safe upper limit of 4000 IU per day.

A woman was hospitalized when she began to show symptoms of weakness, forgetfulness, nausea and vomiting, fatigue, slurred speech.

Increases the level of calcium in the blood

With the help of vitamin D3, calcium from consumed foods is well and correctly absorbed. And this is one of the key functions of the nutrient in our body.

But with an excess of intake of a substance in the body, the level of calcium in the blood also rises, which in this case causes discomfort, disrupts the functioning of the body and is accompanied by potentially dangerous symptoms.

Suspicion of hypercalcemia (exceeding the normal level of a mineral in the blood) is manifested through:

Normal blood levels of calcium are 8.5-10.2 mg/dL, or 2.1-2.5 mmol/L.

An experiment with an elderly man suffering from dementia showed that he consumed 50,000 IU of vitamin D every day for six months, which led to him being often hospitalized with symptoms very similar to or associated with hypercalcemia.

Another case was referred to the health of two men who were taking mislabeled supplements that resulted in excess calcium levels of 13.2-15 mg/dl, or 3.3-3.7 mmol/l.

Only after a year of rehabilitation procedures and a proper diet, the volume of the mineral in the blood returned to normal.

Symptoms of nausea, vomiting, poor appetite

With an excess of trace elements, most of the symptoms that appear are always associated with an increase in calcium levels. In particular, this manifests itself through nausea, vomiting and loss of appetite.

But not all people with hypercalcemia have the symptoms listed above.

A study in a group of 10 people with elevated calcium levels due to vitamin D overdose found that four people experienced nausea and vomiting and another three had loss of appetite.

Such reactions of the body to excessive intake of the nutrient have been recorded in various other experiments. After taking the supplement, the woman complained of nausea and weight loss. The preparation she used contained 78 times the required dose of solar vitamin. And it didn’t match the information on the label.

In cases like these, where the body responded to overvitamination, blood calcium levels were 12 mg/dL, or 3. 0 mmol/L.

Symptoms of abdominal pain, constipation, diarrhea

Symptoms such as abdominal discomfort, constipation or diarrhea often occur in case of digestive dysfunction or disorder. They may be associated with food intolerance or irritable bowel syndrome (IBS). But in the case of an excess of vitamin D are also found.

Such manifestations are characteristic of people who receive too large doses of trace elements to eliminate vitamin D deficiency. In this case, in each case, everything is individual.

One study suggested that a boy complained of abdominal pain and constipation after taking mislabeled vitamin supplements, and his taker was asymptomatic, both of whom overdosed.

Another experiment was carried out on an 18-month-old child – he was given 50,000 IU of vitamin B3 for 90 days. As a result, the body protested with diarrhea, abdominal pain and other unpleasant phenomena. When the supplementation ended, the symptoms immediately disappeared.

Reduced bone mass

Vitamin D is directly related to calcium absorption and bone metabolism, so the body needs to receive the right dose of the substance in order for all the bones in the body to be strong and healthy.

But if the dosage is exceeded, it negatively affects the organs and tissues.

While oversaturation of the sunshine vitamin is always associated with elevated levels of the mineral in the blood, researchers believe that such megadoses can cause a drastic reduction in vitamin K2 in the blood.

K2 is necessary to retain calcium in bone tissue and blood, and due to a supersaturation of vitamin D, the activity of the mentioned nutrient decreases.

To maintain normal bone mass and overall health, you need to control your vitamin D supplementation and remember to saturate your body with vitamin K2. The latter is best obtained from natural sources – dairy products and meat.

Manifestation of kidney failure

If there is an excess of vitamin D in the body, this negatively affects the functioning of the kidneys.

One case study induced a man to be hospitalized with symptoms of kidney failure, hypercalcemia, and other adverse events following a vitamin shot. Initially, the patient received such a recommendation from a doctor.

There are many studies that report moderate to severe impairment of kidney function in people who suffer from solar vitamin overload.

An experiment involving 62 people who received high doses of vitamin D by injection showed that every participant experienced kidney failure. And this did not depend on whether he had initially healthy kidneys or already had other diseases with the organ.

This pathology is treated with oral or intravenous hydration and special medicines.

To summarize

Vitamin D is an essential micronutrient for the overall health of our bodies. If you eat properly and balanced, this does not exclude the possibility that you may need to take supplements to normalize the level of the nutrient in the blood.

But too much vitamin is also bad. It is important to avoid excessive dosages. The maximum allowable daily intake is 4000 IU – this is quite safe if you control blood counts.

When buying nutritional vitamin supplements, it is important to choose products from trusted manufacturers, otherwise the risk of overdose due to mislabels increases.

If you experience any of the strange symptoms or negative sensations described in this article while taking vitamin D supplements, seek immediate medical attention.

D3-CAPS 5000 IU

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• Medicines
• Vitamins and vitamin-mineral complexes

For the treatment of vitamin D deficiency in adults.

Book at the pharmacy

• International non-proprietary name

  Cholecalciferol

• Composition per capsule

  Cholecalciferol (as cholecalciferol oil solution 1 million IU/g) 125 mcg (5000 IU) (for 5000 IU dosage)

• Pharmacotherapeutic group

  Vitamins. Vitamin D and its analogues.
  ATX code: A11CC05

• Pharmacological properties

  Pharmacodynamic effects
  Cholecalciferol (vitamin D3) is formed in the skin under the influence of
  UV radiation and converted to the biologically active form
  1,25-dihydroxycholecalciferol in two stages of hydroxylation, first in the liver (position 25) and then in the kidney tissue (position 1). Along with parathyroid hormone and calcitonin, 1,25-dihydroxycholecalciferol has a significant effect on the regulation of calcium and phosphate metabolism. In vitamin D deficiency, the skeleton does not calcify (leading to rickets) or the bones decalcify (leading to osteomalacia). In terms of production, physiological regulation, and mechanism of action, vitamin D3 is considered to be a precursor of the steroid hormone. In addition to the physiological formation in the skin, cholecalciferol can be supplied with food or in the form of a drug. Since in the latter case it is possible to bypass the inhibition of skin synthesis of vitamin D, overdose and intoxication are possible.

  Pharmacokinetic properties
  Absorption
  Cholecalciferol from dietary sources is almost completely absorbed from the gastrointestinal tract in the presence of dietary lipids and bile acids. Higher doses are absorbed in a ratio of 2:3. Skin exposed to UV radiation synthesizes vitamin D from
  7-dehydrocholesterol.
  Biotransformation
  Vitamin D is transported to the liver by a specific transport protein. Cholecalciferol is metabolized by microsomal hydroxylase to form 25-hydroxycholecalciferol (25(OH)D3, calcidiol), the main storage form of vitamin D3. 25(OH)D3 undergoes secondary hydroxylation in the kidneys to form the predominant active metabolite of 1,25-hydroxycholecalciferol (1,25(OH)2D3, calcitriol). Metabolites circulate in the blood in a bound form with a specific
  α-globin.
  Breeding
  Cholecalciferol and its metabolites are excreted mainly with bile and faeces.
  Vitamin D is stored in adipose tissue and therefore has a long biological half-life. After high doses of vitamin D, serum 25-hydroxyvitamin D concentrations may rise for several months.
  Hypercalcemia due to an overdose may persist for several weeks (see section “Overdose”).
  Preclinical safety data
  Effects in non-clinical toxicity studies with single and repeated administration were observed only at high doses. At very high doses, teratogenic effects have been observed in animal studies. Normal endogenous levels of cholecalciferol showed no potential mutagenic activity in a standard series of tests and carcinogenic activity.

• Indications for use

  D3-CAPS is indicated for the treatment of vitamin D deficiency in adults.

• Instructions for use

  Dosing regimen
  Dosage for adults
  Recommended dose: 1-4 capsules per week (5,000-20,000 IU), depending on the desired serum level of 25-hydroxycholecalciferol (25(OH)D), the severity of the disease, and the patient’s response to treatment.
  After the first month, lower doses may be considered depending on the desired serum level of 25-hydroxycholecalciferol (25(OH)D), the severity of the disease, and the patient’s response to treatment.
  Special patient groups
  Patients with impaired renal function
  Vitamin D should be used with caution in patients with mild to moderate renal impairment. The effect on calcium and phosphate metabolism should be monitored.
  Vitamin D should not be used in patients with severe renal insufficiency (see sections 4.3, 4.4).
  Patients with impaired liver function
  Dose adjustment is not required.
  Children
  Not recommended for children under 18 years of age.

  How to use
  The drug is taken orally, during meals, drinking plenty of water.

• Special instructions

  Special instructions and precautions for use
  High doses of vitamin D can cause vitamin D toxicity if dosed incorrectly. As a consequence: Severe cases of hypercalcemia have been reported after taking a high loading dose of vitamin D.
  During treatment, it is necessary to monitor the level of calcium in the blood serum and monitor kidney function by measuring serum creatinine. Monitoring is especially important in elderly patients receiving concomitant treatment with cardiac glycosides or diuretics (see section 4.8). In case of hypercalcemia, treatment must be interrupted. In case of hypercalciuria or signs of impaired renal function, reduce the dose or stop treatment.
  Vitamin D preparations should be used with extreme caution in patients with impaired urinary calcium and phosphate excretion, in the treatment of benzothiadiazine derivatives and in immobilized patients (risk of hypercalcemia and hypercalciuria). In such patients, plasma and urinary calcium levels should be monitored.
  Vitamin D should be used with caution in patients with impaired renal function. In patients with renal insufficiency receiving treatment with vitamin D preparations, it is necessary to monitor its effect on calcium and phosphate metabolism. The risk of soft tissue calcification should be considered. Vitamin D should not be taken by patients who are particularly prone to calcium-containing kidney stones. In patients with severe renal insufficiency, the metabolism of vitamin D in the form of cholecalciferol is impaired and other forms of vitamin D should be used.
  Caution should be exercised when prescribing vitamin D supplements in sarcoidosis due to the risk of increased levels of its conversion to the active metabolite. In such patients, it is necessary to monitor the concentration of calcium in serum and urine.
  The drug should not be taken in case of pseudohypoparathyroidism (the need for vitamin D can sometimes be reduced by normal sensitivity to vitamin D with the risk of overdose with long-term use). In such cases, other vitamin D derivatives are available.
  All potential sources of vitamin D, such as other vitamin D supplements, foods, foods fortified with vitamin D, dietary supplements, etc., should be considered when prescribing vitamin D to avoid overdose. Additional doses of vitamin D should be taken under close medical supervision . In such cases, it is necessary to more often monitor the level of calcium in the blood serum and the excretion of calcium in the urine.
  The drug contains sodium benzoate (E211), the content of which may cause allergic reactions.

• Pregnancy and lactation

  Fertility, pregnancy and lactation
  Due to the high dose of cholecalciferol, the drug is contraindicated during pregnancy and lactation, unless the clinical condition of the woman requires treatment with cholecalciferol at a dose necessary to prevent vitamin D deficiency.
  Pregnancy
  Vitamin D deficiency is harmful to mother and baby. In animal experiments, high doses of vitamin D have been shown to be teratogenic. Vitamin D overdose during pregnancy should be avoided, as prolonged hypercalcemia can lead to physical and mental retardation, supravalvular aortic stenosis, and retinopathy in the child.
  D3-CAPS, 5,000 IU, capsules, should only be given to pregnant women with laboratory confirmed vitamin D deficiency.
  Breastfeeding
  Vitamin D and its metabolites pass into breast milk. No adverse events were observed in infants.
  D3-CAPS, 5,000 IU, capsules, may only be given while breastfeeding if there is a laboratory confirmed vitamin D deficiency.
  Fertility
  Normal endogenous vitamin D levels are not expected to have any adverse effect on fertility.

• Influence on the ability to drive a car, work with machinery

  Influence on the ability to drive vehicles and work with mechanisms
  The study of the effect on the ability to drive vehicles and work with mechanisms has not been conducted. The impact is incredible.

• Interaction with other medicinal products

  Interaction with other medicinal products and other forms of interaction
  Anticonvulsants (such as phenytoin) and barbiturates can reduce the effect of cholecalciferol due to increased metabolism.
  thiazide diuretics. May reduce the excretion of calcium in the urine and, accordingly, increase the risk of developing hypercalcemia. In such patients, it is necessary to constantly monitor the concentration of calcium in the blood and urine.
  Glucocorticosteroids. Simultaneous administration of glucocorticosteroids may reduce the effect of the drug.
  cardiac glycosides. Oral administration of vitamin D may increase their efficacy and toxicity due to increased calcium levels (risk of cardiac arrhythmias). In such patients, it is necessary to monitor plasma and urinary calcium levels, ECG, and (if indicated) plasma levels of digoxin and digitoxin.
  Metabolites of vitamin D or its analogues (for example, calcitriol). Vitamin D may be combined with vitamin D metabolites or analogues only in exceptional cases and under the control of plasma calcium levels.
  Rifampicin and isoniazid. May reduce the effect of the drug due to an increase in the rate of biotransformation.
  Orlistat may potentially impair absorption of fat-soluble vitamin D.
  Ion exchange resins such as cholestyramine, laxatives such as liquid paraffin. May reduce the absorption of vitamin D from the gastrointestinal tract.
  Actinomycin, antifungal drugs (imidazole derivatives). Influence the activity of vitamin D by inhibiting the conversion of
  25-hydroxycholecalciferol to 1,25-hydroxycholecalciferol.

• Side effect

  Adverse reactions
  Adverse reactions are listed according to system organ classification and frequency of occurrence.
  The frequency is defined as: very often (≥ 1/10), often (≥ 1/100, but
  The frequency of adverse reactions is regarded as unknown, since large-scale clinical trials that would establish their frequency have not been conducted.
  Immune system disorders
  Frequency unknown: hypersensitivity reactions such as angioedema or laryngeal edema.
  Metabolic and nutritional disorders
  Frequency unknown: hypercalcemia and hypercalciuria.
  Gastrointestinal disorders:
  Frequency unknown: constipation, flatulence, nausea, abdominal pain, stomach pain, diarrhea.
  Skin and subcutaneous tissue disorders
  Frequency unknown: itching, rash, urticaria.
  Reporting Suspected Adverse Reactions
  It is important to report suspected adverse reactions after registration of a medicinal product in order to ensure continuous monitoring of the benefit-risk balance of the medicinal product.
  Health care professionals are encouraged to report any suspected adverse drug reactions through the national adverse reaction reporting systems of the member states of the Eurasian Economic Union.
  Republic of Belarus
  220037, Minsk, Tovarishchesky lane, 2a
  Unitary Enterprise Center for Expertise and Testing in Healthcare
  Phone/Fax of the Pharmacovigilance Department: +375 17 242–00–29
  E-mail: rcpl@rceth. by, [email protected]
  http:www.rceth.by

• Overdose

  Overdose
  Acute and chronic vitamin D overdose can lead to hypercalcemia, which can be permanent and potentially life-threatening.
  Symptoms
  Symptoms of hypercalcemia are atypical and may include anorexia, thirst, nausea, vomiting, constipation, abdominal pain, pancreatitis, muscle weakness, kidney stones, fatigue, psychiatric disturbances, polydipsia, polyuria, bone pain, soft tissue calcification, ECG changes and in severe cases, cardiac arrhythmias. Extreme hypercalcemia can lead to coma and death. Typical biochemical findings are hypercalcemia, hypercalciuria, and elevated serum levels of
  25-hydroxycholecalciferol.
  Persistently high calcium levels can lead to permanent kidney damage and soft tissue calcification.
  Treatment
  There is no specific antidote.
  Overdosing requires treatment for the often persistent and, under certain circumstances, life-threatening hypercalcemia.
  The first measure is to stop taking the vitamin D preparation. It takes several weeks to normalize the hypercalcemia caused by vitamin D intoxication. Depending on the degree of hypercalcemia, measures include a low or no calcium diet, fluid intake, increased urinary excretion with loop diuretics, as well as the appointment of glucocorticoids and calcitonin.
  With adequate renal function, calcium levels can be reduced by infusion of isotonic sodium chloride solution with the addition of furosemide and, in some cases, sodium edetate, accompanied by continuous monitoring of calcium and ECG.
  With oligoanuria, hemodialysis (calcium-free dialysate) is necessary.
  Patients on high-dose vitamin D therapy should be informed of the symptoms of a potential overdose.

• Contraindications

  Contraindications for use are:
  – hypersensitivity to the active substance or any of the auxiliary components that make up the medicinal product;
  − hypercalcemia and/or hypercalciuria;
  – nephrolithiasis / nephrocalcinosis;
  – severe renal failure (creatinine clearance
  − hypervitaminosis D.