Hypervitaminosis D is a condition that occurs after taking very high doses of vitamin D.The cause is excess intake of vitamin D. The doses need to be very high, far above what most medical providers normally prescribe.There has been a lot of confusion about vitamin D supplementation. It is extremely unusual for anybody to need more than 2,000 IU of vitamin D a day.For most people, vitamin D toxicity only occurs with Vitamin D doses above 10,000 IU per day.An excess of vitamin D causes abnormally high levels of calcium in the blood (hypercalcemia). This can severely damage the kidneys, soft tissues, and bones over time.ConstipationDecreased appetite (anorexia)DehydrationFatigueFrequent urinationIrritabilityMuscle weaknessVomitingExcessive thirst (polydipsia)High blood pressurePassing large amounts of urine (polyuria) The health care provider will examine you and ask about your symptoms.Tests that may be ordered include:Calcium in the bloodCalcium in the urine1,25-dihydroxy vitamin D levelsSerum phosphorusX-ray of the boneYour provider will likely tell you to stop taking vitamin D.
In severe cases, other treatment may be needed.Recovery is expected, but permanent kidney damage can occur.Health problems that can result from taking too much vitamin D over a long time include:DehydrationHypercalcemiaKidney damageKidney stones Call your health care provider if:You or your child shows symptoms of hypervitaminosis D and has been taking more vitamin D than the recommended daily allowanceYou or your child shows symptoms and has been taking a prescription or over-the-counter form of vitamin D To prevent this condition, pay careful attention to the correct vitamin D dose.Vitamin D toxicityGreenbaum LA. Rickets and hypervitaminosis D. In: Kliegman RM, Stanton BF, St. Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2015:chap 51.Gropper SS, Smith JL. In: Gropper SS, Smith JL, eds. Advanced Nutrition and Human Metabolism. 6th ed Independence, KY: Wadsworth Publishing; Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA.
Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.When you have arthritis, you might be tempted to try anything that could help you feel better. Some people take vitamins and mineral supplements that have been touted for arthritis relief, like calcium, or vitamins C, D, and E. Yet it is possible to go overboard and get too much of these or other nutrients — and that could be harmful. “It is more common for the general population to get too much of a vitamin than it is to have a deficiency, especially for those who make an effort to eat healthfully and take supplements,” says Cindy Moore, director of nutrition therapy at the Cleveland Clinic Foundation. Certain vitamins — such as B and C — are water-soluble. If you take too much of them, your body simply flushes out the extra. Other vitamins — including A, D, E, and K — are fat-soluble. They aren’t good to consume in high doses because your body holds onto the excess. Minerals can be problematic in large doses, too.
Too much iron can be toxic, causing symptoms like fatigue, joint pain, and depression. High-dose calcium supplements have been linked to an increased risk for heart disease as reported in a the National Institutes of Health-AARP diet and health study published in the JAMA Internal Medicine in 2013. And there are other risks, too. Because supplements aren’t regulated by the FDA like medicines, you can never be entirely sure that what’s promised on the label is delivered inside the container. “There is also a risk of vitamins and minerals interfering with medicines people are taking,” says Laura Gibofsky, MS, RD, CDN, a registered dietitian at the Hospital for Special Surgery in New York. For example, vitamins E and K can increase your bleeding risk if you’re already taking a blood thinning medication. Calcium can reduce the effectiveness of antibiotics according to a U.S. Pharmacist online journal article titled Drug Interactions. Whether or not you have arthritis, you need to be wary about supplement interactions and overdoses.
Before taking any vitamin or mineral supplement, check that it’s safe for you. “Make sure you tell your doctor and take them under the doctor’s guidance,” Gibofsky suggests. Your doctor might recommend a supplement to correct a nutritional deficiency, or suggest that you take folic acid to reduce methotrexate side effects if you have rheumatoid arthritis. But unless your doctor says otherwise, it’s best to choose supplements that don’t contain more than 100% of the dietary reference intake (DRI) of any particular nutrient. Some high-dose supplements can contain 10 or more times the amount recommended for your age and gender according to a Colorado State University article titled Dietary Supplements: Vitamins and Minerals. Watch the Fortified Foods, Too It’s hard to overdose on vitamins and minerals from foods alone. However, there’s been a surge in heavily fortified foods, from orange juice boosted with calcium and vitamin D, to nutritional bars loaded with a variety of nutrients.
If you eat a nutritional bar, plus a bowl each of fortified cereal and pasta in one day, you could get well more than the recommended amounts of several vitamins and minerals. Reading labels and avoiding heavily fortified foods can help prevent an overdose.“There is no magic diet for arthritis,” says Gibofsky. To keep your body as healthy as possible, get as many of your nutrients as possible from real foods. “You don’t need to take supplements, when a well-balanced diet that includes all the major food groups is sufficient to provide your body with the appropriate vitamins and minerals,” she says.Remember Tiny Tim from ? rickets, a bone disease caused by deficiency of Vitamin D. Charles Dickens often based his characters on real diseases that he saw around him, and rickets was very common among children in England at the time, because they simply weren’t getting enough Vitamin D. It wasn’t a dietary deficiency: people can make Vitamin D when their skin is exposed to sunlight, but in Britain at the time, air pollution was literally so bad that it prevented people from getting even the small amount of sun exposure needed to avoid rickets.
Rickets causes unusually soft and deformed bones, hence Tiny Tim’s need for crutches. Today, few babies actually get rickets (although it still does happen!) but a lot of people are still suffering from a lower-level Vitamin D deficiency that might contribute to bone problems later in life, poor mental health, immune deficiency or autoimmune disease, and trouble maintaining a healthy weight. Here’s a look at what you need to know about the importance of Vitamin D, how to get it, and when to take a supplement. “Vitamin” D is actually a hormone, and if you really want to impress your friends and appall your enemies, you can pull out the full name: 1,25 dihydroxyvitamin D [1,25(OH)2D], or calcitriol. But call it Vitamin D for now, because the interesting part is what it does. Vitamin D is important for all kinds of processes. Mental health and brain function:, for mood and mental health throughout life, for forming memories and making decisions, and for maintaining brain function in old age.
Low levels of Vitamin D are associated with diseases from depression to Alzheimer’s Disease. Some research has also linked lower levels of Vitamin D to cancer and other diseases, but so far it’s not clear whether that’s causal or just an association (so people who have higher Vitamin D levels are just healthier, and healthier people tend to get less cancer, but it’s not the Vitamin D specifically). So Vitamin D is important. Now the big question: how to get enough? There are actually two different forms of the hormone: D3 is the form that the human body needs. You can get it from food, or you can make it yourself from sunlight. This one is a bit of a wild ride through studies that all conflict each other. Some studies get really precise about blood levels of Vitamin D, and try to quantify exactly what level of Vitamin D in the blood is optimal. The Institute of Medicine that almost all people will be vitamin D-sufficient at a blood level above 50 nmol/L (20 ng/mL), but no more than 125 nmol/L (50 ng/mL).
The advice from there would be to just keep getting more Vitamin D until you hit the optimal blood levels. That’s just great if you know how many nanograms of Vitamin D you have per milliliter of your blood, but it’s just not very helpful for most of us since most people don’t know their blood levels of Vitamin D and don’t want to go having blood drawn every few months to check. In the real world, it makes more sense to look at what consumption of Vitamin D will get most people into a healthy range. In the USA, the RDA of Vitamin D is 600 IU for healthy adults, except for people over 70 where it goes up to 800. But quite a bit of evidence shows that more may be better, especially since a lot of people have trouble absorbing Vitamin D. And there’s also the problem of malabsorption. A lot of people may do better with more Vitamin D because they have trouble absorbing it. For Paleo specifically, a particular problem is gut health. Vitamin D is a fat-soluble vitamin, so to absorb it you have to have a gut that can absorb dietary fat.
Many people who try Paleo have gut problems that prevent them from absorbing dietary fat properly. People with obesity may also need more Vitamin D, because their body fat stores suck up a lot of Vitamin D and hide it away in the fat. that people with obesity need about 40% more Vitamin D – if the RDA is enough for people at a medically normal weight, then the numbers for people with obesity would be 840 IU for people under 70 and 1120 for people over 70. If you’re in one of these groups, it’s especially important to get enough Vitamin D for your actual needs. Some foods contain Vitamin D, but unless you eat a lot of them all the time, they probably won’t provide enough to really live on. The most Vitamin D-rich foods are fatty fish that live in cold waters, like salmon and sardines. ( about the difference between wild-caught and farm-raised salmon). Other fish contain very small amounts of Vitamin D, but nothing really noticeable. So if you ate 6 ounces of wild-caught salmon every other day, you’d be able to get enough Vitamin D from food, but for most people that’s just not going to happen.
Realistically speaking, most of us will have to rely at least partly on the other two sources: sunlight and supplements. Sunlight is the way that humans were designed to get most of our Vitamin D. When sunlight hits your skin, you can synthesize it yourself from cholesterol. Studies have shown that a healthy adult can get most of her Vitamin D from 5-30 minutes of direct sunlight while the sun is high in the sky – it doesn’t take a huge amount. Sunscreen prevents this from happening, so sun exposure with sunscreen doesn’t count for Vitamin D. You can read more about sunbathing and get a closer look at the studies behind all those claims . Food doesn’t provide enough Vitamin D for most adults, and it’s just not realistic for all of us to get enough sun exposure, especially in the winter when a lot of people spend all the best sunlight hours indoors. Vitamin D supplements are one of the most common Paleo recommendations precisely because Vitamin D is so important and so hard to get.
It’s reasonable that even a person eating a great diet might need one – so you can make sure you’re actually getting what you pay for. Overdosing is really only an issue with supplements. Even if you stay out in the sun for a long time, your body has its own way of shutting down Vitamin D production; you’ll just stop making it when you don’t need it. And unless you’re eating multiple pounds of salmon every day, getting toxic amounts of Vitamin D from food is extremely unlikely. WIth supplements, the USDA set the upper intake limit at 4,000 IU per day for all healthy people over 9, including pregnant women. Sunshine can provide as much as 10,000 IU per day, and , but the thing about sunshine is that it has an automatic off switch if you’re getting too much for your particular body. Supplements don’t come with that kind of safety, so they call for a little more caution. It’s very clear that Vitamin D is important, but it’s not totally clear yet how much is the optimal amount to get from food + sunshine + supplements.