How Much Vitamin D is Too Much Vitamin D?
Being fat-soluble, vitamin D can not be excreted out as easily as water-soluble vitamins, thereby, increasing the potential of causing hypervitaminosis. The regular daily allowance for vitamin D for infants is 400 IU/day. Recommended Dietary Allowance of vitamin D in age 1 to 70 years should not exceed 600 IU/day. For adults aged 70 and more, the recommended dosage is 800 IU/day. According to the present literature, more than 95% of in-hospital patients of all age groups, have vitamin D deficiency, resulting in osteoporosis, increased risk of malignancy, and cardiovascular diseases. Even though, it is imperative to correct the deficiency, however, sometimes aggressive correction leads to hypervitaminosis and vitamin toxicity. A journal reported a case of a known diabetic and hypertensive, 72-year-old female who presented to ER with shaking hands and feet, altered mentation, frequent urination, and vomiting for 2 days. There was no history of drug abuse, fever, cough, headache, and seizures. Patient’s GCS was found to be 9/15. All reflexes were normal. Laboratory investigations revealed hypercalcemia and low serum parathyroid levels. Radiological imaging was unremarkable. According to patient’s condition, multiple myeloma, sarcoidosis, milk alkali syndrome, and vitamin D toxicity, and malignancy were considered as differential diagnosis. Further workup was done in order to rule out differentials. This revealed vitamin D levels <150 ng/d, which is considered extremely toxic. More detailed history divulged daily consumption up to 2400 IU of vitamin D by patient daily. Vitamin D was immediately stopped. Patient was admitted in ICU where aggressive treatment by IV fluids, bisphosphonates, diuretics, glucocorticoids, and calcitonin helped in recovery. She was subsequently discharged after improvement of sensorium with advice to avoid sunlight for few months. Source Vitamin D toxicity presenting with altered sensorium and hypercalcaemia https://www.ijaweb.org/article.asp?issn=0019-5049;year=2020;volume=64;issue=10;spage=909;epage=911;aulast=Sarma Image via https://www.drberg.com/blog/vitamin-d-toxicity-is-this-a-danger