Vitamin D can boost health but in excess, it is dangerous for the kidneys and the heart. In Ile-de-France, a 6-month-old infant was hospitalized for 2 weeks because of a vitamin D overdose. What are the risks? The warning symptoms? Answers from Julien Tison, pharmacist.
[Mis à jour le 25 juillet 2022 à 17h45] With the Covid-19 epidemic, the intake of vitamin D has increased in the French population. In question, the publication of studies having presented the possible benefits of this vitamin to prevent infection with the coronavirus. But beware of overdosing! On July 23, 2022, a mother from Fontenay-sous-Bois (Val-de-Marne) reported to our colleagues from Parisian one vitamin D overdose nearly killed her baby. Stagnating weight and fever, the infant is hospitalized: “An ultrasound shows nephrocalcinosis, excess calcium in the kidney. The electrocardiogram, a heart problem” can we read on the Parisian. In question, an incorrectly dosed vitamin D dietary supplement. “Did we fail on a dietary supplement? If it happened to us, it can happen to anyone” warns the baby’s mother. In January 2021, the Lille University Hospital was already alerting to the toxic risk of vitamin D overdose: “Be vigilant and do not take vitamin D supplements without talking to your doctor. The products available on the Internet can be very dangerous“ warned the professionals. What are the signs of an overdose in vitamin D? At the house of the adult ? the baby ? What effects ? What risks ? What to do ? Interview with Julien Tison, pharmacist at the Anti-Poison Center of the Lille University Hospital
What are the symptoms of a vitamin D overdose?
Vitamin D poisoning takes time to set in. “There are no specific symptoms, begins the pharmacist. It is first of all fatigue, drowsiness, irritability, headaches, vomiting, dizziness, diarrhea, abdominal cramps, muscle and joint pain, nausea, it can be confused with many things and we have to react before”. In case of’severe and more advanced poisoningan overdose of vitamin D causes;
Can you overdose on vitamin D-rich foods?
There are no reported cases of vitamin D overdose linked to a natural diet. “Only cases related to excessive supplementation of a food are described” says the pharmacist. Conversely, there are cases of vitamin A overdose by food. A vitamin present in particular in cod liver oilalso very high in vitamin D.”Taking cod liver oil is not trivial, especially for pregnant women because an excess of vitamin A can be teratogenic (risk of fetal malformations).
From what quantity is an overdose of vitamin D?
“There is no toxic dose for vitamin D established to date. It is the accumulation by chronic intake that can lead to intoxication” indicates the pharmacist. The danger arises if the maximum recommended dosages are exceeded (they depend on each drug and are indicated on the instructions) daily and for a prolonged period. Even more so if you have an already very large stock of vitamin D.
► In children: An update of national recommendations for vitamin D doses for children is currently underway. These will align with European recommendations, namely 400 IU per day from 0 to 18 years old in children in good health without risk factors, and 800 IU per day from 0 to 18 years old in children with a risk factor.
► Dosage : different medicinal specialties contain, in varying doses, either vitamin D2 or vitamin D3. The recommended doses are indicated on the leaflets and depend on the indication and the age of the patient. These dosages must be respected.
What are the risks of a vitamin D overdose?
The main risk of vitamin D overdose is hypercalcemia, or an excessive level of calcium in the blood. “Vitamin D’s main function is calcium phosphate metabolism, explains Julien Tison. It is a vitamin that will ensure that we absorb more calcium and which decreases the renal elimination of calcium. In the most severe forms, the accumulation of calcium in the body can be the cause ofkidney damage (nephrocalcinosis) with risk ofchronic renal failure, arrhythmias cardiac and death.
What are the risks of vitamin D overdose in children?
In children, vitamin D is essential for bone growth. It is thus prescribed in France from birth to prevent rickets (disease of growth and ossification). But giving too much can be dangerous : “Complications are equivalent to adults except in small children, under 1 year old because the kidney function is not the same” argues our interlocutor. At this age, the child may be more sensitive to hypercalcemia and its effects on the kidneys. To know : Not giving enough vitamin D to the child within the framework of pediatric recommendations to prevent rickets is also dangerous.
What are the risks of vitamin D overdose in pregnant women?
Vitamin D is considered teratogenic if the dosages are exceeded, that is to say, it is likely to cause malformations in exposed children in utero (during pregnancy). “There is nothing to fear in pregnant women during supplementation, reassures the pharmacist. If you use ampoules, that you respect the dosages and that it is well followed by a doctor, there is no danger. In case of doubt, there is always time to stop supplementation.”
Do not store the baby vitamin D bottle next to essential oils.
What to do in case of vitamin D overdose?
During the Covid epidemic:
► If you are at risk of Covid or if you test positive for Covid-19, do not hesitate to discuss a vitamin D supplement with your doctor.
► If the attending physician deems it necessary, he will prescribe a vitamin D supplement in the form of an ampoule. A reliable treatment, on prescription and reimbursed by Social Security.
Excluding Covid:
► In the event of a suspected vitamin D overdose, medical advice should be sought immediately. The doctor will stop the supplementation the time to assess the risks. The resumption of the treatment can be done according to the quantification of the doses ingested until then, the dosage of vitamin D, the calcemia…
► In the event of isolated hypervitaminosis D, treatment may be limited to simple discontinuation of vitamin D supplementation and medical monitoring.
- Respect the dosage indicated on food supplements or drugs (in children, give preference to prescription drugs rather than over-the-counter food supplements).
- Do not multiply products containing vitamin D.
- .Do not buy vitamin D on the Internetit is always better to take advice from a pharmacist.
- Consult a doctor before taking vitamin D supplements.
- For babies: do not store the bottle of vitamin D in the same place as the essential oils. “We have many mothers who can mistakenly administer 4 or 5 drops from the bottle of essential oil instead of ZymaD®, when the two are placed on the changing table for example” reports the pharmacist. Do not hesitate to call the Poison Control Center 0 800 59 59 59 (toll free 24 hours a day).
Thanks to Julien Tison, pharmacist at the Anti-Poison Center of Lille University Hospital.
Source: Vitamin D in children: use drugs and not food supplements to prevent the risk of overdose. January 27, 2021. ANSM