Prolonged vitamin D intoxication: presentation, pathogenesis and progress

Abstract

Vitamin D toxicity from unactivated vitamin D (calciferol) therapy is currently a rare cause of hypercalcaemia. However, the frequency of this event may increase as high-dose unactivated vitamin D preparations become available. Prolonged vitamin D toxicity can cause reversible hypercalcaemia and partially reversible renal impairment. Parathyroid hormone may not be suppressed with unactivated vitamin D toxicity, especially if renal disease coexists.

A review of the growing risk of vitamin D toxicity from inappropriate practice

“…Seven paediatric cases of hypercalcaemia due to vitamin D intoxication were reported in association with a fish oil supplement, where the stated dose was roughly 4000 times less than the actual dose [31]; in one of these cases, an infant in whom the stated daily dose was 2000 IU day -1 was actually taking 6000 IU day -1 [30]. Toxicity associated with inaccurately manufactured and labelled vitamin D supplements is a globally reported problem [32,[34][35][36][37][38][39][40][41][42][43]. To our knowledge, such errant labelling has not been reported in conjunction with licensed formulations.…”

Vitamin K1 and 25(OH)D are independently and synergistically associated with a risk for hip fracture in an elderly population: A case control study

“…It is considered safe to supplement using 800 IU or 20mg vitamin D in the elderly, and it is indeed recommended (25;57). High doses of vitamin D may be potentially toxic (61). Adverse effects of ultra high doses >50 000 IU cholecalsiferol daily is found in several reports with serum 25(OH)D at 370 nmol/L (62;63).…”

What is quality of medicines?

“…This was due to confusion of units, with the patient receiving 15 mg rather than the intended 15 μg daily. 1 This is not a unique case, for example an under-dosing error affecting several patients was reported recently in Australian Prescriber. 2 The quality of medicines was regulated 107 years ago in the United States by the Safe Food and Drug Act of 1906.…”