The recent media attention has been drawn to the death of an 89-year-old man in England, following the release of a coroner’s report linking the fatality to vitamin D.
David Charles Mitchener was admitted to a Surrey hospital with hypercalcemia, a condition characterized by elevated blood calcium levels. Laboratory tests showed that his vitamin D levels were at the maximum detectable amount, indicating excessive supplementation for at least nine months.
Lawrence Appel, MD, MPH, a professor of medicine at Johns Hopkins University in Baltimore says, “Hypercalcemia can occur from really high vitamin D doses or moderate doses in persons with serious conditions.”
A postmortem examination revealed that Mitchener’s cause of death was vitamin D toxicity and hypercalcemia, along with ischemic heart disease (resulting from narrowed arteries), congestive heart failure, and chronic kidney failure.
Elevated blood calcium levels can result in deposits in the arteries and organs, increasing the risks of cardiovascular and other health issues.
Are Vitamin D Supplements Really Necessary?
According to the National Institutes of Health (NIH), there are valid reasons for taking vitamin D. This nutrient aids in calcium absorption, promotes stronger bones, and is crucial for muscle, nerve, and immune system function.
In 2009, a large study declared vitamin D insufficiency a “growing epidemic,” sparking interest in supplements, according to a Consumer Reports investigation.
Estimates suggest that over one-third of U.S. adults aged 60 and older take vitamin D supplements, and nearly a quarter of Americans have insufficient vitamin D levels for bone and overall health.
A research report projected that global vitamin D sales would increase from 1.3 billion in 2022 to 1.9 billion by 2027.
The craze for vitamin D grew alongside observational studies linking its deficiency to various health issues.
Despite this, several clinical trials have found little or no benefit of vitamin D in preventing or treating cardiovascular disease, cancer, asthma, diabetes, or fractures.
Dr. Appel says, “Vitamin D supplements have been oversold to consumers as a means to prevent or treat many diseases,” while adding that supplements do support bone health.
What’s the Recommended Vitamin D Intake?
According to the NIH, the daily amount of vitamin D you need depends on your age. Adults younger than 70 require 15 micrograms (mcg) or 600 IU (international units) per day, while adults aged 70 and above need 20 mcg (800 IU).
An internist in the department of integrative medicine at Mayo Clinic in Phoenix, Arizona Denise Millstine, MD,says, “Vitamin D requirements vary among individuals, and target vitamin D levels are not agreed upon by all professional societies.”
While many individuals obtain sufficient vitamin D from natural sources such as food and sunlight, those requiring supplementation can opt for two forms: D2 (ergocalciferol) and D3 (cholecalciferol). Both types offer similar benefits and are effectively absorbed by the body through the small intestine. However, research indicates that D3 is more potent and maintains levels in the body for a longer duration.
A blood test can measure the level of 25-hydroxyvitamin D to determine if you’re receiving an adequate amount of the nutrient.
Dr. Appel explains, “I do not recommend vitamin D supplements for general health; however, if one wants to take vitamin D supplements, I would recommend no more than 1,000 IU daily.”
The NIH specifies that the upper limit for adults is 100 micrograms (4,000 IU).
Identifying if You’re in the Vitamin D Danger Zone
Vitamin D toxicity, or hypervitaminosis D, is extremely rare, according to Dr. Millstine, and it is nearly impossible to develop the condition from sun exposure or natural food sources containing vitamin D.
Regularly ingesting excessive amounts of supplements can lead to overdosing, putting your health – and even your life – at risk.
Symptoms of excessively high vitamin D intake include weakness, fatigue, depression, confusion, stupor or coma, excessive urination, kidney stones, renal failure, soft tissue calcifications, conjunctivitis (pink eye), fever, chills, loss of appetite, nausea, vomiting, and constipation.
To monitor your vitamin D intake, health authorities recommend checking nutrition labels on products for the amount of vitamin D they contain. The Dietary Guidelines for Americans also provide information on foods rich in vitamin D, such as fish, milk, yogurt, cheese, and mushrooms, along with the amount of the nutrient in each.
Moreover, if you’re taking a daily vitamin D supplement or a multivitamin, make sure to check the label and be aware of the amount you’re receiving. “In my practice, I see a lot of people taking multiple products that contain vitamin D, which can easily add up,” says Dr. Millstine.
Label warnings regarding excessive amounts of this vitamin are not mandated. The U.S. Food and Drug Administration (FDA) typically does not approve dietary supplement claims or other labeling before the product is marketed.
The coroner’s report on the man who overdosed on vitamin D highlighted that there were no warnings on or in the supplement packaging outlining the specific risks or side effects of taking vitamin D supplements.
The assistant coroner, Jonathan Stevens, wrote in the report, “In my opinion, there is a risk that future deaths will occur unless action is taken.”
Stevens pointed out that current labeling requirements fail to address the potentially severe risks and side effects of excessive vitamin supplements. Implementing appropriate warnings and guidance on dosage may help prevent future deaths.
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