Monday, May 6, 2019

Vitamin D: be careful, excess can cause kidney failure

Beware of the abuse of  food supplements  ! The case of a patient reported in  the Journal of the Canadian Medical Association (CMAJ)  warns us about the over consumption of vitamin D food supplements . If the latter is essential for good absorption of calcium and phosphorus, thus ensuring good bone mineralization , the thresholds defining a deficiency are very low. Beware then over consumption:
it can have serious consequences . A Canadian suffered, after being prescribed too much vitamin D when he did not necessarily need it.
It was when he returned from a trip to Asia, where he had been highly exposed to heat and sun, that the 54-year-old man was admitted to the hospital with a very high creatinine level. This is usually a sign of a kidney problem  : creatinine is a metabolic waste due to the breakdown of creatine, mostly eliminated by the kidneys. Its rate is therefore an indicator of the renal elimination capacity. In the hospital, despite multiple exams, it is impossible for doctors  to explain his condition.

A dose 10 times higher than recommended

The man ended up mentioning that his naturopath had prescribed high doses of vitamin D.However, the patient had no bone fragility or vitamin D deficiency . Another problem: the man was wrong formulation. Instead of buying the one he had been recommended, he had, without knowing it, doubled the dose. "For 2 years and a half, he took 8 to 12 drops every day for a total daily dose of 8,000 to 12,000 International Units", the doctors are surprised. However, the recommended daily dose of vitamin D supplementation is 400 to 1000 Unitsin healthy people, who can increase to 800 or 2000 IU for patients over 50, or those at high risk of osteoporosis (in micrograms, 1 μg equals 40 IU).

Finally, the patient regained normal calcium and vitamin D after one year with treatment with hydroxychloroquine, an antimalarial drug also used in certain autoimmune diseases. Nevertheless, he is still suffering from chronic kidney disease of moderate insufficiency. According to the researchers, this case "calls into question" the way in which this vitamin is used. "The fact that it is found in many over-the-counter products can pose a significant risk for misinformed patients," says Dr. Bourne Auguste. "Patients, like clinicians, would benefit from being better informed about the risks associated with the free use of vitamin D".

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