Vitamin D supplement benefit and risk - side effects from too much

Vitamin D promotes the absorption of Calcium necessary for developing and maintaining healthy teeth and bones. It is also important to nerve cells, including the brain, and seems to act as a regulator of the immune system.  The body makes the vitamin after being exposed to sunlight. Not many foods are naturally rich in vitamin D but it is found in fatty fish such as salmon and milk commonly is fortified with it. You can find vitamin D in an excellent doctor-formulated multivitamin product.

Vitamin D deficiency may be a common but unrecognized problem among U.S. adolescents. Researchers found that among 11- to 18-year-olds living in Boston, nearly one-quarter were deficient in vitamin D, a nutrient that aids in calcium absorption and is vital for healthy bone development. If you wish to buy a Vitamin-D supplement. To learn more about the difference between calcitriol and and vitamin D3 known as cholecalciferol.

Most US kids aren't getting enough vitamin D, raising their risk of weak bones and, possibly, heart disease.

Vitamin D deficiency
The problem is preventable with an adequate diet and time outdoors. The body naturally synthesizes vitamin D when the skin is exposed to the sun, and milk and certain other foods, including many breakfast cereals, are fortified with the vitamin. But U.S. children increasingly fill up on soft drinks at the expense of milk, and spend more time in front of the TV or computer than outdoors.
   Soft drink, juice and iced tea intake are related to a greater risk of vitamin D deficiency. On the other hand, adolescents who drink milk and eat cereal are less likely to be low on vitamin D.
   A high proportion of pregnant women living in the northern United States, and their newborns, have insufficient vitamin D levels, and taking prenatal vitamins may not increase vitamin D levels adequately. A large percentage of African-American women and nearly half of white women tested at delivery had levels of vitamin D that were too low, even though more than 90 percent of them used prenatal vitamins during pregnancy.

What about too much Vitamin D and side effects? What are the risks?
Too much vitamin D ingestion can lead to vitamin D side effects such as nausea, vomiting, poor appetite, weakness, and weight loss. Too much vitamin D can also raise blood levels of calcium, causing mental status changes such as confusion. High blood levels of calcium, known as hypercalcemia, can cause heart rhythm abnormalities. Calcinosis, the deposition of calcium and phosphate in soft tissues like the kidney can be caused by too much vitamin D.
   Too much vitamin D and calcium intake has another potential side effect. It can lead to an increase in total brain lesion volume. Dr. Martha E. Payne of Duke University, Durham, North Carolina, believes too much vitaman D and calcium may lead to vascular calcification, since calcium is taken up into the blood vessel walls. Dr. Martha E. Payne evaluated calcium and vitamin D intakes by food frequency questionnaires and MRI scans in 232 elderly men and women (average age, 71 years). All of the subjects displayed some brain lesions of varying sizes but those reporting the highest intakes of calcium and vitamin D were more likely to have higher total volume of brain lesions. Dr. Payne is concerned that too much calcium either through food or supplements may end up in the blood vessel walls rather than the bone. She reported the study findings at a meeting of the American Society for Nutrition, part of Experimental Biology in May, 2007 in Washington, DC.

Vitamin D and body fat
Among a group of 90 young women living in sunny southern California, those with insufficient levels of vitamin D were significantly heavier and had greater body mass than their counterparts with sufficient levels of vitamin D. Dr. Vicente Gilsanz, of Children's Hospital Los Angeles thinks obesity is influenced by vitamin D insufficiency. Vitamin D insufficiency is common in young women living even in sun-rich area of the United States. Journal of Clinical Endocrinology and Metabolism, January 2009.

Vitamin D and insulin
People with a low level of vitamin D in the blood have poorly functioning insulin-producing cells and show a poor response to insulin, even when their blood sugar levels are normal.

Vitamin D recommended daily dosage
The recommended daily intake of vitamin D is 200 iu for adults younger than 50 years and 600 iu for those older than 70 years. Vitamin D supplementation is especially important in elderly persons because skin synthesis and absorption of vitamin D may be impaired.

Vitamin D and colon cancer
Taking 1,000 to 2,000 international units (IU) of vitamin D each day may reduce the risk of colorectal cancer, according to pooled data from published studies. The current findings contradict some prior individual studies that found that vitamin D intake did not seem to protect against colorectal cancer. However, it is possible that the dose may simply have been too low to provide a benefit. The present analysis, reported in the American Journal of Preventive Medicine, included data from five studies that looked at the association between blood levels of 25-hydroxy-vitamin D, which provides a good estimate of vitamin D levels in the body, and colorectal cancer risk. Dr. Edward D. Gorham, from the Naval Health Research Center in San Diego, California, and colleagues found that as blood levels of vitamin D rose, the risk of colorectal cancer fell. Risk was reduced by 54 percent in groups with the highest vitamin D levels relative to those with the lowest levels. American Journal of Preventive Medicine, March 2007.

Vitamin D and fractures
Getting plenty of vitamin D can help prevent falls among people living in nursing homes.

Vitamin D and multiple sclerosis
Vitamin D3 appears to be helpful in several diseases, including multiple sclerosis. High doses of vitamin D may be required for therapeutic efficacy. Patients with mulptle sclerosis can take enough vitamin D to double their blood levels of vitamin D without the concern of causing hypercalcemia or hypercalciuria.

Vitamin D and Pancreatic Cancer
Taking a Vitamin D supplement may reduce your risk for fatal pancreatic cancer. Vitamin D has shown strong potential for preventing and treating several types of cancer. Regions with greater sunlight exposure have lower incidence and mortality for prostate, breast, and colon cancers. Harvard University researchers examined data from two large, long-term health surveys involving 46,771 men between 40 and 75 years old and 75,427 women between 38 and 65. They found that people who took Vitamin D, 400 IU a day had a 40 percent lower risk of pancreatic cancer. Those who took doses of less than 150 IU per day had a 22 percent reduced risk of cancer. Taking more than 400 IU a day did not reduce the risk further.
   Most multivitamins include vitamin D usually at 100 to 400 units. You could consider getting more sun exposure or taking an additional vitamin D supplement. A supplement of 200 to 600 units a day is sufficient for most people.

Vitamin D supplement decreases mortality
 Dr. Philippe Autier, International Agency for Research on Cancer in Lyon, France, and Dr. Sara Gandini, from the European Institute of Oncology in Milan, Italy, reviewed 18 existing studies on the role of vitamin D use on longevity and found vitamin D ingestion reduced mortality by any cause by 7 percent. "Based on the total body of evidence of health conditions associated with vitamin D deficiency, abetted with the results from this meta-analysis, a more proactive attitude to identify, prevent, and treat vitamin D deficiency should be part of standard medical care," Dr. Edward Giovannucci, from Harvard School of Public Health in Boston, writes in a related editorial. Archives Intern Med 2007;167:1730-1737,1709-1710.

Living in sunny states no guarantee that vitamin D deficiency won't occur
Despite residing in a region with high chronic sun exposure, adults in southern Arizona are commonly deficient in vitamin D deficiency, particularly blacks and Hispanics. American Journal of Clinical Nutrition, March 2008.

Vitamin D side effects from too much vitamin D

Vitamin D deficiency and supplement questions
Q. Dr. John Cannell of the vitamin D council says that vitamin A blocks the absorption of vitamin D3 and that supplementation with A is unnecessary and even detrimental for that reason. What are your thoughts about this? If that information is accurate would taking the vitamin A (in carotene forms) separately from the vitamin D3 be OK?
Thank you for all your good work and for your very sensible recommendations.
   A. Few people need to supplement with vitamin A. Most multivitamin products contain vitamins A and D. For practical purposes we don't think it is an issue taking a multivitamin supplement in terms of vitamin D absorption. We don't think there is a need to take vitamin A supplement by themselves. If beta carotene is considered to be taken as a supplement, it is preferable to consider a carotenoid supplement that includes a number of different carotenoids. Or, just eat a carrot every few days.

A. I just went to a new Internist that came highly recommended. and he drew my blood and said that I am Vitamin D deficient. I have sleep Apnea, Type 2 Diabetes, Chronic Fatigue Syndrome and a whole host of other health problems. the doctor wants me to take 3,000 i.u. of Vitamin D. Is that too much for me to take? I just don't want any other additional health problems. Everything that I have read says to take 400 i.u. of Vitamin D. I am wondering if all my health problems could be the reason that he wants me to take so much.
   A. Different doctors have different opinions regarding the ideal dosage of vitamin D supplementation. We prefer to stay on the cautious side and limit the maximum use to 1000 units a day.

Q. I have two inherited bleeding disorders, von Willebrand disease, type I, and a Factor V deficiency, diagnosed 22 and 16 years ago. I have had trouble maintaining my vitamin D levels. I live in the Midwest. I have allergies to diary and also have asthma, for which I take a steroid nose spray and QVAR inhaler daily. I take a bone building medication to strengthen my bones, Didronel, 400 mg. for 14 days every 3 months. I have had 6 fractures in the past 18 years and nine altogether. My vitamin D level has been as low as 4 and as high as 43. Currently it is 16, having dropped from 28 this past March. It has dropped from 43 a year ago. Under doctor's orders (an endocrinologist) when I take vitamin D supplements, food rich in vitamin D, and Rice Dream, fortified with vitamin D in moderation, but consistently, I tend to bleed more from my nose, gums, and into my skin. At times, I have developed severe itching after taking cod liver oil. When I scratch, my skin becomes irritated and bleeds more. I have been on liquid vitamin D capsules also, but I develop capillary breakage in my legs, and my thighs and calves become as purple as a plum. When I stop the vitamin D, all symptoms vanish. In the past, I have managed well with Caltrate+D in the 200 I.U. version, chewing two tablets daily. However, that product was removed from the market, to increase the amount of vitamin D. Now, those tablets have 600 I.U.  which causes me to get severe headaches, back pain, bleeding from my nose and gums, and stomach pain. Even if I take half a tablet, I get increased bleeding. I also used to take Myadec for 30 years. It had 400 I.U. or 100% of vitamin D . But the Myadec was taken off the market. I have contacted the company to see if I can get the original formula but to no avail. My coagulation specialist is baffled by my response to increasing my vitamin D levels. I eat green vegetables daily, especially leafy green spinach. When I eat salmon, shrimp, tuna, or cod three times a week, my bleeding symptoms increase. I traveled to California to get some sunshine, but my vitamin D levels did not increase significantly. As I have gotten older, I have found my levels of vitamin D have been decreasing. I have been post-menopausal for twelve years, having had early, natural menopause. I am fair-skinned and have considered vertical tanning bed treatments to increase my vitamin D levels but my brother has skin cancer and I fear getting it too.

I have asthma and allergies and adrenal cortisone insufficiency, probably induced by the Flovent drug I take. When it was prescribed, they apparently did not know that any dose over 800 mcg daily would suppress the adrenal output of cortisone, but it was learned later that was the case. I was taking about 1150 mcg daily and developed adrenal insufficiency. My endocrinologist prescribed 20 mg of hydrocortisone daily, but later suggested I reduce that when more recent research indicated that was a high dose. Also, as you probably know, Flovent has a high bioavailability and readily enters the blood stream from the lungs. My vitamin D levels were also low and nobody knew why. I continued to take low levels of vitamin D (400 IU daily) for a long time per the endocrinologist's recommendation, but in time I realized that something was wrong because the measurements were always low in the blood. So, I raised it and that brought up the vitamin D levels in the blood. So, I raised it again. Eventually I was taking about 8000 IU daily and that brought the vitamin D levels in the blood to just above 30. At about the same time I raised the vitamin D levels, I developed reactive hypoglycemia. My endocrinologist at that time recommended that I reduce the dose of hydrocortisone to 15 mg daily, though I found that I could not do so because my asthma and allergies became severely exacerbated, so I settled at 17.5 mg daily, which I was barely able to tolerate. I later raised the vitamin D levels to 12,000 IU daily and found that I did much better with that because it somehow reduced the asthma and allergies and seemed to reduce the reactive hypoglycemia to some extent. The blood level of vitamin D was 64. About the same time as the reactive hypoglycemia developed, I develop ocular hypertension. Whether that is connected, nobody knows. When the new drug Alvesco recently became available, I began to experiment with it. That drug has a very poor absorbability into the blood stream from the lungs, so reduces the amount of glucocorticoids in the blood stream. That had a positive effect on the reactive hypoglycemia AND what is interesting is that I discovered that it had an effect on the absorption of vitamin D. I found that I had to reduce the vitamin D intake or I had problems. At the last measurement, I had a blood level of vitamin D of 59 but was taking only 9000 IU daily. The end result was that when I reduced the glucocorticoids in the blood stream, I found that I absorbed vitamin D better and blood measurements seemed to confirm this. I don't find Alvesco as effective as the Flovent but it does work.

I received word from a reputable PhD that high doses of D3 would not be problematic, so i began a series of serum tests for Vit D 25OH because i have osteoporosis at 67 years. My starting level was 33 with 2000IU of D3. I am at 8000IU and my level jumped to 46. I just increase to 10,000IU to see what happens. No sunbathing of significance as yet. My endocrinologist thinks my body has a difficulty with Vit D so requires more. My Bone mass has leveled out and started increasing. It's likely most people have a serious Vit D deficiency. Interestingly, high Vit A levels caused NTX ratio to skyrocket to 98, so I had to reduce dosage to 10000IU per day, and the level came down to 33. Apparently, one must bioengineer dosages and keep a careful watch for reactions on key parameters. I do this on my own as a former electrical engineer, but God help the masses untrained and careless in these things. Most Doctors in general haven't a clue about these factors and couldn't care less.

I am an elderly female. I have Fibromyalgia / CFS / Lyme Disease w/parallel infections. I had very low Vitamin D level 16 and Dr. had me take 3000-4000 Iu per day. After several weeks my pain levels increased significantly. Maybe Vit. D is an immune modulator and perhaps started producing a kill-off of the infections of the Lyme disease. I lowered the dose and gradually the increased pain leveled off again. The incident however prompted me to look for another CFS / FM MD who subsequently tested for and diagnosed the Lyme disease and, yes, I am now on antibacterials / antiparisitic / antitviral meds plus additional supplements, homeopathics etc etc to try to strengthen and support my immune system and vital organs.

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