Vitamin D poisoning by table sugar

Vieth, Reinhold; Pinto, Tanya; Reen, Bajinder S; Wong, Min M

doi:10.1016/s0140-6736(02)07814-5

Cited by 55 publications

(31 citation statements)

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“…Although VDI in industrialized countries has been usually associated with food products [1][2][3][4][5][6] or dietary supplements, [7][8][9][10][11][12] in Turkey it has always resulted from mistakenly used or unnecessary use of high-dose vitamin D 3 -containing ampules. [15][16][17][18][19][20][21][22] This is the first report, to our knowledge, from Turkey that describes dietary supplement-induced vitamin D toxicity.…”

Section: Discussionmentioning

confidence: 99%

“…Over the past 40 years, it has been usually described as a result of unintentional conditions, such as contamination of cooking oil, [1][2][3] overfortification of milk, 4,5 or adulteration of table sugar. 6 VDI associated with overthe-counter dietary supplements has been reported in adult patients. [7][8][9][10][11][12] However, to our knowledge, pediatric cases of VDI caused by dietary supplements have not been previously reported.…”

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Vitamin D Intoxication Due to an Erroneously Manufactured Dietary Supplement in Seven Children

et al. 2014

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Pediatric cases of vitamin D intoxication (VDI) with dietary supplements have not been previously reported. We report on 7 children with VDI caused by consumption of a fish oil supplement containing an excessively high dose of vitamin D due to a manufacturing error. Seven children aged between 0.7 and 4.2 years were admitted with symptoms of hypercalcemia. Initial median (range) serum concentrations of calcium and 25-hydroxyvitamin D were 16.5 (13.4-18.8) mg/dL and 620 (340-962) ng/mL, respectively. Repeated questioning of the parents revealed use of a fish oil that was produced recently by a local manufacturer. Analysis of the fish oil by gas chromatography/mass spectrometry revealed that the vitamin D 3 content was ∼4000 times the labeled concentration. Estimated daily amounts of vitamin D 3 intake varied between 266 000 and 800 000 IU. Patients were successfully treated with intravenous hydration, furosemide, and pamidronate infusions. With treatment, serum calcium returned to the normal range within 3 days (range: 2-7 days). Serum 25-hydroxyvitamin D levels normalized within 2 to 3 months. Complications, including nephrocalcinosis, were not observed throughout the 1-year followup. In conclusion, errors in manufacturing of dietary supplements may be a cause of VDI in children. Physicians should be aware of this possibility in unexplained VDI cases and repeatedly question the families about dietary supplement use. To prevent the occurrence of such unintentional incidents, manufacturers must always monitor the levels of ingredients of their products and should be rigorously overseen by governmental regulatory agencies, as is done in the pharmaceutical industry. Pediatrics 2014;133:e240-e244 Vitamin D intoxication (VDI) is a rare condition today. Over the past 40 years, it has been usually described as a result of unintentional conditions, such as contamination of cooking oil, 1-3 overfortification of milk, 4,5 or adulteration of table sugar. 6 VDI associated with overthe-counter dietary supplements has been reported in adult patients. [7][8][9][10][11][12] However, to our knowledge, pediatric cases of VDI caused by dietary supplements have not been previously reported. We report here on 7 young children with VDI caused by the consumption of a fish oil supplement that contained an excessively high dose of vitamin D due to a manufacturing error. CASE HISTORIESA 2.5-year-old boy was admitted on September 24, 2011, with a history of fever, weakness, constipation, loss of appetite, nausea, and vomiting for 2 weeks. He was clinically dehydrated. His serum calcium and 25-hydroxyvitamin D (25[OH]D) levels were 13.4 mg/dL (normal range: 8.8-10.8 mg/dL) and 962 ng/mL (normal range: 30-80 ng/mL), respectively. His parents denied taking any drug or dietary supplement containing vitamin D.The second male infant, aged 13 months, was admitted 2 weeks later with a history of weakness, poor appetite, vomiting, weight loss, and constipation for 12 days. His physical examination was normal. His serum calcium and 25(OH)D l...

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Vitamin D Intoxication Due to an Erroneously Manufactured Dietary Supplement in Seven Children

et al. 2014

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“…In April 2006, serum ionized calcium was 1.37 mmol/L and total plasma calcium was 2.63 mmol/L. At this time, the patient was advised to stop taking vitamin D 3 …”

Section: Casementioning

confidence: 99%

Self-prescribed high-dose vitamin D₃: effects on biochemical parameters in two men

Kimball

Vieth

2008

Ann Clin Biochem

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“…It is reassuring to know that vitamin D supplementation is relatively safe and that cases of toxicity are rare and have been observed only when patients are taking > 40,000 IU/day. 43 The IOM recommendations hopefully will not be misinterpreted and cause people to stop taking supplements if their 25(OH)D levels are low. In addition, as was noted in the IOM report, additional research is needed regarding the role of vitamin D in various disease states, including diabetes.…”

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Vitamin D and Diabetes

Martín¹,

Campbell²

2011

Diabetes Spectrum

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Vitamin D poisoning by table sugar

Cited by 55 publications

References 5 publications

Vitamin D Intoxication Due to an Erroneously Manufactured Dietary Supplement in Seven Children

Vitamin D Intoxication Due to an Erroneously Manufactured Dietary Supplement in Seven Children

Self-prescribed high-dose vitamin D₃: effects on biochemical parameters in two men

Vitamin D and Diabetes

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Vitamin D poisoning by table sugar

Cited by 55 publications

References 5 publications

Vitamin D Intoxication Due to an Erroneously Manufactured Dietary Supplement in Seven Children

Vitamin D Intoxication Due to an Erroneously Manufactured Dietary Supplement in Seven Children

Self-prescribed high-dose vitamin D3: effects on biochemical parameters in two men

Vitamin D and Diabetes

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Self-prescribed high-dose vitamin D₃: effects on biochemical parameters in two men