When I read the following article by Dr. John Cannell, I had to reread it several times to be sure I was not missing something. I have been researching and have a couple of friends researching to find other such problems with Vitamin D toxicity. To date there have been other cases found, but none as severe as the ones Cr. Cannell reports.
Should we be concerned? Generally no, but the warning message is there and needs to be heeded. Always know what you are taking and why. Is there a possibility of taking too large a dose? Yes, as Dr. Cannell shows with the three cases, it is possible when you buy from the wrong manufacturer or misread the directions for the dosage. In general, most people do not need excessive doses of Vitamin D unless a doctor prescribes a short-term need.
One of the problems that can arise is when the doctor orders the wrong test for levels of Vitamin D. While this is not uncommon, you need to have some knowledge of the tests ordered and why. First and most common is 25-hydroxyvitamin D (25(OH)D) Vitamin D test for Vitamin D levels. Do not expect a range result as there is currently no consensus on the level which indicates deficiency and the high end is also in question. Most doctors expect high results to be under 100 ng/ml (nanograms per milliliter (ng/ml) 250 nmol/L) and reflect total serum 25(OH)D.
One word of warning – be sure to get a hard copy of your test results. “Many doctors still consider a result of 30 ng/ml (75 nmol/L) to be sufficient when studies indicate otherwise. For this reason, it is a good idea to ask for the exact number value of the results or a hard copy. Results conveyed by use of the words "normal," "within range," or similar wording might still be inadequate.” Many doctors that are knowledgeable like to see results between 50 ng/ml (125 nmol/L) and 90 ng/ml (225 nmol/L).
The other test that doctors may order (but seldom need) is 1,25-dihydroxyvitamin D.
"This test is needed if calcium is high or the patient has a disease that might produce excess amounts of vitamin D, such as sarcoidosis or some forms of lymphoma, 1,25-dihydroxyvitamin D usually is ordered. Rarely, this testing may be indicated when abnormalities of 1-alphahydroxylase are suspected.” Sarcoidosis is a disease of unknown cause, characterized by granulomatous tubercles of the skin, lymph nodes, lungs, eyes, and other structures.
Dr. John Cannell strongly advises that if you take more than 10,000 IU/day that you must check you 25(OH)D regularly.
Please read this article by Dr. Cannell about the three cases of Vitamin D toxicity. Then read this (click in the blue tabs for specific information). Dr. Cannell also discusses Vitamin D deficiency and has a video in this article.
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