How an overdose of vitamin D manifests itself. An excess of vitamin D in the body, possible complications and prevention of hypervitaminosis

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General characteristics of vitamin D

Vitamin D is a fat-soluble compound - cyclic unsaturated high molecular weight alcohol ergosterol, which has antirachitic activity. Vitamin D is often referred to simply as an anti-rachitic factor because it is essential for proper bone growth and formation.

Since vitamin D is soluble in fats, it is able to accumulate in the human body in the cells of various organs. The largest amount of vitamin D accumulates in the subcutaneous adipose tissue and liver. Due to the ability to accumulate in the human body, there is always a certain depot of vitamin D, from which this compound is consumed in case of insufficient intake with food. That is, against the background of insufficient intake from food, vitamin D deficiency develops over a long period of time, until its reserves in the depot are used up.

The ability to dissolve in fats causes the possibility of excessive accumulation of vitamin A when it enters the human body in large quantities. With the accumulation of a high concentration of vitamin D in the blood and tissues of the body, hypervitaminosis develops, which, like hypovitaminosis, leads to impaired functioning of various organs and tissues.

This means that vitamin D must be supplied to the body in strictly defined, optimal doses, since both its excess and deficiency are harmful. You can not take vitamin D in large quantities, as this will lead to hypervitaminosis. And also you can not consume a small amount of vitamin D, as this will provoke its deficiency or hypovitaminosis.

Also, vitamin D prevents muscle weakness, improves immunity, ensures normal blood clotting and optimal functioning of the thyroid gland. According to experimental studies, calciferol helps to restore nerve cells and nerve fibers, thereby reducing the rate of progression of multiple sclerosis. In addition, vitamin D is involved in the regulation of blood pressure and heart rate.

With the external use of vitamin D preparations, the scaly skin in people suffering from psoriasis is reduced.

The norm of vitamin D for consumption and content in the body

The recommended daily dosage of vitamin D for people of different ages is as follows:

Adult women and men over 15 years old - 2.5 - 5.0 mcg (100 - 200 IU);
Pregnant women - 10 mcg (400 IU);
Nursing mothers - 10 mcg (400 IU);
Elderly people over 60 years old - 10 - 15 mcg (400 - 600 IU);
Infants under one year old - 7.5 - 10.0 mcg (300 - 400 IU);
Children 1 - 5 years old - 10 mcg (400 IU);
Children 5 - 13 years old - 2.5 mcg (100 IU).

Currently, micrograms (mcg) or international units (IU) are used to indicate the content of vitamin D in food. In this case, one international unit corresponds to 0.025 µg. Accordingly, 1 μg of vitamin D is equal to 40 IU. These ratios can be used to convert units of measurement to each other.

The list shows the optimal dosages of daily intake of vitamin D, which replenish its reserves and are not capable of provoking hypervitaminosis. Safe from the point of view of the development of hypervitaminosis is the use of no more than 15 micrograms of vitamin D per day. This means that the maximum allowable dosage of vitamin D, which will not lead to hypervitaminosis, is 15 micrograms per day.

Increasing the dose above the recommended optimal values is necessary for people who have an increased need for vitamin D, such as:

Living in northern latitudes with short daylight hours or polar night;
Living in regions with a highly polluted atmosphere;
Night shift work;
Bedridden patients who are not on the street;
People suffering from chronic diseases of the intestines, liver, gallbladder and kidneys;
Pregnant and lactating mothers.

In the blood, the normal content of vitamin D 2 is 10 - 40 mcg / l and D 3 - also 10 - 40 mcg / l.

Symptoms of deficiency and excess of vitamin D

Due to the possibility of accumulation of vitamin D in the human body, both its deficiency and excess may appear. A lack of vitamin D is called hypovitaminosis or deficiency, and an overabundance is called hypervitaminosis or overdose. Both hypovitaminosis and hypervitaminosis D cause disruption of various tissue organs, provoking a number of diseases. Therefore, vitamin D should not be consumed in large quantities, so as not to provoke an overdose.

Vitamin D deficiency

Lack of vitamin D leads to a decrease in the absorption of calcium from food, as a result of which it is washed out of the bones and stimulates the production of parathyroid hormone by the parathyroid glands. Against this background, hyperparathyroidism is formed, in which the leaching of calcium from the bones increases. Bones lose strength, bend, unable to withstand the load, and a person develops various violations of the normal structure of the skeleton, which are manifestations of rickets. That is, lack of vitamin D is manifested by rickets.

Symptoms of vitamin D deficiency (rickets) in children:

Delayed teething;
Delayed closure of fontanelles;
Softening of the bones of the skull, against which the flattening of the occipital lobes occurs with the simultaneous formation of bone growths in the region of the frontal and parietal tubercles. As a result of such processes, a person's head becomes square, which persists for life and is a sign of rickets suffered in childhood;
Deformation of the bones of the face, as a result of which a saddle nose and a high gothic sky can form;
Curvature of the legs according to the type of the letter "O" (popularly this condition is called "legs with a wheel");
Deformation of the pelvic bones;
Thickening of the ends of the tubular bones, as a result of which the knee, elbow, shoulder and ankle and finger joints become large and protruding. Such protruding joints are called rickety bracelets;
Thickening of the ends of the ribs, which leads to the formation of protruding large joints at the junction of the rib bones with the sternum and spine. These protruding junctions of the ribs with the sternum and spine are called rachitic rosaries;
Chest deformity (chicken breast);
Sleep disturbance;

After elimination of vitamin D deficiency, sleep disturbances, irritability and sweating disappear, bone strength is restored, and the level of calcium and phosphorus in the blood gradually returns to normal. However, bone deformities (for example, a saddle nose, chicken breast, curvature of the legs, a square shape of the skull, etc.), which have already formed during the period of vitamin D deficiency, will not be corrected when the vitamin D deficiency is eliminated, but will remain for life and will be a sign rickets suffered in childhood.

Symptoms of vitamin D deficiency (rickets) in adults are:

The development of osteomalacia, that is, bone thinning, from which calcium salts are washed out, which give strength;
Osteoporosis;
Burning sensation in the mouth and throat;

All disorders that have arisen in adults against the background of vitamin D deficiency completely disappear after the normalization of the intake of calciferol in the body.

Vitamin D overdose

An overdose of vitamin D is a very dangerous condition, since in this case there is an intensive absorption of calcium from food, which is sent to all organs and tissues, being deposited in them in the form of solid salts. The deposition of salts causes calcification of organs and tissues that cease to function normally. In addition, excess calcium in the blood provokes severe disorders of the heart and nervous system, manifested by micronecrosis and arrhythmias. The clinical symptoms of vitamin D overdose depend on its degree. Currently, there are three degrees of vitamin D overdose, characterized by the following clinical manifestations:

I degree of hypervitaminosis D- mild poisoning without toxicosis:

sweating;
Irritability;
Sleep disturbance;
Delayed weight gain;
Thirst (polydipsia);
A large amount of urine more than 2.5 liters per day (polyuria);
Pain in joints and muscles.

II degree of hypervitaminosis D- moderate poisoning with moderate toxicosis:

Anorexia;
Periodic vomiting;
Decrease in body weight;
Tachycardia (palpitations);
Muffled heart sounds;
systolic murmur;
Increased levels of calcium, phosphates, citrates, cholesterol and total protein in the blood (hypercalcemia, hyperphosphatemia, hypercholesterolemia, hyperproteinemia);
Decreased activity of alkaline phosphatase in the blood (AP).

III degree of hypervitaminosis D- severe poisoning with severe toxicosis:

Persistent vomiting;
Severe weight loss;
Low muscle mass (hypotrophy);
lethargy;
Low mobility (hypodynamia);
Periods of marked anxiety;
Periodic convulsions;
High blood pressure;
Muffled heart sounds;
systolic murmur;
expansion of the heart;
Attacks of arrhythmia;
ECG abnormalities (widening of the QRS complex and shortening of the ST interval);
Pale skin and mucous membranes;
Cold hands and feet;
Dyspnea;
Pulsation of the vessels in the neck and in the region of the stomach;
Increased levels of calcium, phosphates, citrates, cholesterol and total protein in the blood (hypercalcemia, hyperphosphatemia, hypercholesterolemia, hyperproteinemia);
Decreased levels of magnesium in the blood (hypomagnesemia);
Decreased activity of alkaline phosphatase in the blood (AP);
Complications in the form of bacterial infections (for example, pneumonia, pyelonephritis, myocarditis, pancreatitis);
CNS depression up to coma.

Treatment of vitamin D overdose

If there are signs of an overdose of vitamin D, you should immediately begin to take measures to accelerate the removal of the substance from the body. The process of eliminating excess vitamin D is considered a treatment for hypervitaminosis D, which is as follows:
1. With a mild degree of poisoning, give a person inside vaseline oil, which will reduce the absorption of vitamin D residues present in the intestines. To restore the normal structure of cells as soon as possible and reduce the penetration of calcium into tissues, a person is given vitamin E and A. In order to accelerate the removal of excess calcium, Furosemide is used, and Asparkam or Panangin are used to compensate for losses of potassium and magnesium;
2. With an average degree of poisoning, a person is given vaseline oil, vitamins E and A, Furosemide, Asparkam or Panangin. Verapamil is added to these drugs (eliminates excess calcium deposition in tissues), Etidronate (reduces calcium absorption from the intestines), Phenobarbital (accelerates the conversion of vitamin D into inactive forms);
3. In severe overdose of vitamin D, all drugs used to treat moderate poisoning are administered intravenously. In addition to these drugs, if necessary, glucocorticoids, saline, Calcitrin and Trisamine are administered.

In case of violations of the heart (arrhythmia, shortness of breath, palpitations, etc.) or the central nervous system (lethargy, coma, convulsions, etc.) against the background of an overdose of vitamin D, it is necessary to administer phosphate salt preparations, for example, In-fos, Hyper-fos-K, etc. .

Overdose and deficiency of vitamin D (rickets) in children: causes, symptoms, treatment, answers to questions - video

Vitamin D - indications for use

Vitamin D is indicated for therapeutic or prophylactic use. Prophylactic intake of vitamin D is to prevent rickets in children and vitamin deficiency in adults. Therapeutic intake of vitamin D is carried out as part of the complex therapy of various diseases, accompanied by a violation of the structure of bones and a low level of calcium in the blood. Preventive and therapeutic intake of vitamin D differs only in dosages, otherwise it is carried out according to the same rules. So, for prevention, calciferol preparations should be taken at 400-500 IU (10-12 mcg) per day, and for treatment at 5000-10000 IU (120-250 mcg) per day.

Vitamin D is indicated for use in the following conditions and diseases:

Hypovitaminosis D (rickets) in children and adults;
broken bones;
Slow fusion of bones;
Osteoporosis;
Low levels of calcium and phosphate in the blood;
Osteomyelitis (inflammation of the bone marrow);
Osteomalacia (softening of the bones);
Hypoparathyroidism or hyperparathyroidism (insufficient or excessive amounts of parathyroid hormones);
Systemic lupus erythematosus;
Chronic atrophic gastritis;
Chronic enteritis of any etiology, including celiac disease, Whipple's disease, Crohn's disease, radiation enteritis;
Chronic pancreatitis;
Tuberculosis;
Hemorrhagic diathesis;
Psoriasis;
Muscular tetany;
Menopausal syndrome in women.

Vitamin D for a newborn - should I give it?

Currently, the question of whether to give vitamin D to a newborn child is causing widespread debate in society. Someone thinks that this is necessary, referring to the long experience of mothers, grandmothers and "experienced" pediatricians, who have been working for more than one year. And someone says that this is not necessary, because the child receives all the necessary vitamins from milk. In fact, these are two radical, completely opposite positions, neither of which is correct. Consider when a child needs to be given vitamin D to prevent rickets.

If the child is at least 0.5 - 1 hour a day on the street and is exposed to direct sunlight, while being completely breastfed, and the mother eats fully, then vitamin D is not necessary. In this case, the child will receive part of vitamin D from mother's milk, and the missing amount is synthesized in his skin under the influence of ultraviolet radiation. It should be remembered that a mother's nutritious diet is such a diet in which she necessarily consumes vegetables and fruits every day, and meat, fish, eggs and dairy products at least one day a week. And a child’s walk means his stay on the street, under the sun, and not several hours spent in a closed stroller, walled up from the outside world.

If the child is on mixed feeding, is regularly outside, and the mother eats fully, then he also does not need to give vitamin D, since modern baby food contains all the necessary vitamins and minerals in the right amount.

If the child is completely artificially fed using modern mixtures, then he does not need to give vitamin D, under any circumstances, even if he practically does not walk. This is due to the fact that in modern mixtures there are all vitamins and microelements necessary for the growth and development of the child in sufficient quantities.

If the child is breast-fed or mixed-fed, rarely goes outside without being exposed to solar radiation, and the mother is malnourished, then vitamin D should be given. You also need to give vitamin D if the child is artificially fed not with modern mixtures, but, for example, cow, goat or donor milk, etc.

Thus, vitamin D should be given to newborns only in the following cases:
1. The breastfeeding mother is malnourished.
2. Artificial feeding is carried out not with modern mixtures, but with donor milk of various origins.
3. The child is outside less than half an hour a day.

In principle, in modern conditions of a temperate climate, the need for additional intake of vitamin D by newborns under one year old is very rare, since the nutrition of nursing mothers and the availability of modern, nutrient-rich formulas for baby food have completely eliminated the problem of calciferol deficiency. It should be remembered that the mandatory intake of vitamin D by newborns for the prevention of rickets was introduced more than 40 years ago, when nursing mothers did not always eat well, worked overtime in difficult conditions of factory shops, and there were simply no infant formulas, and “artists” were fed with donor milk, which was necessarily boiled, which means that the vitamins in it turned out to be destroyed. Therefore, in the then existing conditions, vitamin D was a necessity for almost all newborns. Today, conditions have changed and all babies do not need the vitamin. Therefore, it should only be taken when needed.

Vitamin D for children

Vitamin D should be given to children if they are not in the sun for at least one hour a day, do not eat meat at least twice a week and do not eat animal products (butter, sour cream, milk, cheeses, etc.) daily. You can also give vitamin D if you notice that the child has an O- or X-shaped curvature of the legs and a saddle nose is forming. In all other cases, the child does not need to take vitamin D, with the exception of serious diseases, when it is prescribed by a doctor as part of complex therapy.

Vitamin D in summer

In the summer, if a person is in the sun and consumes animal products at least once a week, then you do not need to take vitamin D, regardless of age. At the same time, exposure to the sun means being outdoors in a small amount of clothing (open T-shirts, short shorts, skirts, dresses, swimwear, etc.) under direct sunlight. Such a stay on the street for half an hour in the summer is enough for the endogenous production of the required amount of vitamin D in the skin. Therefore, if a person is outside at least half an hour a day in the summer, then he does not need to take vitamin D.

If a person does not go outside in the summer, for some reason is constantly indoors, or does not undress, leaving most of the skin covered, then he needs to take vitamin D prophylactically.

Vitamin D in foods - where is it found?

Vitamin D is found in the following foods:

Sea fish liver;
Fatty fish, such as salmon, herring, mackerel, tuna, perch, etc.;
Liver beef, pork;
Fatty meats, such as pork, duck, etc.;
Fish caviar;
Eggs;
Milk cream;
Sour cream;
Vegetable oil;
Seaweed;
Forest chanterelle mushrooms;
Yeast.

Vitamin D preparations

In pharmacological preparations of vitamin D, the following forms are used:

Ergocalciferol - natural vitamin D 2;
Cholecalciferol - natural vitamin D 3;
Calcitriol is an active form of vitamin D 3 obtained from natural products;
Calcipotriol (Psorkutan) is a synthetic analogue of calcitriol;
Alfacalcidol (alpha D 3) is a synthetic analogue of vitamin D 2 (ergocalciferol);
Natural fish oil is a source of various forms of vitamin D.

All of these forms are highly active and can be used without any restrictions.

Pharmacological preparations can be single-component, that is, containing only forms of vitamin D, or multi-component, which include vitamin D and various minerals, most often calcium. Both types of preparations can be used to eliminate vitamin D deficiency. However, multicomponent preparations are the best option, since they simultaneously eliminate the deficiency of vitamin D and some other elements.

All forms of vitamin D

Currently, the following preparations containing vitamin D are available on the pharmaceutical market:

Aquadetrim vitamin D 3 (cholecalciferol);
Alphabet "Our baby" (vitamins A, D, E, C, PP, B 1, B 2, B 12);
Alphabet "Kindergarten" (vitamins A, E, D, C, B 1);
Alfadol (alfacalcidol);
Alfadol-Ca (calcium carbonate, alfacalcidol);
Alpha-D 3 -Teva (alfacalcidol);
Van Alpha (alfacalcidol);
Vigantol (cholecalciferol);
Videhol (various forms and derivatives of vitamin D);
Vita bears (vitamins A, E, D, C, B 1, B 2, B 6, B 12);
Vitrum
Vitrum Calcium + Vitamin D 3 (calcium carbonate, cholecalciferol);
Vittri (vitamins E, D 3 , A);
Calcemin Advance (calcium carbonate, calcium citrate, cholecalciferol, magnesium oxide, zinc oxide, copper oxide, manganese sulfate, borate);
Calcium D 3 Nycomed and Calcium D 3 Nycomed forte (calcium carbonate, cholecalciferol);
Complivit Calcium D 3 (calcium carbonate, cholecalciferol);
Multi-Tabs (vitamins A, E, D, C, B 1, B 2, B 6, B 12);
Natekal D 3 (calcium carbonate, cholecalciferol);
Oxidevit (alfacalcidol);
Osteotriol (calcitriol);
Pikovit (vitamins A, PP, D, C, B 1, B 2, B 6, B 12);
Polyvit (vitamins A, E, D, C, B 1, B 2, B 6, B 12);
Rocaltrol (calcitriol);
Sana-Sol (vitamins A, E, D, C, B 1, B 2, B 6, B 12);
Centrum (vitamins A, E, D, C, K, B 1, B 2, B 6, B 12);
Ergocalciferol (ergocalciferol);
Etalfa (alfacalcidol).

Vitamin D oil solution

Vitamin D oil solution can be taken orally or administered intramuscularly and intravenously as needed. In the form of oil solutions of vitamin D, there are the following drugs:

Vigantol;
Vitamin D 3 oral solution in oil;
Videhol;
Oksidevit;
Ergocalciferol;
Etalfa.

Calcium with Vitamin D

Calcium with Vitamin D is a vitamin and mineral complex often used to prevent various diseases associated with bone destruction, such as osteoporosis, osteomalacia, bone tuberculosis, etc. Currently, there are the following preparations containing calcium with vitamin D at the same time:

Alfadol-Sa;
Vitrum Calcium + Vitamin D 3;
Calcemin Advance;
Calcium D 3 Nycomed and Calcium D 3 Nycomed forte;
Complivit Calcium D 3;
Natekal D 3 .

Ointment or cream with vitamin D

Vitamin D ointment or cream is used to treat psoriasis. Currently, the following ointments and creams containing vitamin D are available:

Glenriaz (calcipotriol);
Daivobet (calcipotriol);
Daivonex (calcipotriol);
Xamiol (calcitriol);
Curatoderm (tacalcitol);
Psorkutan (calcipotriol);
Silkis (calcitriol).

Vitamin D - which is better

In relation to any group of drugs, the term "best" is incorrect and incorrect in its essence, since in medical practice there is the concept of "optimal". This means that for each specific case, a strictly defined drug, which doctors call optimal, will be the best. This also applies to vitamin D supplements.

That is, complex vitamin-mineral complexes containing vitamins D are optimal for the prevention of osteoporosis, osteomalacia and other bone diseases. Oil solutions of vitamin D are well suited for the prevention and treatment of rickets in children and adults, since they can be administered not only orally, but also intravenously or intramuscularly. And external creams and ointments with vitamin D are the best drugs for the treatment of psoriasis.

Thus, if a person just wants to drink a course of vitamin D for prevention, then complex vitamin-mineral complexes, for example, Vittri, Alfadol-Ca, etc., will be optimal for him. If it is necessary to prevent rickets in a child, then oil solutions of vitamin D are best suited for this purpose. To eliminate vitamin deficiency and treat various diseases, oil solutions of vitamin D are also the best form.

Vitamin D instructions for use - how to give drugs

Vitamin D is recommended to be used simultaneously with vitamins A, E, C, B 1, B 2 and B 6, as well as pantothenic acid and calcium and magnesium salts, since these compounds improve the absorption of each other.

Tablets, drops and pills of vitamin D should be taken during or immediately after meals. The oil solution can be poured onto a small piece of black bread and eat it.

For the prevention of rickets, vitamin D is taken in the following dosages, depending on age:

Full-term newborns from 0 to 3 years old - take 500 - 1000 IU (12 - 25 mcg) per day;
Premature newborns from 0 to 3 years old - take 1000 - 1500 IU (25 - 37 mcg) per day;
Pregnant women - take 500 IU (12 mcg) per day during the entire period of bearing a child;
Nursing mothers - take 500 - 1000 IU (12 - 25 mcg) per day;
Women in menopause - take 500 - 1000 IU (12 - 25 mcg) per day;
Men of reproductive age take vitamin D 500-1000 IU (12-25 mcg) per day to improve sperm quality.

Prophylactic use of vitamin D can be continued for several years, alternating 3 - 4 week courses with 1 - 2 monthly intervals between them.

For the treatment of rickets and other diseases of the skeletal system, it is necessary to take vitamin D 2000 - 5000 IU (50 - 125 mcg) for 4 - 6 weeks. Then you need to take a week break, after which you will repeat the course of taking vitamin D.

Vitamin D analysis

Currently, there is a laboratory analysis for the concentration of two forms of vitamin D in the blood - D 2 (ergocalciferol) and D 3 (cholecalciferol). This analysis allows you to accurately determine the presence of vitamin deficiency or hypervitaminosis, and, in accordance with its results, make the necessary decision to cancel or, on the contrary, take vitamin D supplements. The concentration of these two forms is determined in venous blood taken in the morning on an empty stomach. The normal concentration of both D 2 and D 3 is 10 - 40 µg / l each. Before use, you should consult with a specialist.

An excess of vitamin D can manifest itself in a wide range of symptoms: vomiting, indigestion, hypercalcemia, manifested in an increased concentration of calcium in the blood. This condition is no less dangerous than. What to do with an excess of vitamin D in the body? Let's find out together.

Calciferol according to the method of formation is usually divided into natural and synthetic. The first variety is found in food of animal origin (D3), the second - in biological additives (D2).

If acute symptoms worsen within a few hours, doctors should be called. In this case, the patient must be provided with plenty of fluids. Children under one year of age are subject to hospitalization without fail. After hospitalization, the visit to the doctors for the baby does not end: the child must be observed for another three years. Under the control of the doctors, the work of the small patient's heart, the composition of urine and blood will be regularly checked.

However, as a rule, to eliminate the signs of hypervitaminosis, it is enough to simply cancel the vitamin complex.

Possible complications and their prevention

The body cannot always fully compensate for the vitamin "hit" on its own. The patient may develop acidosis, hyperacidity, and cardiac arrhythmia. Manifestations of hypervitaminosis D are especially dangerous in the hot season.

You should not prescribe medications and vitamins to yourself. Try to stay in the sun sensibly, avoiding direct sunlight between 11 am and 4 pm.

Neglecting treatment after the appearance of obvious symptoms, the patient dooms himself to toxic damage to internal organs and the central nervous system, deterioration in the permeability of body cells. All this leads to premature aging.

You should always remember the "golden rule" that it is better to prevent a disease than to treat it.

Vitamin D is an essential element of the digestive system. Purpose - the processing of calcium and phosphorus in the small intestine. D is the collective name for a group of elements, the most important being cholecalciferol, D3, and ergocalciferol, D2. Some researchers call them hormones for their participation in metabolism, the production of hormones, and the regulation of division at the cellular level. But, like any substance, taken in excess, it harms. An excess of vitamin D provokes a violation of the functioning of organs and systems.

Daily requirement for vitamin D

Provitamin D3 is synthesized in the skin under the influence of the sun. Cholecalciferol becomes after warming up the temperature of the human body. Simultaneously enters with food:

milk, eggs, cottage cheese, sour cream;
beef liver, meat, fatty fish, fish oil;
forest mushrooms, yeast.

The daily value of this fat-soluble vitamin depends on the age group:

in an adult - 400 IU;
pregnant women - 600ME;
the elderly - 600 IU;
babies up to four years of age - 600 IU;
in children from four to ten years old - 100 IU.

UNIT CONVERTER: VITAMIN D

Cholecalciferol (D3)/ergocalciferol (D2)

Substance form

IU mg µg g mg µg g

Decimals in the result:

Convert

IU conversion ⇄ g/mg/mcg (developed by pharmacists and doctors based on reliable data)

Lack of D3 concentration leads to the development of diseases such as rickets in children, secondary hyperparathyroidism in adults.

Secondary hyperparathyroidism develops due to calcium deficiency. The parathyroid gland produces a sharp release of hormones that cause hypercalcemia in response to a deficiency. But too much vitamin D also poses a threat.

Causes of an overdose of calciferol

An excess of vitamin D occurs against the background of an overdose of drugs containing calciferol in its composition. Occurs with a single dose of a high dose or a constant excess for a long time. Hypervitaminosis in the body of vitamin D is caused by:

if drugs are taken against the background of long walks with high solar activity, an overdose occurs;
if sources of calcium are used at the same time;
if the intake of calciferol is accompanied by a diet of seafood;
acute overdose is possible during the use of an alcohol solution at a dosage of 20 drops for a month;
chronic overabundance occurs when taking alcohol drops at a dosage of 5 drops for two months;
overdose is possible against the background of individual sensitivity, even if normalization is observed.

The video talks about the causes and dangers of overdose:

Symptoms of an overdose of vitamin D

Symptoms of excess vitamin D content are different for acute and chronic conditions.

Signs of acute poisoning

An excess of calciferol in adults leads to:

nausea, vomiting;
increased thirst;
sudden changes in weight;
the appearance of seizures;
arterial hypertension, failure of the heart rhythm;
violation of sleep and rest, asthenic syndrome;
frequent urination.

An acute excess of vitamin D in the body of a child is characterized by signs:

regurgitation fountain after feeding, vomiting;
lethargy, capriciousness;
loose stools, with a sharp unpleasant odor;
convulsive syndrome;
frequent profuse urination;
the skin is dry, covered with a rash.

Signs of chronic overdose

An excess of vitamin D in the body of adults is characterized by symptoms:

loss of appetite;
increased fatigue, irritability;
unmotivated weight loss;
disorder of the digestive tract;
swelling, pain in the lumbar region;
aches in the bones, convulsive manifestations in the calf muscles;
insomnia.

Manifestations of excess vitamin D3 levels in babies:

accelerated closure of a large fontanel;
decreased skin turgor, pallor;
poor weight gain, fasting;
poor hair growth;
cardiac arrhythmias.

Hypervitaminosis in a woman's body of vitamin D is manifested:

nervousness, hysteria;
anorexia;
unstable stool;
unmotivated fever;
convulsive syndrome;
dizziness, fainting;
lack of fluid.

Consequences and danger of overdose

Hypervitaminosis of vitamin D is dangerous for its consequences. An excess of calciferol leads to serious changes in the organs:

deposition of calcium in the kidneys, the result is the formation of stones;
liver pathology - lack of bile secretion into the ducts;
endocrine disorders;
sedimentation of calcium on the walls of blood vessels, the result is atherosclerosis;
changes in skeletal density, pathological fractures;
muscle, joint pain;
osteochondrosis, posture disorders;
clouding of the lens, cornea;
osteoporosis;
decreased density of urine, polyuria.

Why is hypervitaminosis of vitamin D level dangerous for a child?

High calciferol provokes a baby's lag in physical development from peers, mental retardation, memory loss, attention. On the basis of nutritional deficiency of the corneal vessels, inflammatory diseases of the iris occur. There is a high risk of pathological changes in the spine leading to scoliotic deformities.

The danger of overdose in pregnant women

The main danger is the threat of spontaneous abortion. Malfunctions of the excretory system lead to a high risk of eclampsia. An excess of calciferol harms the fetus - a lag in the formation of systems, pathological formation of bones, heart, excretory system.

Consequences of an overdose while breastfeeding

Breastfeeding mothers are at high risk of emotional disturbances - depression, mood swings, exhaustion. Reduced immunity, increased risk of infectious diseases. Excess calcium is deposited in the mammary glands, which causes mastitis, stagnant processes, and loss of milk.

Therapeutic activities

The decision on the methods of therapy is made by the doctor based on the diagnosis. It is necessary to differentiate hyperparathyroidism from an overdose of vitamin D - in both cases, an excess of calcium levels in the blood is observed. If the dosage is exceeded, there is a deficiency of potassium, magnesium, phosphorus, parathyroid hormone. Increased excretion of calcium and phosphate in the urine. The screening test according to Sulkovich with oxalic acid for calcium content gives a positive result.

X-ray images show calcium deposits in the epiphyses - the end sections of the bones that form the joint. The diaphyses of the bones, the middle part, are porous in the pictures, this should not be normal. Biopsy shows calcium deposition in internal systems.

Therapy depends on the severity of the condition. For acute poisoning:

gastric lavage with a gag reflex;
taking laxatives, sorbents;
call an ambulance.

Inpatient treatment includes:

infusion therapy - drip administration of an isotonic sodium chloride solution, Ringer's solution, the goal is blood thinning to reduce the concentration of calciferol;
the introduction of diuretics to remove excess fluid;
glucocorticosteroids - prednisolone, hydrocortisone, to reduce the effect on bone tissue;
ammonium chloride solution - to reduce the risk of stone formation.

For any type of overdose, drugs are prescribed - antagonists:

retinol, at a dosage of six to eight thousand international units;
ascorbic acid, the daily dose is 500 milligrams;
cholestyramine - has the ability to bind calciferol, is used twice a day at a dosage of 500 milligrams per kilogram of body weight.

A diet is mandatory, in which foods are excluded:

fish, fish liver;
chicken eggs;
beef liver;
milk, sour cream, butter.

Folk remedies are aimed at eliminating irritation, insomnia. Apply chamomile, valerian, dill water, tea with lemon balm. If anyone knows interesting recipes, share the available information.

Prevention methods

To prevent an overdose of dietary supplements with calciferol, you should take the drug exactly in the quantities prescribed by the doctor. When treating a small child, monitor the condition so as not to miss the appearance of threatening symptoms. Do not consume foods rich in calcium, calciferol at the same time as dietary supplements. Limit the effect of solar insolation on the duration of therapy.

It is recommended during the use of dietary supplements to regularly check urine tests for the Sulkovich test - the first signs of an overdose are detected in the urine. Checking every two weeks will help to notice the problem in time.

An excess of vitamin D in the blood is what leads to the uncontrolled use of dietary supplements. An overdose of calciferol is more dangerous than a deficiency. The dosage should be agreed with the attending doctors - pediatricians, therapists, gynecologists. You should not prescribe vitamins on your own, even such useful ones as calciferol.

And the substances that our body needs for its proper functioning. It is important to get the prescribed daily dose of this substance in order not to suffer from its deficiency later. How much calciferol does a person need per day? It is enough for adults to receive from three hundred to six hundred IU, and for children under twelve years old it is necessary from four hundred to five hundred IU. From infancy, babies are saturated with vitamin D through mother's milk, and it is also important to walk with the child in the sun, because calciferol, in addition to food, enters our body through the sun's rays. Calciferol deficiency already at an early age threatens such a serious and dangerous disease as rickets.

But this does not mean at all that you need to oversaturate the body with this substance, because otherwise hypervitaminosis of vitamin D may occur, which is no less dangerous than its deficiency. In this article, we will look at the reasons why this phenomenon may occur and the symptoms that you should pay close attention to. And also talk about methods of treatment and prevention.

Why does an overdose occur?

Above, we wrote the allowable daily allowance of calciferol, an excess occurs from exceeding this norm. How is it possible to overdose?

It may arise if you are taking calcium supplements while also taking "ultraviolet baths" and fish oil to strengthen the immune system in this way. But remember that everything is good in moderation.
If you have been taking the drug for about six months, three to five drops, you may also experience an overdose of vitamin D.
Alcohol solution in large doses also provokes a state of acute hypervitaminosis. We are talking about a period of three to four weeks, at a dosage of ten to twenty drops.
For an excess of this substance hypersensitivity to this element can affect, and this can happen when using a small dose.
Remember what to consider and individual intolerance to the drug, because the symptoms will be similar to hypervitaminosis.

It is important to understand that taking any drug is highly discouraged without the supervision and control of a doctor, even taking a seemingly harmless vitamin D. But without the recommendations of a specialist, you can easily overdo it with the dosage, initially determining it for yourself incorrectly. Do not think that if nothing happened after two or three times of taking the drug, then everything is under control, it is not. Calciferol has a cumulative property, so the symptoms appear with prolonged use of the drug, the period can be even six months. In order not to eliminate the consequences of uncontrolled use of the drug, it is better to discuss the dosage with your doctor, for each person it will be individual.

About symptoms

An overdose of calciferol, as it can be both acute and chronic. It is acute in children up to the age of six months, it is enough to use the drug for two to three weeks, and this also applies to people who are hypersensitive to the components of this substance. Symptoms of acute hypervitaminosis manifest differently in adults and children.

Infants may suffer from hypervitaminosis due to parental inattention in observing doses, as well as due to thin adipose tissue, where excess matter accumulates. So what are the symptoms to watch out for?

The baby's sleep is disturbed he will fall asleep for a long time, while often crying at night.
He will vomit often vomiting may also be added.
Hair will grow more slowly.
The child will often want to drink, at the same time, urine will begin to stand out in large sizes.
In addition to sleep, appetite will also worsen, it will be reduced.
The newborn may suffer from cramps and constipation.
Lethargy, weakness and apathy will appear.
The color of the skin takes on a grayish-yellow tint, becomes dry.
The baby is losing weight.
Bone tissue becomes dense.

In older children, the symptoms largely coincide with adults, but there are also individual signs, some of which are extremely dangerous to health:

The child is losing weight.
The skin becomes less elastic.
The body temperature rises.
There is a spasm and cramp in the muscles.
There is an increase in the liver and spleen.
There is a slowdown in the pulse.
And two more serious violations, which can lead to serious consequences. If calcium is deposited in the cornea, it threatens with blindness, and if in the heart, then death can occur.

The well-known pediatrician Evgeny Olegovich Komarovsky in his program answered the question of how not to cause an overdose of calciferol at an early age of the baby. To avoid rickets, while maintaining a normal level of vitamin D in the body, you just need to walk with the child in the sun, with enough of its rays on the face and hands. With walks, too, you should not overdo it, in total they should be no more than two hours a week.

As for adults, here you should pay attention to the following signs that indicate an overdose of the drug:

The process of digestion is disturbed.
There is nausea and vomiting.
Urine is excreted frequently and is cloudy.
There is hypertension.
There may be toothache.
There is lethargy in the joints, drowsiness.
The eyes are inflamed.
Cholesterol rises.
It becomes difficult to breathe.
You can even lose consciousness.

Chronic intoxication is characterized by: muscle pain, sleep disturbance, weakness and regular fatigue, stool disturbance, lower back pain, urination disorders, muscle spasms, weight loss, weakened immunity.

About the methods of treatment

So we talked about what is an overdose of vitamin D in infants, older children and adults, why it occurs, and what are the signs of this. It is important to understand how to treat this problem. Firstly, it is worth noting that the treatment is carried out only under the supervision of a doctor, self-medication is unacceptable here. At the first signs of intoxication of the body, immediately seek help from a specialist. Immediately you will need to exclude from the diet some foods that contain more vitamin D3. We are talking about cottage cheese, milk, chicken eggs and fish oil. Of course, treatment will not do without special additional therapy, in which vitamins B and C are prescribed.

Sometimes there is hospitalization where doctors inject a solution of sodium chloride with glucose to restore lost fluid and reduce intoxication of the body. In addition, antibiotics are prescribed to prevent bacterial infection. Various drugs are also prescribed to eliminate disorders in the heart, blood vessels, and kidneys.

It is important to start treatment immediately otherwise, an overdose threatens you with kidney failure, atherosclerosis, thyroid damage and other dangerous diseases. All these are very serious consequences that can be avoided with the timely help of a doctor. If you have been taking vitamin D for a short time in the wrong doses, then after stopping this drug or reducing the dosage, the symptoms will go away on their own without any medical intervention.

A few words about prevention

As we said above, be sure to consult a specialist before taking this or that drug containing, you can also get acquainted with it in general.

The important point is that it should be taken only in case of an acute deficiency, if there is none, then it will be enough to be in the sun more often and eat the right food rich in vitamin D.

We are talking about meat, fish, dairy products, mushrooms, butter, eggs (especially yolks). This rule applies to both adults and children. Sometimes taking this drug is necessary in the winter, when there is little solar heat outside. But this also requires a doctor's recommendation, never self-medicate yourself, and even more so your child. At the first signs of hypervitaminosis, the drug is canceled or prescribed in a lower dosage.

Always remember that this is your health and it is important to take it seriously, not allowing yourself to take certain drugs. An experienced doctor will always be able to help you in these matters and at the same time avoid unpleasant consequences. Be healthy!

Vitamin D is a unified name for a whole group of fat-soluble biologically active substances formed under the influence of ultraviolet radiation in animal and plant tissues. Part of the vitamins of this group is synthesized in the cells of the human body, some come exclusively from the outside.

Source: depositphotos.com

The D vitamins include:

vitamin D 2 - ergocalciferol;
vitamin D 3 - cholecalciferol;
vitamin D 4 - dihydroergocalciferol;
vitamin D 5 - sitocalciferol;
vitamin D 6 - stigma-calciferol.

Currently, the term "Vitamin D" refers to two forms - D 2 and D 3 , colorless crystals, odorless, resistant to high temperatures. The activity of vitamin D preparations is expressed in international units (IU): 1 IU contains 0.000025 mg (0.025 μg) of chemically pure vitamin D.

Dietary sources of the vitamin are some types of algae, fatty fish, fish oil. To a lesser extent - butter, cheese and other fatty dairy products, egg yolk, caviar, forest (not grown in artificial conditions) mushrooms, yeast.

Vitamin D is a unique biologically active substance that combines the functions of a vitamin and a hormone, in which it acts on intestinal cells, stimulating the production of a carrier protein necessary for calcium transport, as well as kidneys and muscles, where it enhances Ca 2+ reabsorption. The main task of vitamin D is to ensure the absorption of calcium and phosphorus from the small intestine into the systemic circulation. The absorption of these microelements in the intestine (maximally in the duodenum) is carried out due to active transport against the electrochemical gradient, this transition through cell membranes becomes possible only with the help of a calcium-binding protein dependent on vitamin D.

Other functions of vitamin D:

stimulates cell proliferation and development (often used topically in dermatology to reduce skin manifestations of diseases);
participates in the synthesis of monocytes;
inhibits the growth of cancer cells, which makes it effective in the prevention and treatment of certain types of tumors, including malignant blood diseases;
affects the level of insulin, thereby the level of glucose in the blood;
provides adequate neuromuscular interaction.

The therapeutic dose of the vitamin is 100-4000 IU, depending on the age and functional state of the body. Exceeding this threshold provokes symptoms of an overdose, the so-called D-vitamin intoxication.

Some researchers indicate as toxic a much larger dose of the vitamin - about 1 million IU per day.

Signs of an overdose

Vitamin D overdose can be both acute and chronic.

Acute overdose develops, as a rule, in children of the first six months of life when taking unreasonably high doses of vitamin D preparations for 2-3 weeks, or in individuals with individual hypersensitivity to the substance. Acute vitamin intoxication is characterized by violent symptoms, and signs of dehydration come to the fore:

a sharp decrease in appetite up to its complete absence;
drowsiness, lethargy;
agonizing thirst;
dry skin and mucous membranes;
increased blood pressure;
slowing of the pulse;
nausea, frequent vomiting;
increased urination;
unstable stool: diarrhea alternating with constipation;
the appearance of clonic-tonic convulsions, muscle rigidity is possible;
short-term loss of consciousness.

Source: depositphotos.com

Chronic intoxication develops for a long time (6 months or more) with regular intake of vitamin doses slightly exceeding the therapeutic one. Her symptoms:

irritability;
increased fatigue;
sleep disorders;
muscle and bone pain, cramps, muscle twitches;
weight loss;
dyspeptic disorders (loss of appetite, nausea, vomiting, stool disorders);
enlargement of the liver and spleen;
dull aching pain in the lumbar region, increased urination, swelling (mainly on the face) - signs of kidney damage;
decreased immunity, manifested by susceptibility to colds and other infectious and inflammatory diseases.

As a result of chronic overdose, there is a toxic effect of vitamin D on cell membranes, metabolic disorders with an increase in the content of Ca 2+ ions in the blood and urine, acidification of the internal environment of the body, and the deposition of calcium salts in organs and tissues.

First aid for overdose

With a simultaneous ingestion of an ultra-high dose of vitamin D, it is necessary:

Rinse the stomach (drink 1-1.5 liters of water or a weak solution of potassium permanganate and induce a gag reflex).
Take a saline laxative (Magnesium sulfate).
Take an adsorbent (Enterosgel, Polysorb, Polyphepan according to the scheme or activated carbon at the rate of 1 tablet per 10 kg of body weight).

With the development of symptoms of intoxication against the background of systematic use, it is necessary to immediately stop the drug and consult a doctor.

Antidote

There are no specific antidotes for vitamin D.

According to some data, it is advisable to take antioxidant drugs, for example, vitamin E (tocopherol), which prevent the damaging effects of vitamin D.

When is medical assistance required?

Medical assistance is needed if:

a child, a pregnant woman or an elderly person has been injured;
uncontrollable vomiting or diarrhea;
neurological symptoms (convulsions, intense headache);
symptoms of dehydration (severe thirst, dry skin and mucous membranes, a decrease in the amount of urine separated, a change in its concentration, a decrease in blood pressure, tachycardia);
traces of blood appeared in the vomit or feces;
the victim is limited to contact or is unconscious.

The victim, depending on the severity of the condition, receives outpatient treatment or is hospitalized in the specialized department of the hospital, where further pharmacotherapy of D-vitamin intoxication is carried out:

therapeutic diet with restriction of products containing calcium and vitamin D;
parenteral administration of an isotonic solution of 0.9% sodium chloride and 5% glucose in order to restore lost fluid and reduce symptoms of intoxication;
the introduction of a 4% solution of sodium bicarbonate to eliminate acidosis;
forced diuresis;
oxygen therapy;
vitamins of groups A and B, ascorbic and pantothenic acid to level the side effects of vitamin D;
antibiotic therapy (penicillins, cephalosporins) to prevent the addition of a secondary bacterial infection;
glucocorticosteroids (Prednisolone) in a short course to normalize intracellular processes;
therapy of concomitant complications (cardiac glycosides, adrenergic blockers, metabolites are used to correct cardiovascular disorders; nitrofuran preparations and nalidixic acid derivatives for the treatment of renal pathology; neuroprotectors for neurological symptoms, etc.).

Possible consequences

An overdose of vitamin D can cause the following complications:

kidney failure;
accession of a secondary infection;
deposition of calcium crystals in the kidneys with subsequent development of renal failure;
toxic hepatitis;
myocardial toxicity;
vascular calcification, early atherosclerosis;
damage to the thyroid and parathyroid glands.

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