vitamin D capsules, overdose on vitamin D, more vitamin D

Doctors generally assume that North Americans are so well nourished that they never need to worry about supplements. In fact, they sometimes fuss that people who take vitamin pills could overdose on vitamin D or vitamin A, fat-soluble vitamins that are stored in the body. Is that worry justified?

It turns out that many Americans have low levels of vitamin D circulating in their bodies. This is especially true of African-Americans, since dark skin takes more time to make vitamin D in the presence of sunshine. Those with adequate levels of 25-hydroxyvitamin D, the usual measured metabolite, have generally been taking supplements (Journal of Nutrition, April, 2015). What about people in other countries?

Australians and Vitamin D:

Q. I’m glad you have been writing about vitamin D. Even here in Australia, many people have low levels of vitamin D.

White people are at risk for skin cancer, with 48 percent of skin cancers occurring in people of Celtic descent. (There are a lot in Australia). But we have gone overboard: we work indoors, apply sunscreen and wear hats. No wonder we end up low in vitamin D.

If you are an indigenous Aussie, either Aboriginal or Torres Strait Islander (TSI), and work for the government, you get free vitamin D tablets. A TSI friend is a lawyer and works indoors.

She is very dark-skinned and thus in need of more vitamin D. However, she spends her weekends doing the traditional TSI woman’s work of fishing while wearing very little clothing.

She told me that the government worried about ‘too much vitamin D’ when most of the new reef rangers were TSI people. Is that even possible?

A. If the reef rangers were taking vitamin D pills in addition to working out in the tropical sunshine, they could get too much vitamin D. But it would be from the pills, not from the sun exposure. The body has feedback mechanisms to keep it from making excessive vitamin D (Mayo Clinic Proceedings, April, 2012).

Can You Overdose on Vitamin D?

Excess vitamin D can indeed result in toxicity. This has happened, particularly when an infant or young child is given vitamin drops so they overdose on vitamin D (Journal of Steroid Biochemistry and Molecular Biology, April, 2015). Adults taking high-dose supplements can also overdose on vitamin D (Food and Chemical Toxicology, June, 2012).

You are right that many fair-skinned people in sunny climates can become low or even deficient in vitamin D by spending most of their time indoors. This happens in the southern US as well as in Australia.

We have written about this problem in our Guide to Vitamin D Deficiency. It tells how to tell whether you need vitamin D supplements and what can result if you don’t get enough vitamin D.

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  1. TessieH
    Baytown TX

    A friend of mine has a kidney stone. Her doctor said that taking too much vitamin D can cause kidney stones. Is this true? And how much is too much?

  2. Thai

    I live in the greater Sacramento area and all my doctors test us for Vit D levels at our yearly appointments. So far, Medicare and Blue Shield have paid for it. It can change over the years, so it’s important to have it tested regularly. Mine went down, so I increased my D3 supplement to 5,000 IU from 1,000 IU. My new internist said it can go down with age, but I was surprised it went down 30 points over the past four years! I don’t like it when doctors blame things on just getting older, unless it’s true for the specific issue!

  3. Mickie

    Medicaid has paid for every d3 blood test done on me. I have tested deficient in the past also have had to recieve reclast infusios for osteoporosis. Without the d3, the infusion doesn’t work as well. So, I now take daily calcium and d3. 2000 units of d3.

  4. Carey

    Cindy, next time you do a blood test at your checkup, ask them to test your vitamin D levels.

  5. Cindy M. Black

    Oops, I guess it was Cheryl in South Carolina instead of Bruce. The bylines are kinda hard to match up with the comments.

  6. Cindy M. Black
    Seattle, WA

    I just returned to this comment thread… Bruce in Texas, I found your mention of pain in the ischial tuberosity extremely interesting. I’ve never taken more than 5,000 units of D3 per day, so I doubt that excessive D3 was the cause, but a few months ago I developed severe “pain in the butt” myself, and was utterly dumbfounded. I didn’t even know it had a name or that anyone else had experienced it. I was so embarrassed I never mentioned it to a soul. Figured it had to be my imagination; why would anyone have “pain in the butt?”
    Now, thanks to you, I’ve been Googling ischial tuberosity pain and educating myself. My pain finally vanished as mysteriously as it came, but next time (hope there isn’t one!) I’ll be on top of it much better. Thanks!
    PS, I do ski hard, and I speedwalk 3 miles a day. So it probably had something to do with that.

  7. Janne

    According to LabCorp, levels of Vit D (determined by Hydroxy 25 test) should be between 32 and 100. Several alternative doctors I read state that 50 – 60 is fine unless you have other health problems, then the numbers should be somewhat higher than that.

    One doctor whose monthly newsletter I subscribe to (Dr. Brownstein) says that the majority of new patients who come to him have sub-levels of Vit D and need to take supplemental Vit D.

    There ARE conditions where Medicare WILL pay for this test. Just ask your doctor when having blood work.

  8. Terry

    Vitamin D blood test IS a Medicare covered expense. Go ahead and ask your doctor to do the test.

  9. Chris
    Andrew, IA

    What is the correct amount of Vi. D3 for people to take? I take 3,000IU.

  10. Cindy M. Black
    Seattle, WA

    I WILL NEVER KNOW whether I’m taking the right dosage of vitamin D, because every article cites a BLOOD LEVEL instead of a per-day dosage. There is simply no way I’m going to pay for such a test, and I doubt it’s a Medicare-covered expense. I’m sure there are many, many more people in this same situation. I take 2,000 units of vitamin D per day and try to get a reasonable amount of sun; however that’s challenging in Seattle in the winter.

  11. JP Marx

    You at PP quote “Those with adequate levels of 25-hydroxyvitamin D, the usual measured metabolite, have generally been taking supplements”–and end with “Excess vitamin D can indeed result in toxicity.” More not-so-helpful info from Blue Cross Blue Shield: “Our bodies also can produce all of the vitamin D we need throughout the year by getting five to 30 minutes of sun twice a week during the spring, summer and fall. The U.S. Preventive Services Task Force doesn’t recommend sun exposure as a way to boost vitamin D levels, because it increases the risk for skin cancer.” BCBS feels that testing is not warranted.

    Are you aware that Medicare will pay only for one Vitamin D test per lifetime?

    This confusion is doing no one a favor…

  12. Joan

    I am often disappointed after reading what looks like an invitation to get more information that turns into an informative sales pitch urging one to buy a product on the spot leading one to wonder if these products are endorsed by the PEOPLES’S PHARMACY or just paid advertisements? More disclaimers needed for unsuspecting readers!

  13. Sharon

    We have been taking 20,000 IU now for about a year or so—-my last Vit D3 level was 70 and my husband’s was 60. A chiropractor friend takes 30,000 IUs a day and his level is about the same, maybe a little higher. We have read that the Vit D Council feels a level of up to even 100 is still safe.

    My husband had a pancreatic cancer recently and he was told to keep taking high levels of D3—but no more than 20,000 IU daily. Vitamin D3 is crucial. Does anyone feel what we are taking is too much? Most doctors we talk to think you don’t need ANY supplemental D3 and that even 5000 a day would be too much. We think most doctors are uninformed about the need for higher D3 levels and none we hear about ever order yearly D3 tests! Interested in other opinions here.

  14. Cheryl
    South Carolina

    My rheumatologist was alarmed when my Vitamin D result was 9, and she prescribed the 50,000 IU regime for 8 weeks to try to correct this. Unfortunately, this dosage precipitated unbearable pain in my ischial tuberosity that did not allow me to sit or even lie in bed without extreme discomfort. There were nights when I was literally screaming in pain until it resolved. I had weeks of physical therapy, along with very strong pain medications to endure this.

    Why did this happen? I apparently have hyperparathyroidism. The body down regulates Vitamin D in this condition to prevent excess calcium being absorbed. Raising my Vitamin D level also raised my calcium levels, causing the pain syndrome.

    Why I am so sure it was the Vitamin D supplementation that caused it? Over several months the pain resolved to the point that it was bearable. Then my endocrinologist again tested my Vitamin D and decided to “fix” it. The same 50,000 IU regime was prescribed, and the pain syndrome re-occurred with a vengeance. I would recommend that anyone with very low Vitamin D levels have a parathyroid hormone test before undertaking this kind of supplementation. I was in agony from this error in prescribing and it took almost a year of my life to resolve it.

  15. Bruce

    I find it annoying that the danger of “high dose” supplements was mentioned WITHOUT stating what constitutes a high dose. I THINK would be 50,000 mgs, but who knows.

    • Terry Graedon

      Anything over 5,000 IU daily is a high dose. But many people tolerate or even need a dose of 2,000 to 4,000 IU. There is such variability among us that it may be impossible to say what dose is ideal for everyone.

  16. Debi
    Burlington, NC

    The article on Vitamin D overdose possibilities was sketchy to say the least. It had little to no helpful information in it. I am going to have to research elsewhere to find what I need to know. You usually have better information than this. I’m disappointed…

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