Vitamin D intoxication in patients with cystic fibrosis: report of a single-center cohort
Scientific Reports | (2021) 11:7719 https://doi.org/10.1038/s41598-021-87099-w
Thomas Plante-Bordeneuve1, Silvia Berardis2,5, Pierre Bastin, Damien Gruson3, Laurence Henri, & Sophie Gohy1，5*
Patients accidentally getting the extremely high doses got average vitamin D levels of 185 ng
Vitamin D toxicity is associated with accidental overdoses due to manufacturing or intake errors and its secondary hypercalcemia can result in severe morbidity. Although patients with cystic fibrosis are potentially at increased risk for this intoxication as prescription of vitamin D preparations is a common practice in this population, the frequency of such events is currently unknown. We performed a retrospective analysis of all the files of cystic fibrosis patients followed at the Cliniques universitaires Saint-Luc over a 10-year period, recording 25(OH)- and 1,25(OH)2 vitamin D levels as well as demographic data, lung function tests, Pseudomonas aeruginosa infection and results from pharmacological analysis of magistral liposoluble vitamins preparations. A total of 244 patients were included in the study. 13 patients (5%) had serum vitamin D levels corresponding to vitamin D overdose. Patients who had experienced an overdose were more likely to be F508del homozygous or suffer from exocrine pancreatic insufficiency. 2 patients developed significant hypercalcemia necessitating monitoring and hospitalization. Errors in the preparation of magistral liposoluble vitamin pills were identified in several intoxicated patients. Retrospective assessment of the dosing errors with the local pharmacists showed that trituration and dosing errors were their most frequent causes.
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- In our population, the median prescribed dose of 4000UI of D3 could not explain the observed 25(OH)D levels, and further analysis of the available vitamin D concentrations contained in the compounded prescribed pills revealed that patients were taking a median 69 times the prescribed dosage. “
Note: Many US companies send every batch of Vitamin D out for independent checking of dose size and contaminates
Example companies include: Bio-Tech Pharmacal and BioinnovationsPharmacal. both of which are on Amazon
- A vitamin D level of 746 ng due to medication error was not toxic – April 2015
- 1000 IU of vitamin D (per kg) can indeed be toxic – 1947
- Note: For many decades medical textbooks missed the "per kg" part
Overview Toxicity of vitamin D has the following chart