A man in the UK ended up in a hospital recently after he took seven times the recommended dose for Vitamin D supplements. As per the details published in British Medical Journal Case Reports, he had been taking the supplement along with over 19 others on the recommendations of a private nutritionist. The report also mentioned that he had had various health issues, including tuberculosis, an inner ear tumour, a build-up of fluid in the brain, bacterial meningitis, and chronic sinusitis.

“He had been taking high doses of more than 20 over the counter supplements every day containing: vitamin D 150000 IU—the daily requirement is 10 mcg or 400 IU; vitamin K2 100 mg (daily requirement 100–300 µg); vitamin C, vitamin B9 (folate) 1000 mg (daily requirement 400 µg); vitamin B2 (riboflavin), vitamin B6, omega-3 2000 mg twice daily (daily requirement 200–500 mg), plus several other vitamin, mineral, nutrient, and probiotic supplements,” the report adds.

The report also states that globally, there is a growing trend of hypervitaminosis D, a clinical condition characterised by elevated serum vitamin D3 levels with women, children, and surgical patients most likely to be affected.

We all know that vitamins are essential nutrients to keep the body healthy. While vitamin A is known for improving vision and immune system, vitamin B12 is beneficial for function and development of brain and nerve cells. Vitamin C, on the other hand, is a powerful antioxidant and vitamin D helps in absorption of calcium, magnesium, and phosphate. Vitamin E helps maintain skin, eyes, and the immune system.

However, taking an excessive amount of any one vitamin can lead to serious health problems, a condition referred to as hypervitaminosis or vitamin toxicity. As per the National Poison Data System of the US, vitamins were responsible for 59,761 toxic exposures in the country, 42,553 of which were in children aged under 5 years, in 2017 alone.

The recent case of vitamin toxicity in the UK also points to a larger problem—how vitamin supplements are sold over the counter, often without prescription and consumed without any professional medical advice.

Supplements and capsules for various vitamins are easily available at local chemists and medical stores, and in different quantities and brands—from organic and ayurvedic to multinational pharmaceuticals. Gummies and chewables of vitamin supplements, too, have developed a strong market in the country and globally.

According to market research organisation Straits Research’s latest report titled ‘Clinical Nutrition Market: Information by Route of Administration (Oral, Enteral), Application (Cancer), End-User (Pediatric, Adults, Geriatric), and Region — Forecast till 2030’, the global clinical nutrition market was valued at $34,825 million in 2021. It is projected to reach $60,350 million by 2030, growing at a CAGR of 6.3% during the forecast period (2022–2030).

Medical practitioners support the consumption of vitamins with generally little or no harmful effect. However, what remains to be kept in mind is that the constitution of one’s body is different from the others and one’s vitamin intake needs may differ from the other. The existence of other medical conditions in the body may also worsen the side effects.

Dr Siddhant Bhargava, a fitness and nutritional scientist, says, “Adding supplements to your wellness routine can have some health benefits. They contain essential vitamins, minerals, herbs, amino acids, enzymes, and other such ingredients and come in a variety of forms such as capsules, gummies, powders, tablets, drinks, and energy bars. These supplements are known to help you get adequate amounts of essential nutrients which can improve overall health and help manage some health conditions.”

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Bhargava is the co-founder of Food Darzee, a Mumbai-headquartered health and nutrition company that personalises the food as per the exact nutritional requirements of the customers.

Dr Sorabh Datta, chief resident at Baptist Health – University of Arkansas for Medical Sciences, Internal Medicine Program, says that although the recommended dietary allowance of vitamin E is 15 mg/day, many supplements are produced at much higher daily dosages, such as 100 to 1000 mg. “Vitamin E toxicity can cause major bleeding events. These can be serious, including the potential for intracranial haemorrhage. Similar is the case with other supplements,” he says.

Once developed, vitamin toxicity can last for several weeks, and symptoms can last several weeks and can even adversely affect the body. Symptoms of vitamin toxicity may include fatigue, headache, vomiting, irritability, mood swings and so on. Hence, doctors suggest taking vitamin supplements only after getting checked and in case of deficiencies.

Nutritionists also suggest preferring natural sources of vitamin intakes through fruits, nuts and vegetables. “Although products sold as dietary supplements come with a label that has a list of active ingredients and other contents such as fillers, binders, and flavours including a serving size suggestion, a doctor might decide on a different amount after a detailed assessment of your health. It is because dietary supplements if taken with other medications or in excessive amounts or taken for an unidentified medical problem can be dangerous to your health,” Bhargava explains.

For instance, overdosing on vitamin A leads to an adverse condition known as hypervitaminosis A, symptoms of which may include fatigue, headache, vomiting, etc. Similarly, consuming too much vitamin C, a water-soluble vitamin that gets transported to your tissue via body fluids, may lead to gastrointestinal upset including symptoms like diarrhoea and nausea, he adds.

Datta further suggests that regular screening enquiries about the use and dose of vitamin and mineral supplements may help to optimise a patient’s nutrient intake and avoid potential harm from inappropriate use of supplements.

Vitamin A toxicity: Fatigue, headache, vomiting, vision changes, bone pain, etc Vitamin B3 toxicity: Reddening of the skin, itchiness, burning, etc Vitamin B6 toxicity: Loss of coordination, skin lesions, disrupted digestion, etc Vitamin C toxicity: Diarrhoea, cramps, nausea, etc Vitamin D toxicity:Kidney stones, nausea, recurrent vomiting, constipation, excessive thirst, excessive urination, confusion, weight loss, etc

Vitamin A: Milk, eggs, fish oils, tomatoes, red bell pepper, leafy green vegetables, mango Vitamin B12: Animal liver and kidneys, fortified cereal, beef Vitamin C: Broccoli, strawberries, citrus fruits, bell pepper, blackcurrants Vitamin D: Salmon, red meat, liver, egg yolks Vitamin E: Almonds, sunflower seeds, pumpkin, spinach, peanuts Vitamin K: Kale, mustard greens, green beans, broccoli, chicken, kiwi, avocado

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