What are the symptoms of hypervitaminosis D (Vitamin D toxicity)?

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Last updated: April 30, 2025View editorial policy

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From the Guidelines

Hypervitaminosis D is a condition that occurs when excessive vitamin D builds up in the body, typically from supplement overuse, and can cause symptoms such as nausea, vomiting, weakness, and kidney problems, and treatment involves stopping vitamin D supplements and limiting dietary calcium, as recommended by recent studies 1.

Symptoms of Hypervitaminosis D

  • Nausea and vomiting
  • Weakness and frequent urination
  • Kidney problems and bone pain
  • Calcium deposits in soft tissues
  • Hypercalcemia, leading to confusion, fatigue, constipation, loss of appetite, and heart rhythm abnormalities
  • In severe cases, kidney stones, kidney failure, or calcification of blood vessels

Causes and Risk Factors

  • Excessive vitamin D intake from supplements
  • Increased sensitivity to vitamin D in some individuals
  • Certain medical conditions, such as kidney or liver disease

Diagnosis and Treatment

  • Diagnosis is typically made through blood tests to measure vitamin D and calcium levels
  • Treatment involves stopping vitamin D supplements and limiting dietary calcium
  • Increasing fluid intake and possibly medications like bisphosphonates or corticosteroids to lower calcium levels
  • Most cases resolve within weeks to months after stopping excess vitamin D intake, as reported in recent studies 1

Prevention

  • Avoiding excessive vitamin D intake from supplements
  • Maintaining a balanced diet and healthy lifestyle
  • Regular monitoring of vitamin D and calcium levels, especially in individuals at risk for hypervitaminosis D, as recommended by recent guidelines 1

From the Research

Hypervitaminosis D Symptoms

  • Confusion, apathy, recurrent vomiting, abdominal pain, polyuria, polydipsia, and dehydration are common clinical symptoms of vitamin D toxicity 2
  • Hypercalcemia, hypercalciuria, and hyperphosphatemia are considered initial signs of vitamin D intoxication 3
  • Cardiac injury and symptomatic hypercalcemia can occur as a result of excessive vitamin D supplementation 4
  • Individual responses to supraphysiologic concentrations of vitamin D can vary widely, making it difficult to define a toxic concentration 4

Laboratory Findings

  • Serum 25-hydroxyvitamin D [25(OH)D] concentrations higher than 150 ng/ml (375 nmol/l) are a hallmark of vitamin D toxicity due to vitamin D overdosing 2
  • Elevated serum calcium, phosphorus, and 1,25(OH)2D levels can be indicative of hypervitaminosis D 5, 3, 2
  • Asymptomatic hypercalcemia can be caused by the intake of vitamin D even in doses recommended for the general population and considered safe 2

Treatment Approaches

  • Glucocorticoids and bisphosphonates can be used to treat hypercalcaemia induced by hypervitaminosis D 5
  • Cessation of vitamin D supplements can lead to a decline and normalization of 25(OH)D and urine calcium levels 6
  • Intravenous fluids and calcitonin can be used to treat symptomatic hypercalcaemia 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Vitamin D Toxicity-A Clinical Perspective.

Frontiers in endocrinology, 2018

Research

Can adverse effects of excessive vitamin D supplementation occur without developing hypervitaminosis D?

The Journal of steroid biochemistry and molecular biology, 2018

Research

How much is too much? Two contrasting cases of excessive vitamin D supplementation.

Clinica chimica acta; international journal of clinical chemistry, 2017

Research

Hypervitaminosis D without toxicity.

Proceedings (Baylor University. Medical Center), 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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