Vitamin D Toxicity

[Stefanie (Ziba)]

Remy's Vitamin D levels were low the first three years (pre-fructose-free and supplementation). Last October, his D level was 56 which is above the target, but good. He has been on Biogaia probiotics with 400IU Vitamin D for the past two years. Nothing has changed in the past 8 months other than he is eating a lot ombre dairy. Yesterday, labs showed:

Liver Panel is totally normal for the fist time!!!
(Yay)

Vitamin D is 146 which is in the "Toxicity" range. 
(Hmmm...)

So, his Vitamin D level tripled in 8 months for no apparent reason. From everything I have read, it usually takes insanely high doses of Vitamin D to reach toxic levels and the fear is that calcium levels in the blood rise abnormally (which his have not done).

I am going to switch to Biogaia without Vitamin D, but I am just curious if anyone has any insights. I have a few theories...

P.S. We are outside every day for an hour or two (with sunscreen) and he tans very easily.

[Stefanie (Ziba)]

I started giving him Magnesium powder in January since it is nearly impossible to get MG if you do not eat fruits and veggies. Maybe that is at least part of the explanation:


www.nutraceuticalsworld.com/contents/view_breaking-news/2013-03-07/association-magnesium-essential-to-absorption-of-vitamin-d-calcium

[antonia]

I don’t have any answers regarding why his d levels would get so high. But nutrient toxicity has been a concern of mine since starting the HFI diet. Particularly since the diet is so high in dairy, and there is no such thing as a multivitamin without calcium, A and D. It’s pretty much all or nothing.

Interactions between vitamins and minerals are so very complex. I don’t know if you’ve ever seen a Naturopathic Doctor for Remy but maybe they could provide some insight. They seem to be better at that sort of thing. Our ND has been the only one that has helped us with basic nutrient testing, our ped office told us they didn’t know where to start.

Congrats on the liver levels! I hope he is feeling okay.

[lucky]

Hi ziba,

Congrats on Remy’s great liver panel results. That’s wonderful. Really, really wonderful. 💕

I have a few thoughts on your vitamin D concerns. But beforehand, I have a couple of questions (if you don’t mind) as our info for proper vitamin D levels are different than what you quote.

1./ How old is Remy? (..I’m wondering if the optimal D range differs in certain ages).

2./ Did the specialist alert you to this “toxicity” level? And if so.. were recommendations given?

[Stefanie (Ziba)]

Hi Lucky,

Thank you for your warm reply!
Remy is 3, but he will turn 4 in just two weeks. Labs were just done this week.
His geneticist ordered the tests and results can through on my portal Thursday afternoon, but his office is closed Friday, so I have not gotten his interpretation yet. I did call our bed who said he has never dealt with too high a Vitamin D level. He only sees a lot of deficiencies.


Antonia,

I may need to look for an ND to consult with since I feel I know more than every doctor when it comes to nutrition (and yet I feel I don't know nearly enough). I know it will be more out-of-pocket, but you are right, it is worth it. I also worry about ODing on certain vitamins because of the high dairy intake and also worry about mineral deficiencies because of the lack of vegetables in his diet.

[Stefanie (Ziba)]

P.S. I did find one British doc on line who essentially said "Toxic level ranges in the US are too low. One would have to get into the 300s to see high calcium levels and hence symptoms"...

[lucky]

Hi ziba,

While you wait the weekend till Remy’s genetics dr is next in, I think I have some useful info for you. I will take it straight from official documents (given to us by a very high level specialist) and also current Canadian lab work standards.

It will take some time for me to gather, but I’ll definitely post it by tomorrow so you can review it before the work week starts.

It should be useful for everyone, here. 😊

[lucky]

Hello all,

With regards to vitamin D levels...

As always, *consult with a specialist* to confirm any information given on this site (or other). Some values may differ for different *ages* and/or countries.

We live in Canada.


1./
The following is from official Lab work results:

(* This is from when my son was *8 yrs old* and all blood work afterward. Not sure if it’s applicable for younger ages as I don’t have available lab info before that age.*)



25-Hydroxy Vitamin D:

Deficiency: < 25 nmol/L
Insufficiency: 25 - 75 nmol/L
Sufficiency: 76 - 250 nmol/L
Toxicity: > 250 nmol/L



* season, race and dietary intake affect 25-Hydroxy Vitamin D levels. Highest levels are found in the summer months and lowest levels during the winter.



2./
The below excerpt is from an official document sent to us in 2012 (*son was 10 yrs old*) from a Mitochondrial specialist (who added vitamin D testing to others needed).


Quote:

“Upon review of recent blood work, it was noted that ..... has a low Vitamin D level of ..... nmol/L, (recommended Vitamin D level greater than 80 nmol/L).

In general, levels below 30 nmol/L may be associated with long term health risks including osteoporosis, a slight increase in cancer and a slight increased risk in cardiovascular disease from epidemiological studies.

Dr. ........ is recommending taking 2000 IU of Vitamin D daily. General recommendations are for 1000 IU daily for all Canadians except during November to April where on average most people do not make any Vitamin D. During these months the current push is towards a recommendation of 2000 IU daily for all Canadians.”

............

Keep in mind:

* My son was 10 yrs old at the time. Because his vitamin D levels were consistently low, all drs have since recommended he be on 2000 IU per day regardless of season until lab results show he is within the healthy range (75 -250 nmol/L -but preferably higher than 80 nmol/L).

* These “daily amt needed” figures reflect an older child or adult’s need.

* The above vitamin D “healthy range” of 75-250 nmol/L may or may not be accurate for all ages.

* If the healthy range is accurate for all ages -undoubtedly *DAILY* vitamin D amts will be different for an infant / small child to that of an 8 yr old / adult. It would simply take less D for a small child to reach a safe level. Never give more than what is recommended by physicians. Ever.

.............

*Daily vitamin D amounts given *FOR INFANTS & YOUNG CHILDREN must be confirmed by a physician. For safety. 😊

.............

This is why baseline blood testing and follow up blood work is important. It’s needed for accuracy.

[lucky]

Hi ziba,

I wanted to keep the above post separate from my thoughts...


In Canada, we don’t have the same portal system for accessing all medical files/lab work. So quick personal access to random test results are usually not easily available.

Luckily for us, for the past several yrs, my son’s specialty paediatrician (Harvard trained) has graciously given us copies of lab work as a courtesy.

I normally just file them as not much makes sense to me unless a specialist explains the relevance of lab results needing to be monitored.

Yes, all medical info is technically ours -but patients don’t normally get a copy as it is commonly stored in files with each specialist involved (and a complete file with our family physician).

Just recently, as my son is very stable & thriving and soon to age out of his paediatrician’s practice, we requested a complete copy of his entire file. This includes all notes and lab work. Everything. It is at a marginal cost as everything has to be copied, but well worth a file set that we ourselves can store for the future.

Our medical system stores medical files for 10 yrs from the last visit. But by having our own personal copy, it will ensure its storage indefinitely should there be a future need for my son in his adult years, or even if questionable issues arise with his future children.

My son’s paediatrician was very open to the idea of making a copy of his entire file (as to date, there are strong suspicions to a metabolic issue as FBPase deficiency, but still.. unanswered questions).

As an additional safety measure, by us having a complete file of everything, if one day needed, future doctors can (under any time constraints) quickly review to see what paths were investigated and go forward from there.

I plan on scanning the entire paper file to electronically save it. And upon recommendation from our paediatrician, also give a USB electronic file to our general physician to ensure an absolute complete copy is always accessible there too.

[lucky]

Now back to vitamin D...

I can’t speak to proper vitamin D levels for your son’s age, as it may differ. So that’s something to clarify with your son’s specialist.

The lab results I have at home (I don’t yet have his complete file) start when my son was age 8, and those all show the safe Vitamin D standards in the above previous post. I am under the impression that it is the same for adults.


** But for infants & young children...

- Safe vitamin D levels may differ.
- Safe vitamin D daily dosage DEFINITELY differ.

So please CONFIRM daily dosage and if there is an “age appropriate reference interval” for the optimal healthy range in younger children, like Remy.


Like your Dr’s experience, we in Canada are usually used to dealing with low D levels needing to increase.

I know that’s not currently your issue, but for others out there... we in cold winter climates are always told that vitamin D levels in our bodies are highest after summer and lowest in winter. We just don’t get enough sun in the winter so we rely on our body’s summer vitamin D stores to carry us through winter till spring. By then, we are on fumes and need sun exposure to help our skin make more. Hence vitamin D supplements.

I see you are in a warmer climate.

That, and being out in the sun for 1-2 hours per day will do wonders for your son’s vitamin D stores. Additional supplements in his daily vitamins, vitamin D drops, Biogaia (with vitamin D included in it) and especially the magnesium -all may have increased his vitamin D stores a lot in that short time.

I’m thinking it’s the magnesium that really increased it the most.

As a mom, that’s my first thought. Reduce. But also monitor with future follow-up blood work.

The sun alone is the best way to get vitamin D. And although you have sunscreen on your son, you mention he tans easily. I would suspect that means the suns rays are getting through the sunscreen to tan him. And if so, most likely converting more vitamin D than you think. That, and the magnesium.


What I would do...

1./
Follow up with your specialist to confirm correct “age specific” healthy ranges for Vitamin D. And proper daily requirements.

2./
Inform your specialist of all vitamin D supplements given. And maybe work out a plan for giving a little magnesium to keep your son regular (bowel wise etc.), but not too much to interfere with D.

*Getting vitamin D naturally and consistently through-out the year in climates like yours is really optimal. We were told even 20-30 min per day makes a huge difference.

Here in Canada we envy your warm seasons. 😊

3./
I’m sure your son’s drs/specialist will decide to monitor blood levels. But at the very least, with this issue, I’d want to watch out for Vitamin D, calcium & magnesium and how each affects the other.



On a side note, in case this is new information to others...

1./
If vitamin D levels get too low it will drag down iron levels.

2./
Low vitamin D levels are associated with respiratory issues. So if your child has asthma, keeping proper vitamin D levels helps greatly.

3./
Those with naturally darker skin have a harder time converting the sun’s rays into vitamin D.

4./
Vitamin D is needed for bone growth, so during growth spurts vitamin D levels will lower. It will also lower during fall winter months in colder climates (as we don’t have enough sun exposure and thereby use up our vitamin D summer stores).


* If anyone is interested in more info, a quick google search for “vitamin D deficiency symptoms” is very informative.

Good luck 😊

[Stefanie (Ziba)]

Lucky,

Thank you for your thorough replies and research!

I calculated that Remy was getting 1200IU from various supplements...add to that a very high dairy diet and being outdoors in Florida with and without sunblock (without int eh early morning) and the magnesium supplementation...and it does make sense that his numbers went up. I appreciate your digging g up reference ranges. While Remy is half your son's age. surely the ranges in Canada overall seem to be less alarming. His level of 146 is probably not as dangerous as the lab report makes it sound (seeing Geneticist for a checkup soon and will discuss more but I did talk to his pediatrician again who contacted a pedi endocrinologist and he said "those levels are not concerning as long as calcium levels are normal and no symptoms of toxicity are being observed". )

So, I switched him to Biogaia without Vitamin D, which still gives him 800 IU from other supplements. Since we are the heat of summer, I think this Vit D supplementation level, diet and mag supplement will be sufficient to keep up his D levels (in the sufficient range), but we will see when we repeat labs in October and I will adjust from there.

Thanks again to all of you for chiming in.

[ukbill]

I cannot take any Magnesium at all makes me feel very ill when I have tried. So I suspect the info on no MG without Vegises is wrong somehow, I certainly have never had an issue with it.
Multi vitamins are needed for people who are vegetarian and Vegan not for people who eat lots of meat and animal fats. (like us).
When you look around a "health" food shop at all the vitamins and stuff its all to help Vegetarians and Vegans never to balance a Meat eating diet. Fro one good reason.. Veggies (counter to popular opinion) contain far less minerals and vitamins than meat, well animal fat to be precise.
If I take multi vitamins I become crippled quite quickly with excessive vitamin A crystallizing out in my joints producing a Gout type condition that is incredibly painful and debilitating.
I have just thought however I do drink mineral water that contains a lot of Mg and Calcium in it. our tap water is also quite "hard" (it comes largely from underground limestone aquifers) So maybe thats where it is coming from?

[ukbill]

I have never heard of Toxicity to Vitamin D3 I take a supplement (2400 IU a day) summer and winter.
no blood test has flagged this up. However the way we do blood tests in the UK means it unlikely its been tested for.
I did try some different Vitamin D3 tablets recently but they gave me very bad dreams. (this has often been reported)
So stopped using them and went back to my usual supplier.
I feel so very much better and more positive on them than before.. however I do work nights so my exposure to sunlight is little to none for 6 to 8 months of the year.

[Stefanie (Ziba)]

Hi Bill,

You are right that there are some meats/fish that have good mag amounts (https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/), but my son gets so little of these foods that mag is probably necessary. Plus, he gets backed up a lot and the mag powder helps a lot.

As for Vitamin D, I think the word "toxicity" may be overused here in the US. I reduced his supplement to 1/2 and I will see what his levels are in the Fall.

Thanks everyone for your replies :-)