Widow looking for answers after Quebec man dies in Texas Ironman competition
The widow of a Quebec man who died competing in an Ironman competition is looking for answers.
A British man's overdose on vitamin D is a cautionary tale for people who are considering adding supplements to their lives, according to a paper published Tuesday in the journal BMJ Case Reports.
After a visit with a private nutritionist, the man began taking more than 20 over-the-counter supplements every day, including 50,000 international units (IU) of vitamin D three times a day. That's a dose hundreds of times higher than standard nutritional recommendations.
Within a month, the man began suffering from nausea, abdominal pain, diarrhea and repeated bouts of vomiting, along with cramping in the legs and ringing in the ears.
The man, whose name was not disclosed, heard about the supplements from a radio talk show and contacted the nutritionist on the show afterward, said Dr. Alamin Alkundi, a coauthor of the report and an endocrinologist at William Harvey hospital in East Kent in the U.K., who treated the man.
"Registration by regulator is not compulsory for nutritionists in the U.K. and their title is not protected, so anybody can practice as a nutritionist," Alkundi said in an email.
Unlike water-soluble vitamins, which the body can easily eliminate, vitamin D and its cousins A, E and K are stored in the liver and fat cells of the body until they are needed. Consuming well over the daily recommended dose can build up to toxic levels.
The man in the case study was taking a daily dose of 150,000 IU of vitamin D, which was "375 times the recommended amount," Alkundi said. The U.K. National Health Service typically recommends 400 IU of vitamin D a day for children over age 1 and adults.
The man stopped taking the supplements when his symptoms began, but his condition didn't improve. By the time he was referred to the hospital two months later, he had lost 28 pounds (12.7 kg) and his kidneys were in trouble. Tests showed he had overdosed on vitamin D, a condition called hypervitaminosis D.
The body needs vitamin D. The vitamin's main job is to help the body absorb calcium from the intestines -- in fact, the body cannot absorb calcium unless vitamin D is present. The vitamin also plays a role in immune health, brain cell activity and how muscles function.
In the United States, 15 micrograms, or 600 IU of vitamin D a day, is recommended for adults up to 69 years old, according to the National Institutes of Health. For adults age 70 and up, the dose rises to 20 micrograms or 800 IU each day. The recommended amount for infants, children and adolescents was recently doubled by the American Academy of Pediatrics to 10 micrograms or 400 IU per day.
A 2017 study found 3% of Americans took more than the tolerable upper limit of 4,000 IU daily for adults, thus putting themselves at risk for toxicity. About 18% took more than 1,000 IU daily.
Too much vitamin D in the blood leads to hypercalcaemia, which occurs when the calcium level in your blood is above normal. The man in the BMJ case study was diagnosed with hypercalcaemia, which can weaken your bones, create kidney stones, and interfere with how your heart and brain work.
The man was hospitalized for eight days and treated with drugs to lower the levels of calcium in his blood. A followup two months later found his blood calcium levels had dropped to almost normal. While the man's vitamin D level had also significantly improved, it was still high, Alkundi said.
"A plan to periodically monitor both parameters in clinic was established to track the declining levels to normal levels. We have had contact with him and he reported (he feels) much better, but still not back to his normal self," Alkundi said.
"He is very eager for his story to be known to alert others," Alkundi added.
Signs of a vitamin D overdose can include drowsiness, confusion, lethargy and depression, and in more severe cases it can lead to stupor and coma. The heart can be affected: Blood pressure can rise and the heart can begin to beat erratically. In severe cases, the kidneys can go into renal failure. Hearing and vision can be affected.
The body makes adequate vitamin D when the skin is exposed to sunshine. In fact, going outside in a bathing suit for 10 to 15 minutes during the summer "will generate 10,000 to 20,000 IU of vitamin D3 in adults with light skin pigmentation," according to the AAP.
However, going into strong midday sunlight isn't advised due to the risk of skin cancer, so dermatologists and the AAP say it's best to use sunblock if you will be exposed for any prolonged length of time. Sunscreens can reduce the body's ability to process vitamin D.
Vitamin D supplementation may not be needed for many children and teens, the AAP said, since many foods such as milk, eggs, cereals and orange juice are often fortified with vitamin D. Breastfed infants should be given 400 IU of supplemental vitamin D daily, starting in the first few days of life and continuing until the baby is weaned to milk or formula fortified with vitamin D, the AAP advised.
If vitamin D supplements are being considered, daily levels of vitamin D obtained from food should be factored into the decision, experts caution. In addition to fortified foods, eggs, cheese, shiitake mushrooms, salmon, swordfish, tuna, rainbow trout and beef liver contain vitamin D, as does cod liver oil.
Anyone concerned about their vitamin D levels should have them evaluated by a doctor, experts say.
"Patients are encouraged to seek the opinion of their general practitioners regarding any alternative therapy or over-the-counter medications they may be taking or desire to initiate," Alkundi said.
The widow of a Quebec man who died competing in an Ironman competition is looking for answers.
Former NDP leader Tom Mulcair says that what's happening now in a trash-littered federal park in Quebec is a perfect metaphor for how the Trudeau government runs things.
The world is seeing a near breakdown of international law amid flagrant rule-breaking in Gaza and Ukraine, multiplying armed conflicts, the rise of authoritarianism and huge rights violations in Sudan, Ethiopia and Myanmar, Amnesty International warned Wednesday as it published its annual report.
A photographer who worked for Megan Thee Stallion said in a lawsuit filed Tuesday that he was forced to watch her have sex, was unfairly fired soon after and was abused as her employee.
Facing pushback from physicians and businesspeople over the coming increase to the capital gains inclusion rate, Prime Minister Justin Trudeau and his deputy Chrystia Freeland are standing by their plan to target Canada's highest earners.
The Senate passed legislation Tuesday that would force TikTok's China-based parent company to sell the social media platform under the threat of a ban, a contentious move by U.S. lawmakers that's expected to face legal challenges.
People living near a wildfire burning about 15 kilometres southwest of Peace River are being told to evacuate their homes.
The U.S. Senate has passed US$95 billion in war aid to Ukraine, Israel and Taiwan, sending the legislation to President Joe Biden after months of delays and contentious debate over how involved the United States should be in foreign wars.
A Winnipeg man said a single date gone wrong led to years of criminal harassment, false arrests, stress and depression.
The giant stone statues guarding the Lions Gate Bridge have been dressed in custom Vancouver Canucks jerseys as the NHL playoffs get underway.
A local Oilers fan is hoping to see his team cut through the postseason, so he can cut his hair.
A family from Laval, Que. is looking for answers... and their father's body. He died on vacation in Cuba and authorities sent someone else's body back to Canada.
A former educational assistant is calling attention to the rising violence in Alberta's classrooms.
The federal government says its plan to increase taxes on capital gains is aimed at wealthy Canadians to achieve “tax fairness.”
At 6'8" and 350 pounds, there is nothing typical about UBC offensive lineman Giovanni Manu, who was born in Tonga and went to high school in Pitt Meadows.
Kevin the cat has been reunited with his family after enduring a harrowing three-day ordeal while lost at Toronto Pearson International Airport earlier this week.
Molly Knight, a Grade 4 student in Nova Scotia, noticed her school library did not have many books on female athletes, so she started her own book drive in hopes of changing that.
Almost 7,000 bars of pure gold were stolen from Pearson International Airport exactly one year ago during an elaborate heist, but so far only a tiny fraction of that stolen loot has been found.