Vitamin Overdose

Recurrent attacks of severe abdominal pain, renal stones, abnormal moods, and an attack of pancreatitis could well be due to an excess consumption of vitamin D. Dr Ambrish Mittal, a Delhi based endocrinologist, says he sees several patients with abnormally high blood calcium levels due to hyper-vitaminosis D, many of whom develop serious consequences such as swelling of the pancreas.

Dr Vjay Kher, chief of nephrology at Medanta Hospital agrees that there is a lurking epidemic of vitamin D overdose resulting in high levels of blood calcium, that choking kidneys and causing renal failure.

Vitamins are catalysts that in very small doses, regulate actions of several enzymes and make our body function smoothly. The discovery of this group of substances 100 years ago was indeed a major leap in medicine. Dr George Wald was awarded the Nobel Prize for discovering Vitamin A and proving its indispensable role in nurturing the rods in the retina that allow us to perceive light, and hence provide us vision.

Deficiency of vitamins soon came to be recognized, and the dramatic improvement of the patient’s condition almost as soon as the therapeutic dose entered the body started appearing as miracles.  Scurvy and delayed wound healing could now be treated with Vitamin C, Beriberi with Thiamine (VitamineB1), osteomalacia with vitamin D, night-blindness and dry cornea with Vitamin A and so on.

The question then that started being asked was “Why wait for deficiencies to occur before administering a therapeutic dose of the vitamin to cure it? If Vitamins are “good” things, then an extra dose should benefit more!”

That unfortunately is not always the case.  While consuming high doses of vitamins that are soluble in water (Vitamins B and C), and hence pass out through urine if taken in excess, are perhaps still somewhat safe, the fat soluble ones (Vitamins A, D, E, K) do not have an easy way out once they get into our bodies. And that is when the problem starts.

The condition of hyper-vitaminosis D has another angle. With the entry and popularity of bone scans  (dexa scans) and vitamin D estimation tests in India, our scientists, started reporting that as many as 90% of Indians were deficient.

What they thought they were raising was a national alarm in the population’s health interests however went a bit awry. They failed to define what was “normal” Indian standard, and shied away from asking that if almost everyone in the population showed a value that was less than that measured in the West, could the “normal” for us Indians be indeed different?

Vitamin D therefore came to be prescribed in higher and higher doses to make our Indian bone measurements meet up to that of the Westerners, and started echoing our national legacy of trying to catch up with our colonial masters. And while Westerners are now reducing their vitamin consumption, we are escalating our doses and gulping them at considerable risk to our health.

As published in HT City ( Hindustan Times) dated 14th October, 2012.