David Michener, 89, was admitted to East Surrey Hospital in May last year with hypercalcemia, a condition in which there is too much calcium in the blood. He received treatment but died in hospital 10 days later. In December, a coroner’s inquest ruled Michener’s death was a “death due to misadventure.” This British term implies that his death was due to an action he took deliberately, not just by chance. Michener’s suspected dangerous behavior? Excessive intake of vitamin D.

Michener’s cause of death was manifold. His autopsy report listed hypercalcemia, acute renal failure, congestive heart failure, and ischemic heart disease as causes, in addition to vitamin D toxicity. Still, Surrey’s assistant coroner Jonathan Stevens was concerned enough about the role supplements played in the 80-year-old’s death that he issued what he called a report to prevent future deaths. Submitted to court.

According to a January 19 report, Michener had been taking vitamin D supplements purchased from NaturPlus UK for at least nine months before his death. Some of the retailer’s products contain vitamin D, but the compiled report does not specify which, how often, or in what doses. Not yet. In any case, the document claims that NaturPlus UK’s packaging did not contain adequate warnings about overdosing on the supplement.

“Vitamin supplements can pose potentially very serious risks and side effects if taken in excess,” Stevens wrote. “Current food labeling requirements do not require describing these risks or side effects.” [on] package. ”

He added: “In my opinion, action should be taken to prevent future deaths, and I believe you have the authority to take such action.”

The report has been sent to NaturPlus UK, the Food Standards Agency and the Department of Health and Social Care, with responses required by 15 March.

Without vitamin D, the body cannot absorb calcium and therefore cannot build and maintain strong bones. This nutrient, also known as calciferol, is also important for immune, nervous, and musculoskeletal health. However, few foods naturally contain vitamin D, and dietary supplements containing vitamin D cost about 10 cents. However, too much vitamin D can be dangerous.

How much vitamin D should I take each day?

In the United States, the amount of vitamin D in products is usually expressed in international units (IU) and/or micrograms (mcg). The Office of Dietary Supplements recommends a daily vitamin D intake of 600 IU (15 mcg) for adults ages 19 to 70 and 800 IU (20 mcg) for adults age 71 and older.

Dr. Joanne Slavin, a professor in the Department of Food Science and Nutrition at the University of Minnesota, said it’s difficult to understand the idea that vitamins are toxic because people tend to have positive associations with them.

“We know that fat-soluble vitamins in particular are at risk. The ones we’re most concerned about are vitamin A and vitamin D,” says Slavin. luck, refers to them as nutrients of concern. Vitamins A, D, E, and K are fat-soluble. That is, it dissolves in fats and oils and is stored in the liver and adipose tissue. “If you take too much over a long period of time, you can reach higher levels than necessary, and your body can’t really get rid of it.”

To prevent overconsumption, the Office of Dietary Supplements has established a daily upper limit (UL) that can be safely consumed. For example, people age 9 and older may be taking up to 4,000 IU (100 mcg) of vitamin D per day.

“At least in the United States, supplements cannot exceed the UL in a single dose,” Slavin says. “But you can take 10 doses, but you can’t control it.”

In the UK, the Scientific Advisory Committee on Nutrition recommends 400 IU (10 mcg) per day for everyone aged 4 and over. This country follows the European Food Safety Authority’s UL of 4,000 IU (100 mcg) per day for those 11 years and older. At least two NaturPlus UK supplements contain 5,000 IU (125 mcg) of vitamin D per capsule.

Michener’s vitamin D levels were tested before he died. The coroner’s report gave a score of 380, which was “the highest level the laboratory could record.” The unit of measurement was not listed, but the number was probably expressed in nanomoles per liter (nmol/L) from a blood test. The U.S. Dietary Supplement Administration considers readings above 125 nmol/L to be high enough to cause health problems.

In 2022, nearly 10,500 cases mentioning vitamin D were reported to the U.S. National Toxicology Data System, up from about 5,900 in 2012.

Because vitamin D helps regulate calcium levels in the body, hypercalcemia is a direct result of vitamin D toxicity, says Jamie Allan, Pharm.D., associate professor in the Department of Pharmacology and Toxicology at Michigan State University.

“Signs of increased calcium include weakness, fatigue, and bone pain,” Alan says. luck on mail. “More serious symptoms may include stupor, coma, kidney stones, stomach ulcers, nausea, vomiting, diarrhea, and irregular heartbeat.”

Although vitamin D toxicity is rare, it’s a good idea to always monitor your intake and let your doctor know about any supplements you’re taking, Alan says.

“Commercial supplements can be unreliable as to what ingredients are in the supplement and how much you actually take,” Allan said, adding that some companies, such as Consumer Labs, do independent testing. It pointed out. “If you’re thinking of trying an OTC supplement, it’s worth checking out.”

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How can I get a safe amount of vitamin D?

Vitamin D is also called the “sunshine vitamin” because the nutrient is produced in the body when sunlight comes into contact with bare skin. However, genetic and environmental factors, such as having dark skin or living in a smoggy area, can limit vitamin D production in the body. Wearing sunscreen, which protects your skin from carcinogenic UV rays, also impedes this process. Where you live and the season also affect vitamin D conversion.

“So milk [is] “Vitamin D is fortified in the United States to make it available to most people,” Slavin said. luck. “In the 1940s everyone drank two glasses of milk a day, but now no one does.”

The USDA recommends eating the following foods to ensure you get enough vitamin D in your diet.

• light tuna can
• canned sardines
• flounder
• Fortified low-fat or fat-free American cheese
• fortified orange juice
• freshwater rainbow trout
• herring
• Low-fat or non-fat milk
• Plain low-fat or fat-free yogurt
• low fat plain kefir
• raw mushrooms
• salmon
• tilapia
• Unsweetened soy, rice, or almond milk

According to the Office of Dietary Supplements, many cereals are fortified with vitamin D, and other foods such as eggs, beef liver, chicken breast, and cheddar cheese also contain small amounts of vitamin D.

Learn more about how to take vitamin D safely below.