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To: CholeraJoe
In my medical career, I have had the opportunity to care for several patients who were intoxicated with fat-soluble vitamins, two with Vitamin A and two with Vitamin D.

Say it ain't so, Joe.

A little more info, por favor. What was the source of the vitamin D? If the source was through supplement then why do sunbathers not suffer the same?

18 posted on 10/26/2009 5:18:58 AM PDT by decimon
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To: decimon; Liberty Ship

The two hypervitaminosis D patients had been intoxicated as a result of supplementation by their physicians. Both had undergone surgery on their necks for cancer and as can happen in such surgery the parathyroid glands were damaged. This resulted in a low serum calcium causing irritability, and possibly uncontrollable muscle spasm. At the time, (late 1970’s) the only available treatment was supplemental oral calcium and large doses of Vitamin D.

What the treating physicians did not realize, was that the parathyroid gland damage is often transient and may recover in several days. Both of these patients received three weeks of high dose calcium gluconate orally, and Vitamin D. (ergocalciferol or D2) Probably 2-3 grams daily. Activation of Vitamin D to 25 hydroxy form is not rate limited in the liver and is totally dependent on how much precursor is available. So both of these patients must have had massively elevated serum levels, but that test was not available at the time.

Both developed coma, renal failure and marked elevation of their serum calcium levels. They were successfully treated with IV fluids, diuretics and steroids, but it took several weeks for them to wake up and recover kidney function. One of them suffered from kidney stones for years thereafter.

You asked why sun worshipers don’t suffer the same problem. It’s probably because conversion of 7-dehydrocholesterol to D3 in the skin is rate limited by the amount of UV exposure and as the skin tans, progressively less and less UV light penetrates deeply enough to convert the 7-dhc to D3.

I’m not a Vitamin D expert by any stretch. I haven’t treated either deficiency or intoxication in years.


25 posted on 10/26/2009 6:04:15 AM PDT by CholeraJoe ("I want to see you make decisions without your televisions.")
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