One systematic review and meta-analysis of 11 randomized, controlled trials published through 2018 of vitamin D supplementation alone (10–20 mcg [400–800 IU]/day or more at least every week or as rarely as once a year) for 9 months to 5 years found that the supplements provided no protection from fractures in 34,243 older adults [ 81]. Vitamin D levels greater than 100 ng/mL may be harmful. Toxicity symptoms have been reported at extremely high blood levels in cases where people took megadoses (very high doses) of vitamin D supplements for extended periods of time. Elevated blood calcium levels Even though vitamin D toxicity isn’t common, you may be at risk if you misuse over-the-counter vitamin D supplements, prescription vitamin D supplements, or injections.

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For example, an 18-month-old child who was given 50,000 IU of vitamin D3 for 3 months experienced diarrhea, stomach pain, and other symptoms. These symptoms resolved after the child stopped taking the supplements ( 15). Summary

Her vitamin D levels were discovered to be 265 ng/mL, which equals 130,000 IU and is over 30 times the generally recommended safe upper limit of 4,000 IU per day ( 7). Keeping that in mind, it’s still helpful to know what signs and symptoms to look for. Frequent illness or infectionshaving a health condition that affects nutrient absorption, such as Crohn’s disease or celiac disease ( 65, 66, 67) The RDA for calcium also varies by age. Children ages 4–8 need about 1,000 mg of calcium daily. Children ages 9–18 need approximately 1,300 mg daily. Adults ages 19–50 need about 1,000 mg daily. Over 50, most people need 1,200 mg per day ( 35). Summary Individuals with obesity who have undergone gastric bypass surgery can also become vitamin D deficient. In this procedure, part of the upper small intestine, where vitamin D is absorbed, is bypassed, and vitamin D that is mobilized into the bloodstream from fat stores might not raise 25(OH)D to adequate levels over time [ 66, 67]. Various expert groups—including the American Association of Metabolic and Bariatric Surgery, The Obesity Society, and the British Obesity and Metabolic Surgery Society—have developed guidelines on vitamin D screening, monitoring, and replacement before and after bariatric surgery [ 66, 68] Vitamin D and Health

The best way to prevent vitamin D deficiency is to ensure you’re getting enough vitamin D in your diet and/or through sun exposure. But be careful about being in the sun for too long without sunscreen. Excessive sun exposure puts you at an increased risk for skin cancer. In a 2021 case report, a 64-year-old man accidentally took 200,000 IU of vitamin D per day because he misunderstood medication instructions. He showed altered mental status and other serious symptoms related to hypercalcemia. For instance, one review of 17 studies found that vitamin D deficiency was associated with a significantly higher risk of developing colorectal cancer ( 18).Older adults are at increased risk of developing vitamin D insufficiency, partly because the skin's ability to synthesize vitamin D declines with age [ 1, 61]. In addition, older adults are likely to spend more time than younger people indoors, and they might have inadequate dietary intakes of the vitamin [ 1]. People with limited sun exposure Aside from medical conditions that can lead to vitamin D deficiency, biological and environmental factors that put someone at an increased risk of vitamin D deficiency include: For this reason, some companies fortify orange juice with vitamin D and other nutrients, such as calcium. One cup (237 mL) of fortified orange juice with breakfast can start your day with up to 100 IU of vitamin D, or 12% of the DV ( 31).