Excess Vitamin D poisoning especially concerning for diabetics

A friends Mom died from too much of a supposed "good thing" last year.  She was a diabetic with poor kidney function and an overdose of vitamin D meant she suffered a lingering illness and painful death.  Given the increases in diabetes we see in the US, I feel  that sharing her story here is the responsible thing to do and I hope to prevent the same tragedy. 

Before I continue I must include a disclaimer:  I am NOT a health care provider - no dietisian, no nurse, no physician.  I am an educated middle-aged woman with some common sense and desire to share information.   I urge any reader - anyone for that matter - who has questions about Vitamin D to talk with their health care provider or do their own research.   There are several very credible sources (Mayo Clinic for example) that post more information about the benefits and risks of Vitamin D and other supplements, please seek them out.    

Vitamin D is necessary for many functions in the human body and especially important for elders since it helps the body absorb calcium and retain bone mass.  Too much vitamin D can have painful side effects - the most severe  - and risky to elders - are high blood pressure, kidney stones or a build up of calcium in soft tissues like the heart and kidneys. In My friend's case, her mother died of kidney failure due to calcium build up.  She had so much calcium in her blood that her kidneys worked like mad to filter it out. The calcium built up there in her kidneys.   She had reduced kidney function due to the diabetes and the increased demand was more than her damaged kidneys could tolerate.

What was the source of the vitamin D? Her supplements, her vitamins. For several years, my friends Mom ordered special vitamins from a pharmacy out of state.   Due to an error at the pharmacy too much Vitamin D was added to a certain batch that was shipped to this elder.  The vitamins looked just the same as always. With no way to know about the excess vitamin D, she took her pills faithfully as she'd always done.  After a couple few weeks she began to feel bad; after three weeks she ended up in the hospital with kidney failure.  No one had anyway of preventing this error, except the pharmacist that made her vitamins and his supplier who changed the wholesale packaging and concentration.    Had she known about the risks associated with her supplements, she might have been in tune to slight symptoms before she was too ill to recover.   I hope that anyone with diabetes, will learn the risks and subtle signs of early vitamin D poisoning.   

Too much OJ leads to crisis and hospitalization

A friends father recently had a health scare due to OJ - yes, orange juice, that healthly bright beverage that Florida citrus growers push into trees and onto grocery shelves.   The problem comes when the OJ is fortified with vitamins and minerals - it can be too much for a body to handle, especially an elderly body that already contains medications and supplements. 

Here's what happened:  My friends father, age 84, had heart surgery about three months ago and, after a three of weeks in a rehab facility, was well enough to be home alone.  He was warned about eating right and getting enough vegetables so he thought some fruit or vegetable juice would be good for him;  he'd get fluids and the benefit of the fruit (fiber, vitamins, minerals, etc.).  He drank one 16 to 20 ounce glass of OJ a day.   After 5 weeks he had trouble breathing, was retaining fluid and his potassium levels were sky  high.   His orange juice of choice was fortified with calcium, multiple vitamins and minerals plus added sugar, preservatives and flavors.  With his existing prescriptions and supplements more than a few ounces of this OJ was the LAST thing he should have.  Eating the oranges would be fine with the natural benefits.  

After more than 5 days in the hospital, he was fine and back to normal.  To help him understand what and how to eat better, his daughter in law requested a meeting with a dietician to identify drug-food interactions and what might be helpful or beneficial for him.   The lesson learned are:

• when it comes to supplements - in food or in pill form, we really need to be mindful of interactions
• after surgery and before your loved one goes home, ask to speak with a dietician about drug interactions, special foods to avoid or add to a diet, be there when they talk with your loved one and try to get the doctor to join in too
  
• Ask the dietician to WRITE IT ALL DOWN - this might be hard but tell them ahead of the appointment that your elder needs written instructions, copy these and send a copy to their regular physician
• Create a food and prescription schedule for your loved one.  This doesn't have to be a minute by minute play by play of their day and you can include a variety of things they can or should have for each meal.   
• Help your loved one shop and, if they select "banned" things, remind them of the interaction and possible consequences; if possible, get them to put it back.