Preventing Osteoporosis and Managing Vitamin D Intake: Case Study and Treatment

2024-01-06 17:21:35

A 48-year-old man had osteoporosis and had artificial hip joints on both sides. Because he believed that “supplementing more vitamin D can preserve bones,” he swallowed 2 to 3 health supplements every day. As a result, he developed “hypercalcemia.” I almost needed kidney dialysis, but fortunately, my kidney function returned to normal following emergency treatment.

Man’s love of drinking leads to osteoporosis and he actively preserves bone following hip replacement

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Chen Zhengguo, an attending physician at the Department of Hepatobiliary and Gastroenterology at Ajou University Hospital, said that because the patient was engaged in a heavy job, he would invite friends to have two drinks following work, which led to alcoholic cirrhosis, osteoporosis, and avascular necrosis of the femoral head. Not only was he unable to stand for long periods of time, but it was extremely painful even when he walked. His condition improved slightly following he had an artificial hip joint replaced, which led him to constantly explore how to “preserve his bones.”

Lost consciousness following taking too much vitamin D

Later, he heard that “supplementing more vitamin D can preserve bones and prevent osteoporosis.” This made him very excited. He went to the pharmacy to buy health food. The original recommended dosage was 1 tablet per day, but he took 2~ 3 tablets. More than 2 months later, symptoms such as constipation, lethargy, frequent urination and thirst began to appear. Recently, he was found unconscious lying in the living room and was rushed to the hospital by his family.

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Excessive active vitamin D3 may cause hypercalcemia and damage the kidneys

Chen Zhengguo pointed out that following a blood test, it was found that the calcium ion in the man’s blood was as high as 14.5 mg/dl (normal is 8.5-10.5 mg/dl), and his kidney function score directly deteriorated from more than 80 points to more than 20 points. After questioning, he found that it was because of active vitamins. D3 overdose. After emergency discontinuation and a large amount of fluid replenishment, the man regained consciousness. He returned to the doctor a week later and the values ​​returned to normal.

Vitamin D3 is divided into “active” and “inactive”

Lin Xuanren, attending physician at the Department of Nephrology and Director of the Peritoneal Dialysis Unit of Asia University Hospital, pointed out that vitamin D3 is divided into “active” and “inactive”. If we use the metaphor of a factory, inactive vitamin D3 is like a raw material. After being taken, it is processed by the factory (ie, metabolized by the liver and kidneys) before it becomes active vitamin D3. It can act on bones, gastrointestinal tract and kidneys to help bone osteogenesis and improve bone function. Calcium concentration in blood. Therefore, when the dosage of active vitamin D3 exceeds the standard, it will often directly cause fatal hypercalcemia. Therefore, active vitamin D3 will only be used for medical purposes, such as patients with acute hypocalcemia or hypoparathyroidism.

It is recommended to supplement “inactive” vitamin D3 as it is safer

Lin Xuanren suggested that people should supplement with “inactive” vitamin D3, which is less likely to cause calcium and phosphorus imbalances and is less harmful to the human body when taken in excess. Although vitamin D3 helps with osteoporosis, long-term excessive intake can also cause harm. It is recommended to supplement inactive vitamin D3 through sun exposure, diet, etc. If symptoms of hypercalcemia occur, you must seek medical treatment as soon as possible to find out the underlying cause, so that hypercalcemia can be completely cured and prevented.

◎ Picture source/provided by Asia University Hospital
◎ Data source/Yada Hospital

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