Recent research and discussions have prompted questions about whether excessive vitamin D can cause kidney stone formation.
Supplementing with vitamin D is generally safe, but excessive intake can cause kidney stones. Understanding this balance is essential for everyone aiming to improve their health, especially those dependent on vitamin D supplements.
This article will explore the nuances of the Vitamin D and kidney stone connection, highlighting what you need to know to maintain a healthy balance.
Does vitamin D affect the kidneys?
It's important to understand the function of vitamin D in the body before exploring the relationship between vitamin D and the risk of incident kidney stone formation. Vitamin D is important for calcium absorption and boosting the immune system.
However, high levels of vitamin D may cause excessive calcium absorption, which could strain the kidneys. But why does increased urinary calcium excretion increase the risk of kidney stones? Let's look at that below.
Is there a connection between vitamin D and kidney stones?
According to the US National Institutes of Health, around 11% of men and 6% of women in the US developed kidney stones at some point in their lives.
Genetics, diet, and inadequate fluid intake can increase the risk of developing kidney calcium stones.
Calcium oxalate kidney stones are the most common type, followed by calcium phosphate stones. Hypercalciuria, the increased excretion of urine calcium, is a critical risk factor for developing symptomatic kidney stones.
Some research has identified absorptive hypercalciuria, characterized by increased intestinal calcium absorption in most idiopathic hypercalciuria cases.
Calcium intraluminal concentration affects intestinal calcium absorption, while 1,25-dihydroxyvitamin D, or calcitriol, the active form of vitamin D, is primarily responsible for transcellular calcium absorption.
Vitamin D must first be activated as 25-hydroxyvitamin D in the liver and then converted to calcitriol in the kidneys to exert its biological effects, regardless of whether it is created in the skin from 7-dehydrocholesterol or absorbed from the diet or supplements.
Another study found that multiple groups simultaneously documented high calcitriol levels in idiopathic hypercalciuria stone formers, indicating that high calcitriol levels may cause absorptive hypercalciuria.
In individuals who develop kidney stones, a correlation exists between calcitriol serum levels and urine calcium elimination, which is a risk factor for developing new kidney stones.
Can excess vitamin D cause kidney stones?
The skin can only produce around 10,000 IU of vitamin D after total body exposure to UV light, while the daily requirement is about 200–600 IU.
Hypervitaminosis D, another name for vitamin D intoxication, is a rare but potentially dangerous illness that develops when your body has too much vitamin D.
Vitamin D intoxication is usually caused by excessive intake of vitamin D supplements rather than from dietary sources or sun exposure.
When you expose your skin to sunlight, your body regulates the production of vitamin D. Even fortified foods provide limited vitamin D.
Excess vitamin D can cause hypercalcemia and excessive calcium in the blood. The symptoms of this condition include nausea, vomiting, weakness, and frequent urination. Vitamin D poisoning may also cause the formation of calcium stones and discomfort in the bones.
The US Recommended Dietary Allowance for most adults is 600 IU of vitamin D daily, which is many times lower than this quantity. It has been proven that toxicity can result from consuming 60,000 international units (IU) of vitamin D daily for several months.
This study about vitamin D intoxication published in the Indian Journal of Nephrology discusses the case of a 70-year-old man with acute renal failure and mental obscurity.
He was discovered to have hypercalcemia upon inspection, and on further inquiry, it was discovered that this condition was secondary to injections of a slow-release vitamin D substance.
Sometimes, doses above the RDA are used to address medical conditions like vitamin D deficiency, but only when a doctor is present and for a predetermined amount of time. When using high amounts of vitamin D, blood levels should be checked.
Should I discontinue vitamin D if I have kidney stones?
Elevated calcium levels in urine are a common and significant risk factor for developing kidney stones that contain calcium in people with kidney stones.
Doctors may hesitate to provide vitamin D therapy to patients with vitamin D deficiency if they also have kidney stones and high calcium levels in the urine. This is because vitamin D enhances calcium absorption into the blood by the intestines.
They are worried about the potential risk of raising the calcium level in the urine, increasing the likelihood of calcium stones developing again.
What causes kidney stones?
Kidney stones are solid items that form from urine-based compounds. They can be calcium oxalate, uric acid, struvite, or cystine.
Urine contains various waste products that can form crystals with excessive waste and insufficient liquid. As a result, the crystals attract more substances and form solid particles that will continue to grow unless they are eliminated from the body through urination.
The kidney, being the main chemical regulator of the body, typically eliminates these compounds via urine.
Adequate hydration or other substances in the urine can prevent or eliminate most kidney stones.
Here are the substances that cause the stones to form:
- Calcium
- Oxalate
- Urate
- Cystine
- Xanthine
- Phosphate
The stone may remain in the kidney after it forms or move through the ureter and into the bladder.
Small stones can pass through the body via urine without causing discomfort, but immobile stones may cause urine backup in the kidney, ureter, bladder, or urethra. Consequently, this is what causes the pain.
A kidney stone may also be more likely to develop if you:
- Had kidney stones before
- Have a family member who has kidney stones
- Do not drink enough water
- Consume a lot of sodium (salt), sweets, or protein
- Are obese and/or have undergone intestinal surgery
- Afflicted with polycystic kidney disease
- Have a condition that results in excessive levels of cystine, uric acid, or calcium in your urine
- Have a medical condition that results in swelling or harm to your joints, digestive system, or both
- Take certain medications, such as calcium-based antacids or diuretics (water pills).
What are the signs and symptoms of excess vitamin D in the body?
Hypercalcemia is the primary cause of vitamin D toxicity signs and symptoms. Vitamin D overdose symptoms include:
Elevated blood levels
The body's vitamin D concentration must be greater than 100 nanograms (ng) per milliliter (mL) for it to be toxic or hazardous.
Vitamin D concentrations in the blood that are higher than 100 ng/mL. Vitamin D toxicity can occur when the body has too much vitamin D, which can result in a condition known as hypervitaminosis D.
Serum concentrations of vitamin D over 150 ng/mL are considered to be indicative of vitamin D intoxication.
Blood vitamin D concentrations above 100 ng/mL are considered hypervitaminosis D. Serum concentrations exceeding 150 ng/mL are considered vitamin D intoxication.
Although there are varying recommendations for the ideal vitamin D levels, levels between 30 and 60 ng/mL are likely the best and may protect one's health.
Even if a person takes large doses of vitamin D supplements, their blood vitamin D levels are unlikely to be excessive or dangerous if they are healthy.
The majority of occurrences of vitamin D poisoning are brought on by incorrect supplement dosage and written prescription mistakes.
High blood calcium levels
Your body can more easily absorb calcium from your diet if you have vitamin D. In fact, this is one of its most important roles.
Consuming too much vitamin D can cause uncomfortable and harmful symptoms by raising blood calcium levels.
Hypercalcemia, or abnormally high blood calcium levels, is the main factor contributing to vitamin D toxicity symptoms.
Calcium levels in the blood should be between 8.5 and 10.8 mg/dL. According to research, people who take over 10,000 IU of vitamin D daily and have symptoms should be checked for hypercalcemia.
Hypercalcemia can be fatal, so it needs to be treated right away.
Gastrointestinal symptoms
The main negative effects of vitamin D repletion are linked to high blood calcium levels.
Hypercalcemia's primary signs and symptoms include:
- Nausea
- Vomiting
- Constipation
- Poor appetite
However, the symptoms vary from person to person.
After taking a supplement that was later discovered to contain 78 times more vitamin D than what was claimed on the label, one woman reported experiencing nausea and weight loss.
It's important to note that these symptoms appeared in reaction to exceptionally high vitamin D3 doses that resulted in calcium levels higher than 12 mg/dL.
Other symptoms include:
- Polydipsia, or increased thirst
- Frequent urination.
- Confusion, lassitude, and exhaustion
- Weakness in the muscles and trouble walking
- Bone ache
- Kidney stones
How much Vitamin D does the body need?
According to estimates, 95% of Americans don't consume enough vitamin D through diet alone. Concerned about vitamin D deficiency?
How much vitamin D do you need? Let’s look at the amount of vitamin D our body needs.
Infant vitamin D recommendations
The Centers for Disease Control and Prevention states that newborns should receive 400 international units (IU), or ten micrograms (mcg), of vitamin D daily.
A 2015 study found that since human milk contains 5 to 80 IU per liter, ensuring your child gets enough vitamin D through dietary supplements or appropriate sun exposure is essential.
The CDC notes that rickets, a rare disorder in Western nations but one that can cause growth delays, may result from a vitamin D shortage.
Children and teens' vitamin D recommendations
According to the Harvard T.H. Chan School of Public Health, observational research suggests that higher amounts of vitamin D may help prevent the development of type 1 diabetes in adolescents, even though the recommended daily allowance (RDA) for children and teens is 600 IU (15 mcg).
Consult your primary care physician if you think your kid or teen needs more vitamin D.
Vitamin D recommendations for adults
The National Institutes of Health Office states that persons aged 19 to 70 should consume 15 micrograms (IU), or 600, of vitamin D daily. The maximum quantity deemed safe for adults is 4,000 IU, the acceptable upper limit.
Elderly vitamin D recommendations
For persons aged 70 and above, the RDA is 800 IU. Your body no longer produces, absorbs, and digests vitamin D as well as it did when you were younger.
Among other potential health consequences, these problems may raise the risk of osteoporosis.
How do I get my vitamin D levels back to normal range?
The primary goal of supportive clinical therapy for vitamin D intoxication is to reduce calcium levels.
Stop taking calcium and vitamin D pills. Additionally, avoid extended bed rest in order to prevent hypercalcemia from inactivity.
Dehydration should be treated with isotonic saline to improve renal calcium clearance.
Bisphosphonates and calcitonin can be used to treat severe hypercalcemia (serum calcium >14 gm/dL) brought on by severe toxicity. It is advised to dose as follows:
- Inject 4 U/kg of calcitonin intramuscularly and repeat the procedure every 12 hours for up to 48 hours.
- Pamidronate 90 mg IV over 2 hours and zoledronic acid 4 mg IV over 15 minutes are two IV bisphosphonates that can be given simultaneously.
- It has been demonstrated that co-administration of calcitonin with bisphosphonates increases the effectiveness of calcitonin.
- Prednisone 40 mg/d or hydrocortisone 100 mg/d for five days.
Bisphosphonates' impact can last longer than calcitonin's and can prevent tachyphylaxis. As a result, when taking these drugs, calcium levels should be closely monitored.
IV glucocorticoids are controversial and usually reserved for treating vitamin D toxicity related to granulomatous disease. This drug acts by lowering plasma calcium levels by lowering calcitriol levels.
It helps control calcium levels in the body by reducing intestinal absorption and boosting urine outflow of calcium.
Patients may need hemodialysis to treat refractory hypercalcemia or renal failure.
To prevent vitamin supplement usage, patient counseling is necessary.
The Endocrine Society advises patients on high-dose vitamin D replacement treatment to keep track of their serum levels of calcium and 25-hydroxyvitamin D.
How do I get excess vitamin D out of my system?
Under the supervision of your doctor, you'll probably cease taking vitamin D pills. They will also restrict dietary calcium intake.
Your physician might also need to administer intravenous (IV) fluids and prescribe drugs like bisphosphonates and steroids.
Hemodialysis may be necessary as a treatment if you have kidney failure. This replaces your kidneys' function of removing waste and excess water from your blood.
Most people with vitamin D toxicity recover without experiencing any severe health problems, and they often never experience it again.
How do I take vitamin D?
It is best to take vitamin D tablets with food to improve absorption. Being a fat-soluble vitamin, vitamin D does not dissolve in water and is best absorbed in the bloodstream when consumed with foods high in fat.
Taking vitamin D tablets after a meal is advised to improve absorption. In fact, a study involving 17 people found that when taking vitamin D with the biggest meal of the day, the individuals experienced a 50% increase in their 25(OH)D level.
In another trial, vitamin D supplementation boosted blood levels by 32% after 12 hours. This was compared to vitamin D supplementation alone with a low-fat lunch for 50 older people.
Avocados, nuts, seeds, whole milk, other dairy products, and eggs are all healthy sources of fat that help your body absorb more vitamin D.
Can I take vitamin D without consulting a doctor?
Even though vitamin D has many important advantages, that doesn't imply you should go to your neighborhood pharmacy and buy a bottle immediately.
Before beginning a program, it's critical to comprehend a few concepts regarding supplements.
According to the NHS, every adult should consider taking a 10-microgram supplement in autumn and winter because the sunlight is not strong enough for the body to make vitamin D.
The agency also advises those susceptible to low vitamin D levels, such as those with darker complexion, to take a supplement all year round.
Adults in the US are advised to consume 15 micrograms, and a large portion of the nation's milk, breakfast cereals, margarine, yogurts, and orange juice are fortified as well.
The bottom line is that even though many people can get vitamin D supplements without a prescription, talking to a doctor is still a good idea.
This is especially true if you have underlying medical issues or concerns about how vitamin D will affect your health.
Should I take vitamin D daily?
According to current recommendations, adults should take at most the equivalent of 100 micrograms per day. Since vitamin D is fat-soluble, it can be stored in your body and doesn't need to be taken daily.
This indicates that taking 500 micrograms of vitamin D once a month, or 20 micrograms daily, would be safe. Your doctor or pharmacist is not poisoning you, so don't be concerned.
To get the daily equivalent, which is what matters, divide the monthly dose by 30.
Should I take vitamin D in the morning or at night?
There is no set schedule to take vitamin D. The most important aspect is to be consistent in following your doctor's advice to take it daily. However, a lot of people prefer taking supplements, such as vitamin D, in the morning.
In addition to being frequently more convenient, taking your vitamins in the morning is also simpler to remember.
This is particularly true if you take several supplements, as staggering vitamins or prescriptions throughout the day might be difficult.
To ensure that you get the most out of your vitamin D supplement, taking it with a substantial meal is a good idea.
You can try setting an alarm or keeping your supplements near your dining table as a quick reminder to take them.
Can vitamin D and vitamin D3 be taken together?
You can take both forms of vitamin D without worrying about any negative interactions. Instead, the body converts both forms of vitamin D into the same active form of calcitriol.
Since vitamin D is stored in fat, monitoring daily supplements is important.
Vitamin D and D3 supplements are safe to consume, although the two vitamin types have different potency levels.
Can calcium and vitamin D be taken together?
To maximize your calcium absorption and function, you also need vitamin D. The majority of the calcium you consume through food is inactive; thus, for calcium to perform its intended function, it must be changed into an active form. In this situation, vitamin D is useful.
Even though vitamin D is its most popular name, it is also known as calciferol, cholecalciferol, ergocalciferol, vitamin D2, and vitamin D3. It is still vitamin D, whether it is ergocalciferol or calcifediol.
According to studies, using calcium and vitamin D supplements in moderation is safe, especially for people over 65. However, the two supplements are not particularly helpful when taken in excess.
Who should avoid taking vitamin D supplements?
Cholecalciferol should not be taken if you have ever experienced a vitamin D allergy or if you have any of the following conditions:
- Excessive blood calcium levels (hypercalcemia)
- When there are too many vitamin D levels present in the body, it can lead to hypervitaminosis D.
- Malabsorption which is a condition where the body has difficulty absorbing nutrients from food.
Inform your physician if you've ever had a renal illness, a cardiac condition, or an electrolyte imbalance.
You should know that some cholecalciferol formulations may contain substances like sugar, aspartame (phenylalanine), peanut or soybean oil, or specific food coloring.
If you use cholecalciferol and have allergies, diabetes, or phenylketonuria (PKU), consult your doctor first.
A nursing or unborn child may suffer negative effects from taking too much vitamin D. If you are pregnant or breastfeeding, it is important to consult with a doctor before using cholecalciferol.
You might require a different dose during pregnancy or while you are nursing.
Give cholecalciferol to children only under physician supervision. The dose for your child will vary according to age, weight, food, and other factors.
What is the best form of vitamin D?
The consensus among experts is that vitamin D3 is superior to vitamin D2.
Most over-the-counter vitamin D pills contain D3, but you should carefully examine product labels to ensure that's what you're getting.
The effectiveness of vitamin D3 "cholecalciferol" vs vitamin D2 "ergocalciferol" in raising blood levels of the vitamin has been the subject of continuous debate.
According to a study that evaluated their impact on blood levels, vitamin D3 supplements tend to elevate blood concentrations of the vitamin more and maintain those levels longer than vitamin D2 supplements.
Get the Why Not Natural vitamin D3 supplement today to improve your health.
What's the key difference between vitamin D2 and vitamin D3?
The distinctions between vitamin D2 and vitamin D3 are numerous. A good place to start is by observing that they come from many sources. Although they both work to raise vitamin D levels in the body, vitamin D2 and D3 are derived from different sources.
Fortified meals like cereals and wild mushrooms are a few plant sources that produce vitamin D (D2). Experts use international units (IU) to quantify this vitamin type, and supplements exceeding 50,000 IU are regarded as "prescription only."
There are other over-the-counter supplements with IU below this cutoff. Due to the difficulty of extracting vitamin D2 from its sources, it is expensive to produce. This is why fortified meals like milk products often have it.
On the other hand, vitamin D3 is produced by foods like liver, fatty fish, fish oil, egg yolks, and fish.
When exposed to enough sunlight, your skin is a significant source of vitamin D3. Because of this, some people call vitamin D3 the "sunshine vitamin." Without exception, vitamin D3 is available over-the-counter.
What are the benefits of vitamin D?
The benefits of vitamin D extend beyond bone health. Numerous physiological processes depend on vitamin D. The benefits of vitamin D are detailed below:
It strengthens your bones
Vitamin D is essential for bone health. It helps calcium absorption in the gut, which is necessary for regular bone mineralization. It is vital for both bone growth and preventing brittleness.
Vitamin D can help prevent osteoporosis by decreasing bone density and quality when combined with calcium.
It can help strengthen muscles
According to a 2018 study, vitamin D is important for muscle growth. Lack of vitamin D can enhance the likelihood of weak muscles, elevating the chance of falling.
Elderly people should take particular note of this. Since falls are a regular issue and can cause serious disability and even death in elderly people, vitamin D may aid in strengthening muscle strength.
It supports the immune system and fights inflammation
Vitamin D can support the development of immunity. Fighting off dangerous germs and viruses can help the immune system.
A 2017 study found an increased risk of low vitamin D levels, influenza, and other respiratory illnesses during winter weather and in high latitudes.
Another 2017 analysis of 25 randomized control trials published in BMJ showed that vitamin D supplements could potentially benefit viral infections like influenza and coronavirus.
The analysis concluded that regular vitamin D supplementation, either daily or weekly, reduced the risk of acute respiratory infection, especially in people with a vitamin D deficiency.
It can help support oral health
A review published in Nutrients in 2020 found that vitamin D may lessen the risk of tooth decay and cavities because it aids in the body's calcium absorption.
It may help treat hypertension
A 2019 research by Current Protein & Peptide Science reports that vitamin D may help cure high blood pressure, one of the symptoms of cardiovascular disease.
Even a brief lack of vitamin D can cause organ damage and directly increase blood pressure, claim the review's authors.
The researchers suggested that vitamin D supplementation could be a new way to manage hypertension due to the strong correlation between vitamin D and hypertension.
It may help with weight loss
It is a well-known fact that there is a correlation between obesity and a deficiency in Vitamin D; therefore, increasing your vitamin D intake may aid in weight loss.
A 2013 study published in Nutrition Journal indicated that vitamin D, calcium supplements, and a calorie-restricted diet helped overweight and obese people lose weight.
It may help battle depression
Both the sun and vitamin D might make you feel happier. A study published in Neuropsychology in 2017 said scientists discovered "a significant relationship between depression and vitamin D deficiency."
It is recommended that people with depression undergo screening and receive treatment for vitamin D deficiency. This approach is simple and affordable, but it may also lead to better outcomes for those with depression.
However, more studies are required to determine whether low vitamin D levels cause or result from depression and comprehend its specific mechanisms.
Takeaway: Take the recommended dose of vitamin D supplements to avoid the formation of kidney stones
The correlation between vitamin D and kidney stones is a complex one. While excess vitamin D may increase the risk of calcium oxalate stone formation, it doesn't necessarily mean that vitamin D directly causes kidney stones.
Before beginning or making changes to your vitamin D supplementation routine, consult a healthcare expert to be sure you are maximizing your health and reducing any possible risks.
Your doctor can help you choose the dosage and kind of vitamin D most suited to your unique needs, ensuring that you enjoy all of its many advantages while protecting the health of your kidneys.
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