Vitamin D toxicity Pregnancy Lactation Renal failure Use of cardiac glycosides, thiazide diuretics, calcium-channel blockers

Not seen with doses <2400 IU/day Doses >3800 IU: hypercalcaemia, soft tissue calcification Fatigue, headache, nausea, vomiting, metallic taste, abdominal cramps, myalgia, tinnitus, arthralgia, constipation, polyuria, polydipsia

Cumulative toxicity possible

Between 50,000 and 200,000 IU/day: signs of hypercalcaemia 50,000-200,000 IU daily: nausea, vomiting, anorexia, calcification of soft tissue and organs, cardiac arrhythmias

Vitamin/ mineral

Australian and New Zealand RDI for adults


Dose range used in practice

Major uses

(oral or topical forms)





Men: 10 mg alpha-


50-3200 Ill/day

Treating deficiency Prevention of secondary deficiency (e.g. malabsorption syndromes, cystic fibrosis)

Prevention of cardiovascular disease, certain cancers, Ischaemlc stroke In high-risk hypertensive patients, nitrate tolerance Enhancing Immune function In the elderly Slowing progression of Alzheimer's dementia Improving symptoms In PMS, menopause, Intermittent claudication Reducing pain In OA and RA

Hypersensitivity People with Impaired coagulation, Inherited bleeding disorders, history of haemo rrhaglc stroke, vitamin K deficiency or at risk of pulmonary embolism or thrombophlebitis Suspend use of supplements 1-2 weeks before major surgery

Adverse effects are dose-related and tend to occuronlyatvery high doses (>1200 lU/day) Side-effects Include diarrhoea, flatulence, nausea and heart palpitations Increased risk of bleeding If vitamin K deficiency present

Vitamin E Is relatively non-toxic Doses as high as 3200 mg/day have been used for 12 years without signs of toxicity

Vitamin E

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