hypervitaminosis

ビタミン過剰症 　

WordNet

1. an abnormal condition resulting from taking vitamins excessively; can be serious for vitamins A or D or K

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/02/08 20:12:12」(JST)

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Vitamin overdose
Classification and external resources
Specialty	endocrinology
ICD-10	E67.0-E67.3
ICD-9-CM	278.2, 278.4
Patient UK	Hypervitaminosis

Hypervitaminosis refers to a condition of abnormally high storage levels of vitamins, which can lead to toxic symptoms. The medical names of the different conditions are derived from the vitamin involved: an excess of vitamin A, for example, is called hypervitaminosis A.

Hypervitaminosis primarily affects the fat soluble vitamins, as these are stored by the body for longer period than the water soluble vitamins. However, avoiding excesses of both classes of vitamins can make the condition hard to get.

Generally, toxic levels of vitamins stem from high supplement intake and not from dietary sources. Toxicities of fat-soluble vitamins can also be caused by a large intake of highly fortified foods, but foods rarely deliver dangerous levels of fat-soluble vitamins.

The Dietary Reference Intake recommendations from the United States Department of Agriculture define a "tolerable upper intake level" for most vitamins.

High dosage vitamin A; high dosage, slow release vitamin B₃; and very high dosage vitamin B₆ alone (i.e. without vitamin B complex) are sometimes associated with vitamin side effects that usually rapidly cease with supplement reduction or cessation.

Fat soluble

With few exceptions, like some vitamins from B complex, hypervitaminosis usually occurs more with fat-soluble vitamins (D, E, K and A or 'DEKA'), which are stored in the liver and fatty tissues of the body. These vitamins build up and remain for a longer time in the body than water-soluble vitamins.

Conditions include:

• Hypervitaminosis A
• Hypervitaminosis D
• Hypervitaminosis E
• Hypervitaminosis K, unique as the true upper limit is less clear as is its bioavailability.

According to Williams' Essentials of Diet and Nutrition Therapy (Mosby, 10th Edition) It is difficult to set a DRI for vitamin K because part of the requirement can be met by intestinal bacterial synthesis.

• Reliable information is lacking as to the vitamin K content of many foods or its bioavailability. With this in mind the Expert Committee established an AI rather than an RDA.
• This RDA (AI for men age 19 and older is 120 µg/day, AI for women is 90 µg/day) is adequate to preserve blood clotting, but the correct intake needed for optimum bone health is unknown. Toxicity has not been reported.

Minerals

High doses of mineral supplements can also lead to side effects and toxicity. Mineral-supplement poisoning does occur occasionally, most often due to excessive intake of iron-containing supplements.

Comparative safety statistics

In the United States, overdose exposure to all formulations of "vitamins" was reported by 62,562 individuals in 2004 (nearly 80% [~78%, n=48,989] of these exposures were in children under the age of 6), leading to 53 "major" life-threatening outcomes and 3 deaths (2 from vitamins D and E; 1 from polyvitaminic type formula, with iron and no fluoride). This may be compared to the 19,250 people who died of unintentional poisoning of all kinds in the U.S. in the same year (2004). In 2010, 71,000 exposures to various vitamins and multivitamin-mineral formulations were reported to poison control centers, which resulted in 15 major reactions but no deaths.

Before 1998, several deaths per year were associated with pharmaceutical iron-containing supplements, especially brightly colored, sugar-coated, high-potency iron supplements, and most deaths were children. Unit packaging restrictions on supplements with more than 30 mg of iron have since reduced deaths to 0 or 1 per year. These statistics compare with 59 confirmed deaths due to aspirin poisoning in 2003 and 147 deaths known to be associated with acetaminophen-containing products in 2003.

See also

• Avitaminosis
• Orthorexia nervosa

References

UpToDate Contents

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• 1. ビタミンDの概要 overview of vitamin d
• 2. ビタミンAの概要 overview of vitamin a
• 3. 高カルシウム血症の原因 etiology of hypercalcemia
• 4. ビタミンKの概要 overview of vitamin k
• 5. 高カルシウム血症の治療 treatment of hypercalcemia

English Journal

• Association of dietary consumption and serum levels of vitamin A and β-carotene with bone mineral density in Chinese adults.

• Chen GD1, Zhu YY1, Cao Y1, Liu J1, Shi WQ1, Liu ZM2, Chen YM3.
• Bone.Bone.2015 Oct;79:110-5. doi: 10.1016/j.bone.2015.05.028. Epub 2015 May 28.
• BACKGROUND: Former studies suggested an adverse effect of hypervitaminosis A on bone health, while the effects of retinol and its precursor (β-carotene) remain uncertain in populations consuming vitamin A (VA) mainly from plant sources.OBJECTIVE: We investigated the association of serum, dietary re
• PMID 26027509

• Rising trend in vitamin D status from 1993 to 2013: dual concerns for the future.

• McKenna MJ1, Murray BF2, O'Keane M2, Kilbane MT2.
• Endocrine connections.Endocr Connect.2015 Sep;4(3):163-71. doi: 10.1530/EC-15-0037. Epub 2015 Jun 1.
• BACKGROUND: The Institute of Medicine 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D specified higher intakes for all age groups compared to the 1997 report, but also cautioned against spurious claims about an epidemic of vitamin D deficiency and against advocates of higher intak
• PMID 26034120

• High provitamin A carotenoid serum concentrations, elevated retinyl esters, and saturated retinol-binding protein in Zambian preschool children are consistent with the presence of high liver vitamin A stores.

• Mondloch S1, Gannon BM1, Davis CR1, Chileshe J2, Kaliwile C3, Masi C3, Rios-Avila L4, Gregory JF 3rd4, Tanumihardjo SA5.
• The American journal of clinical nutrition.Am J Clin Nutr.2015 Jul 15. pii: ajcn112383. [Epub ahead of print]
• BACKGROUND: Biomarkers of micronutrient status are needed to best define deficiencies and excesses of essential nutrients.OBJECTIVE: We evaluated several supporting biomarkers of vitamin A status in Zambian children to determine whether any of the biomarkers were consistent with high liver retinol s
• PMID 26178727

Japanese Journal

• 尿路結石による腎後性腎障害を合併したHenoch-Schönlein 紫斑病の1 例

• 日本小児腎臓病学会雑誌 26(2), 292-296, 2014
• NAID 130004495424

• Advantage of a low glycemic index and low phosphate diet on diabetic nephropathy and aging-related diseases

• The Journal of Medical Investigation 54(3,4), 359-365, 2007
• NAID 130004822561

• ビタミンD含有量の高い未熟児用粉乳での長期保育によるビタミンD中毒の危険性

• Pediatrics international : official journal of the Japan Pediatric Society 46(4), 439-443, 2004-08-01
• NAID 10018369152

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