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Hypervitaminosis D
Other Resources UpToDate PubMed

Hypervitaminosis D

Contributors: Michael W. Winter MD, Catherine Moore MD, Paritosh Prasad MD
Other Resources UpToDate PubMed


Hypervitaminosis D refers to excess vitamin D ingestion. This most often occurs due to overingestion of vitamin D. Very few foods contain high levels of vitamin D, so excess ingestion typically results from overdosing on supplements. The recommended upper-limit daily dose for adults is 4000 international units (IU) daily, but the upper-limit dose is lower for infants and children. Patients with renal disease, osteoporosis, or inflammatory bowel disease may require significantly higher doses (10 000-50 000 IU daily). Patients requiring high levels for repletion should have surveillance levels checked.

The primary complication of excess vitamin D levels is hypercalcemia. In the acute setting, hypercalcemia can result in nausea, emesis, altered mental status, weakness, polyuria, and polydipsia. Chronic vitamin D toxicity can result in the precipitation of kidney stones as well as bone demineralization and subsequent bone pain. Hypervitaminosis D in children can result in brain injury.


E67.3 – Hypervitaminosis D

27712000 – Hypervitaminosis D

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Differential diagnosis of Hypercalcemia:
  • Primary hyperparathyroidism
  • Sarcoidosis
  • Lung cancer
  • Multiple myeloma
  • Thiazide diuretics
  • Lymphoma
  • Tuberculosis
  • Coccidioidomycosis
  • Familial hypocalciuric hypercalcemia
  • Milk-alkali syndrome
  • Chronic lithium use (see Lithium nephropathy)
  • Vitamin A toxicity
  • Immobilization

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Management Pearls

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Reviewed:12/12/2018
Last Updated:12/12/2018
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Hypervitaminosis D
A medical illustration showing key findings of Hypervitaminosis D : Fatigue, Nausea/vomiting, Constipation, Hypercalciuria, Muscle weakness, Polyuria, Ca elevated
Copyright © 2024 VisualDx®. All rights reserved.