The use of vitamin and herbal supplements has become a common and widely used nutritional source for much of the developed world. While vitamins and minerals are essential for maintaining health, people can definitely have “too much of a good thing.”¹ Some people consume massive doses in the false belief that “megavitamins” will make them healthier. For instance, when vitamin A supplement is used at 10 times the recommended daily allowance (RDA) for a prolonged period of time, toxicity may occur.²

Vitamins can be divided into two categories—water-soluble and fat-soluble. Some people are under the misconception that excess vitamins are excreted from the body naturally and are, therefore, harmless.³ That is not the case with fat-soluble vitamins A, D, E, and K. These are stored mostly in the liver.² However, water-soluble vitamins, such as B-complex and vitamin C, are excreted in the urine.⁴

Vitamin A toxicity is referred to as hypervitaminosis A.⁵ The continued and prolonged use of too much vitamin A from supplements as well as fish oil, liver, and kidney oil and even carrots can result in chronic hypervitaminosis. Signs of this condition may include dry skin and lips, hair loss, and brittle nails. It may even alter bone metabolism.³

Fortunately, the excessive ingestion of carotenes does not usually result in toxicity, but it will discolor the skin. Our patient, shown here, did admit to using large amounts of supplements on a regular basis. In addition, she was extremely lean and reported that she exercised constantly, which gave the impression of a compulsive personality.

Signs and symptoms of hypervitaminosis A will subside over time with the cessation of the supplements.

References

1. Charen E, Harbord N. Toxicity of herbs, vitamins, and supplements. Adv Chronic Kidney Dis. 2020 Jan;27:67-71.
2. Hammoud D, El Haddad B, Abdallah J. Hypercalcaemia secondary to hypervitaminosis A in a patient with chronic renal failure. West Indian Med J. 2014 Jan; 63:105-108.
3. Saljoughian M. Hyervitaminosis: a global concern. US Pharm. 2021 Oct 15;46:47-50. Available at https://www.uspharmacist.com/article/hypervitaminosis-a-global-concern . Accessed March 23, 2022.
4. Roop JK. Hypervitaminosis – an emerging pathological condition. Int J Health Sci Res. 2018 Oct;8:280-288.
5. Wu B. Vitamin A toxicity. DermNet NZ. 2015 Oct. Available at www.dermnetnz.org/topics/vitamin-a-toxicity . Accessed March 23, 2022.