Abstract #1401609: A Case of Vitamin D Toxicity Associated with Weight Loss During a Low Carbohydrate Diet

Vitamin D is a commonly prescribed, fat-soluble vitamin important for calcium homeostasis and bone health. Toxicity (VDT) rare typically caused by aggressive supplementation or manufacturing errors. In epidemiologic studies, levels correlate inversely with adiposity, dietary weight loss associated increases in 25-hydroxyvitamin [25(OH)D] level. stored adipose tissue it postulated that risk factor the development of VDT. Here we present case VDT during low carbohydrate diet. A 74-year-old man CKD stage 3a benign prostatic hyperplasia presented to ED intractable emesis preceded subacute nausea, anorexia, constipation. He reported following very diet intentional from 83.9kg (BMI 25.86) 71.9kg 21.7) over five months. taking D3 250μg (10,000 IU) daily which was self-prescribed prior admission at least 12 On admission, he mildly bradycardic hypertensive. Laboratory evaluation revealed serum creatinine (sCr) 5.2 mg/dL (0.66-1.28, baseline 1.24 3 months prior), 12.9 (8.4-10.2), albumin 3.8 g/dL (3.2-4.8), 25(OH)D >150 ng/dL (30-100). Intact PTH suppressed 13.2 pg/mL (14-72) 1,25-dihydroxyvitamin 71 (18-72). PTH-related protein, urine electrophoresis were within reference ranges. The patient treated hypercalcemia intravenous fluids, prednisone 20mg daily, on hospital day eight, pamidronate 30mg. Upon discharge nine, 10.5 mg/dL. instructed stop all containing supplements. One month after discharge, sCr 1.9 8.7 theorized be clinically relevant quantities released loss. Due presentation setting loss, there are limited number cases described. Few clinical trials measuring concentrations people obesity have been performed. study confirmed patients lower normalize significant supporting hypothesis acute causing symptomatic chronic supratherapeutic supplementation. As illustrated this case, rapid doses can result Additional studies needed clarify mechanisms regulate kinetics persons obesity.