Abdominal discomfort, leg...

A middle-aged man complained of frequent vomiting, nausea, abdominal discomfort, leg cramps, tinnitus, dry mouth, increased thirst, diarrhoea, and weight loss (12.7 kg). He was referred to the hospital by his general practitioner. The patient had complained for almost three months, with the symptoms starting about one month after starting a vitamin regimen therapy as recommended by a private nutritionist. Vitamin D 15 000 IU (daily requirement: 10 mcg (or 400 IU per day)), vitamin K2 100 mcg (daily requirement: 100-300 g), vitamin C, and vitamin B9 were all being taken daily by the patient (folate) 1000mcg (daily requirement: 400 μg). The patient's general practitioner ordered the first round of blood tests, which revealed acute kidney injury with serum creatinine (166 mol/L; ref: 64-106 mol/L) and increased serum calcium (albumin adjusted) (3.9 mmol/L; reference (ref): 2.2-2.6 mmol/L) and serum vitamin D of >400 nmol/L (ref: >50 (vitamin D sufficiency). The tests indicate hypervitaminosis.1