DEAR DR. GOTT: Now 67, I’ve suffered with “pings” of sharp pain in my shoulders for three years. I could hear and feel the tendons and muscles pop when I moved or reached for something. My uncle, 94, claims to have “not an ache or pain” and recommended I take 40,000 units of vitamin D3 daily. I tried 20,000 with no results. I tried 30,000 with some relief. I tried 40,000 units and am mostly symptom free. I had been to MDs, chiropractors and had acupuncture and massages all with little or no results. What might have been my diagnosis? Are there any long-term side effects from this seemingly high dose?
DEAR READER: Vitamin D is fat soluble and found naturally in very few foods (fish liver oil, fatty fish, beef liver, cheese, and egg yolks). It is best known for promoting calcium absorption, but also maintains adequate blood calcium and phosphate levels, is needed for normal bone growth and remodeling, reduces inflammation, and modulates cell growth and neuromuscular and immune functions. The recommended daily allowance (RDA) for healthy children and adults ages one to 70 is 600 international units (IU) a day. For those over the age of 70, 800 IU should be consumed daily. The tolerable upper intake has been set a 4,000 IU daily for healthy individuals ages 9 and up.
Because vitamin D is fat-soluble, excesses aren’t eliminated from the body through urine, but are stored. In normal, healthy individuals, taking more than recommended may lead to toxicity over time, as the levels of the vitamin build up within the body. You are currently taking 10 times more than the highest dose that is still considered safe.
In individuals who have an underlying condition that causes chronic D deficiency, high doses such as what you are taking may be recommended, but only under physician direction and supervision. Vitamin D can also interact with several medications so it is important for people considering this regimen to check with their physician before starting it.
My advice to you is to discontinue the supplementation and see your doctor. You are attempting to treat something without actually knowing what is wrong. I cannot determine what your diagnosis is, but I suspect it is the result of overuse or from an injury. A referral to an orthopedic specialist is in order. He or she can then examine you and order appropriate testing to include blood work, X-rays, and a CT or MRI.
Readers who are interested in learning more can order my Health Reports “Managing Chronic Pain” and “Vitamins and Minerals” by sending a self-addressed, stamped number 10 envelope and a $2 (for each report) US check or money order to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print an order form from my website, www.AskDrGottMD.com.