Vitamin Toxicity Follow-up
- Author: Mark Rosenbloom, MD, MBA, FAAEM; Chief Editor: Asim Tarabar, MD more...
Further Inpatient Care
Admit patients with the following conditions:
- Risk for suicide
- Intractable emesis
- Altered mental status
- Neurologic symptoms
- Serious co-ingestions
- Severe dehydration
- Metabolic derangements (eg, hypercalcemia, severe electrolyte abnormalities, ECG changes, renal or liver damage)
Complications
- For complications of vitamin toxicity, see Physical.
Prognosis
- The prognosis is generally excellent. According to the American Association of Poison Control Centers' National Poison Data System, in 2007, more than 58,000 acute or chronic vitamin overdoses were documented, with 17 major adverse outcomes and 1 death.[3]
Patient Education
- Remind parents of children who ingested vitamins of the appropriate ways to childproof their homes and emphasize the need to use child-resistant bottles.
- Instruct adults who have unintentionally overdosed on vitamins as part of their megavitamin regimen on the serious adverse effects of such chemicals.
- For excellent patient education resources, visit eMedicine's Drug Overdose Center and Poisoning - First Aid and Emergency Center. Also, see eMedicine's patient education articles Iron Poisoning, Drug Overdose, Activated Charcoal, and Poison Proofing Your Home.
North America, Asia lead vitamin and supplement usage. Nielsen Wire. Available at http://blog.nielsen.com/nielsenwire/consumer/north-america-asia-lead-vitamin-and-supplement-usage/. Accessed March 20, 2009.
Griffin RM, Hoffman H. Live well vitamins & supplements center. WebMD. Available at http://gnc.webmd.com/vitamin-facts. Accessed March 22, 2009.
Bronstein AC, Spyker DA, Cantilena LR Jr, et al. 2009 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 27th Annual Report. Clin Toxicol (Phila). Dec 2010;48(10):979-1178. [Medline].
Dietary Supplement Fact Sheet: Vitamin A and Carotenoids. National Institutes of Health - Office of Dietary Supplements. Available at http://ods.od.nih.gov/factsheets/vitamina.asp. Accessed July 5, 2007.
Pazirandeh S, Burns DL. Overview of vitamin A. UpToDate. Available at www.uptodate.com. Accessed July 5, 2007.
Bakerman S. ABC's of Interpretive Laboratory Data. 4th ed. Scottsdale, AZ: Interpretive Laboratory Data, Inc; 2002.
Brody JE. In vitamin mania, millions take a gamble on health. In: New York Times. October 26, 1997:1, 20.
Cristoph RA. Vitamins. In: Manual of Toxicologic Emergencies. Year Book Medical Publishers; 1989:490-5.
Dietary Supplement Fact Sheet: Vitamin E. National Institutes of Health - Office of Dietary Supplements. Available at http://ods.od.nih.gov/factsheets/vitamine.asp. Accessed March 20, 2009.
Fischbach F. A Manual of Laboratory and Diagnostic Tests. 7th ed. Lippincott Williams & Wilkins; 2004.
Food and Nutrition Board. Recommended Dietary Allowances. 10th ed. National Academy Press: Washington, DC; 1989.
Goldfrank L, Lewis R. Vitamins. In: Goldfrank's Toxicologic Emergencies. 5th ed. Prentice Hall; 1994:535-44.
Hathcock JN. Vitamins and minerals: efficacy and safety. Am J Clin Nutr. Aug 1997;66(2):427-37. [Medline].
Hoffman RS. Thiamine hydrochloride. In: Goldfrank L, ed. Goldfrank's Toxicologic Emergencies. 5th ed. New York: Prentice Hall; 1997:825-6.
Med Lett Drugs Ther. Toxic effects of vitamin overdosage. Med Lett Drugs Ther. Aug 3 1984;26(667):73-4. [Medline].
Meyers DG, Maloley PA, Weeks D. Safety of antioxidant vitamins. Arch Intern Med. May 13 1996;156(9):925-35. [Medline].
NIH Clinical Center. Vitamin E. National Institutes of Health - Office of Dietary Supplements. Available at http://ods.od.nih.gov/factsheets/vitamine.asp. Accessed July 5, 2007.
Sachter JJ. Vitamins. In: Handbook of Medical Toxicology. Little Brown & Co Inc; 1993:399-402.
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