Multiple vitamin overdose

Definition:

This poisoning is from multiple vitamins.

Poisonous Ingredient:

Can be any ingredient in the vitamin supplement, but usually iron or calcium.

Where Found:

Numerous vitamin supplementation combinations

Note: This list may not be all inclusive.

Symptoms:

Body as a whole
- Bone pain
- Burn more easily in the sun
- Cloudy urine
- Headache
- Increase amount of urine output
- Increase need to urinate
- Irritability
- Joint pain
- Loss of hair (from chronic overdose)
- Mental changes
- Mood changes
- Muscle pain
- Muscle weakness
Eyes, ears, nose, and throat
- Dry, cracking lips (from chronic overdose)
- Increased sensitivity of the eyes to light
- Irritation of the eyes
Skin
- Flushing (from Vitamin B3)
- Dry cracking skin
- Itching
- Yellow-orange discoloration of varies areas of the skin
Gastrointestinal
- Loss of appetite
- Constipation (from iron or calcium)
- Nausea and/or vomiting
- Stomach pain
- Weight loss (from chronic overdose)
Nervous system
- Convulsions (seizures)
Cardiovascular
- Electrical disturbances (arrhythmias) in the heart

Home Treatment:

Do not induce emesis (vomiting), unless instructed to do so by Poison Control or by a physician. For any acute or suspected overdose, seek emergency medical care immediately.

Before Calling Emergency:

Determine the following information:

The patient's age, weight, and condition
The name of the product (ingredients and strengths, if known)
The time it was swallowed
The amount swallowed

Poison Control, or a local emergency number:

They will instruct you if it is necessary to take the patient to the hospital. See Poison Control centers for telephone numbers and addresses. Take the container with you to the emergency room.

What to expect at the emergency room:

Some or all of the following procedures may be performed:

For swallowed poison
- Placement of a tube down the nose and into the stomach (a nasogastric tube, or an NG tube) to wash out the stomach
- Activated charcoal administration
- Take a blood sample taken to determine salicylate level in blood
- Give IV fluids
- Admission to the hospital
- Treat the symptoms
- Vitamin A levels
- Iron antidote
- Calcium antidote

Expectations (prognosis):

Niacin flush (Vitamin B3) is uncomfortable, but lasts only 2-8 hours. Vitamins A and D may cause symptoms when large daily doses are taken, but are rarely toxic in a single ingestion. The B vitamins rarely produce any symptoms. Iron and calcium overdoses have good prognoses, if treated early.

Review Date: 2/2/2002
Reviewed By: Kevin G. Wheeler, M.D., Department of Emergency Medicine, Boston Medical Center, Boston, MA. Review provided by VeriMed Healthcare Network.

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