Staying Fit
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Vitamin use is commonplace among older Americans. Research has found that 78 percent of adults 50 and older take vitamins or supplements, according to a 2021 AARP survey. For adults 65 and older, that rises to 83 percent. Although vitamins can be valuable for those who have a deficiency, older Americans need to be cautious about how many they take and aware of potential interactions with medications.
Overconsumption can lead to serious health problems and can even be fatal.
An 89-year-old British man died of an overdose of Vitamin D supplements in February 2023 in England.
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Vitamin D helps the body absorb calcium, but going over the daily recommended intake can cause hypercalcemia, a condition in which the calcium level in the blood becomes too high.
Supplements are heavily marketed, sometimes with unsubstantiated claims. The Food and Drug Administration (FDA) doesn't regulate the supplement market in the same way it does medications.
“While there’s some regulation on how they’re produced, the FDA isn’t really reviewing them to make sure that they’re safe or effective before they go to market,” says Lauren Haggerty, clinical pharmacist at Johns Hopkins Medicine.
Haggerty says companies say a supplement will prevent heart disease when there isn’t evidence to support that claim.
There are two types of vitamins: water-soluble and fat-soluble. Water-soluble vitamins typically flush out of the user’s system when there’s too much but not an extremely high dose, Haggerty says. Fat-soluble vitamins, A, D, E and K, are best absorbed with meals with healthy fats and are stored in the body.
“We definitely want people to be cautious with [fat-soluble vitamins] because they will just build up in the system, and those are the ones that can cause more toxicity in excess,” says Wendolyn Gozansky, M.D., a geriatrician and chief quality officer with Kaiser Permanente.
Speak to your doctor first
Many people take supplements before consulting with their doctor.
“A lot of patients will consume vitamins because they were sold them by some marketing strategy or someone’s recommendation,” says Matthew Farrell, M.D., family medicine physician at the Ohio State University Wexner Medical Center. Because of this, many people take supplements they don’t need.
“I make it a point to be sure that I’m asking people everything that they’re taking for their health and understand what that is so that I can be sure that I know that they’re getting the right amount of what they need,” Gozansky says.
The majority of people receive sufficient vitamins through their diet and don’t need supplements. “The best way to get your vitamins and minerals is to eat a really well-balanced diet,” Gozansky says.
What does a well-balanced diet look like? “For most people, if they’re eating a pretty balanced diet with fruits and vegetables, whole grains, low-fat proteins, dairies and beans, then I would say [they] most likely [don’t need a supplement] unless it’s recommended by a doctor because they’re specifically deficient in something,” Haggerty says. It’s a lot easier for the body to absorb nutrients through food rather than a pill, and there’s less concern of overconsumption. “It’s pretty rare for someone to take too much of a vitamin through their diet,” Haggerty says.
Here are five common vitamins and minerals that people can overconsume. Be aware that upper safe limits for these vitamins include combined amounts from vitamins and food.
1. Vitamin A
Vitamin A is important for vision, the immune system, cell division and more. Most people get sufficient vitamin A, also known as retinol, through diet. According to the National Institutes of Health (NIH), women should consume 700 micrograms of retinol activity equivalents (RAE) per day and men should have 900 mcg RAE.
An excess of vitamin A is absorbed in the body and can build toxicity in the liver. Acute toxicity, called hypervitaminosis A, occurs when a person repeatedly takes a higher dose, more than 4,000 international units (IU) daily over months, which is more than 100 times the recommended dietary allowance, according to the NIH.
“You can have some acute symptoms like nausea, vomiting, vertigo, blurry vision,” Farrell says. Other symptoms typically include severe headache, aching muscles and coordination problems. In severe cases, too much vitamin A can cause an increase in cerebral spinal fluid pressure, leading to drowsiness and, eventually, coma and even death.
If you have a preexisting liver condition, excess vitamin A is concerning. “It can hurt your liver if you already have liver problems,” Haggerty says.
Recommended daily amount*
- 700 mcg for women
- 900 mcg for men
Overdose
- 25,000 IU a day can cause chronic poisoning.
- The safe upper limit for adults is 3,000 mcg.
Foods with vitamin A
- Beef liver
- Sweet potato, baked in skin
- Spinach
- Carrots
*Note: All recommended daily amounts are from the NIH.
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