Multiple vitamin overdose

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Definition
Multiple vitamin overdose is poisoning from swallowing more than the recommended amount of multiple vitamins.

Poisonous Ingredient

Any ingredient in a multiple vitamin supplement can be toxic in large amounts, but the most serious risk comes from iron or calcium.

Where Found

Numerous vitamin supplementation combinations
Note: This list may not be all inclusive.

Symptoms

• Body as a whole
  o Bone pain
  o Sun-sensitive (more likely to sunburn)
  o Cloudy urine
  o Headache
  o Increase amount of urine output
  o Increase need to urinate
  o Irritability
  o Joint pain
  o Loss of hair (from chronic overdose)
  o Mental changes
  o Mood changes
  o Muscle pain
  o Muscle weakness
  
• Eyes, ears, nose, and throat
  o Dry, cracking lips (from chronic overdose)
  o Increased sensitivity of the eyes to light
  o Irritation of the eyes
  
• Skin
  o Flushing (from Vitamin B3)
  o Dry cracking skin
  o Itching
  o Yellow-orange discoloration of areas of the skin
  
• Gastrointestinal
  o Loss of appetite
  o Constipation (from iron or calcium)
  o Nausea and Vomiting
  o Stomach pain
  o Weight loss (from chronic overdose)
  
• Nervous system
  o Convulsions (seizures)
  
• Cardiovascular
  o 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:

• Patient’s age, weight, and condition
  
• The name of the product (ingredients and strengths, if known)
  
• When it was swallowed
  
• The amount swallowed

Poison Control, or a local emergency number
Call Poison Control or your 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:

• Placing a tube down the nose and into the stomach (a nasogastric or NG tube) to wash out the stomach
  
• Administering activated charcoal
  
• Taking a blood sample
  
• Giving IV fluids
  
• Admission to the hospital
  
• Treating the symptoms
  
• Checking Vitamin A levels in the blood
  
• Giving iron antidote or 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.

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