Risk of Hypercalcemia in the Elderly Patients with Hypervitaminosis D and Vitamin D Intoxication

We aimed to evaluate the risk of hypercalcemia in the elderly population with hypervitaminosis D and vitamin D intoxication.

A total of 121 patients with a 25(OH) vitamin D level > 100 ng/mL from patients aged ≥ 65 years who applied to our hospital between 2014 and 2020 were included in this study. Sixty-nine patients with 25(OH) vitamin D levels of 100 - 150 ng/mL were determined as D hypervitaminosis; 52 patients with 25(OH) vitamin D levels > 150 ng/mL were determined as vitamin D intoxication. People with a calcium level above 10.2 mg/dL were considered as hypercalcemic patients.

Of 121 patients with D hypervitaminosis and vitamin D intoxication, 103 (85.1%) were normocalcemic, and 18 (14.9%) were hypercalcemic. Hypercalcemia was detected in 9 out of 69 patients with hypervitaminosis D; 8 of them had mild hypercalcemia and 1 person had severe hypercalcemia. Hypercalcemia was detected in 9 of 52 patients with vitamin D intoxication; mild hypercalcemia was found in 7 people, moderate hypercalcemia in 1 person, severe hypercalcemia in 1 person. There was no statistically significant difference between the incidence of hypercalcemia in patients with D hypervitaminosis and vitamin D intoxication (p = 0.514). It was observed that a total of 3 (16.7%) of the hypercalcemic patients with D hypervitaminosis and vitamin D intoxication died.

In the elderly population with hypervitaminosis D and vitamin D intoxication, most of the patients were seen as normocalcemic. However, severe hypercalcemia, which was life-threatening and resulted in death, was also observed. Using vitamin D in elderly patients should be performed according to the guideline recommendations. Calcium level and clinical findings should be checked during follow-up.