Toxicity of Vitamins and Supplements In Children
A recent article in Medscape reported that in the last 3 years, almost 2,000 children were hospitalized for vitamin and mineral toxicity. These were from over-the-counter supplements. Some of these cases involved severe illnesses, requiring a hospital stay of 4 to more than 8-days. Some of these were intentional ingestions by teens, others by curious children drawn to a colorful bottle. Most were easily accessible.
Despite being sold over the counter, supplements are not necessarily safe, nor are they FDA-regulated. That means their safety and effectiveness are not truly known since they haven’t been studied. Labels are not always accurate or complete for what is in the container. Supplements, even vitamins, should be kept in a safe place, out of sight and reach, especially from toddlers, like prescription medication. Vitamins, supplements, and medication should NEVER be called candy.
Vitamins and minerals are micronutrients, and our body needs them in small amounts. Since we get most of what we need from our diet, combining dietary sources with additional supplements is often unnecessary. Taken in excess, these supplements can be dangerous.
The Food and Nutrition Board sets guidelines for the RDA (recommended daily allowance) for vitamins and minerals according to age. These serve as a guide for good nutrition.
I will review some of the more common supplements that have been causes of hospital admission.
Vitamins and Minerals
Fat-Soluble Vitamins
Vitamins A, D, E, and K are fat-soluble vitamins, meaning they can be stored in the body; thus, levels can build up. Water-soluble vitamins (dissolve in water and include C and B vitamins) are excreted in the urine. They don’t typically cause problems unless taken in extreme doses.
Fat-soluble vitamins taken in high doses can cause harmful effects. Vitamin K is the least likely in this group to cause toxicity. Vitamin A is one of the more common causes for which children were seen and hospitalized.
Too much vitamin A can lead to hypervitaminosis A and cause nausea, vomiting, blurry vision, increased intracranial pressure, and coma.
Vitamin D excess results in high calcium levels, causing nausea, vomiting, muscle weakness, and irregular heartbeat.
High-dose Vitamin E can interfere with blood clotting.
A child's hands hold a colorful assortment of pink, elephant-shaped vitamins that look like candy. Vitamins with iron are highly toxic in excess.
Iron, including iron-containing multivitamins
Too much iron can be highly toxic, leading to GI bleeding, coma, and death. Iron overdose is a leading cause of death in children under 6, due largely to supplements, including kids’ vitamins. The shapes and colors are attractive to young children, and often taste good, so kids are drawn to them. Again, never call these supplements candy!
Zinc
Zinc is present in numerous supplements, including cold preparations and homeopathic medicines. Zinc toxicity symptoms include nausea, vomiting, diarrhea, abdominal pain, headaches, drowsiness, and problems with motor skills.
Energy Supplements
Please see last week's article Are Energy Drinks Safe for Kids?, 9/9/2026,
Energy drinks/shots/powders are loaded with caffeine, a stimulant. These supplements often contain other caffeine-containing substances, such as guarana, which further increase the caffeine content.
Symptoms of caffeine toxicity can occur with heavy caffeine use of more than 400 mg daily and include:
High blood pressure
Racing heart, palpitations
Abnormal heart rhythms
Vomiting
Disorientation
Insomnia
Headaches
Irritability
Tremors
Stomach upset
Caffeine toxicity is potentially fatal, especially if exercising in the heat.
Protein supplements
Most kids don’t need additional protein beyond what they get in their diet. Some protein powders are difficult for kids to digest, leading to gas, bloating, and diarrhea. Too much protein puts a strain on the kidneys, leading to dehydration, kidney stones, and kidney damage. Many protein supplements contain heavy metals like lead, cadmium, and arsenic. Plant-based protein supplements contain higher lead levels than dairy or animal-based supplements. These metals won’t be listed on the label. Most of these supplements are designed for adult use. Children cannot tolerate the same doses as adults.
Most children who eat a well-rounded, varied diet with all four food groups do not need supplements. Picky eaters, children with malabsorption issues, and those who don’t eat animal products are exceptions. Before considering a supplement, discuss with your doctor, who can give further guidance. Keep supplements in a safe place, as you would prescription medicines or any poisons. Realize that supplements are not regulated and that everything in the container is not necessarily listed on the label.
Taking more than the recommended amount of vitamins and minerals is not necessarily beneficial and can be dangerous.
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