Vitamin D poisoning by table sugar

We tested various foods from the household, including white table sugar sampled in December, 1999, after the son fell sick from drinking sweetened tea. One gram of sugar contained 21.4 mg vitamin D3, measured after extraction into ethanol. When the sugar was dissolved in water, the distinctive, long, white crystals of vitamin D3 floated up when centrifuged, and we did high performance liquid chromatography which confirmed their composition. A second sugar sample in January, 2000, contained 3.2 mg of vitamin D per gram of sugar. Assuming an average of 12.6 mg vitamin D3 per gram of sugar, and a conservative usage of 100 g sugar per month, the patient and his father had consumed more than 1.3 g of vitamin D3 per month, or 42 000 (mu)g/day (1 700 000 IU/day), in vast excess of the minimal toxic level (95 (mu)g, 3800 IU per day),1 for 7 months. This isolated incident was caused either by the intentional or accidental mixing of crystalline vitamin D3 into the table sugar of this family. When last seen, in April, 2001, the son's serum 25(OH)D was 250 nmol/L; creatinine, 125 mmol/L. The father was last seen in June, 2001, his serum 25(OH)D was 181 nmol/L; creatinine, 179 (mu)mol/L. Both had no symptoms, and continued to take prednisolone.