Vitamin A: Skin and subcutaneous tissue disorders: Dermatitis, photosensitivity reactions.
Vitamin C: Blood and lymphatic system disorders: Hemolysis [after large oral doses of ascorbic acid in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency].
Immune system disorders: Delayed-type allergic response.
Psychiatric disorders: Insomnia, sleepiness.
Nervous system disorders: Headache.
Vascular disorders: Flushing.
Gastrointestinal disorders: Abdominal cramps, diarrhea (at a dose of 1 g or more daily), esophagitis (rare), flatulent distention, gastric discomfort, heartburn, intestinal obstruction (rare), nausea, transient colic, vomiting.
Renal and urinary disorders: Increased urination (mild), kidney stone formation (associated with large dosages of ascorbic acid reportedly have been limited to individuals with preexisting renal disease).
Injury, poisoning and procedural complications: Erosion of dental enamel.
Vitamin E: Endocrine disorders: Thyroid problems.
Nervous system disorders: Dizziness, headache.
Eye disorders: Blurred vision.
Vascular disorders: Hypertension, thrombophlebitis (vein inflammation related to a blood clot).
Gastrointestinal disorders: Nausea, diarrhea, abdominal pain/intestinal cramps.
Skin and subcutaneous tissue disorders: Rash.
Musculoskeletal and connective tissue disorders: Myopathy (pain or weakness in the muscles).
Reproductive system and breast disorders: Breast soreness/gynecomastia, gonadal dysfunction.
Investigations: Creatinuria (increased concentrations of creatine in the urine), increased serum creatine kinase, serum cholesterol, and triglycerides; increased urinary estrogens and androgens.
Doses of vitamin E greater than 1,000 mg (equivalent to 1,490 IU) daily for prolonged periods have occasionally been associated with increased bleeding tendency in vitamin K-deficient patients such as those taking oral anticoagulants. It has also been suggested that it may increase the risk of thrombosis in some patients, such as those taking estrogens.
Zinc: Doses of zinc up to 30 mg/day are generally well-tolerated.
Metabolism and nutrition disorders: Loss of appetite.
Psychiatric disorders: Drowsiness.
Nervous system disorders: Headache, metallic taste.
Gastrointestinal disorders: Abdominal pain/cramps, diarrhea, dyspepsia, gastritis, gastrointestinal discomfort/irritation, nausea, vomiting.
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