Pyridoxine Hydrochloride (Vitamin B6): Long term (i.e., 2 months or longer) administration of large (megadose) dosages (e.g., usually 2 g or more daily) of pyridoxine can cause sensory neuropathy or neuronopathy syndromes.
Other side effects reported with megadoses of pyridoxine include peripheral neuropathy, unsteady gait (manner of walking), loss of limb reflexes/numbness and tingling in feet and hands, hyperesthesia (increased sensitivity to any stimulation), muscle weakness, impaired or absent tendon reflexes; bone pain, headache, dizziness, sleepiness, nausea, upset stomach, breast tenderness, photosensitivity on sun exposure, and exacerbation of acne.
Sodium ascorbate (Vitamin C): Prolonged intake of vitamin C (ascorbic acid) in excess of 2 g per day may lead to nausea, abdominal cramps, diarrhea, and nose bleeds. Elevated serum glucose levels, gastrointestinal obstruction, and esophagitis have also been reported in those taking high oral doses of vitamin C.
In people with kidney disease, excess vitamin C also may contribute to oxalate-containing kidney stones. In healthy people, epidemiological studies do not support an association between excess vitamin C intake and kidney stones.
High vitamin C intakes may also boost iron absorption - useful for some, but problematic for people with hemochromatosis, a metabolic disease that cause excess iron accumulation.
Zinc: Sign of acute zinc toxicity (doses >200 mg daily) include gastrointestinal pain/cramps, nausea, vomiting, diarrhea, loss of appetite, headache, lethargy (sleepiness), muscle pains, and fever.
Prolonged zinc supplementation may cause impairment of copper and iron status, and anemia at doses >50 mg/day; immune deficiency, reduced blood high-density lipoprotein (HDL) levels, and gastric erosion at doses >150 mg daily.
Long-term (average 6.3 years) ingestion of supplemental zinc (80 mg/day) has also been linked to a significant increase in hospitalizations for urinary tract infection and kidney stones.
What to do when the patient has taken more than the recommended dosage: If the patient has taken more than the recommended dosage, consult a doctor or contact a poison control center right away.
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