Vitamin Toxicity in CKD/ESRD Patients; Avoid "Airborne"

Krissi's picture

Have you seen the news about "Airborne"?

"...The makers of 'Airborne'... will refund money to consumers who bought the product, as part of a $23.3 million class action settlement agreement [based on false advertising]..."

Did you know that if you're a chronic kidney disease (CKD) or kidney failure (ESRD) patient, you shouldn't be taking this stuff anyway? Wanna know why?*

Let's begin by examining the Airborne nutritional label for its original product:

Alright, let's get the obvious out of the way first: Potassium and sodium?? We all know you don't need any extra portions of these two. In fact, I'm surprised (disturbed?) by the level of sodium in one dose of what some call a medicine.

Here are some things you might not realize, but you should certainly be aware of (about this and other products)...

Vitamin A

There is a 100% daily dose of Vitamin A in just one pop. The manufacturer recommends taking "...an Airborne tablet [with water]... Repeat every 3-4 hours or as needed, not to exceed 3 doses in a day."

If you follow the dosing directions, you're going to get THREE TIMES the recommended safe daily dose (5,000 IU) of Vitamin A.

Vitamin A toxicity can cause: altered mental status, severe dehydration, neurological deficits, metabolic derangements, liver toxicity, significant hypercalcemia.

What are the recommendations for kidney failure patients and Vitamin A supplementation? "[in ESRD patients] levels are usually elevated; supplementation not recommended, may cause toxic levels".

The bottom line: ESRD patients should avoid vitamin A supplements. Since this vitamin is fat-soluble, not water-soluble, it can build up to higher than normal levels in people on dialysis.

Vitamin C

Three doses of Airborne will provide the body with 4,671% of the daily safe dose. Because Vitamin C is water soluble, it is usually safe in higher doses when taken by healthy people, but if you're a kidney failure patient, you're playing on an uneven field.

ESRD patients do need a certain amount (60-100 mg/day supplement recommended for CKD/dialysis patients) of Vitamin C because of its beneficial effects: [it] helps the body absorb iron, helps manufacture collagen, form and repair red blood cells, bones and other tissues, keeps capillary walls and blood vessels firm, protects against bruising, maintains healthy gums, heals cuts and wounds, and keeps immune system healthy.

But in very large doses, Vitamin C in kidney failure patients "can cause severe side effects such as oxalate deposits in bone and soft tissues and may interfere with the absorption and metabolism of vitamin B12".

The bottom line: ESRD and CKD patients should consult their nephrologist before taking additional Vitamin C supplements.

Vitamin E

If taken as recommended, "Airborne" will provide 300% of the safe daily dose. And like Vitamin A, Vitamin E is also a fat-soluble vitamin and can quickly build up into toxic levels.

However, the 'safe daily dose' for a CKD or ESRD patient is only 8-10mg per day. Just one dose of Airborne actually provides not 300%, but 900% of the safe daily dose for kidney patients.

Scary.

"Megadoses of vitamin E may produce headaches, tiredness, double vision, and diarrhea in humans." Very high doses (800 mg) may increase blood clotting time, especially for people on blood thinners.

The bottom line: ESRD patients should avoid vitamin E supplements. Since this vitamin is fat-soluble, not water-soluble, it can build up to higher than normal levels in people on dialysis.

The other Airborne Ingredients

The following additional ingredients in Airborne are in minute or insignificant amounts. Here is some brief information about them:

Vitamin B2 - is beneficial to CKD and ESRD patients (in correct doses). However, it is recommended that OTC supplements for all vitamins be cleared by your nephrologist before use. Consult your Nephrologist before use.

Magnesium - The risk of magnesium toxicity increases with kidney failure, when the kidney loses the ability to remove excess magnesium. Signs of magnesium toxicity can include changes in mental status, nausea, diarrhea, appetite loss, muscle weakness, difficulty breathing, extremely low blood pressure, and irregular heartbeat. AVOID

Zinc - Possible benefits in CKD and ESRD patients (in correct doses). Consult your Nephrologist before use.

Selenium - Possible benefits in CKD and ESRD patients in regards to improving mental health (in correct doses). Consult your Nephrologist before use.

Manganese - Acute kidney failure can be caused by a toxic exposure to manganese. Manganese toxicity is most likely to occur where the environment is contaminated with manganese and not from dietary or supplement intake. For example, miners who work in areas where large amounts of manganese dust are present have shown symptoms of brain disease and other nervous system disorders. There seem to be no known benefits of additional supplementation of manganese in CKD and ESRD patients. Consult your Nephrologist before use.

Herbal Extract Proprietary Blend - As the product label doesn't indicate amounts of ingredients or the purpose of each, it is strongly recommended to NEVER take a product with unspecified (and usually not FDA evaluated) ingredients. These herbs and extracts might very well interfere with your prescription medications or dialysis treatments and cause unexpected side effects. AVOID.

Amino Acids - Possible benefits in CKD and ESRD patients (in correct doses). Consult your Nephrologist before use.

MY BOTTOM LINE

It is usually recommended to avoid additional dietary vitamins and supplements not prescribed by your doctor or administered by your dialysis nurse.

Because "Airborne" contains many more possible toxic dose ingredients, while in contrast very few possible beneficial ingredients, why take the risk?

Resources

  • National Kidney and Urologic Diseases Information Clearinghouse
  • DaVita; The ABCs of vitamins for kidney patients
  • Health A-Z; Vitamin toxicity
  • eMedicine; Vitamin A Toxicity
  • Science Direct; Role of selenium depletion in the effects of dialysis on mood and behavior
  • *Disclaimer: This blog post should not be used as a substitute for qualified medical advice. The contents herin represent information found on the internet and from my own personal medical experiences. Please consult your Nephrologist before changing any diet or supplements you are on.