What can occur with long term vitamin D toxicity?

• A. Soft tissue calcification
• B. Increased bone density
• C. Hypocalcemia
• D. Hyperkalemia

Answer: (A)

Long-term vitamin D toxicity pushes calcium into the bloodstream, causing sustained hypercalcemia. When calcium and phosphate remain elevated, calcium salts can deposit in soft tissues and organs, leading to soft tissue calcification such as in the kidneys, blood vessels, lungs, and other tissues. This deposition is the hallmark consequence of chronic excess vitamin D. Increased bone density is not the typical outcome—bone remodeling is disrupted by the ongoing high calcium levels. Hypocalcemia would not occur with toxicity, as serum calcium is elevated rather than reduced. Hyperkalemia isn’t a direct consequence of vitamin D excess either.