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Debugging my Vitamin A excess? Does it matter?


brendanhill

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Hello. I am 35 male with BMI of 25.7.  Today I logged my meals on cronometer.com:

- Breakfast: porridge/berries/nuts/seeds/BSmolasses
- Lunch: green salad with tofu, sprouts, dressing
- Dinner: bulgar wheat, white beans, some veggies and seeds
- Snacks: fruit

Calories ~85% of, most targets hit and I am supplementing B12 and vitamin D. (Plus I eat fish 2-3 times a week... which I did not today.)

I discovered to my horror (GASP) that I was at ~1300% the RDI for Vitamin A with a whopping ~38000IU - well past the maximum recommended 10000IU per day.

I have ruled out data entry errors and instead discovered that:

~80g of sweet potato is enough to reach the max 10009IU...
~45g of carrots is enough to get about 75% of max....
...glus chicory greens, pumpkin and spinach combined more than the max.

Thing is that these all seem like extremely modest serving sizes and I had no idea that combined that would push me to almost 4x the maximum recommended limit.... let alone 13x the recommended amount...!

I find this disconcerting because I though of spinach, chicory greens (leafy greens in general), carrot and sweet potato as stable foods which you couldn't really overdose on.

I read only about excess Vitamin A generally being caused by high supplementation and leading to build up in liver and other unwanted effects so I am mildly disconcerted.

Does 38000IU of Vitamin A on a typical day really matter? Do I really need to consciously avoid combining these high-Vitamin A foods on a given day? (Does anyone ever really eat less than 80g of sweet potato in one sitting? Isn't sweet potato a stable food for some?) 

All of the above could be said of Vitamin K as well for which I was  600% of RDI and over 2x the maximum recommended 250µg - mostly from chicory greens and spinach. Again I have always thought of leafy greens were "have as much as you want" type foods....! Is that not true?

Attached is my daily breakdown FYI, all feedback is welcome although I'm mostly concerned about A and K. Thanks for any advice.

cronometer20200804.pdf

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It’s vitamin A as beta carotene. You won’t overdose because the body must convert it to retinol. This process is highly regulated. If you were eating liver and cod liver oil which are not plant sourced then you might be concerned. As for vitamin K  there is generally no toxicity from dietary exposure. I am 67 and I have been getting similar doses from my diet of both of these nutrients for over 20 years now! Not a problem

Edited by Mike41
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Mike has it. Beta carotene from food is not a concern, the body converts as much as it needs. In general, higher levels of beta carotene and vitamin K from food are healthy - this has been consistently shown in studies. The only concern has been when taking in beta carotene from supplements - i.e. away from the food matrix in which it occurs naturally - then it has shown it can be deleterious, especially for smokers. Vitamin K from food is generally safe, and there are no issues in getting "excess" (again - from food, i.e. when it is part of the food matrix) - the only issue is if you are on blood thinners, sometimes it is recommended that you cut back on high vitamin K foods. Otherwise, you're good to go. 

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Thanks for the reassurance. I'm surprised at the amount of advice out there that 10000IU+ can be bad without drawing these distinctions... e.g.:

https://www.health.harvard.edu/newsletter_article/vitamin-a-and-your-bones#:~:text=Levels of up to 10%2C000,the risk of fetal damage.

"Levels of up to 10,000 IU (3,000 mcg) have been considered safe. Beyond that, though, vitamin A can build up to cause liver damage and brain swelling; pregnant women who ingest too much run the risk of fetal damage"

https://www.everydayhealth.com/drugs/vitamin-a

"Consuming large amounts of vitamin A poses a health risk. For instance, studies indicate that abnormally high levels of vitamin A in the blood suppress bone rebuilding, increase bone loss, and increase one's risk for osteoporosis. Symptoms of sudden vitamin A overdose include increased pressure in the space between the skull and the brain, nausea, stomach pain, vomiting, and skin peeling."
"The Tolerable Upper Intake Level (UL) of vitamin A for men and women over 18 years old is 3,000 micrograms (mcg) or 10,000 IU a day."
"Vitamin A can be toxic in high doses."

Similarly I'm surprised that cronometer.com has default 10000IU which comes up as red alarm if you go over.

Anyway I can remove the upper limit in settings so it doesn't scare me every day 😛

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Yep, as long as it's from pla

On 8/3/2020 at 4:36 PM, brendanhill said:

Thanks for the reassurance. I'm surprised at the amount of advice out there that 10000IU+ can be bad without drawing these distinctions... e.g.:

https://www.health.harvard.edu/newsletter_article/vitamin-a-and-your-bones#:~:text=Levels of up to 10%2C000,the risk of fetal damage.

The Harvard newsletter article does note: "The Harvard researchers added the important observation that beta-carotene did not contribute to the risk of fracture."

Those above are correct, I've never seen any study suggesting that consuming high levels of carotenoids is harmful, other than possibly giving your skin slightly reddish pigmentation at very high doses 🙂

This may also be useful:

https://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals/carotenoids

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On 8/3/2020 at 10:46 AM, brendanhill said:

Hello. I am 35 male with BMI of 25.7.  Today I logged my meals on cronometer.com:

- Breakfast: porridge/berries/nuts/seeds/BSmolasses
- Lunch: green salad with tofu, sprouts, dressing
- Dinner: bulgar wheat, white beans, some veggies and seeds
- Snacks: fruit

Calories ~85% of, most targets hit and I am supplementing B12 and vitamin D. (Plus I eat fish 2-3 times a week... which I did not today.)

I discovered to my horror (GASP) that I was at ~1300% the RDI for Vitamin A with a whopping ~38000IU - well past the maximum recommended 10000IU per day.

I have ruled out data entry errors and instead discovered that:

~80g of sweet potato is enough to reach the max 10009IU...
~45g of carrots is enough to get about 75% of max....
...glus chicory greens, pumpkin and spinach combined more than the max.

Hi Brenden!

When most nutrition software calculates "Vitamin A", they lump together Vitamin A acetate -- the stuff you shouldn't get too much of -- together with caretenoids.  All of the foods you listed were full of (desirable) caretenoids.  You have nothing to worry about -- the opposite.

  --  Saul

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  • 1 year later...

Hello all,

just few cents on the topic.

My case made me curious and I started to search for a possible explanation how it happened; so far I think the precision of conversion rate limiting for carotenoids is not so tough like for K1 (because of consequences are not so devastating like with K1) but I am not an expert in this area.

One year ago my serum retinol was 0.54 in the diapason 0.3-0.7, several months before the test I was on CR (pescetarian diet with some cheese), constantly dropping weight from BMI 23+ to 19+. I could say it was maybe a bit malnutrition (I had daily formal 1g protein per kg per body weight but no idea how good this protein was absorbed, at least blood morphology looked not perfect). After the retinol analysis taken I went almost strictly vegetarian, with one week of few eggs in the morning during vacation and very rare few grams of cheese. For the last half a year I am completely plant-only, except omega3 supplements and 1-2g of collagen daily. Two weeks ago I went for another serum retinol test and discovered 0.77 mg/l in the diapason 0.3-0.7. This was a bit unexpected because my regimen was pretty stable for months, I am getting 2000-3300% RDA as beta-carotene and lutein+zeaxanthin according to cronometer and every third day a small amount (300 micrograms) of retinal from a children multivit capsule. I also have 20g of crispy bread daily, was not able to find any info on possible fortification of it, however even if this is the case - it is not required in EU and is risky for vendor to do it, and not make a lot of sense, thus I assume there is no preformed retinol/retinal in it.

If it is not a lab error then I am curious to understand if I have a kind of risks to get even higher, for pre-formed retinol/retinal overdoses there is one cure - cut it down in the sources, but for my case cutting small multivit perhaps makes no sense and cutting a lot of vegs is a sad option. Trying to read a book "Carotenoids and Vitamin A in Translational Medicine" to see if I can understand the topic better, it has a ref that up to 0.8 is ok but such references are rare so if somebody knows where to look for thing like this I would appreciate it.

Br,

Igor

forgot to say - I read the book about a/d3/k2 triade and because of this and my calcium and pth I started to supplement d3 and k2 daily (except few sunny months when d3 is paused), controlling periodically pth, calcium and d3 levels, now I have maybe not ideal but stable and "good enough" status of this stuff

 

 

Edited by IgorF
forgot about d3k2
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  • 10 months later...

Hello,

I am interested in cr and have been reading some of these posts. The vitamin a topic is near and dear to my heart so I thought I would chime in here. I did poison myself with beta carotene in 2017 and have still not recovered. I was vegan and in pretty good shape (50 yo female). I was juicing a lot and favored carrot juice. I drank a lot of this orange poison. I turned orange myself. I thought this was so healthy this orange glow. Then I got very very sick. Uncontrollable vomiting, couldn't eat, lost a lot of weight. Went to the doctor. Had very high liver enzymes. LOW blood retinol.

Diagnosed with hypervitaminosis a. Serum retinol is not a good indicator of what you have in your liver. My serum retinol levels went high, very high, after stopping all bc and retinol. Took almost 3 years to get blood into normal range, and it still fluctuates into high, with eating as low VA as I possibly can. It has been a nightmare. The biochemistry of beta carotene is such that it is cleaved into 2 retinyl esters and then stored in fat. If you have no fat or you fill it up, it goes to your liver. It is fat soluble and you just don't pee it out if you take in too much. You store it and you accumulate it. Slowly or quickly. You are doing it too, just not as fast as I did it. It adds up. The only way you get rid of it is to STOP all sources of BC and retinol. Then it takes years to get it out. I could go on and on here but you can look into this by googling grant genereux. He is a Canadian engineer who writes a blog about his experience and research on vitamin a. He has 3 free ebooks you can download from his blog site. You can also watch some videos on you tube by a naturopathic doctor Garret Smith who goes by nutrition detective. Do not be fooled into thinking that beta carotene from plants is harmless, or even worse, that it is good for you.  It nearly killed me. I look forward to joining this forum and learning more from all here, I have already learned a lot specifically about blood glucose monitoring. I am now bordering on prediabetic and trying to find a diet that works. I can only eat low VA/bc foods. Right now that's mostly cabbage, apples, tofu, beans. But my BG levels are not ideal, likely a result of liver damage from the orange devil, beta carotene.

Claire

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Welcome to the forum! And...Really impressive recount of a hypervitaminosis caused by vegetable sources. I myself wouldn't have believed it possible, but in your case,  by regularly juicing so many carrots you could of course ingest a quantity of BC/RET which is way beyond what can be ingested naturally without juicing, also BC/RET probably exhibited frequent spikes in your blood. I wonder about the metabolism of BC/RET, its interaction with fat cells and the possibility that you are a slow metabolizer, I'm curious to read Grant Generaux. 

Are you eating vegan presently?

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AFAIR I read about some guy who died with carrot juice way to overload, not with preformed form in polar bear's liver.

maybe this is the source https://www.nytimes.com/1974/02/17/archives/carrotjuice-addiction-cited-in-britons-death.html

https://www.grunge.com/894959/how-carrot-juice-killed-an-english-scientist-in-1974/

https://shows.acast.com/unusual-deaths-true-stories/episodes/f6ce1796-f761-4ba8-a06e-8c85de5f3c3a

 

Some sources are mentioning he also taken some tab form also but even if not, the amounts of juice he used probably are so far behind the possibilities of the body to ratelimit the conversion that the "break on conversion" usually mentioned in textbooks should not be taken into account for such corner cases.

Or maybe there are also some rare SNPs we don't know about. Some are described in Masterjohn's vits101, my feeling is that they are 0.1-0.01% in the population but I could be wrong with this.

(my current intake is arount 90mg of precursors and no preformed vitA, serum is 0.5 in 0.3-0.7, perhaps this is like a median in the studies)

Another story confirming that models we use to understand the complex systems are limited and something will definitely emerge when big enough samples are available to study.

And that extreme dietary habits could work not the way they are described by textbooks, common wisdom etc.

 

Br,

Igor

 

Edited by IgorF
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I have gone through many diet experiments since the poisoning. One thing that makes VA poisoning worse is low protein and zinc deficiency which was also part of my problem. Adequate protein, low fat, and high soluble fiber are most important, as well as fixing mineral deficiencies. I have osteoporosis (VA kills your bones), celiacs (based on high antibodies in blood, I didn't do the biopsy), and IBS mixed c/d with high methane producing bacteria. I'm also dealing with blood sugar dysregulation/prediabetic. All of these things can be attributed to VA poisoning. I had none of these things prior to VA poison. It doesn't just go away when you stop consuming the poison. Once your liver realizes that you are no longer intoxing, it starts trying to get rid of it and that's when the fun really begins. My food choices are very limited. I have recently added in a small amount of home made milk kefir and home made yogurts (l. Reuteri and other beneficial bacteria from William davis MD book). Yes dairy has VA in it but I believe that I am far enough along in the detox to handle it and it has other benefits (bacteria and calcium). It's all an experiment. The dairy could be a mistake, but I check blood work regularly, in fact I'm going today. So that's my diet now, cultured dairy, apples (I used to skin them but now I don't), tofu, cabbage, cucumber (peeled), potatoes (peeled), navy beans. I'm not perfect though, and occasionally do have some gluten free treats. But if you eat them last, and never on empty stomach, the effect on BG is minimal.  I have also been following some of the hacks in the glucose revolution book by Jessie I (I think she goes by glucose goddess on social media) to control blood sugar. That has been working pretty good. Eating food in order (carbs last), exercise after eating (that's walking for me as i also needed a hip replacement since the poison, the joint pain was crippling).  I am going to start front loading calories. I already do TRE, usually 5-8 hour window. Just going to move the window up earlier based on reading McCoys gcm thread and other threads here.

Just a warning to you good people about beta carotene. Yes I way over did it. So I had acute toxicity. But the chronic toxicity is just as bad. It sneaks up on you. You never suspect it. All that bc adds up and the more you eat, the more you store. Are your poops orange? No probably not. That means all those sweet potatoes, carrots, and yes, spinach, are just going to your liver and slowly, ever so slowly, shutting it down. The Japanese, Okinawa, do not eat orange sweet potato. Their sweet potato is different. It's purple not orange. 

You can do your own experiment. Test your blood retinol. Quit bc/VA as much as possible (you can't go zero, impossible, it's in everything). Check your blood retinol in 3-6 months. You will be surprised by what you find. If you feel sick during this time, it's not deficiency. That's impossible in that small time frame with a fat soluble vitamin. It's toxicity. Your body is trying to get it out. It's a poison on the way in and a poison on the way out. Some people suffer immensely, some like grant, only see benefits. Everybody is different and human beings are complex. We know very little.

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As far as masterjohn goes, he is VA toxic. He is not a well man. Nutrition detective has a good analysis on him and his VA toxicity. He is so far down the rabbit hole with his pubmed science that he can't see the forest for the trees. I have followed him closely and learned some things from him, but overall he is a disaster. Never take nutrition advice from someone as sick as he is. He blames it all on genetics. So dumb. He is killing himself. I think eating a lot of liver and other organ meat was his poison of choice. I do have mad respect for him though for his COVID stance.

 

Edited by asa t
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As far as genetics. I am not a slow converter based on bcom gene. No problem there. Although I do have mthfr mutations as do most people. I have historically high hcy, but supplementing folate (400-800mcg of methyl folate) has brought it down into better range. Getting it checked again today, hoping it's down in 7-8 range. B12;did not help, only folate.

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A paper from 2019 https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/carotene-in-the-human-body-metabolic-bioactivation-pathways-from-digestion-to-tissue-distribution-and-excretion/CAE419E20C28FDACB62F41CAF91DB646

still mentiones a lot of things not well understood in carotenoid pathways.

My overall feeling from it - seems if the very complicated net of pathways will be artificially overloaded - no one can predict how it could be broken, perhaps not in a single place, maybe similar like longterm "energy posisoning" of the body causes d2

Autors mention that probably a combo of many carotenoids that exist in natural sources is also a part of rate limiting in the main pathway and shifted balance with simple component formulas can influence this harmfully.

Hm, having no better explanation I would assume it plausible, even if it will be wrong on the low levels.

Here it is described that orange juice could have the ratio significantly shifted https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7764007/

so maybe at elephant doses the things really can break the homeostasis and the mechanism will wreac havoc.

 

 

Br,

Igor

 

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Genetic variation in carotenoids absorbability - 3 times interpersonal difference (on lutein)

https://www.hal.inserm.fr/inserm-00628593/file/Borel_-_Nutrigenetic_and_carotenoids.pdf

(on scihub with pictures)

Also, absorbtion could be increased with prereleasing them from food matrix like in carrot juice

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520933/

The less studied area - passive and transporter-assisted intestinal absorption (pic at p.56)

https://ciad.repositorioinstitucional.mx/jspui/bitstream/1006/727/1/Cervantes-Paz B_DC_2016.pdf

 

Keeping all potential factors together it could be the case that some people are really at risk with big (unbalanced?) intakes of carotenoids but the complexity of the topic is not allowing to build a simple schema for individual strategy behind - "do have plenty, but be moderate".

 

I am now curious to do a beta-carotene test to see how it looks in my case, already thought of it some time ago but forgot completely. 

 

Br,

Igor

Edited by IgorF
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  • 1 month later...

Got my beta-carotene test results.

Lab reported it as 261.8 in 7.5-85 ug/dl range. A quick googling gives 270-300 as a higher norm. I assume lab that did my test used their calibrated range in the report which is based on local people who could have different nutritional habits.

I consumed no pre-formed vitamin a from food or pills for a long enough time to be sure all my needs are covered only by precursors conversion. No idea what about other precursors, their concurrency and so on, the topic is too complicated and not studied deep enough (because of lower importance for public healthcare I think). Also I have no tests for them available.

My serum retinol taken 2 months before was exactly in the middle of the lab's range - 0.5 in 0.3-0.7

My precursors intake in the last 3 months:

alpha-carotene: 3600

beta-carotene: 39200

lutein+zeaxanthin: 34000

lycopene: 11500

So with such huge amounts it seems body has its limits for them to circulate, maybe not so precisely tuned as k1 but seems regulated. No idea about tissue stores that are broken in the cases of poisoning - am I feeling it to a risky level or body drops the excess somehow.

Maybe it is a good idea to cut down all possible yellows I do have in my diet for some time but I can't imagine what to choose instead of them.

In any case, for no SNPs that breaks the things 2 years with ~90mg of precursors daily (maybe it was 60-70 in the first year), taken from fruits and vegs (almost all raw), no juices, no purees and so on, seems should not poison an ordinary person.

On the other hand, a huge intake of precursors and pills with even small dose of preformed vit a could be questionable in a long run. That is my conclusion based on n=1 case.

Br,

Igor

 

EDITED TO ADD:

sometimes, but relatively rarely I observe some carotenodermia on my palms

https://www.wikidoc.org/index.php/Carotenodermia

 

Edited by IgorF
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I would browse some data on vitamin A toxicity, there is lots in the web. Before the popularity of supplements, AFAIK toxicity was usually limited to rare cases of liver overconsumption (for example, polar explorers eating liver of white bears).

 

 

 

 

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Yes, preformed vit a seems has no reliable brakes in our metabolism, so the body pushes it to the longterm stores due to its stickiness to hydrophobic molecules (until some limit).

But it seems there are less known anecdotal cases when there could happen intoxication with very high doses of precursors which are regulated better (seems brakes are more reliable for precursors). 1200 micrograms in the circulation with hundreds of days of almost 100 milligrams of daily intake suggests - the abundance is dropped out of the body by design. The anecdotal cases have this in common - purified precursors intake as juices and/or purees. It could be the case that precursor abundance when it comes bound to fibers is helpful in the regulation. While the underlying chemistry is different the mechanics could be comparable to purified sugars - they are more harmful in the engineered foods in the same or lower amounts than in the whole food with their much more complicated texture.

Maybe the texture itself is the answer what is wrong with engineered foods, not magic molecules absense (except vitamines of course) and nutritional variability but just an unexpected form of huge part of already wellknown groups of nutrients (too simple hypothesis offcourse).

Br,

Igor

Edited by IgorF
corrected ug/dl to correspond 4 liters of blood
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An interesting old study of beta-carotene, some insight on dose-response could be picked from there and another thing - the main subject of the study is also interesting

 Beta-carotene as a photoprotective agent in erythropoietic protoporphyria
M M Mathews-Roth, M A Pathak, T B Fitzpatrick, L C Harber, E H Kass

    PMID: 5442632 DOI: 10.1056/NEJM197005282822204

(available via scihub)

 

I remember myself suffering for years from photodermatitis, many years ago I used some framework in a dermatology textbook to assess my skin type and it was in lower 40% (= more sensitive) from the perspective of sunburn risks and so on.

Last years I see almost no effect from sun exposures that did me bad in the past. Quantitatively - 2-4 times more exposure.

I attributed it to my combined vitamin status in general or b3 and d3 in particular because approach to just have a lot of b3 from supplement as described in the literature just made no difference. Now after the study posted I started to think that it could be rather beta-carotene that plays a significant role in the scheme - the same timeframe I had sunburns and photodermatitis I also experienced significantly worse twilight vision, thus I think I used to live for a long time with low vit a and its precursors status.

Br,

Igor

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