Vitamin A Toxicity...?

Recently, I have been seeing opinion articles and practitioners on social media touting that all Vitamin A (which is a fat soluble vitamin) is toxic, needs to be avoided at all costs and even "detoxed" from the body, including food and even vegetable sources of A. This information may be confusing, especially to the chronically ill, who are often desperate in their search for answers.

It is my opinion that this is a very dramatic stance on a nutrient that I consider to be a requirement to life and health. Taking an "all or nothing" stance seems to be quite popular these days, as the art of moderation and common sense is all but lost.

One article on Butter Nutrition is getting a lot of attention for putting this Vitamin A issue in the spotlight. Link here. I have many issues with this article, and my rebuttal comments were deleted from the comments section on the site. Therefore, I will review that information here.

Vitamin A Toxicity Symptoms

The symptoms of Vitamin A toxicity listed in this article widely overlap with the symptoms for Vitamin A deficiency, Vitamin D deficiency, as well as many other nutrient deficiencies, but that information is not given to the reader. The deficiency symptoms listed on the blog article include (emphasis added):

blurry vision or other vision changes*
osteoporosis**
swelling of the bones**
bone pain**
poor appetite
dizziness
nausea and vomiting
sensitivity to sunlight
dry, rough skin*
itchy or peeling skin*
cracked fingernails*
skin cracks at the corners of your mouth*
mouth ulcers*
yellowed skin (jaundice)**
hair loss**
respiratory infection*
confusion
kidney damage

*Also Vitamin A deficiency symptoms (source)

**Also Vitamin D deficiency symptoms (many of which may overlap with Vitamin D toxicity symptoms) (source) (source)

Poor appetite, dizziness, nausea and vomiting, confusion and kidney damage are typical signs of any sort of toxicity, but they are also symptoms that can be common in chronic illness for a wide variety of reasons, and based on individual factors. Sensitivity to sunlight can be caused by other nutrient deficiencies, including several B vitamins. (source)

Vitamin A deficiency can also cause anemia, fatigue, diarrhea, bladder or vaginal infections, and poor or delayed wound healing. (source)

Since Vitamin A and D are both fat-soluble vitamins, they may accumulate in the body more readily when compared to water-soluble vitamins. Fat soluble vitamins may "compete" with each other if they are not in balance. Vitamin A and D show a need to be in balance and have a synergy with each other when they are in correct proportion. Therefore, many Vitamin A toxicity symptoms listed are actually Vitamin D deficiency symptoms.

Studies have also shown that Vitamin D protects against Vitamin A toxicity, again, likely due to the balance needed between vitamins. Read more here: Weston A. Price on Vitamin A Toxicity.

Since the Vitamin A toxicity symptoms listed above from the Butter Nutrition article can be due to many factors beyond just Vitamin A, one should not self-diagnose with Vitamin A toxicity simply based on this list of symptoms.

Vitamin A Toxic Levels

The Butter Nutrition article also goes on to explain that many foods are high in Vitamin A, and uses this information to prove their point that many may be getting toxic levels of Vitamin A. They cite the following levels of Vitamin A in foods (emphasis added):

Liver 338% DV in 100grams~
Sweet potatoes 769% DV in 1 cup~~
Carrot 44% DV in 1 medium~~
Kale 206% DV in 1 cup, chopped~~
Salmon 25% DV in 100grams~
Butter 11% DV in 1 tablespoon~
Cheddar Cheese 12% in 2 ounces~
Eggs 24% DV in 3 hard-boiled eggs~

One thing that should strongly be taken into consideration when discussing Vitamin A toxicity is the type of Vitamin A. These food sources listed above do not distinguish between Preformed Vitamin A (such as Retinol) and Provitamin A (such as Beta-Carotene, which is actually a precursor to "true" Vitamin A). Preformed Vitamin A comes from animal sources, and Provitamin sources come from plants and need to be converted in the body to form Retinol. Based on how slowly this conversion happens, Beta-Carotene is considered safe even at mega doses (source). Again, this is why the sources of Vitamin A should be distinguished between types.

The RDA (Recommended Daily Allowance) for Vitamin A is 900mcg for males ages 19-50 and 700mcg for females of the same age. This requirement goes up for pregnant or lactating women. Most Vitamin A supplement doses are listed in terms of IU's. 1 IU of vitamin A is the equivalent of 0.3mcg of retinol, or 0.05mcg of Beta-Carotene. (source) (source)

The above food sources from Butter Nutrition's article total the following, per serving:

~Preformed A / Animal Sources: 24,048 IU (1,873IU without liver), or ~7,200mcg (only 632mcg without liver)

~~Provitamin A / Plant Sources: 43,940 IU (~2,197 mcg)

Since most people do not eat a serving of liver (3 oz) daily, all of the other foods listed add up to 2,829mcg...IF they were all eaten daily.

Yes, 2,829mcg is above the RDA listed of 700-900mcg. However, toxic levels associated with Vitamin A are currently established at 25,000IU per kg of body weight for an acute toxic dose (meaning taken within a short period of time). With an average adult weighing in at 160lb or 72kg, this would mean a dose of 1,800,000IU would be a toxic dose.

The chronic toxic dose (taken every day over 6-15 months) is 4,000 IU per kg of body weight, or 288,000IU daily for an average-sized adult. The above food sources total only 64,988IU, or 45,813IU without liver. (source)

And, since Beta-Carotene sources have not been shown to be converted quickly enough to exhibit toxicity, if we consider only the Preformed / Retinol food sources, those totals again are only 24,048 IU with liver daily, or 1,873 IU without liver. That is a far cry from the chronic toxic levels of 288,000 IU daily as listed above. (source)

If we are talking about supplementation with Retinol (or Medications such as Accutane), then, yes, one would need to watch their intake. This is the major reason why I prefer food sources of nutrients over isolated, synthetic, and supplemental sources. I personally wouldn't even supplement with doses anywhere close to the toxicity levels determined, as I like to be conservative. Again, moderation and common sense is key. And, as always, please consult with a trusted and experienced health practitioner when working with isolated nutrients, particularly fat-soluble ones.

It is my opinion that many may actually not be getting enough Retinol via food sources. In today's environment (high-stress and toxic), the body's requirement of nutrients may be much higher than the RDA levels.

Genetic variants and thyroid status may also cause some to have issues with efficiently converting Beta-Carotene into Retinol.

The BCMO1 gene helps to control this conversion, and many Caucasians seem to have mutations in this gene SNP. These individuals may, therefore, require more Retinol via food or supplemental sources than others. (source)

Hypothyroid patients may also have issues converting Beta-Carotene into Retinol. They may exhibit yellow to orange tinted skin for this reason. (source) (source)

Nothing in the body exists in a vacuum, and there are many, many factors when considering individual nutrient needs.

Vitamin A Benefits

Ok, so, why do we need Vitamin A? Why would avoiding Vitamin A and trying to rid it from the body, as some are pushing, be a potentially terrible idea? Here are just a few of the roles that Vitamin A may play in the body:

Vitamin A has been found to increase cell tolerance and differentiation. What this means is that Vitamin A status may be a key factor in autoimmune diseases. (source)

Vitamin A is also required for mitochondrial energy production. (source)

It is needed in the mucous membranes in the intestines, which are crucial to fighting infection and warding off disease. Vitamin A is also needed vision and eye health. (source)

It is needed for normal growth, development, and for thyroid health. (source)

Vitamin A may help utilize iron in those with iron-deficiency anemia. (source)

It may help decrease the risk of some types of cancers. (source)

Vitamin A may be beneficial in those diagnosed with autism. (source)

Vitamin A depletion can result in increased sympathetic nervous system activity. (source)

Testing for Vitamin A

Testing may be inaccurate, or difficult to determine body stores, as the current testing method is via blood and Vitamin A is stored in fat. However, if you do decide to test, be sure to choose the Retinol test, not Beta-Carotene.

Also, be sure to fast for at least 12 hours and do not take food or supplements containing vitamin A for at least 48 hours leading up to the test. More: https://www.lifeextension.com/Vitamins-Supplements/itemLC017509/Vitamin-A-Blood-Test