Vitamin A toxicity (also called Hypervitaminosis A) might be one of the reasons eating "too healthily" might actually make you sick.
Do any of these signs and symptoms of vitamin A toxicity sound familiar to you?
- 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
- headache
- irritability
- rash
- weight gain and obesity [11]
What is Vitamin A?
Vitamin A is considered by nutrition science as one of the fat-soluble vitamins along with vitamin D (actually a hormone), vitamin E, and vitamin K. Excess fat soluble vitamins like vitamin A are shuttled to tissue for storage, whereas excess water-soluble vitamins get excreted in urine.
Vitamin A is known for its role in a healthy immune system, eye health, reproduction, hormone production, as well as growth and development. Some amount of vitamin A is found in almost all foods, but the most abundant sources are usually easy to identify by their bright colors (usually red, orange and green from vitamin A carotenoids). "Eating the rainbow" has been said to be an easy way to get not only optimal nutrition, but to make sure you get an abundance of vitamin A in your diet.
Vitamin A is found in plant foods in the form of proform A carotenoids and also found in animal products (retinol - preform version). The plant version of vitamin A carotenoids requires conversion in your body to become useable vitamin A, a process that's efficiency has a genetic component, i.e. the conversion rate varies per person based on gene expression like BCMO1 (rs11645428). Animal sources like liver and egg yolks do not require conversion for use.
How Vitamin A Toxicity Can Occur
It's not unlikely for a client to say to me, "I eat healthier than everyone I know, but I'm also the sickest." I'm now suspicious that vitamin A toxicity or excess may be a part of the problem.
Here's why:
Vitamin A has been long touted as a nutritional superstar, although its found in almost all foods but most abundantly in a whole foods diet. By policy, it was added to low-fat milk products in 1970's. It's also found in multivitamins, supplements (cod liver oil is a big one here), skin creams (especially anti-aging creams), sunscreen, pharmaceutical drugs for acne (like Accutane, Isotretinoin and Tretinoin), and increases in the body if you're on the birth control pill. [2] Depending on your health history of the above, vitamin A toxicity or excess may impact you, perhaps at much lower dosage levels than reported in scientific literature.
Vitamin A in Common Health Foods
I know what some of you are thinking, "but vitamin A is important for hormonal balance, thyroid health, and fertility." But let me show you how easy it can be to get too much, especially considering once "seasonal foods" are often now available year-round. Here's an example of some commonly eaten "health foods" that are high in vitamin A (retinol):
- Liver 338% DV in 100grams
- 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
- Fortified cereal — up to 60% in 1 cup
Then we have proform vitamin A called (beta carotene) that is not hard to find in plants. Examples include:
- Sweet potatoes 769% DV in 1 cup
- Carrot 44% DV in 1 medium
- Kale 206% DV in 1 cup, chopped
Do you see how one could easily get the daily value of vitamin A through eggs, a few tablespoons of butter, and a carrot or two?
Then layer on a multivitamin and possibly other supplementation containing vitamin A (like cod liver oil) that doubles or triples what they are already getting from food? Then they also might have a history of using the birth control pill (which increases vitamin A), use of vitamin A containing prescription drugs, sunscreens with added vitamin A and beauty creams (like tretinoin cream in 'skin cycling' routines) that puts their intake way over the top.
To stack the deck even further are organ meat supplements. Organ meats are wildly growing in popularity these days as a great way to get real food nutrition with liver specifically is one of the richest sources of vitamin A available.
Getting Too Much
If you're following along with me here, you can see the probability for someone aggressively seeking "health" to accidentally overdose on vitamin A is actually quite likely if supplements are involved. It quickly becomes a game of getting too much (not too little), a problem that can lead to liver damage.
Hypervitaminosis A, or vitamin A toxicity is well documented in the literature, but science claims this only happens through long-term use of dosages significantly beyond the Tolerable Upper Intake Level of 10,000 IU of vitamin per day for adults. Common examples given for documented toxicity are usually well over 40,000 IU of vitamin A per day.
According to a 2006 study:
"The acute and chronic effects of vitamin A toxicity are well documented in the literature. Emerging evidence suggests that subtoxicity without clinical signs of toxicity may be a growing concern, because intake from preformed sources of vitamin A often exceeds the recommended dietary allowances (RDA) for adults, especially in developed countries. Osteoporosis and hip fracture are associated with preformed vitamin A intakes that are only twice the current RDA."
The Livertox database which covers clinical and research information on drug-induced liver injury confirms similar findings, "Vitamin A in high doses is a direct toxin. Excess vitamin A is stored in stellate cells in the liver and accumulation can lead to their activation and hypertrophy, excess collagen production, fibrosis and liver injury. The toxicity is dose related and can be reproduced in animal models." [10]
A 2018 study that looked at cadaver liver samples (liver biopsy is the gold standard of assessing vitamin A toxicity, but it is too expensive and invasive to be used on the living) found that 33% (9 out of 27 liver samples) had hypervitaminotic concentrations of vitamin A. Only 22% of samples (6 out of 27) were found to be vitamin A deficient, supporting the premise that vitamin A toxicity is more prevalent than deficiency.
Certain groups of people should be extra cautious about getting too much vitamin A, especially in supplement form. Vitamin A should especially be cautioned around pregnancy as excessive amounts of vitamin A are linked to birth defects and malformations. [7,8] In those with Gilberts syndrome, a genetic condition that increases bilirubin levels in the blood, vitamin A may slow the UGT enzyme further reducing the clearance of bilirubin. Even kids may be getting too much vitamin A, especially those who take supplements. [9]
Theory - Vitamin A : A toxin not a Vitamin?
There is a very interesting theory circling the internet that vitamin A and it's precursor, carotenoids, may not be a vitamin after all, but instead a toxin that is harmless at low levels but has a tipping point when it's storage in the liver is exhausted.The theory originates from Grant Genereux, who contends that vitamin A toxicity happens at far, far lower levels than documented in the literature and is a cause of body-wide poisoning and perhaps the real cause of autoimmune disease. You see, 90% of vitamin A is stored in your liver, and released into the bloodstream on a as-needed basis. But what happens when your liver's storage capacity is full? The theory assumes that when the liver is already overwhelmed by vitamin A, it accumulates in tissues and fat storage leading to systematic inflammation, most specifically noted in changes to the skin, bones, and vision.
According to Genereux, "If your average daily intake is more than your body’s daily usage, then it’s more or less inevitable. If you indulge just a little bit too much on milk, dairy, eggs, certain fish, etc. or any of the vitamin A precursors, then this will happen much sooner. If you supplement with cod liver oil, or a vitamin A supplement, or any vitamin A derivative; it will be much sooner. It could be in your twenties or teens or even at birth! It also depends very significantly on what fats you consume that vitamin A with."
Genereux also comments that "It simply boils down to the fact that we are all being very slowly potentially poisoned. If you’ve been living in North America for fifteen or more years, this definitely includes you. "
The verdict is still out on this theory, and the prevalence of vitamin A toxicity and subtoxicity is widely unknown. However, it's never a bad idea to check in on your own intake.
How to reverse vitamin A toxicity
If you suspect you've taken too much vitamin A through synthetic supplementation, there are a few things you can do right away.
First, take a look at all your multivitamins, supplements, lotions, prescription drug history, and beauty products to assess your intake. If there is excess, especially in supplemental form, consider eliminating it. Then take stock of your diet. If necessary, consider decreasing your intake of high vitamin A food for a period of time, like liver and loads of dairy, to give your body a vitamin A detox of sorts.
A vitamin A detox diet might be temporarily helpful to bring storage levels of vitamin A down (read more about the diet specifics here). In the simplest form, such a diet would consist of animal proteins, along with organic grains, as well as white fruits and vegetables (think white rice, white potatoes, cauliflower, parsnips, peeled apples, bananas, pears, etc.).
Depending on the severity of the toxicity more drastic dietary measures or interventions might be necessary, so always talk to your doctor. A simple blood lab for Vitamin A (available to US clients only) can give some insight into severity of the issue. Experimenting with your diet may also be convenient and insightful.
Bottom line: Don't overdo vitamin A from food sources, reconsider vitamin A supplements, and invest in vitamin A blood lab testing if you suspect toxicity.
Do you have a history of vitamin A toxicity? Please share in the comments!
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References:
- https://ggenereux.blog/wp-content/uploads/2016/10/extinguishing-the-fires-of-hell2.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1632878/
- https://www.healthline.com/nutrition/foods-high-in-vitamin-a#section2
- https://www.ncbi.nlm.nih.gov/pubmed/16469975
- https://nutritionrestored.com
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6692705/
- https://www.sciencedirect.com/science/article/abs/pii/S0890623897001020
- https://www.greenmedinfo.com/blog/why-birth-defect-linked-vitamin-used-prenatals
- https://www.ewg.org/research/how-much-is-too-much
- https://www.ncbi.nlm.nih.gov/books/NBK548165/
- https://www.mdpi.com/2072-6643/14/3/610
- https://www.health.harvard.edu/newsletter_article/vitamin-a-and-your-bones
Also published on Medium.
Beatriz
I think that you only get toxicity from retinol , not beta-carotene , am I wrong?
Catherine
Great question.
Retinol is the bigger problem leading to toxicity, but I have not found *good enough* research yet on the impact of carotenoids IF the liver is already "full" of Vitamin A and subtoxicity/toxicity are already present.
According to the Linus Pauling Institute, "Although β-carotene can be converted to vitamin A, the conversion of β-carotene to vitamin A decreases when body stores of vitamin A are high. This may explain why high doses of β-carotene have never been found to cause vitamin A toxicity."
Genereux's research (although still a theory) assumes toxicity from carotenoids + retinol.
Abundantly,
Catherine
Beatriz
Thank you so much for your answer. My body doesn't "tolerate" very well beta-carotene as I get orange palms.Sometimes I use a vitamin a (retinol) supplement in a low dose but I think that I will no buy it again!
Lee
Don’t not do something because one person says not to, may I humbly suggest you do your own research and see what you need. Many people find support with supplementing retinol from codliver oil and our ancestral diet had us eating organ meats high in vitamin A much more than we do now. The article suggests liver congestion as a possible culprit to why some people are showing signs of toxicity and so with our highly polluted world, the real solution may lie in supporting the liver. Point is, this article poses a question about possible risks, and is an opinion expressed here more than scientific proof. In a world where there is an over-abundance of information, it’s important to read between the lines. Wishing good health to all -
SuziQ
I personally have Gilbert's syndrome and had non alcoholic fatty liver disease. My husband juiced carrots kale and green apple daily for us. My sun started to turn really yellow then orange. I thought this was the high bilirubin. After a couple of years the fatty liver reversed itself due to the healthy eating but my husband raised the beta carotene was causing my skin to be orange so he cut way back. My skin has all but returned to its normal coloring. It is probably due to the fact that I was eating so healthy and overdoing with the juice that my liver had too much A and was indeed stirring it in my skin tissue. Interesting phenomenon. Thank you for the research that proves it.
Christina
Low thyroid function can cause the decreased conversion of beta carotene and the colored skin that goes with it. Maybe worth looking into.
Crystal
I've seen that myself a few times after eating carrot salad, Christina. My palms will turn yellow if I eat carrot salad every day for too long. And I have hypothyroidism and am on Armour Thyroid 90 mg a day.
Hamp
12 carotenoid s yield 1 retinol from orange red yellow veg. Green plants is even lower, tack on general pop low enzyme Load, toxicity and you are no where near in danger...
Also most research was done in 1995 using synthetic beta carotene in pregnancy also in smokers with cancer...
Barbara L Dyjak
" Such a diet would consist of animal proteins with the exception of pork (beef, chicken, turkey, white fish)" What does that leave?
Isn't there a test for vitamin A toxicity?
Catherine
Hi Barbara,
I've updated the post to clarify, "Such a diet would consist of animal proteins with the exception of pork and salmon (beef, chicken, turkey, white fish are typically low in vitamin A, so they are okay)"
I will be writing more on this very soon.
Abundantly,
Catherine
Aimee
Is pork high in vitamin A or do you have another reason to avoid it? It is my best tolerated meat.
Arti
Is there a way to be tested for not only vitamin A levels, but all of them (vitamins, minerals, fats, etc.), to ensure that my body is getting what it needs & not just guessing what it needs? I know there is the hair analysis test, but doesn't that just test mineral levels? Also, I read that hair can be tested, but urine testing in conjunction with that is best. Not sure how accurate that is. There are so many options out there, but it's hard to figure out just which one(s) is right for me. I take so many supplements it seems, but I want to figure what I actually need. I'm just not sure how to go about that. Thanks any help on this!
Missy70
Yes there is a special blood test offered by SpectraCell Laboratories that will give you your cellular levels for all the major nutrients. My Dr. tested me a couple of years ago and it was super useful to adjust my supplementation. I have the genetic mutation that doesn’t convert beta carotene to vitamin A, and my results said my cellular levels of vitamin A were borderline low. I have bad night vision and dry skin so it made sense.
Peter
What is a good source of Omega 3 that does not contain vitamin A?
Christina
Many of the toxicity symptoms overlap with deficiency symptoms. Do your own research and don't jump to conclusions based on blog articles that you are toxic in a very important vitamin. I am also not convinced that beta carotene will cause the same toxicity as retinol. The foods listed above lumped both beta carotene and retinol into the same bucket (liver is high in retinol, but sweet potatoes are high in beta carotene, not retinol). The 40,000 IU toxicity levels specified in the article (I've seen most point to toxicity at 100,000 IU of retinol per day), as well as the studies referenced, are referring to retinol. The foods listed above total less than 3,000 IU of retinol per day - if they were all eaten in the same day. It is, therefore, my opinion that the only way to become toxic in vitamin A is to be taking large doses of synthetic vitamin A (retinol). Again, to the other readers - do your own research and think critically.
Barbara
This is very hard to believe but you will be smart to let the ideas marinate in your mind. You're wrong and I swear to all that is wise and holy. Re-think everything you thought you knew about nutrition and health. Vitamin A never was a vitamin to begin with. Deficiency symptoms are toxicity symptoms. Read Grant Genereux's books. Read Matt Stones blog posts on Vitamin A at 180degreehealth, follow Dr Garrett Smith on facebook and nutritionrestored. Vitamin A receptors were never unique to just vitamin A to begin with. Different substances can act as ligands for V. A. receptors. Sometimes poisonness substances can be healthy imposters.
Kari
I find it very interesting that the low vitamin a diet is almost the same as the low salicylate diet. Many people find relief from rashes, asthma, tinnitus, and other problems by going on a low salicylate diet. My own kids have to watch their intake of salicylates or they get adhd symptoms. This is based on the work of Dr. Ben Feingold from the 1970s. He found his patients had relief from allergies and even behavior issues by going low salicylate. I personally feel that some pf the amazing results people are noticing is because they are removing most salicylates. I do agree that vitamin a toxicity is a thing...especially when there is a zinc or copper deficiency.
Barbara
This is very hard to believe but you will be smart to let the ideas marinate in your mind. You're wrong and I swear to all that is wise and holy. Re-think everything you thought you knew about nutrition and health. Vitamin A never was a vitamin to begin with. Deficiency symptoms are toxicity symptoms. Read Grant Genereux's books. Read Matt Stones blog posts on Vitamin A at 180degreehealth, follow Dr Garrett Smith on facebook and nutritionrestored. Vitamin A receptors were never unique to just vitamin A to begin with. Different substances can act as ligands for V. A. receptors. Sometimes poisonness substances can be healthy imposters.
Jami Taylor
I have some of these signs but I am currently breastfeeding. I can try to make the dietary changes to see if it helps but what is your recommendation on cutting my prenatal vitamins?
Carotenoides
This is very important! Very common
cedric
http://orthomolecular.org/library/jom/2003/pdf/2003-v18n0304-p131.pdf
" Klenner himself took at least 75,000 IU daily for 15 years with no toxicity."
susan
Thanks for this post, very enlightening.
Pete
I think that from supplements of vit. A or any other supplements its very easy to get hig dosages and toxicity. But to get to the point of hypervitaminosis - some toxic dosages of a vitamins or minerals from food its not that easy. Our body knows how to deal with high dosages of some kind of vitmains and minerals. But anyway the best way is to eat many various combinations of foods and nothing in high quantities.
Jeff
I've read from good sources that Vit A is never toxic if balanced by the other fat soluble vitamins...ratios are important. A/D/E/K should all be raised together...as would likely be the case if getting these nutrients from natural sources.
David Hagersten
Hi Jeff!
Please share your good sources.
-Why else bring it up?
Here is a good source. A 2016 report by Charles M. Benbrook (1949-) "Trends in glyphosate herbicide use in the United States and globally".
doi: 10.1186/s12302-016-0070-0
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044953/
Please check table 2 for the accumulated use of glyphosate. Here is a quote from the article showing the crazy amounts of glyphosate that are now used.
"Two-thirds of the total volume of glyphosate applied in the U.S. from 1974 to 2014 has been sprayed in just the last 10 years. The corresponding share globally is 72 %."
suzanne
Oh yes! A few months before Covid I started noticing my thumb would tremor when trying to read a book or turn the pages. Thought it was because of aging. Then I would feel kind of "jumpy" inside. Then dry heaves especially in the morning. Would feel extreme nausea off and on during day. Asked my functional medical doc, my primary care doc, a sport medicine doc specializing in heart disease, and a well-known nationally holistic doc. They couldn't explain it. I was getting worried. I knew from the past if I took too much magnesium I would feel nauseated. I take alot of supplements and was afraid to stop as I felt it was helping my immune system prevent getting Covid. Getting Covid had us all scared thanks to our misguided gov't. My holistic doc looked at my supps and asked why I took so many. We went down the list and I gave a good answer for each (eye, bone, Vit. D, C, dessicated liver pill.......). He gave me a high dosage of Vit. A. Can't remember why. I finally found something online saying too much Vit. A could cause some of these symptoms. Even Vit. C can cause nausea, etc. if one takes too much. It is really important to do your own research and even then it can have deleterious results. I started to think about my liver pills. I was taking the full dosage which equalled a small piece of liver if one ate cooked liver. It finally dawned on me that why in the heck would I take a full dosage. I weighed 130 lbs, 5'2". Why would the dosage be the same for me as a 200 lb person?? Supplement bottles never point this out! So, I stopped the A and guess what, my symptoms stopped! I was elated! We had been on a RV trip and I felt so nauseated I insisted we go to an Urgent Care to get something for the nausea. They gave me an anti-nausea tiny pill one puts under their tongue. It worked well. They gave me extra to take if I needed them. We had to turn around and go back home because we were so scared that I had something awful.
I am fine now. Much more cautious about my supps. I didn't realize cod liver oil had so much A and I did start that a few months ago for the Omega 3 benefits (along with my Krill Oil and Astaxanthin) so I better watch the amount. I take only one liver pill or Organ pill a day now instead of 4 to 6. I do have my blood tested once to twice a yr. to watch some important markers for me (I have LPa - lipoprotein little 'a' and take niacin to keep it down but 20% of our population carries this gene and it puts one at a much higher risk for HD). The niacin does bring it down, but its still not the complete answer. Everyone should get their blood tested for LPa. Its not expensive. Docs will say why bother u can't do anything about it, but thats not exactly true. More docs are becoming aware of LPa. One can watch their health markers for other risks for HD and they are developing a new drug to lower it.
Anyway, taking reputable supplements and listening to doctors - whether standard or holistic isn't always the answer. They don't know everything. You have to be your own advocate!!! Do your own research from several sources - online or books, etc.
I wish I had read this article years ago. Barbara writes below that 'defiency symptoms are toxic symptoms'. We need to remember that. Less reliance on supps and more on eating the right organic foods if one can. I never took many supps until I hit my late 60's and now I am 72. I am continually reading about health and nutrition. I also skip most supps on the weekends (I once heard Mercola say he does the same). I just found a new service that tests one's blood markers more informatively than the standard ones. One can read more at functionhealth.com about it. Its new from Dr. Mark Hyman.