Vitamin A – Let’s Start at The Beginning
Are you taking (on average) about 10,000 iu of Vitamin A a day? If you are a practitioner, do you recommend that your clients or patients take 10,000 iu of Vitamin A a day or 75,000 iu a week? If not, in my opinion, you are doing yourself and/or your patients/clients a dis-service. Vitamin A is so basic that its like beginning with the letter A in the alphabet, or the song Do, Re Mi in the musical The Sound of Music. How basic is Vitamin A? Consider that the immune system won’t work well without it. In other words, without Vitamin A, a window of opportunity is extended to viruses, bacteria, fungi and parasites and to cancer. In my opinion, any treatment or preventative efforts for cancer or chronic or acute infections is seriously flawed unless Vitamin A is included.
The confusion about Vitamin A stems from several factors: many distinct and very different forms exist, with very different functions, very different safety profiles and different names for the same molecule. So “let’s start at the very beginning” and clear up this confusion.
Retinol, Retinal and 4 carotenoids including beta carotene are all referred to as Vitamin A. Retinol, also called retinoic acid, is the immune builder which I recommend for every adult in the doses listed above, and I would also call it the “real and natural” Vitamin A. Beta carotene is also called Vitamin A, or preVitamin A, but it is very different. Beta carotene and other carotenoids are antioxidants, which is certainly important. Retinal, also called Retinaldehyde or Vitamin A aldehyde, is critical for the chemical basis of animal vision in the retina of the eye. The diagram (1) (see PDF) shows how one is metabolized into others.
β Carotene is derived from plants and providing that your liver is working well (a big if!), is metabolized into Retinal, which allows you to have vision. Note the arrow can only go one way and Retinal cannot be reformed into β Carotene. Retinol is then synthesized from Retinal and the double arrows indicate that the conversion is reversible, although once Retinol (“real, natural Vitamin A”) is formed the reverse reaction back to Retinal is unlikely.
In order to have enough Retinol (“real Vitamin A”) around to improve your resistance to cancer and infections, you are probably going to have to supplement with “natural” Vitamin A derived from cod liver oil. These generally are very inexpensive supplements and they come in easy to consume, small gelatin capsules. Because they are fat soluble and hang around for longer periods of time, you can even take them once or twice a week as long as you average about 10,000 iu a day.
10,000 iu a day sounds like a lot, and I am often asked if that’s safe, as a lot of misleading information about fat soluble Vitamins is floating around the internet suggesting that toxicity can be related to consuming too much Vitamin A. I don’t know of any toxicity studies related to “natural, real Vitamin A” but I have not done an exhaustive literature search, and it appears to me its just the same old same old, Big Pharma, scare tactics intended to frighten consumers away from supplements, stay or get sick, and keep consuming profitable drugs.
First let’s address the issue about getting enough Retinol from β Carotene (see table below. As you can see, if β Carotene is dissolved in oil, and you have good liver function, about ½ of it might make it to Retinol. However, under normal circumstances, less than 10% is converted to Retinol, which means you would probably have to consume enough β Carotene to turn your skin color orange to make enough Retinol for optimal function.
Next let’s address the toxicity issue. In the next chart below, you can see that the Institute of Medicine of the National Academies recommends microgram (μg) daily intakes for Retinol at “adequate” levels, enough to give one average resistance to cancer and infections, which means having an average risk of getting cancer over 60 years old and getting the flu and a few colds every year or so.
The listed “upper limit” levels, AKA optimal daily intakes, are roughly the levels I recommend – because, gosh’ darn’ it, I really hate to see my patients or anyone get cancer, chronic infections like Lyme, parasites and candida, and even acute illnesses like the flu. There is an old saying that the only evil is ignorance and sometimes it rings true when it comes to Vitamin A.
3000 (μg) micrograms of Vitamin A (Retinol) is equivalent to 10,000 iu so you can see that for adults, 10,000 iu a day is at the optimal level. 5000 iu of Vitamin A a day will do it 5-12 yo, and if a child is under the age of five, about 1000 iu per year of life is recommended.
The reason we must supplement Retinol or “real natural, Vitamin A” is because – as I have often suggested in my writing – we modern folks have a diet which has greatly deviated from that which kept our ancestors alive and well for eons. When food is scarce, our ancestors didn’t throw away the organ meats – the liver, kidneys, spleens, intestines, hearts, brains etc. – but instead made all types of slimey concoctions. Once again, Weston Price was right.
Interestingly, the predators at the top of the food chain, like lions, after making a kill, prefer to eat the highly nutritious organ meats and leave the choice steak cuts to the vultures. They know where the viatmins are! Also parents, around the time that I showed up, were ill-advised to stop forcing their kids to slurp that bad-tasting cod liver oil (where Vitamin A comes from) because its benefits were supposedly a myth and generations of healers prior to that time just didn’t have good science. They did however observe the astonishing benefits of fat soluble Vitamins when given to kids, but those observations were considered to be placebo effects.
Retinol or “real, natural, Vitamin A” only comes from animal sources (that I know of), so vegetarians beware, you are probably not going to get enough from purely non-animal sources, especially if your liver is taxed with some other problem. The inexpensive Vitamin A supplements look like the typical Vitamin D3 supplements (you need 5000 iu a day of that by the way) and are purified and distilled out of the toxicity-suspect, cod liver oil. I consider Retinyl Palmitate, a common supplement in so-called mycelized A to also be toxic, and of course the pharmaceutical for acne, Retin-A or Tretinoin, to be extremely toxic. Imagine that. We allow massive deficiencies in Vitamin A to injure the immune systems of our kids and teenies, they go on to suffer from predictable skin infections like acne, then we destroy their livers in the name of clinical science with a bizzare drug analogue Retin-A or Tretinoin for their acne, and we call ourselves civilized!
Oh, it gets even worse. When Retinol arrives at the receptor of a cell, it “knocks on the door” and a G-protein “answers the door” to send the signal on the rest of the cell. The pertussis vaccine decouples G-proteins in some vulnerable kids, which means that Vitamin A fails to work, and this is one of the significant dozen or so causes of autism. Dr. Mary megson in noting that autistics are often night-blind, discovered this factor (info@Megson.com) and that autistic patients often doo much better with doses of Retinol upwards of 50,000 iu a day. To deprive autistics a trial of high dose Vitamin A is negligence in my estimation.
Finally, the diagram below is a functional medicine test of Vitamin A status, which in those who consume orange or yellow vegetables, or in those who think they are supplementing Vitamin A by taking β Carotene, generally gets a result similar to this. There’s plenty of β Carotene but little Vitamin A. I don’t order this test anymore, except ocassionally on my cancer patients or critically ill patients who can afford to shell out some extra cash for additional testing. I simply prescribe 10,000 iu of Retinol or “real natural, Vitamin A” for every single patient and if the liver, pancreas, and gastro-intestinal function and fat absorption is reasonably functional, its very rare for them to remain deficient in Retinol.
But who would believe me in a skeptical world! No article would be complete without hearing from the experts. This abstract (2) below sums it up nicely.
Abstract: In populations where Vitamin A availability from food is low, infectious diseases can precipitate Vitamin A deficiency by decreasing intake, decreasing absorption, and increasing excretion. Infectious diseases that induce the acute-phase response also impair the assessment of Vitamin A status by transiently depressing serum Retinol concentrations.
Vitamin A deficiency impairs innate immunity by impeding normal regeneration of mucosal barriers damaged by infection, and by diminishing the function of neutrophils, macrophages, and natural killer cells. Vitamin A is also required for adaptive immunity and plays a role in the development of T both-helper (Th) cells and B-cells. In particular, Vitamin A deficiency diminishes antibody-mediated responses directed by Th2 cells, although some aspects of Th1-mediated immunity are also diminished. These changes in mucosal epithelial regeneration and immune function presumably account for the increased mortality seen in Vitamin A–deficient infants, young children, and pregnant women in many areas of the world today.
Like Vitamin D, a rediscovered, endemically-deficient Vitamin, Vitamin A will soon be found to be critical for immunity by main-stream medicine, and I predict that all clinicians will soon be testing for it and prescribing it. Heck, it may even get popular enough someday to catch the interest of Big Pharma who will want to get into the action. Given the incidence of more-recently recognized chronic infections (e.g., Lyme, candida), of the old killers (HIV, TB), autoimmune disorders, cancer and childhood spectrum disorders (especially autism), everyone should be supplementing with Vitamin A.
A PDF copy of this article with graphics is available here:
1- Lord and Bralley, Laboratory Evaluations for Integrative and Functional Medicine, Figure 2.1, p. 22.
2- Charles B Stephensen (2001) VITAMIN A, INFECTION, AND IMMUNE FUNCTION, Annual Review of Nutrition, Vol. 21: 167-192 (Volume publication date July 2001), USDA Western Human Nutrition Research Center at UC Davis, and Nutrition Department, University of California, Davis, California.