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Andrew's Progress Log

#1 · July 15, 2023, 5:40 am

Quote from Andrew W on July 15, 2023, 5:40 am
Hello everyone,

First of all, I want to say a huge *Thank You* to @ggenereux2014 for all of his work, and for inviting me to join the forum.

I am starting this progress log to add to the data pool, and possibly get some advice along the way. I will try to give as complete a view of my health history as possible, whilst also keeping the word count down as best as I can. I have added a picture chart providing a "timeline" of my dietary history and health issues, but will use the body of text below to elaborate a bit.

I am a 32 year old male (nearly 33) - White (if that matters) - 6 ft 1 | 175lbs | "in-shape" for most of my life

Age 0-19 - Standard Western Diet (I was breast-fed as a baby). My diet contained: meat, vegetables (lots of carrots and broccoli), orange juice, eggs, dairy, lots of grains and cereals (breakfast cereals and muesli), bread and sandwiches, potatoes, lots of sweets and junk food - probably a strong dose of vA. I was always a very slim kid, quite athletic, I swam competitively through most of my childhood and teenage years.

As a kid, I didn't really have any major symptoms - but I always had puffy eyes / dark circles as a teenager. I also had mild insomnia as a teen, which I attributed to the overly intense swimming training schedule.

I didn't eat liver through MOST of my childhood. However, between the ages of 17 and 19, I was regularly given pork liver pate at my grandparents house after cutting their grass: cheese and ham on a nice fresh loaf, with brussels pate. I probably ate a "healthy" portion at least once a fortnight, if not once per week. Lo and behold, my first "autoimmune" symptoms began around this time, specifically Obsessive Compulsive Disorder and Vitiligo.

Age 20-22 - At university, I was very poor. I didn't have much money for food, and my diet contained: cereal grains and milk, cheese and ham sandwiches, lots and lots of pasta and tomato sauce, some low quality meats (e.g. pork sausages). I instinctively knew that my diet was lacking in nutrition, so it was around this time that I started taking a multi-vitamin every single day - I cannot remember the dose of vA, but I am certain that it did contain a "healthy" (unhealthy) dose - vA, Bs, vC, vD3, minerals...

It was around this time that my OCD and Vitiligo progression were OUT OF CONTROL. The OCD rituals probably took up around 4 hours out of my day, possibly more - it was pure hell. And my vitiligo progression was so fast too - what had begun as a couple of dots, quickly spread to ZERO pigment on my hands, feet, inside of my fore-arms etc. etc. Anxiety was also through the roof. It was a wonder I was able to keep up with my studies (maths w. economics).

Age 23-24 - After university, I went back home to live with my parents, as I had gotten my first job and was saving some money. I returned to my old diet pre-university. Nothing improved symptom-wise. I cannot remember if I had dropped my multivitamin at this point or not... I certainly stopped soon after though. It was around this age that I first noticed some mild gynecomastia - it occurred in both sides of the chest, but was extremely sensitive and tender on the right side for a few months. This REALLY bothered me. Whilst the lumps were (still are) only about the size of a grape, it is not how a male chest should be, especially not a young, fit, athletic 23 year old. (I now attribute this to undiagnosed "autoimmunity" in the thyroid and liver dysfunction leading to undesirable hormonal changes and inflammation in the tissues -> elevated estrogen).

Age 25-28 - Went "paleo". Amazingly, my OCD symptoms cleared up quite a bit upon quitting grain consumption. I got quite lean ("six-pack" look) at this time. I generally felt a bit better, but was still eating a lot of broccoli, carrots, eggs, some dairy. I was also eating chicken livers w. onions for a spell - whilst I had "cleaned up" my diet, I was still quite high in vA.

My "autoimmune" conditions continued to get worse though, and I began to suffer some new symptoms (which I thought were unrelated at the time). I attributed this to "leaky gut" and figured I needed to go even further into an "auto-immune" / gut-health protocol. My symptoms included all of the above, but now also: digestive problems (white tongue, some constipation), vein and circulation problems (spider veins appearing on feet, knees and ribs. Minor varicose veins beginning on legs), some sexual issues (slight premature ejaculation), my hair fall accelerated, and the sides of my hair were experiencing greys coming through.

Age 28-30/31 - In trying to re-gain my health, I probably did the worst thing I possibly could - I went on the "carnivore diet" - i.e. meat only, and included liver regularly to ensure I got the required "nutrients". I ate goose liver, calves liver, chicken liver, lambs liver, you name it - about half a pound of liver once per week / once per month (I varied it over time).

During this time, I got very lean and stayed relatively muscular, but none of my health problems improved. In fact, they all continued to get worse. No new symptoms really, just a worsening of what I already had. Although, my lips became INCREDIBLY dry and cracked (with a dry mouth) during this time which was not something I had really noticed before except fleetingly - I needed to use lip balm every single day, multiple times (I still have to do this to this day). I also developed SEVERE sexual function issues at this times, specifically premature ejaculation... sorry to be crass, but I had gone from a guy who could go for an hour in my early 20s, to a guy who couldn't last 10 seconds in my late 20s ... I still have this problem to this day. I believe the cause is an inability to relax the pelvic floor -> caused by excess calcium / not enough potassium and magnesium in the muscle tissue (creating tightness) -> caused by stressed metabolism / low thyroid function -> caused by "autoimmunity" in the thyroid -> caused by vA?

I also noticed that I was thinning on my crown after a haircut left my hair shorter than usual - this was a huge shock to me, and prompted me to change my diet again.

Age 31-32/33 - I had to admit that carnivore was not working for me. After some searching, I found Ray Peat's teachings, and Danny Roddy's videos on hair loss. I decided to give it a shot. My diet included: meat, dairy, eggs, orange juice, potatoes, rice, cola, sweets, and still continuing with semi-regular liver consumption as per Ray's advice.

Zero symptoms improved. I had a blood test taken in Jan 2023 - Thyroglobulin and TPO antibodies were THROUGH THE ROOF, and probably had been for YEARS. TSH was also elevated - I began using thyroid hormone supplementation in Feb/March 2023 after much deliberation. After 3-4 months of this, still no improvements to any symptoms. Zero. In-fact, things started to get much worse in recent weeks - varicose veins, and now a sub-clinical varicocele that is causing some chronic discomfort, and has me VERY worried. Epididymal cyst occurred spontaneously on the right side (could be coincidence).

Now, a side-note: I have NEVER believed the mainstream view of autoimmunity. I just don't buy that the immune system randomly decides to attack the body. But I also found Ray's theory to be very lacking - his theory of autoimmunity in the thyroid (to my understanding) was basically that:

(1) The thyroid function is low / sluggish
(2) The pituitary then increases TSH to try to kick-start the sluggish thyroid, which is in itself an inflammatory hormone.
(3) other stress hormones and estrogen rise as a result of the stressed metabolism too, which are also inflammatory.
(4) The thyroid antibodies then appear as a RESPONSE to the inflammation from above processes, not the cause of it.

I never quite bought into this theory either ... something wasn't adding up. Why was the thyroid function low / sluggish in the first place? In Ray's view, the low thyroid function PRECEDES the autoimmunity. But it made much more sense to me that the autoimmunity and corresponding inflammation in the area would be the things to precede (or cause) the poorly functioning thyroid, NOT the other way around......... "what came first, the chicken or the egg?". I couldn't quite square this in my own mind...

Additionally, Ray's explanation might explain "autoimmunity" in the thyroid, but what about my vitiligo (or any other autoimmune condition)? Was the vitiligo occurring randomly due to high stress hormones and high estrogen? It's onset certainly did coincide with a stressful time for me... but why is it not reversible upon supplementing thyroid hormone and removing stressors?

I then found Grant Genereux's information from the RP forum on the off-chance c. June 2023, and decided to read through his books ... and here I am. I found the theory and supporting evidence very convincing. I am a little skeptical that any of this will work for me (I am desperate to get well, but don't want to get my hopes up in the same way that I have done in the past), but am eager to give things a go. I don't anticipate I will have any trouble sticking to the diet - compared to the carnivore diet (which I did for c. 2 years), there is actually quite a lot of variety.

Current Diet, as of July 1 2023 (just two weeks ago) : Beef, Chicken, White Rice, Potatoes, Beans, Apples, Bananas, Some Honey / Sugar

It has been only two weeks. I am not noticing any improvement in symptoms yet except for ONE thing: I have noticed a drastic reduction in hair fall on the comb in the morning and evening in just the last 4-5 days. Could be a complete coincidence, but I will continue to monitor this. I am fully aware that it may take 5 years + to see any benefit (and that a benefit is not guaranteed), but I am confident that I can meet nutritional needs whilst staying very low vA and stick to the plan long term. So this is what I will do.

--------

It could well be true that vA is the cause of many / all of my autoimmune conditions and symptoms. And I firmly believe that most of my other health issues are due to downstream impacts of my autoimmunity (especially the thyroid dysfunction), and possibly also just a symptom of the autoimmunity itself:

"Autoimmunity" from vA -> leads to:

(1) Thyroid Stress -> Hypothyroidism and damaged metabolism -> low energy / malaise / damage to sexual function / insomnia etc.

(2) Liver / Kidney Stress -> Estrogenic Symptoms, Venous Insufficiency, Toxicity Build-Up

(3) Brain Stress -> OCD, Anxiety, Insomnia, General Stress and Inability to Relax

It all adds up.

--------

To contribute to the science more concretely, I plan to:

Take photos of: my hair loss, my hair greying, my vitiligo (just certain patches), my vein issues (spider veins, varicose veins), my face (puffy eyes), my lips. I will upload these to this thread. I am committing to taking these now as BEFORE photos, and will update with AFTER photos / progress photos as time goes by. I do not want this to turn into another "BEFORE" photos thread, followed by a disappearance / never providing after photos or an update (as can occur after the motivation and excitement wear off ...) so am committed to doing this, provided this website and forum are still up-and-running.

Take a blood test measuring: serum vA (I know this fluctuates over time even on a low vA diet as excretion occurs), autoimmunity markers, and other hormonal markers. I will do this in the next month or so. And will re-test every 1-2 years to see how things are changing.

Best wishes - talk to you all soon.

Hello everyone,

First of all, I want to say a huge *Thank You* to @ggenereux2014 for all of his work, and for inviting me to join the forum.

I am starting this progress log to add to the data pool, and possibly get some advice along the way. I will try to give as complete a view of my health history as possible, whilst also keeping the word count down as best as I can. I have added a picture chart providing a "timeline" of my dietary history and health issues, but will use the body of text below to elaborate a bit.

I am a 32 year old male (nearly 33) - White (if that matters) - 6 ft 1 | 175lbs | "in-shape" for most of my life

Age 0-19 - Standard Western Diet (I was breast-fed as a baby). My diet contained: meat, vegetables (lots of carrots and broccoli), orange juice, eggs, dairy, lots of grains and cereals (breakfast cereals and muesli), bread and sandwiches, potatoes, lots of sweets and junk food - probably a strong dose of vA. I was always a very slim kid, quite athletic, I swam competitively through most of my childhood and teenage years.

As a kid, I didn't really have any major symptoms - but I always had puffy eyes / dark circles as a teenager. I also had mild insomnia as a teen, which I attributed to the overly intense swimming training schedule.

I didn't eat liver through MOST of my childhood. However, between the ages of 17 and 19, I was regularly given pork liver pate at my grandparents house after cutting their grass: cheese and ham on a nice fresh loaf, with brussels pate. I probably ate a "healthy" portion at least once a fortnight, if not once per week. Lo and behold, my first "autoimmune" symptoms began around this time, specifically Obsessive Compulsive Disorder and Vitiligo.

Age 20-22 - At university, I was very poor. I didn't have much money for food, and my diet contained: cereal grains and milk, cheese and ham sandwiches, lots and lots of pasta and tomato sauce, some low quality meats (e.g. pork sausages). I instinctively knew that my diet was lacking in nutrition, so it was around this time that I started taking a multi-vitamin every single day - I cannot remember the dose of vA, but I am certain that it did contain a "healthy" (unhealthy) dose - vA, Bs, vC, vD3, minerals...

It was around this time that my OCD and Vitiligo progression were OUT OF CONTROL. The OCD rituals probably took up around 4 hours out of my day, possibly more - it was pure hell. And my vitiligo progression was so fast too - what had begun as a couple of dots, quickly spread to ZERO pigment on my hands, feet, inside of my fore-arms etc. etc. Anxiety was also through the roof. It was a wonder I was able to keep up with my studies (maths w. economics).

Age 23-24 - After university, I went back home to live with my parents, as I had gotten my first job and was saving some money. I returned to my old diet pre-university. Nothing improved symptom-wise. I cannot remember if I had dropped my multivitamin at this point or not... I certainly stopped soon after though. It was around this age that I first noticed some mild gynecomastia - it occurred in both sides of the chest, but was extremely sensitive and tender on the right side for a few months. This REALLY bothered me. Whilst the lumps were (still are) only about the size of a grape, it is not how a male chest should be, especially not a young, fit, athletic 23 year old. (I now attribute this to undiagnosed "autoimmunity" in the thyroid and liver dysfunction leading to undesirable hormonal changes and inflammation in the tissues -> elevated estrogen).

Age 25-28 - Went "paleo". Amazingly, my OCD symptoms cleared up quite a bit upon quitting grain consumption. I got quite lean ("six-pack" look) at this time. I generally felt a bit better, but was still eating a lot of broccoli, carrots, eggs, some dairy. I was also eating chicken livers w. onions for a spell - whilst I had "cleaned up" my diet, I was still quite high in vA.

My "autoimmune" conditions continued to get worse though, and I began to suffer some new symptoms (which I thought were unrelated at the time). I attributed this to "leaky gut" and figured I needed to go even further into an "auto-immune" / gut-health protocol. My symptoms included all of the above, but now also: digestive problems (white tongue, some constipation), vein and circulation problems (spider veins appearing on feet, knees and ribs. Minor varicose veins beginning on legs), some sexual issues (slight premature ejaculation), my hair fall accelerated, and the sides of my hair were experiencing greys coming through.

Age 28-30/31 - In trying to re-gain my health, I probably did the worst thing I possibly could - I went on the "carnivore diet" - i.e. meat only, and included liver regularly to ensure I got the required "nutrients". I ate goose liver, calves liver, chicken liver, lambs liver, you name it - about half a pound of liver once per week / once per month (I varied it over time).

During this time, I got very lean and stayed relatively muscular, but none of my health problems improved. In fact, they all continued to get worse. No new symptoms really, just a worsening of what I already had. Although, my lips became INCREDIBLY dry and cracked (with a dry mouth) during this time which was not something I had really noticed before except fleetingly - I needed to use lip balm every single day, multiple times (I still have to do this to this day). I also developed SEVERE sexual function issues at this times, specifically premature ejaculation... sorry to be crass, but I had gone from a guy who could go for an hour in my early 20s, to a guy who couldn't last 10 seconds in my late 20s ... I still have this problem to this day. I believe the cause is an inability to relax the pelvic floor -> caused by excess calcium / not enough potassium and magnesium in the muscle tissue (creating tightness) -> caused by stressed metabolism / low thyroid function -> caused by "autoimmunity" in the thyroid -> caused by vA?

I also noticed that I was thinning on my crown after a haircut left my hair shorter than usual - this was a huge shock to me, and prompted me to change my diet again.

Age 31-32/33 - I had to admit that carnivore was not working for me. After some searching, I found Ray Peat's teachings, and Danny Roddy's videos on hair loss. I decided to give it a shot. My diet included: meat, dairy, eggs, orange juice, potatoes, rice, cola, sweets, and still continuing with semi-regular liver consumption as per Ray's advice.

Zero symptoms improved. I had a blood test taken in Jan 2023 - Thyroglobulin and TPO antibodies were THROUGH THE ROOF, and probably had been for YEARS. TSH was also elevated - I began using thyroid hormone supplementation in Feb/March 2023 after much deliberation. After 3-4 months of this, still no improvements to any symptoms. Zero. In-fact, things started to get much worse in recent weeks - varicose veins, and now a sub-clinical varicocele that is causing some chronic discomfort, and has me VERY worried. Epididymal cyst occurred spontaneously on the right side (could be coincidence).

Now, a side-note: I have NEVER believed the mainstream view of autoimmunity. I just don't buy that the immune system randomly decides to attack the body. But I also found Ray's theory to be very lacking - his theory of autoimmunity in the thyroid (to my understanding) was basically that:

(1) The thyroid function is low / sluggish
(2) The pituitary then increases TSH to try to kick-start the sluggish thyroid, which is in itself an inflammatory hormone.
(3) other stress hormones and estrogen rise as a result of the stressed metabolism too, which are also inflammatory.
(4) The thyroid antibodies then appear as a RESPONSE to the inflammation from above processes, not the cause of it.

I never quite bought into this theory either ... something wasn't adding up. Why was the thyroid function low / sluggish in the first place? In Ray's view, the low thyroid function PRECEDES the autoimmunity. But it made much more sense to me that the autoimmunity and corresponding inflammation in the area would be the things to precede (or cause) the poorly functioning thyroid, NOT the other way around......... "what came first, the chicken or the egg?". I couldn't quite square this in my own mind...

Additionally, Ray's explanation might explain "autoimmunity" in the thyroid, but what about my vitiligo (or any other autoimmune condition)? Was the vitiligo occurring randomly due to high stress hormones and high estrogen? It's onset certainly did coincide with a stressful time for me... but why is it not reversible upon supplementing thyroid hormone and removing stressors?

I then found Grant Genereux's information from the RP forum on the off-chance c. June 2023, and decided to read through his books ... and here I am. I found the theory and supporting evidence very convincing. I am a little skeptical that any of this will work for me (I am desperate to get well, but don't want to get my hopes up in the same way that I have done in the past), but am eager to give things a go. I don't anticipate I will have any trouble sticking to the diet - compared to the carnivore diet (which I did for c. 2 years), there is actually quite a lot of variety.

Current Diet, as of July 1 2023 (just two weeks ago) : Beef, Chicken, White Rice, Potatoes, Beans, Apples, Bananas, Some Honey / Sugar

It has been only two weeks. I am not noticing any improvement in symptoms yet except for ONE thing: I have noticed a drastic reduction in hair fall on the comb in the morning and evening in just the last 4-5 days. Could be a complete coincidence, but I will continue to monitor this. I am fully aware that it may take 5 years + to see any benefit (and that a benefit is not guaranteed), but I am confident that I can meet nutritional needs whilst staying very low vA and stick to the plan long term. So this is what I will do.

--------

It could well be true that vA is the cause of many / all of my autoimmune conditions and symptoms. And I firmly believe that most of my other health issues are due to downstream impacts of my autoimmunity (especially the thyroid dysfunction), and possibly also just a symptom of the autoimmunity itself:

"Autoimmunity" from vA -> leads to:

(1) Thyroid Stress -> Hypothyroidism and damaged metabolism -> low energy / malaise / damage to sexual function / insomnia etc.

(2) Liver / Kidney Stress -> Estrogenic Symptoms, Venous Insufficiency, Toxicity Build-Up

(3) Brain Stress -> OCD, Anxiety, Insomnia, General Stress and Inability to Relax

It all adds up.

--------

To contribute to the science more concretely, I plan to:

Take photos of: my hair loss, my hair greying, my vitiligo (just certain patches), my vein issues (spider veins, varicose veins), my face (puffy eyes), my lips. I will upload these to this thread. I am committing to taking these now as BEFORE photos, and will update with AFTER photos / progress photos as time goes by. I do not want this to turn into another "BEFORE" photos thread, followed by a disappearance / never providing after photos or an update (as can occur after the motivation and excitement wear off ...) so am committed to doing this, provided this website and forum are still up-and-running.

Take a blood test measuring: serum vA (I know this fluctuates over time even on a low vA diet as excretion occurs), autoimmunity markers, and other hormonal markers. I will do this in the next month or so. And will re-test every 1-2 years to see how things are changing.

Best wishes - talk to you all soon.

Uploaded files:

puddleduck, Rachel and 4 other users have reacted to this post.

#2 · July 15, 2023, 12:08 pm

Quote from Andrew W on July 15, 2023, 12:08 pm
Just to add a couple more points I missed:

I also have been experiencing a lot of skin turnover / shedding for a number of years now (since c. age 25). Not severe "desquamation", but a lot of skin comes off when bathing most days. Regular "exfoliation" is required.

I will likely also be supplementing minerals: Sodium (salt), Potassium (KCl Salt), Magnesium (MgCl2 topically) and Calcium (CaCO3 orally) - plus some zinc. But will see how this goes.

I know there has been a lot of talk about time-to-depletion before, but I have had another look into this:

The human liver is approximately 1500g

https://www.sciencedirect.com/science/article/abs/pii/S0308814605005728 "In the present study, 90 animal livers of five different species (pig, cattle, calf, chicken, turkey) were examined for their vitamin A contents. [...] The liver vitamin A contents ranged between 6.5 and 18.9 mg RE/100 g in pigs, from 1.1 to 6.7 mg RE/100 g in cattle and from 1.6 to 16.6 mg RE/100 g and 2.7 to 21.5 mg RE/100 g in chickens and turkeys, respectively. The livers of calves contained the smallest amount of vitamin A, with variation from 1.3 to 3.2 mg RE/100 g."

In IU (1mg = 3333 IU vA - suspicious numerology there) =

Pigs = 21.7k-63k IU / 100g

Cattle = 3.7k-22.3k IU / 100g

Chickens = 5.3k-55.3k IU / 100g

Turkeys = 9k-71.6k IU / 100g

Calves (Young Cow) = 4.3k-10.6k IU / 100g

If we take the highest value (worst case scenario) of turkeys = c. 70k IU of vA per 100g, and apply this to the human, this would imply a total storage of 70k*15= 1,050,000 IU (c. 1 million IU total)

Let's assume that 3000IU (0.9mg) of vA is excreted per day (3000 IU is approximately the "RDA" to prevent going into a "depletion state" / to maintain vA levels on average), this would mean that : 1,050,000 (total) / 3000 (used per day) = 350 days to depletion (c. 1 year).

Let's also factor in that, even on a low vA diet, there is a good chance that we will take in c. 300 IU per day (in our beef / meat, especially if there is some fat), we can make that number 2700 net loss per day. That would make it 388 days to depletion.

If we create an absolute disaster scenario, where we double the storage saturation per 100g of the worst case scenario (to 140k IU/100g) and halve the excretion rate to 1500 IU per day, we still end up with 140,000 * 15 = 2,100,000 IU -> 2,100,000 IU / 1500 IU = 1400 days = 3.83 Years to depletion. If we do just one of these, then we get 700 days (1.92 years).

1 year = best estimate (based on the highest observed liver saturation of vA of the 90 animals). 2 years = extra conservative scenario. 4 years = absolute disaster case.

Based on this, I would expect 1 year of strict vA restriction to be a good estimate for depletion, 2 years to be safe.

This does not mean that symptoms will have resolved completely in 1-2 years, just that vA would be depleted in this time. It is likely to take extra time to resolve certain symptoms (if they even can be resolved) - just because the poison has been removed, it does not mean that recovery will occur immediately in tandem.

That said, this theory may be blown out the water by what Grant mentions in this vid at the 5:50 mark: https://www.youtube.com/watch?v=gqbelhIdg1Q c. "10%-15%" drop in blood serum levels per year has been observed. Grant also mentions that he dropped his to near zero in about 4 years though... Additionally, this is SERUM levels, which are not always reflective of tissue levels. For example, the liver may have excreted 50% of its total vA storage compared to year 0, but average blood serum levels may not have decreased much in that time, due to the re-absorption of vA-laden bile into the blood between meals -> whilst total amount in the body has reduced, the amount in the blood at any given time may not have changed drastically.

Nevertheless, seeing that people are regularly observing improvements within the first year, it is fair to guess that the reduction of toxic load in the liver is having systemic benefits, despite the similar blood serum level.

Maybe this little exercise will be helpful to people, maybe not, but just a thought experiment from me.

Cheers.

Just to add a couple more points I missed:

I also have been experiencing a lot of skin turnover / shedding for a number of years now (since c. age 25). Not severe "desquamation", but a lot of skin comes off when bathing most days. Regular "exfoliation" is required.
I will likely also be supplementing minerals: Sodium (salt), Potassium (KCl Salt), Magnesium (MgCl2 topically) and Calcium (CaCO3 orally) - plus some zinc. But will see how this goes.

I know there has been a lot of talk about time-to-depletion before, but I have had another look into this:

The human liver is approximately 1500g
https://www.sciencedirect.com/science/article/abs/pii/S0308814605005728 "In the present study, 90 animal livers of five different species (pig, cattle, calf, chicken, turkey) were examined for their vitamin A contents. [...] The liver vitamin A contents ranged between 6.5 and 18.9 mg RE/100 g in pigs, from 1.1 to 6.7 mg RE/100 g in cattle and from 1.6 to 16.6 mg RE/100 g and 2.7 to 21.5 mg RE/100 g in chickens and turkeys, respectively. The livers of calves contained the smallest amount of vitamin A, with variation from 1.3 to 3.2 mg RE/100 g."
In IU (1mg = 3333 IU vA - suspicious numerology there) =
1. Pigs = 21.7k-63k IU / 100g
2. Cattle = 3.7k-22.3k IU / 100g
3. Chickens = 5.3k-55.3k IU / 100g
4. Turkeys = 9k-71.6k IU / 100g
5. Calves (Young Cow) = 4.3k-10.6k IU / 100g
If we take the highest value (worst case scenario) of turkeys = c. 70k IU of vA per 100g, and apply this to the human, this would imply a total storage of 70k*15= 1,050,000 IU (c. 1 million IU total)
Let's assume that 3000IU (0.9mg) of vA is excreted per day (3000 IU is approximately the "RDA" to prevent going into a "depletion state" / to maintain vA levels on average), this would mean that : 1,050,000 (total) / 3000 (used per day) = 350 days to depletion (c. 1 year).
Let's also factor in that, even on a low vA diet, there is a good chance that we will take in c. 300 IU per day (in our beef / meat, especially if there is some fat), we can make that number 2700 net loss per day. That would make it 388 days to depletion.
If we create an absolute disaster scenario, where we double the storage saturation per 100g of the worst case scenario (to 140k IU/100g) and halve the excretion rate to 1500 IU per day, we still end up with 140,000 * 15 = 2,100,000 IU -> 2,100,000 IU / 1500 IU = 1400 days = 3.83 Years to depletion. If we do just one of these, then we get 700 days (1.92 years).
1 year = best estimate (based on the highest observed liver saturation of vA of the 90 animals). 2 years = extra conservative scenario. 4 years = absolute disaster case.

Based on this, I would expect 1 year of strict vA restriction to be a good estimate for depletion, 2 years to be safe.

This does not mean that symptoms will have resolved completely in 1-2 years, just that vA would be depleted in this time. It is likely to take extra time to resolve certain symptoms (if they even can be resolved) - just because the poison has been removed, it does not mean that recovery will occur immediately in tandem.

That said, this theory may be blown out the water by what Grant mentions in this vid at the 5:50 mark: https://www.youtube.com/watch?v=gqbelhIdg1Q c. "10%-15%" drop in blood serum levels per year has been observed. Grant also mentions that he dropped his to near zero in about 4 years though... Additionally, this is SERUM levels, which are not always reflective of tissue levels. For example, the liver may have excreted 50% of its total vA storage compared to year 0, but average blood serum levels may not have decreased much in that time, due to the re-absorption of vA-laden bile into the blood between meals -> whilst total amount in the body has reduced, the amount in the blood at any given time may not have changed drastically.

Nevertheless, seeing that people are regularly observing improvements within the first year, it is fair to guess that the reduction of toxic load in the liver is having systemic benefits, despite the similar blood serum level.

Maybe this little exercise will be helpful to people, maybe not, but just a thought experiment from me.

Cheers.

ggenereux, puddleduck and 5 other users have reacted to this post.

#3 · July 17, 2023, 10:56 am

Welcome here, @andrew2! 😁 Thank you for posting your story and calculations. Quite interesting! You’ve been through a lot. I hope this dietary approach makes a big difference for you.

Have you noticed if your sweat has color to it, btw?

We’re the same age, but I had a less lengthy and less extreme history of liver ingestion. Noticed mild improvements in symptoms within the first month, and became “deficient” (according to a serum retinol test) after 3 years, which is the same amount of time it took my body to let got of excess adipose tissue. Mineral supplementation has been helpful for me, and I’m still finding ways to improve my remaining symptoms approaching year 5.

It’s good to be prepared stick it out for a while, as you are. 🙂 But it’s also exciting when you see little changes. I hope the hair-fall improvement trend continues for you. That improved for me, too.

One of the things some of us are doing, is taking a fiber supplement (such as psyllium) throughout the day to absorb bile (nutritionist Karen Hurd came up with that idea for addressing other bile toxicity problems in her clients).

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#4 · July 17, 2023, 11:28 am

Hi @puddleduck ( Beatrix Potter?? 🙂 ),

Thank you kindly for the warm welcome.

I don't tend to perspire excessively (being in a generally cooler climate), but I'm pretty certain it's clear / colourless when I do...

Interesting that you found it to take around three years - I guess I have a long road ahead! The only thing I can think of to explain that finding is that: in reality, the human body may not excrete anywhere near 3000 IU per day - OR that there is a lot of vA stored elsewhere in other tissues too that the body still has to get rid of (like in the adipose tissue as you mentioned), not just the liver! I'll see if I can pin down some more-concrete information.

Thanks for the heads up on the minerals - I think it definitely makes sense to add a little bit, judging by the state of the soil etc., and by the reduced mineral content in our food. Though it is probably best to start low and slow.

I'm somewhat fortunate that I caught my hair loss issue very early. I think there's still time to sort things out. And I'm glad yours has improved too - it can be a huge hit to the self-esteem, especially in 20s/30s.

Thanks for the recommendation on the psyllium - I've not used that before so will check it out!

Best wishes.

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#5 · July 18, 2023, 5:26 am

I've conducted another little thought experiment around time to depletion, please see the attached photo I made via excel. Essentially:

TL;DR : based on vA concentrations in animals (not humans) and extrapolating to the human, it appears that a reasonable estimate for average time to depletion is 1.51 years for men, and 1.94 for women - or 1.5-2 years. This estimate is not perfect by any means -> it actually assumes that men and women's liver capacity is identical (which is false), but also assumes that men and women use / deplete vA at different rates (which is true, but compounds strangely with the first assumption). Additionally, animal vA concentrations in the liver are shown to be highly variable - both across species and within species. I have used a few examples: the highest liver concentration measured in a study of 90 animals (the highest happened to be in a turkey), plus the calves average from another study (which was the highest average concentration of the species measured). All estimates are academic at this stage.
I found one study conducted on young adult women - where liver stores were predicted / extrapolated by interesting methods: (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3798076/#:~:text=The%20mean%20(%C2%B1SD)%20liver,(513%20%CE%BCg%2Fg). Based on the average estimate + one standard deviation (to be safe), I estimated that it would take 1.55 years for men and 1.99 years for women to deplete. Interestingly, this number matches up quite closely to the extrapolations I made from animal liver. However, if we take the worst case, it would be c. 3.5 years for men and 4.5 years for women to deplete.

Sooo many extrapolations here, and best guesses. But I am now inclined to think that 2 years is a best estimate for total depletion for the average person on a strict vA-restricted diet. As mentioned in the previous comment, this would not necessarily be enough time to have a full reversal of symptoms caused by vA toxicity (if they even can be reversed) - full healing may take much longer or may never occur.

I conducted this exercise because a huge question for people starting this plan is: "How long is it going to take?". I remember seeing estimates of 200 days to depletion (c. 0.5% of total vA stores at day zero used daily), but it seems that this is wishful thinking for most.

I guess all we can do is:

(1) continue to be strict with vA restriction.

(2) ensure that the bowel / GI are moving daily.

(3) support ourselves with rest, nutrition, and low stress.

(4) wait and hope.

References:

RDAs :
Vitamin A in liver of humans and animals:
- Animal study (of 90): https://www.sciencedirect.com/science/article/abs/pii/S0308814605005728
- Animal Study UK (of 649): https://www.ema.europa.eu/en/documents/mrl-report/vitamin-summary-report-committee-veterinary-medicinal-products_en.pdf
- young adult women: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3798076/#:~:text=The%20mean%20(%C2%B1SD)%20liver,(513%20%CE%BCg%2Fg).
Percentage of total vA in the body that is stored in the liver:
- US: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3798076/#:~:text=The%20amount%20of%20vitamin%20A,storage%20(5%2C%206).
- EU: https://www.ema.europa.eu/en/documents/mrl-report/vitamin-summary-report-committee-veterinary-medicinal-products_en.pdf

Uploaded files:

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#6 · July 18, 2023, 6:56 am

Thanks for attempting to figure this out. There was a study in 1982 where the hepatic removal of Vitamin A was 226,000 IUs per day for a 62 year old man. It was measured by liver samples I think. Even if you suggest half was going into the body it's likely the man was excreting 100,000 IUs of Vitamin A per day which in weight terms is still not very much in milligrams (30) compared to average stools weighing 500 grams. In this study the man was also given 4,000 IUs of Vitamin A per day and yet still removed these very large amounts of vitamin A from the liver.

It's all to do with Vitamin A metabolism. Improve choline, betaine, protein, taurine and other nutrients like zinc, selenium, molybdenum, B1, B2 and B6 and the body is well capable of excreting large amounts of vitamin A. The strict avoidance of vitamin A is not the best way to detox it. Low Vitamin A without enough choline has led to some people getting in great difficulties with too much going into the body. A restricted diet also in my opinion means a poorer gut microbiome so you dont tolerate all foods and you detox less. Get the bile flow optimal and we detox much more. That may not work for everybody on the beef, beans and rice approach. A restricted diet threatens bile flow particularly if choline isnt good. Serum retinol can go down with poor bile flow.

Reversible hepatotoxicity associated with hepatic vitamin A accumulation in a protein-deficient patient (gastrojournal.org)

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#7 · July 18, 2023, 10:31 am

Quote from Andrew W on July 18, 2023, 10:31 am
Hi Andrew (nice name!)

Thanks very much for the information. Yes I had seen some information knocking around about choline, and am certainly aware of the importance of B vitamins (I had been considering mega-dosing B1 for some time but decided against it). Regarding choline - the best source is probably eggs (as I'm sure you know), but I will likely avoid eggs because:

(1) they are still packed with vA (not like liver, but still quite high). I appreciate your views around not necessarily restricting 100%, but improving the body's ability to detox, however...

(2) I also just don't tolerate eggs.

I'm inclined to agree RE: the minerals and proteins too. Although, I do notice significantly more hair fall on days after high animal protein (c. 100g+ of animal protein) vs. lower animal protein days (c. 60g or less) - I have tested and re-tested this MANY times and there is a definite correlation - no idea why this is happening.

My diet will likely be: beef, chicken, rice, beans, potatoes, apples, bananas, some fruit juice on occasion (apple and apple & berry), some honey etc. - hopefully not too deficient in choline, but possibly...

-----

Thanks for the study you linked - very interesting that their study suggests a far higher excretion rate of vA than c. the RDA (which was what my estimates were based on). I will look into this further and revise things if I find a better "average". However, that paper raises a whole bunch more questions:

The maximum vA observed in any animal / human liver that I could find was one woman in the study I linked with c. 2,500,000 IU of vitamin A (likely c. 3,500,000 IU in the body overall based on percentages). The person in the study you linked with extreme levels of 9700 IU/g per day would have 14,550,000 IU stored in his liver in total (with an estimated liver size of 1500g or 1.5kg). Let's take a high of 10,000,000 IU as a high round number.

If the human body can excrete 100,000 IU of vA per day (c. 30mg) as per the stated example, that would mean 35 days to deplete vA almost entirely for the woman, and 145 days for the person in the study you linked, and a round 100 days for the 10mill example. Based on people's experiences, serum tests and anecdotes of recovery path, this does not appear to be a common excretion rate (to my knowledge). I would have guessed that almost everyone would feel significantly better, with continuing reversal of symptoms, past the 3 month mark, and that this "detox setback" that seems to occur a few months in would not happen at all... but it apparently does.

In further questioning, I notice what may be either an error in the paper that you shared: "during this period when he was on a normal diet, daily removal of hepatic vitamin A was estimated to be 226,000 IU*" ... "*based on an estimated liver weight of 15,000g" ... the average liver is not 15000g, it is 1500g, 10x less. I haven't understood the method exactly, but perhaps the excretion rate was actually also 10x less (22,600 IU)?

This would imply a drastically longer time to depletion than 100k or 226k per day -> 3,500,000 / 22,600 = 156 days. or -> 14,550,000 / 22,600 = 644 days

Although, that doesn't match their "table 1" on page 2 - which clearly shows 19000 -> 9000 between weeks 3 and 12... call it half depletion in 63 days.

Just double-checking their table... 10,000 IU per gram lost in 63 days (as shown in table1 - 19000IU/g in week 3 to 9000IU/g in week 12). That's 10,000 * 1500 = 1,500,000 IU lost in 63 days, implying a daily excretion rate of 1,500,000 / 63 = 23,809 IU per day.

Again, something in the paper doesn't seem to be adding up. I believe they are over-stating the man's liver retinol stores (and excretion rate) by a factor of 10x - unless I have greatly misunderstood.

Still, even if we use this 23,809 IU excretion per day, and apply it to the highest concentration in the women's study I linked earlier, we are talking: c. 3,500,000 IU total / 23,809 IU = 153 days, or 5 months. That is obviously drastically less time than my initial estimate of the 2-3000 IU excreted per day.

If this is the case, why are people still noticing issues after 6 months? And why is it taking 5 years+ to see reversal of certain symptoms? Why did @ggenereux2014 require 4 years on his diet for serum retinol to approach zero, and @puddleduck require c. 3 years to reach the "deficient" status?

Hi Andrew (nice name!)

Thanks very much for the information. Yes I had seen some information knocking around about choline, and am certainly aware of the importance of B vitamins (I had been considering mega-dosing B1 for some time but decided against it). Regarding choline - the best source is probably eggs (as I'm sure you know), but I will likely avoid eggs because:

(1) they are still packed with vA (not like liver, but still quite high). I appreciate your views around not necessarily restricting 100%, but improving the body's ability to detox, however...

(2) I also just don't tolerate eggs.

I'm inclined to agree RE: the minerals and proteins too. Although, I do notice significantly more hair fall on days after high animal protein (c. 100g+ of animal protein) vs. lower animal protein days (c. 60g or less) - I have tested and re-tested this MANY times and there is a definite correlation - no idea why this is happening.

My diet will likely be: beef, chicken, rice, beans, potatoes, apples, bananas, some fruit juice on occasion (apple and apple & berry), some honey etc. - hopefully not too deficient in choline, but possibly...

-----

Thanks for the study you linked - very interesting that their study suggests a far higher excretion rate of vA than c. the RDA (which was what my estimates were based on). I will look into this further and revise things if I find a better "average". However, that paper raises a whole bunch more questions:

The maximum vA observed in any animal / human liver that I could find was one woman in the study I linked with c. 2,500,000 IU of vitamin A (likely c. 3,500,000 IU in the body overall based on percentages). The person in the study you linked with extreme levels of 9700 IU/g per day would have 14,550,000 IU stored in his liver in total (with an estimated liver size of 1500g or 1.5kg). Let's take a high of 10,000,000 IU as a high round number.

If the human body can excrete 100,000 IU of vA per day (c. 30mg) as per the stated example, that would mean 35 days to deplete vA almost entirely for the woman, and 145 days for the person in the study you linked, and a round 100 days for the 10mill example. Based on people's experiences, serum tests and anecdotes of recovery path, this does not appear to be a common excretion rate (to my knowledge). I would have guessed that almost everyone would feel significantly better, with continuing reversal of symptoms, past the 3 month mark, and that this "detox setback" that seems to occur a few months in would not happen at all... but it apparently does.

In further questioning, I notice what may be either an error in the paper that you shared: "during this period when he was on a normal diet, daily removal of hepatic vitamin A was estimated to be 226,000 IU*" ... "*based on an estimated liver weight of 15,000g" ... the average liver is not 15000g, it is 1500g, 10x less. I haven't understood the method exactly, but perhaps the excretion rate was actually also 10x less (22,600 IU)?

This would imply a drastically longer time to depletion than 100k or 226k per day -> 3,500,000 / 22,600 = 156 days. or -> 14,550,000 / 22,600 = 644 days

Although, that doesn't match their "table 1" on page 2 - which clearly shows 19000 -> 9000 between weeks 3 and 12... call it half depletion in 63 days.

Just double-checking their table... 10,000 IU per gram lost in 63 days (as shown in table1 - 19000IU/g in week 3 to 9000IU/g in week 12). That's 10,000 * 1500 = 1,500,000 IU lost in 63 days, implying a daily excretion rate of 1,500,000 / 63 = 23,809 IU per day.

Again, something in the paper doesn't seem to be adding up. I believe they are over-stating the man's liver retinol stores (and excretion rate) by a factor of 10x - unless I have greatly misunderstood.

Still, even if we use this 23,809 IU excretion per day, and apply it to the highest concentration in the women's study I linked earlier, we are talking: c. 3,500,000 IU total / 23,809 IU = 153 days, or 5 months. That is obviously drastically less time than my initial estimate of the 2-3000 IU excreted per day.

If this is the case, why are people still noticing issues after 6 months? And why is it taking 5 years+ to see reversal of certain symptoms? Why did @ggenereux2014 require 4 years on his diet for serum retinol to approach zero, and @puddleduck require c. 3 years to reach the "deficient" status?

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#8 · July 18, 2023, 10:37 am

Furthermore, quick sense check: if the body was regularly able to excrete, say, 100k IU of vA per day, then surely VERY few people would ever end up with any vA in their livers at all.

200g of beef liver (probably the highest dietary source of vA readily available) is c. 15mg of vA -> 15 * 3333 = 49,995 IU

So let's say someone ate 200g of beef liver every single day, plus another 10,000 IU of vA from elsewhere (e.g. carrots, eggs, whatever) - a quite high amount.

60,000 IU per day is obviously far below a 100,000 IU per day excretion rate. Even in the upper tier of vA consumption, someone should hypothetically not be accumulating any at all if excretion rates of 100-200k per day were possible.

That doesn't seem to make sense.

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#9 · July 18, 2023, 1:21 pm

Maybe it has to do with where the VA went. For instance, I've got some yellow patches on the back of teeth that seem very very permanent.

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#10 · July 18, 2023, 2:30 pm

Hi @lil-chick !

Good point. Although, I would be very surprised if the liver were to churn out 200,000 IU of vA every day and inadvertently send it straight into the tissues. I would have expected it would try to let it out in a controlled manner over time for full excretion from the body.

As has been mentioned in other posts, and the LYL guys: a high proportion of our bile is reabsorbed every day, meaning that a lot of vA could be re-absorbed with it. But usually, this would be sent back to the liver again (as much as possible). The body is storing it there rather than the tissues (again, as best as possible). I don't think we'd have a situation where that 200k was just being funneled straight to other body parts - part of the livers function is to stop this from happening in the first place.

So, for the gentleman in the paper shared by @andrew-b to be having such a drastic reduction in liver vA levels (c. a 50% drop in 2-3 months), it would make sense to me that the majority of that would have been excreted. Especially as the man did not observe a worsening in symptoms.

But again, pure speculation on my part - I'm very new to all this. I should probably stop typing and listen.

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