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Low vA alone can't fix accutane damage, as the damage is already done
Correct me if my understanding is wrong, but I am very sure that there is no pathway for retinoic acid (active form) to turn back into retinol (storage form). Accutane is in the active form of 13-cis-retinoic acid, so that means that the medication is in the active form when it is delivered to the cells where its effect is used up; there is no storage of any unused retinoic acid as it needs to be in the retinol form to be stored.
So that implies low vA alone can't fix accutane damage, as the damage is already done. In fact, many accutane victims who are young probably don't have much vA/toxin accumulation to begin with so probably aren't even vA toxic.
What are the thoughts of the people in this forum on my observations? I think other people have pointed this out too in different posts.
Hey @ilyas,
It is documented that the damage caused by accutane is often permanent, non-reversible.
But, that is not always true. Even so, I think that people who have been damaged by accutane should expect a long slow road to recovery. Think in terms of multiple years, not months.
You are correct in stating that there is no pathway for RA to convert back to retinol. But, that’s not the right way to think about it. The mechanism of damage is that RA binds to the cell’s DNA/RNA. That is often enough to kill the cell, and if not it critically damages the cell where it can no longer function correctly. Once RA is bound to DNA/RNA that cell is forever more poisoned. There is no going back. The only pathway to rid the RA from there is for the cell to die off and its debris to get discarded.
So, very basically speaking, what accutane does (and it is documented to do exactly this) is to kill off a huge number of cells throughout the body (although the claimed target site is just the sebaceous glands). We are usually talking about many billions of cells being poisoned / killed. And the real target cells are stem cells and epithelial cells in all tissues. Once that happens, it’s done. If nerve cells are killed off then that damage is probably permanent, or nearly permanent.
The second thing accutane does is greatly reduces the body’s defensive resources to defend itself from additional RA damage when the source of that RA is from diet. These defensive resources are enzymes, specialised proteins, reserves of B vitamins such as niacin, choline etc.
So, the first goal of a low vA diet is to reduce and eventually prevent more damage from being done. Then the second goal is to eventually give the body the time to heal from that damage that has already occurred. This means replacing all the cells that have been damaged and killed off. Once again, think years.