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Myth: Serum Retinol is not a useful measurement of subclinical VA toxicity
Serum retinol is a useful measure of subclinical Vit A toxicity. Studies clearly show that serum levels tend to rise as we get older in line with bioaccumulation of VA in the liver. Multiple people have posted serum levels over time showing them getting lower. It is said that normal serum levels range from 15 mcg/dL to 60 mcg/dL. I'm still getting plenty of VA toxicity symptoms and my measurement 3 months ago was 50 mcg/dL. So it seems likely that the normal values are like the normal values for serum ferritin, far too liberal. I'm guessing that when we reduce our serum retinol levels to less than about 40 mcg/dL is when we have depleted a large portion of our liver stores and are no longer VA toxic. That is my target anyway.
A review of previous studies revealed that plasma retinol increases from a mean of approximately 35 micrograms/dL (1.22 mumol/L) at preschool age to a plateau of approximately 60 micrograms/dL (2.09 mumol/L) by age 40 y in men and 60 y in women.
https://academic.oup.com/ajcn/article-abstract/46/6/989/4716122
I would say that serum retinol is a useful measure of vA toxicity for many but not all people.
I closely follow Dr Garrett Smith’s work & he has cases of people who were low serum retinol & then as they went on the Vit A detox diet had high serum retinol that then came down slowly. If someone is low in protein or zinc, for example, they could have low retinol binding protein (RBP) & so even if they have high levels of vA in the liver this is not reflected in the serum retinol due to lack of RBP. This is not a black & white matter.
However, I think for many it is a useful way of monitoring detox.
@jaj Exactly the same applies to copper. You can have low copper in serum and even on hair test, but already damaged liver from copper toxicity for example. Once you can't make systemic proteins like ceruloplasmin, RBP etc.. Things like retinol, copper etc. stay in the liver. So you can have clear symptoms of deficiency, but toxic levels in the liver on in case of copper also in other tissues like brain.. Retinol will spill to fat tissue.. So copper and retinol in serum will be high only when the body "dumps" it to the blood and during that time you will know that this is happening..
Yes totally agree. Serum retinol is a useful marker but only if you understand the whole process & what is happening for individuals at particular times.
Hard to imagine many cases like that in Western populations but I guess there are plenty of vegetarians and others following fad diets low in protein and zinc.
A lot of blood work is not 100% accurate, for example serum ferritin can be inaccurate hence iron panels are normally done. Perhaps there is other blood work that can be done alongside serum retinol to get a more accurate picture?
Quote from tim on May 7, 2020, 7:24 amHard to imagine many cases like that in Western populations but I guess there are plenty of vegetarians and others following fad diets low in protein and zinc.
A lot of blood work is not 100% accurate, for example serum ferritin can be inaccurate hence iron panels are normally done. Perhaps there is other blood work that can be done alongside serum retinol to get a more accurate picture?
Hard to imagine zinc deficiency in western population? When everything from stress, sugar, masturbation etc. etc.. depletes zinc? Really? In terms of protein once you are deficient in zinc your digestion is fucked and I am not even talking about anti acid drugs that completely neutralize your stomach acid etc.. This idea that in western countries are no deficiencies is INSANE. Especially when you look around how most people eat.. But yes protein or zinc deficiency is not the only reason why you will be low in systemic protein. It is about liver health overall People in western countries are the last people on earth that have healthy liver with all tose drugs/meds/chemicals etc..
Plenty of people may have zinc insufficiency but overt deficiency to the point where RBP is severely depressed will not be that common in people eating the SAD. It could be more common in vegans and those following fad diets.
I was thinking about @are and her serum levels and the detox path in general yesterday.
This idea came to me that one of the reasons WHY this process is so long is because the blood must not ever be overloaded with VA. It would be so harmful. And that is probably why it gets pushed out of the skin (in flakes and papules and oils and sebum) and out of the breath as well, in addition to the routes we normally think of (like feces and urine). Because probably there is a very finite limit to how much VA can be pushed anywhere at any time.
And so, I think that it won't be a surprise for serum VA levels to NOT fall precipitously suddenly or soon...after adopting a lowered VA diet. And if you are still having detox symptoms, it isn't surprising for it to NOT fall precipitously.
Then I tried to come up with a visualization of what is going on. Let's say you want to know the population of a town. Can you tell it by counting people walking on elm street at a certain time of day? No, of course you can't.
The body normally would put it's population of VA into the liver, and we, the overloaded, for whatever reason, have started storing VA here and there around that body as well.
Another metaphor that I can think of is the magazine hoarder. For a long time, he had a room that he devoted to his magazines. Eventually his collection rose to the ceiling and blocked the doorway. So he started storing the magazines in closets and attics and the cellar. He knows he can't have magazines blocking his halls, kitchen and bath or normal living becomes onerous. If he is feeling well, he can take a stack of magazines out to the curb and put them in his recycle bin, but if he tries to take too many he throws his back out. He might, out of desperation, ditch small stacks out the windows of his house, ruining it's esthetics, but that is what he sometimes resorts to. He can throw one magazine in his fireplace at a time, but any more than that will put out the fire. And this is when he is feeling good and sane. If he is feeling bad, he might not get rid of any. Or he might just move it from room to room, not making any headway. You can NOT tell how many magazines he has under his roof... by looking at his hallway.
Agree , but I remember when I stopped my A supplements ( 30000IU ) without even starting a low A diet , my body started dumping it ( my edema which I had developed during intake ) reduced drastically , I could see visual changes in a matter of days in pictures . Important factor is the ability of the body to mobilize it efficiently.
This study explains it
https://www.gastrojournal.org/article/0016-5085(82)90132-9/pdf
The subject acquired the the ability to mobilize the high retinol in his system increasing his protein intake
@lil-chick love the analogy 😀
When I think about all the fat I put on when I became vA toxic (falling away nicely now btw) I think of cheap badly built (or is that just me) Ikea storage units - hastily put together to store excess stuff - don’t look great but keep the extra stuff tucked away. I’ve had to empty them out & get rid of the stuff before I can collapse & get rid of the storage units. I like a visual!
@naveen that is such an interesting paper. Worth a re read. It surprises me just how quickly he gets rid of the vA out the liver. He must have super good metabolism/excretion to empty it out that quickly. Also makes me think how keen his body is to dump all the excess vA.
It makes the point that it’s vA in the blood causing many of the symptom problems. When it’s tucked away in the liver it’s less harmful... until storage reaches full! Also makes me think how different capacities for liver storage of vA must have a big effect on how much vA someone copes with before getting symptoms.