Quote from tim on November 22, 2020, 2:15 pm

@jiri

It's probably better to split egg consumption up you're right. Im not too worried, they are the only thing I eat that has significant vA.

Let me know if the supplement helps.

Quote from tim on January 3, 2021, 5:06 am

Hi @are,

Accutane inhibits the enzyme in the eye responsible for producing retinal that is used for vision. Hypervitaminosis A doesn't tend to cause those symptoms to the same degree.

Quote from ggenereux on January 4, 2021, 8:29 am

RE: Accutane inhibits the enzyme in the eye responsible for producing retinal that is used for vision.

No, Accutane directly destroys the meibomian glands  and ocular surface.

The presence of isotretinoin in the tear film was believed to exacerbate ocular surface disease by further increasing
tear osmolarity.

Although isotretinoin’s detrimental effects on the meibomian glands and tear film are well established, the extent to which
the dosage of isotretinoin influences disease severity is unclear

Source:UC Berkeley Previously Published Works
Title
Effects of isotretinoin on meibomian glands
Permalink
https://escholarship.org/uc/item/41k4v4h1
Journal
Optometry and Vision Science, 92(9)

 

 

Quote from tim on January 4, 2021, 10:08 am

Isotretinoin (13-cis retinoic acid) slows rhodopsin regeneration and chromophore recycling by inhibition of the retinoid isomerase and 11-cis retinol dehydrogenase enzymes that are necessary for the synthesis of 11-cis retinal. Administering isotretinoin in patients who already have low vitamin A stores may lead to rapid development of night blindness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533586/

@are @ggenereux2014

Arena why do you think it's an issue with the meibomian glands as opposed to the lacrimal glands? The first step of VAD is lacrimal gland dysfunction, dry eyes. ATRA is needed to prevent dry eyes which is why tretinoin isn't associated with dry eyes yet isotretinoin causes big problems.

Quote from ggenereux on January 4, 2021, 11:41 am

Hi @tim-2,

RE: why do you think it's an issue with the meibomian glands as opposed to the lacrimal glands?

The meibomian glands secrete an oil based substance, whereas the lacrimal glands secretes a water based substance.

The oil emulsifies and carries RA and other retinoids.

I've also read in another report that the meibomian glands are really the equivalent of the skin's sebaceous glands; the known target of accutane.

 

 

Quote from tim on January 4, 2021, 4:00 pm

Quote from ggenereux on January 4, 2021, 8:29 am

RE: Accutane inhibits the enzyme in the eye responsible for producing retinal that is used for vision.

No, Accutane directly destroys the meibomian glands  and ocular surface.

The presence of isotretinoin in the tear film was believed to exacerbate ocular surface disease by further increasing
tear osmolarity.

Although isotretinoin’s detrimental effects on the meibomian glands and tear film are well established, the extent to which
the dosage of isotretinoin influences disease severity is unclear

Source:UC Berkeley Previously Published Works
Title
Effects of isotretinoin on meibomian glands
Permalink
https://escholarship.org/uc/item/41k4v4h1
Journal
Optometry and Vision Science, 92(9)

 

 

Tear osmolarity sounds more like a lacrimal gland issue. The second sentence is an observation that accutane affects meibomian glands so it's not evidence that it's not due to the mechanism I mentioned for lacrimal gland dysfunction. Regardless, I'm not claiming that all of accutane's negative effects around the eye are due to retinal enzyme inhibition but lacrimal gland dysfunction seems to be.

Quote from tim on January 4, 2021, 4:23 pm

Quote from Arena on January 4, 2021, 11:16 am

@tim-2 I have taken countless of tests and pictures of my eyes at the opthalmologist. The lacrimal glands work perfectly fine, and my vision is very good, I don’t need glasses at all. About a year after isotretinoin I had 50% of meibomian gland dropout, pictures of my meibomian glands 1.5 years ago showed about 70% dropout (if I remember correctly). So, my eye problems are due to meibomian gland dropout. I have almost just scar tissue left. So it is very painful physically and psychologically, hence my looking for advice/input

edit: @tim-2 my opthalmologist explicitly said my gland problems were due to isotretinoin, and my problems started the day after my first isotretinoin dose.

I don't know what the mechanism is for meibomian gland dysfunction caused by accutane, if I get around to it I'll have a look but I suspect it's not known as the mechanism for accutane's effect on sebaceous glands is not known.

Sounds like you need to detox the Accutane asap so it may be worth using all the known antidotes for retinoic acid toxicity such as taurine, many of the b vitamins, vit c, vit d low dose if you can't get high uvb sunlight, vit k2 (low dose), natural vit e, sunlight, make sure you are eating enough animal protein.

Smoking is likely the fastest way to clear Accutane. See my latest yt video about it. Not suggesting you do it. I personally smoke one Manitou organic cigarette per day.

Quote from mmb3664 on January 4, 2021, 6:01 pm

Quote from tim on January 4, 2021, 4:23 pm

Smoking is likely the fastest way to clear Accutane. See my latest yt video about it. Not suggesting you do it. I personally smoke one Manitou organic cigarette per day.

@tim-2 From what I remember, the comments on your YouTube video also suggested that inhaling smoke from another source, like a camp fire, might have the same effects on using up vA that smoking cigarettes would. Since making your video, have you found any evidence in support of or opposition to that theory? Do you think one would experience any "detox symptoms" using this approach of smoke exposure to reduce vA levels?

Quote from tim on January 4, 2021, 10:25 pm

@mmb3664

Yes, my understanding is it's due to chemicals inherent in smoke per se rather than just tobacco smoke.

Both sunlight and smoke convert retinoids into carcinogenic breakdown products but keep in mind that carotenoid breakdown products from just eating a carrot are carcinogenic so it's more about the carcinogenicity of retinoids per se. Retinoids may be a major cause of skin cancer from sun exposure (I posted a relevant study on the ray peat forum) and lung cancer from smoking.

To the average person the idea of smoking to deplete vA sounds crazy. I think it may have a place though if people are really suffering from accutane and need to deplete it as fast as possible.

Both sunlight and smoke could increase detox symptoms which is why small amounts regularly are likely the right strategy.