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Vitamin A Toxicity  -- Deception From Merck

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[Karl Note:  Vitamin A, all by itself, is an excellent preventive for both cancer and heart disease.  If more people knew this, they would not take so many drugs. So, the drug companies have a very considerable interest in scaring you away from taking  Vitamin A.  Here you see a typical set of scare tactics, by one of the large drug companies.  The title, "Vitamin A Toxicity" is enough scare you away.  But, when you read the text you find that the dosages they are talking about are far, far higher than you will find in most vitamin formulas.  This is a false claim of danger.  But, look at all the other essential vitamins -- where Merck is ready to tell you about their toxicity. Click on a few to read the "bad news."]

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The Merck Manual of Diagnosis and Therapy    Section 1. Nutritional Disorders    Chapter 3. Vitamin Deficiency, Dependency, And Toxicity Topics [General] Vitamin A Deficiency Vitamin A Toxicity Vitamin D Deficiency And Dependency Vitamin D Toxicity Vitamin E Deficiency Vitamin E Toxicity Vitamin K Deficiency Vitamin K Toxicity Thiamine Deficiency And Dependency Riboflavin Deficiency Niacin Deficiency Vitamin B6 Deficiency And Dependency Vitamin B6 Toxicity Biotin Deficiency And Dependency Pantothenic Acid Deficiency Vitamin C Deficiency Vitamin A Toxicity Excessive intake of vitamin A may cause acute or chronic toxicity. Acute toxicity in children may result from taking large doses (> 100,000 µg or 300,000 IU); it manifests as increased intracranial pressure and vomiting, which may lead to death unless ingestion is discontinued. After discontinuation, recovery is spontaneous, with no residual damage; only two fatalities have been reported. Within a few hours of ingesting several million units of vitamin A in polar bear or seal liver, arctic explorers developed drowsiness, irritability, headache, and vomiting, with subsequent peeling of the skin. Megavitamin tablets containing vitamin A have occasionally induced acute toxicity when taken for a long time. Chronic toxicity in older children and adults usually develops after doses of > 33,000 µg (100,000 IU)/day have been taken for months. In infants who are given 6,000 to 20,000 µg (20,000 to 60,000 IU)/day of water-miscible vitamin A, evidence of toxicity may develop within a few weeks. Birth defects have been reported in the children of women receiving 13-cis-retinoic acid (isotretinoin) for skin conditions during pregnancy (see Drugs in Pregnancy in Ch. 249). Massive doses (50,000 to 120,000 µg or 150,000 to 350,000 IU) of vitamin A or its metabolites are given daily to persons with globular acne. Although the treatment is effective, it puts the patient at risk for vitamin A toxicity. Although carotene is metabolized in the body to vitamin A at a slow rate, excessive ingestion of carotene does not cause vitamin A toxicity but produces carotenemia (carotene blood levels > 250 µg/dL [> 4.65 µmol/L]). This condition is usually asymptomatic but may lead to carotenosis, in which the skin (but not the sclera) becomes deep yellow, especially on the palms and soles. Carotenosis may also occur in diabetes mellitus, myxedema, and anorexia nervosa, possibly from a further reduction in the rate of conversion of carotene to vitamin A. Symptoms, Signs, and Diagnosis Sparse coarse hair, alopecia of the eyebrows, dry rough skin, and cracked lips are early signs. Later, severe headache, pseudotumor cerebri, and generalized weakness are prominent. Cortical hyperostosis and arthralgia are common, especially in children. Hepatomegaly and splenomegaly may occur. Normal fasting plasma retinol levels range from 20 to 80 µg/dL (0.7 to 2.8 µmol/L). In vitamin A toxicity, fasting plasma levels may exceed 100 µg/dL (3.49 µmol/L), up to 2000 µg/dL (69.8 µmol/L). Differential diagnosis may be difficult because symptoms are varied and bizarre, but they usually include headache and rash. Prognosis and Treatment Prognosis is excellent for adults and children. Symptoms and signs usually disappear within 1 to 4 wk after stopping vitamin A ingestion. However, prognosis for the fetus of a mother taking megadoses of vitamin A is guarded.

	Copyright © 1995-2002 Merck & Co., Inc., Whitehouse Station, NJ, USA. All rights reserved. Terms of Use.

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