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Nutritional Diseases
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Chelsea Kesty, Madeline Hooper, Erin McClure, Emily Chea, Cynthia Bartus
Hypervitaminosis A can be deadly. It is important to correct toxic over-supplementation and monitor systemic retinoid patients. The incurred liver damage may be irreversible, and women of childbearing potential may risk fetal defects.
Micronutrients
Published in Chuong Pham-Huy, Bruno Pham Huy, Food and Lifestyle in Health and Disease, 2022
Chuong Pham-Huy, Bruno Pham Huy
Since vitamin A is fat-soluble, it can be stored longtime in the body, primarily in the liver. Routine intake of large amounts of vitamin A supplements or polar bear liver over a period of time can result in toxic symptoms, including liver damage, bone fractures, joint pain, increased intracranial pressure, dizziness, alopecia (hair loss), headaches, vomiting, blurry vision, insomnia, fatigue, weight loss, drying of the mucous membranes, skin desquamation, coma, and even death (3, 9, 33, 56–58). Children are more sensitive than adults to a high retinol intake. These toxicities only occur with preformed vitamin A (retinoid), but not with carotenoids such as β-carotene. Hypervitaminosis A is usually a result of consuming too much preformed vitamin A from supplements or therapeutic retinoids (56). High intakes of preformed vitamin A supplement (more than 1,500 µg/day, only slightly higher than the RDA) can reduce bone mineral density, and increase fracture risk (56). In addition, there is also evidence that retinol is teratogenic (causing developmental malformation of the fetus and birth defect). Consequently, it has been suggested that pregnant women or those who are trying to become pregnant should not take vitamin A supplements and should not eat liver or liver products in high amounts (9, 33). Nevertheless, pregnant women are advised not to consume more than 3,000 µg/day (10,000 IU) vitamin A supplement to avoid risk of fetal toxicity (3, 33, 56). Consult a doctor before using vitamin A supplement if you are pregnant.
Exercise and pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Many active women will begin pregnancy underweight. Among these women, there is an increased awareness of body image, and many of them will continue to consume inadequate low-calorie diets during their pregnancies. To compensate for these low-calorie diets, they will frequently turn to excessive use of vitamins. Excessive intake of vitamins can result in an increased incidence of congenital malformations. Excessive ingestion of vitamin D could result in a neonatal syndrome consisting of supravalvular aortic stenosis, elfin facies, and mental retardation (35). Hypervitaminosis A may cause urogenital anomalies, ear malformations, cleft palate, and neural tube defects (36). The iron status should be assessed since many of these women may have preexisting depleted iron stores.
Evaluation of the changes in sebum, moisturization and elasticity in acne vulgaris patients receiving systemic isotretinoin treatment
Published in Cutaneous and Ocular Toxicology, 2021
Güllü Gencebay, Özge Aşkın, Server Serdaroğlu
Acne vulgaris is a frequent challenge in the outpatient clinics because not only patients are using off-the counter products but also have a propensity of being unsatisfied due to their increased anxiety caused by the disease. Providing effective treatment for acne requires a good history and detailed dermatologic examination12. The treatment modalities can be divided into two groups: topical and systemic. Systemic treatment modalities include systemic antibiotics (e.g. macrolides and tetracyclines), hormonal therapies and oral isotretinoin12,13. Oral isotretinoin is an FDA approved treatment modality that has been used for nodulocystic acne lesions since 198214. Isotretinoin is a pre-drug that is transformed into its metabolites which have high affinities towards the retinoic acid nuclear receptors (RAR and RXR) and retinol binding protein. This way isotretinoin decreases follicular hyperkeratinization and thus decreases comedone formation. Isotretinoin also decreases the colonisation of propniobacterium acnes indirectly and has anti-inflammatory properties. Six weeks of isotretinoin therapy is known to reduce the sebum production up to 90%15. The therapy should be initiated at 0.5–1 mg/kg/day and if the patient tolerates the drug, the dose may be increased up to 1 mg/kg/day. The frequently encountered side effects of the drug are mucocutaneous, ophtalmic and skeletal symptoms resembling hypervitaminosis A, which subside when the therapy is stopped16.
Hypervitaminosis D without toxicity
Published in Baylor University Medical Center Proceedings, 2020
Jasmin Rahesh, Victoria Chu, Alan N. Peiris
Vitamin D deficiency is a common problem, with a prevalence of approximately 37% in US adults.1 Reasons for this high prevalence may include inadequate sunlight exposure and poor dietary intake of vitamin D. Vitamin D status is best assessed by 25(OH)D levels. Physician-prescribed vitamin D is one source of replenishing 25(OH)D vitamin D levels. However, vitamin D can also be purchased over the counter (OTC). These OTC products are not regulated by the Food and Drug Administration (FDA), and wide variations in content may be seen. Excessive intake of vitamin D appears to be a growing risk and can result in toxicity.2 This is only rarely a dispensing error.3 Marked hypervitaminosis D without toxicity has rarely been reported. We describe marked hypervitaminosis D in a woman without clinical or biochemical manifestations of toxicity, which resolved with cessation of OTC supplements.
Pseudotumor Cerebri Syndrome with Resolution After Discontinuing High Vitamin A Containing Dietary Supplement: Case Report and Review
Published in Neuro-Ophthalmology, 2018
Jason T. Chisholm, Michelle M. Abou-Jaoude, Amy B. Hessler, Padmaja Sudhakar
One of the most well-established secondary causes of PTCS is hypervitaminosis A, and there is good evidence that this syndrome can be induced if enough vitamin A is ingested.6,19 Studies have found serum vitamin A levels, in the form of retinol, to be significantly higher in idiopathic PTCS patients,20,21 and others have found significantly higher retinol levels in the cerebrospinal fluid as well.21–23 In 2007, Warner et al. found that the ratio of retinol to retinol binding protein (RBP) in the CSF was higher in patients with PTCS and was >1.0, suggesting the presence of unbound retinol, which they theorized may be toxic to arachnoid villi and lead to impaired CSF resorption.21 Increased RBP in the serum of individuals with PTCS has been reported in two studies, suggesting that the unbound toxic retinol in the CSF may be due to insufficient RBP transfer into the CSF compartment.21,24