VITAMIN A: Infection fighter, skin protector
Ancient Egyptians used cooked liver as a remedy for night blindness, but many centuries passed before we understood why. And in 1915, when we found the answer—vitamin A—the modern age of nutrition dawned. In the eighty years since, we’ve discovered even more ways in which this nutrient assures our health. Although night blindness is the officially recognized deficiency disease of vitamin A, many maladies are inextricably linked with how much of the nutrient circulates in our bodies. As one of our major antioxidants, it’s an invaluable ally against heart disease and other degenerative conditions. 1 It’s needed for healthy reproduction, hormone stability in women, proper growth, blood sugar balance, and defense against infections, to cite just a few of its responsibilities.
THE ORIGINAL INFECTION FIGHTER
Vitamin A earned its reputation as the “infection vitamin” long before vitamin C usurped the title. Despite C’s powerful ability in this area, vitamin A is just as necessary a part of the infection-fighting process. It shores up the immune system in myriad ways, with much of its work occurring in the mucous membranes that line the gastrointestinal tract. At the first hint of a cold, I start to take between 50,000 and 100,000 IU of vitamin A daily, along with large doses of vitamin C and zinc. This nutrient prescription, I think, is one of the reasons.I haven’t missed a single day of work because of an illness for more than three decades. Taking large short-term doses also improves recovery from stronger respiratory and sinus infections. And an oral supplement program combined with direct skin treatments will slow a herpes outbreak.
The bloodstream’s level of retinol, as vitamin A is more technically known, is one of the major factors that account for why children in industrialized countries don’t die from such seemingly benign viral infections as the measles, unlike the kids in underdeveloped nations. Meeting vitamin A needs throughout the world could save 1.2 million-2.5 million lives every year. The number of deaths from respiratory disease would plunge by 70 percent; the number of deaths from diarrhea-related diseases would drop by 39 percent. 2 Surprisingly enough, vitamin A deficiencies still exist in the United States, although perhaps they are not as critical as in the rest of the world. Of twenty Long Beach, California, children who had the measles, one small study found, half were deficient in vitamin A—yet all of them were well fed. Children are extremely susceptible to vitamin A deficiencies, partly because infections drain their little bodies’ retinol stores. However, just a single 20,000 IU dose can quicken their recovery from chicken pox and virtually eliminate its possible complications. 3 Further, infants would face fewer life-threatening lung infections if they were fed vitamin A supplements regularly. 4 In view of the subtle adverse consequences of childhood vaccinations, I find myself recommending a strategy based on childhood supplementation with vitamin A and other nutrients; it’s equally effective and far safer.
Retinol reinforces the immune system’s resistance to any infectious disease, even AIDS, where the impact has been studied extensively. Some scientists assert that even a modest supplement program of vitamin A, between 13,000 and 20,000 IU per day, may slow the disease’s advance. 5 People with AIDS are at least two hundred times more likely than their otherwise healthy counterparts to have low levels of the vitamin, even when their vitamin intake from food is adequate. Doctors can predict the life expectancy of someone with AIDS just by measuring blood concentrations of retinol. 6
As I talk to patients with skin disorders and scan the literature in search of new therapies, it sometimes seems that traditional dermatologists will prescribe a cortisone-derived cream for just about every skin disorder they encounter. Old habits die hard, I suppose—but “then, I may have an equally narrow focus. For almost 100 percent of the skin conditions I treat, I prescribe vitamin A. I also recommend it preventively to keep skin healthy. As the pharmaceutical industry knows full well, vitamin A is ideally suited to nourish and heal the skin. Look at the passionately promoted products at the cosmetic counter. Their active ingredients, frequently, are retinoids, the synthetic versions of vitamin A. Nature holds the patent on the real thing, which forces the companies to develop these inadequate imitations. I may be unduly skeptical, but I think natural vitamin A, because it is safer, is a better product. The treatment of acne is a good example of vitamin A’s value. If you’re prone to persistent pimply eruptions, I’d bet a blood test would reveal that you’re in the low end of the vitamin A range. The skin typically clears on a strong supplement program, using a dosage between 200,000 and 500,000 IU per day for three or four months. That’s a big dose, one that requires a physician’s oversight because of the likelihood of side effects. I doubt, however, that its toxicity comes close to that of isotretinoin, one of the patentable pharmaceuticals. Women who are even remotely likely to get pregnant, for example, can’t take the drug because it magnifies the risk of birth defects astronomically. No one who has acne needs to worry about any possibility of treatmentrelated side effects. I’ve discovered through my practice how to complement the impact of natural vitamin A, making lower doses as effective as higher amounts. First, sugars and refined carbohydrates must be eliminated from the diet. By including vitamin E, zinc, pantothenic acid, GLA, and the beneficial bacteria as part of the acne therapy, you can get by with only 100,000 IU of vitamin A, a much safer dosage. Psoriasis also improves from taking vitamin A supplements. Of the medical trials I’ve reviewed, the most effective protocol used is 100,000 IU, along with some additional vitamin D.
Vitamin A’s critical value to the skin is but one aspect of its benefit to all epithelial tissue. Epithelium is the layer of cells that form the outermost layer of the skin. If you think about this, both the digestive and the respiratory tract are in contact with the external environment. I had always used vitamin A as part of the Atkins Center protocol for emphysema, a form of chronic obstructive pulmonary disease (COPD). Scientific studies show that people with severe pulmonary disease exhibit low vitamin A levels; those patients who take vitamin A supplements exhibit improved lung function.
Because of its close connection to mucous membranes and epithelial cells, vitamin A proves to be a worthwhile treatment addition for certain intestinal illnesses. It has helped my several hundred colitis and Crohn’s disease patients, and its value for treating and preventing duodenal ulcers was emphasized by the Harvard study showing that men with the highest vitamin A intake had a 54 percent lower risk of ulcer than those whose intake was lowest.
Although it is often overshadowed by the more widely known beta-carotene, vitamin A continues to impress scientists as a cancer preventive and treatment. 10 One reason is that it apparently goes a long way toward halting a tumor’s reemergence following surgery. One study tested the vitamin on 307 people who underwent operations for lung cancer. Some of them took 300,000 IU of the vitamin daily for a year; the others did not. After twelve months the vitamin takers remained free of new tumors for a longer period of time and developed far fewer tumors than the people who did not use supplements. 11 Without vitamin A’s round-the-clock vigil, other cancers are also much more likely to attack, including prostate cancer 12 and certain forms of leukemia. The cells that make up the surface layer of our skin, called epithelial cells, seem to depend heavily on it, too, for protection from malignancies. People who develop these skin cancers, including basal cell carcinoma and squamous cell carcinoma, frequently have significantly tower than average blood levels of retinol. 13 Longtime tobacco chewers often will notice the growth of a whitish coating on the soft mucous membranes inside their mouths. The appearance of this condition, called leukoplakia, often foreshadows cancer, but vitamin A has, in some experiments, caused it to vanish. Administering 32,000 IU daily for six months reduced the formation of new lesions and allowed for complete remissions in more than half of the tobacco chewers who took it.
Women’s Health Concerns
Retinol can be one of a woman’s most needed nutrients. Some of premenstrual tension’s bothersome symptoms disappear under the vitamin’s influence and may not return even after discontinuing the supplement program. In one study, 50,000 IU per day reduced heavy menstrual bleeding; 14 in other research, a larger daily amount (150,000 IU) was useful in treating benign breast disease. 15 Taken along with folic acid and boron, vitamin A contributes to minimizing hot flashes and other menopausal symptoms. It is not always true that higher doses bring better results. It is said that amounts above 8,000 IU may cause birth defects, but I have not seen any convincing studies to back up this warning. Women who are pregnant or who plan to have a child should consider limiting their A supplementation to no more than 8,000 IU per day unless there is compelling reason to use more. Avoiding the vitamin completely, however, is not wise. Women need a good supply of it, not only to make hormones, including progesterone, but to nourish the fetus and reduce the risk of pregnancy-related complications, such as low birth weight. 16 In studies of retinol-deficient mothers-to-be, researchers have found no ill effects from daily dosages as high as 6,000 IU. 17 Don’t just guess at how much retinol you and your baby will need. Ask your obstetrician to authorize lab tests for vitamin A (and while you’re at it, many of the other nutrients, especially folic acid).
Whether injured by a sunburn or a surgical incision, skin heals better with vitamin A supplements, because the nutrient stimulates the release of a compound that facilitates tissue repair. It also generates collagen synthesis in the wound, improves the quality of new tissue, and lowers the risk of an infection. 18 Along with zinc, vitamin A should be taken routinely immediately before and after any kind of surgery.
Blood Sugar Disorders
Although a carbohydrate-restricted diet and certain sugar-metabolizing supplements control diabetes-like problems quite well, every little bit helps when you confront the world’s most serious metabolic disease. Because of a relatively recent study suggesting that vitamin A might add to blood sugar stability, I make sure to include the nutrient in antidiabetes protocols. A study based on fifty-two healthy people found that those who consumed more than 10,000 IU of vitamin A per day metabolized glucose better than those who took in less than 8,000 IU. Researchers conclude that the nutrient allows the body to use insulin more efficiently, helping the hormone to get blood sugar into the body’s cells. 19 If the finding is replicated, retinol will represent a major step toward beating insulin resistance, the disorder behind both Type I and Type II diabetes, high blood pressure, high triglycerides, hypoglycemia, and obesity.
An average adult should consume about 5,000 IU of vitamin A every day. For a retinol-deficiency-related illness, you may need to take up to 100,000 IU per day. Cod liver oil and liver are the best sources, followed by butter, egg yolks, cream, and whole milk. Cereals and skim milk, even when fortified with the nutrient, are not good sources. For a supplement source, vitamin A paImitate is the version commonly found in multivitamin formulations, and it usually meets our needs. Vegetarians should note that it is synthetic and not derived from any animal. If your body’s vitamin A stores must be replenished in a hurry, as would be necessary at the outset of an acute respiratory infection, use the mycellized version, which bypasses the liver and is absorbed easily, thus reducing the likelihood of a toxic accumulation. Even in amounts of 100,000 IU a day for months at a time, mycellized vitamin A has never caused any documented side effects. This safety record does not mean, however, that therapeutic dosages need not be monitored by a doctor. Mycellized A performs impressively against sinus and other acute infections, especially when combined with mycellized vitamin E, Its liquid doesn’t taste great, but it’s worth tolerating for quick, impressive results. Other forms, such as retinol palmitate and emulsified preparations, have also logged impressive results.