Over the past few years this has been intensely debated within the alternate health spheres, particularly Ray Peat forums.
I would like to explore this deeper as a Self-Meta. Examining all sides of arguments. Mainly on the opposing view(s) by Grant Generoux and Dr. Grant Smith.
This is largely a WIP / work in progress live-draft share for public reading. Any or all mistakes including spelling errors, placeholder indicators and/or unfinished passages remains visible. However, I retain the right to temporarily unpublish this entire feature writeup, due to the complex nature of the subject, and with inevitable need for splitting these into multiple part(s). Meanwhile ~ my thoughts, on this nuanced subject remains strictly preliminary. And that I am yet to formulate any conclusions, for as long as this "Live Draft Notice" remains visible.
Since the beginning of this initiative I am absolutely not affiliated, nor do I speak for - on behalf for any "influencer", "brand" or entity. This Self-Meta is entirely a product, concept, and initiative of my own curiosity to both purvey bespoke dialogues that are otherwise hidden amidst pedestrian or mainstream medium(s). As general reminder once again, this Self-Meta is neither prescriptive advice nor cannot it indemnify anyone. For those new to this concept initiative, welcome! please acquaint yourselves with this starting page here. Live-it-forward, AW.
Reaching close to a decade since incorporating various forms of low carbohydrate, I am an advocate of consuming most organ meats for their micronutrients. Chiefly among them ~ livers. There is a feeling of certain nourishment, quite difficult-to-describe, such that I am yet to experience nor find elsewhere from so called "superfoods".
My interest in Vitamin A also coincide within the views of Dr Ray Peat's favour. That of which, despite controversial towards high sugar, yet also liberal in saturated fats ~he is pro-Vitamin A from raw, but not cooked ~ carrots and also recommends, although in sparing amounts ~ livers and organ meats.
Despite the proclaimed anti-estrogenic attributes and all around synergy with all other key fat soluble vitamins - D, E and K2; it seems very difficult and hard to argue against Vitamin A at first. Considering their historic significance, and widely-established essentiality not only within mainstream academia, but also alternate health circles, Weston Price Foundation included.
However in recent years saw a curious, yet turbulent controversy(s) firstly stemming within Ray Peat forums. Particularly from one thread (which, names nor title shall not be mentioned) focused primarily on Grant Generoux's hypothesis that Vitamin A, is not and never should have been considered ever, to be a nutrient. The thread has attracted multitude hundred(s) of pages.
This led me to read, albeit time-restrictive ~ Grant Generoux's free to view ebook "Extinguishing The Fires of Hell.". Weighing at 430 pages, it requires careful, slow and patient reading to this day. I am yet to fully read this through, word-for-word. However, all his assertions, including the charts, well referenced citations, and the nostalgic visuals all seemingly legitimate and persuasive. But it is Grant's own N=1 experiment proving the most interesting, that is shared until in the much later Chapter(s) #25 in the book (@page 368).
Recent weeks counting months also led me to self-enquire my own dietary recalls, comparing and introspecting for differences in my WOL (way of life) from my WOE (Way of eating) specifically where and when possible ~ surrounding Vitamin A rich foods coming from predominantly carrots and my own DIY livers pate. Recalling whether or not I have indeed feeling better with lesser Vitamin A, the opposite, or perhaps still undecided. I have no conclusion as of the very publically-sharing of this Self-Meta.
Nevertheless, there is much controversy, that has only gained traction in recent years. Hence, This Self-Meta I hope ~ brings together a more rounded introspection on this yet another complicated subject, just like Vitamin D.
This is a live WIP listing subject to further revision overtime.
Whilst this page is published live temporarily as draft, only a few citations are listed here, subject or until time necessitates me to continue drafting on the nuanced aspects offline. Also note that in the later sections on Vitamin A's role on specific autoimmunity (particularly - AS / Anyklosing Spondyltis) feature an entire list of citations amounting to the dozens. Hence outlining each and every one of them is likely encumbering to read.
As kind reminder, whilst videos & podcasts are persuasive and easy-to-digest mediums ~ they by no means represent permissive discount from further reading and/or research.
Lastly, unlike its predecessor, this Self-Meta is written entirely in first person for a less-formal impression.
Besides from the main over-arching title "Should Vitamin A be avoided?" I have decided to break this down into several more layer(s) of question.
“Roasted ox liver, pressed, applied (topical to the eye).” ~ Egyptian Papyrus Ebers (~1550BC)
There is no one (1) historic "event" uncovering simultaneously ~ both the presence, and/or the function of Vitamin "A", as we know it. But there appears to be ancient evidences and/or records proclaiming that Vitamin A rich foods we've known (livers, particularly) have been used both topically and orally as medicinal nutrition.
Fast forward to 18th to 19th century saw a period of experimental models to study the effects of malnutrition on both human and animals. Commonly noted signs were volatility to infections, as well as vision loss. During these period, researchers were trying to idenitfy what key micro nutrients, apart of macronutrients (carbohydrates, proteins and fats) and minerals that are associated with growth (bodily tissue), overall development. Between 1906 to 1920, a particular compound (or back then, called "Accessory Factors") were found to be fat soluble, has an "amine" group in its chemistry*, and mostly coming from milk, eggs (particularly the yolks) and cod liver oil. In 1918, these factors were then given a name "Fat-soluble-A", before then renamed as "Vitamin A" , in 1920. In 1931, organic biochemist Paul Karrer successfully extracted the compound from cod liver, and marked the first discovery of Vitamin A's structure.
Vitamin A in dietary forms come as either "preformed" (retinyl esters) from animal sources ~ eggs, liver, butter, milk and also on fortified cereals. Alternatively "provitamin" (carotenoids / Beta Caraotenes) which as one implies ~ carrots, collard greens, and squash.
Noteworthy is that caretonoids are NOT only found on bright coloured vegetables - carrots, squash, peppers and/or pumpkins. The green(s) in Kale and Brocolli for example, as defined by their Clorophyll ~ also contain some Vitamin A. Beneath the chlorophyll exposes oranges and yellows when oxidised. These phenomenon may also explain the colour transitioning between (green) to (yellows to deep oranges) amongst fruits as they ripen.
Like all other fat solubles (Vitamins E, D and K2) the presence of fats, and optimum gall-bladder at producing enough bile (10:50) to help emulsify, packaging and transport through the small intestines. From there ~ both forms (Provitamin or Preformed) undergo their three possible (3) conversions:
A specific version that Generoux's Book highlighted ~ Retinol Palmitate (pg 70). This is the alcoholic form (~"ol") bound to palmitic acid ~ a saturated fat off palm oil and often re-named in various synonyms "All-trans-retinyl", "Palmitate", and "retinol hexadecanoate" to name a few. It is the added form throughout not only the food supply, but also in sunscreen products (pg 348).
There is also another form albeit less discussed in the alternative health circles ~ "Anhydroretinol"; a potentially yet another damaging metabolite of Vitamin A. The Youtube® presentation by Meredith Arthur, registered dietician, explained these in quite a nuanced detail; including a discussion on the various genes and enzymes most volatile that some individuals may be inherently born with, that inevitably and adversely affect Vitamin A metabolism. Information like these can be immensely useful for those considering a nutrigenomics consultant.
Note that in Australia, the RDA for Vitamin is measured differently in mcg.
According to the NRV / nutrient reference value for Australia & NZ ~ One (1) IU / International Unit of Activity ~ is equivalent to 0.3 of mcg.
From the above reference, the RDI / Recommended Dietary Intake were suggested as:
Elswhere suggested ~ the RDA is 900 mcg. This equates to 3000 IU. Plasma reference ranges suggests to be 18-60mg/dl.
Toxicity or upperlimits (UL) appears to vary widely.
Interestingly Beta Carotenes are widely thought to be safe, irrespective of dosage. The Australian ERV does not have any data suggesting what constitutes UL on this preformed Vitamin A, despite the warnings it did share that suggest dose-dependent correlation with lung cancers. Nevertheless, the ERV page rationale for abscence of UL on Beta carotene was simply due to "insufficient evidence" for harmful symptoms, other than "yellowing of skin".
Gathering from large pools of research ranging from case-studies, animal, and mechanistic ~ the two oppositions to the Vitamin A paradigm (Grant Generoux and Dr. Garrett Smith) assert two primary arguments. Firstly that Vitamin A, irrespective dietary or supplemental intake is not and should not be a nutrient. And secondly, Vitamin A's under-recognised correlations with auto-immunity and all-mortality risk factors.
The controversy seemingly initiated from one (1) Ray Peat forum thread. This led to gradual recognition of Grant Generoux's Book. The thread have gathered HUNDREDs of pages.
One of many prime reasons why this has gained traction in a lot of the alternative health community is firstly the filtering through the confusion, the nuanced mechanism and before then~ difficulties at extrapolating actionable decisions given that both dietary and supplemental forms (caretinoids and retinyl esters). Both forms are already so ubiquitous and prevalent throughout our food supply; making it very difficult, for anyone to suspect its causal role ~ independently that is, amongst all other moving and/or confounding variables.
Another controversy (and difficulty) is the inaccuracy(s) surrounding objective assesments for Vitamin A toxicity and symptoms believed to have a "U" curve. Serum Vitamin A, as Grant asserts in his book is poor indicator of status. Research appears to agree, that among individuals who express Vitamin A toxicity symptoms, paradoxically showed serum normal levels (Kristina Penniston KL & Tanumihardjo SA 2006). Adding to this confusion, toxicity symptoms appears shared whether one is deficient or excess intakes, thus possibly leading to U curve like inference. This is just one (1) out of many dozens of other proclamations examining the difficulty and confusion. But at the time of drafting this Self-Meta ~ succinctly rewriting these for concise lay reading are enormously difficult and time consuming.
Irrespective a growing number of insights, among them very interesting anecdotes, continue to stem within forums dedicated to these exclusion protocols. Chiefly among them the newly-transitioning Ray Peat, and Generoux's own discussion board .
Albeit / despite some disagreements proclaiming against the hypothesis of Vitamin A being "poison" (see here, and here) remains noteworthy.
Another source worth referring to is Meredith Arthur, a dietician who is also aware of Vitamin A controversy. However, coming from deeper mechanistic background, she nonetheless believes that Vitamin A, despite the negative correlations are not the same in all forms.
"Retinol" in particular as asserted appears to have an essential role to general energy production, as well as to safeguard against yet another harmful conversion to another form of Vitamin A, known as "Anhydrovitamin A". (41:40)
From observing, reading and listening through all the main references, including podcasts and guest interviews in various channels as listed in the beginning of this Self-Meta:
Other interesting notes indirect to Vitamin A, lead us to Carnivore Diets and how it has recently grained fame for addressing auto-immune conditions. The famous 2021 study from Harvard (Lennerz BS et al. 2021) observed improvements amongst 2029 participants. Looking at the "perceived" symptoms documented ~ all eye health related concerns appears generally "improved" or "stable", with the diet. Noteworthy however is that throughout carnivore sphere in general, including Shawn Baker ~ all consider organ meats as only optional. An article by Optimising Nutrition examining Shawn Baker's micronutrients input ~ all appears to be very low on Vitamin A. This mildly suggests, only hypothetically that a lowered Vitamin A intake may have likely a part of, or a contributing factor ~ that led to relieve many of symptoms above.
Generoux's Book primarily focuses around Vitamin A's correlations with auto-immunity. For context ~ Autoimmune disease is a highly complicated stream of condition(s). There are over (possibly more than) eighty (80) thus-far known separate disorder(s). Each affecting anywhere from psychology to physiology. A possible list, though of course high level suggest the following as surrogate effects:
To name a few. For a full list, reading Generoux's book is highly recommended (pg 88).
Other more metabolic health specific symptoms (Olson JM et al. 2023) include the following though not exclusively limited:
For pathology / blood panels ~ liver function tests (particularly for the below two enzymes), in addition to complete blood count (CBC) seems recommended.
Noteworthy is that serum Vitamin A (normally suggested as 1-3 picoMol/L) may not be realiable indicators for toxicity. As there are multiple case studies strongly suggesting toxicity symptoms do manifests, despite normal serum readings (Penniston KL & Tanumihardjo SA 2006).
As Vitamin A gets catabolized originating from the dietary or supplemental ~ Preformed (Retinyl Esteres) or Provitamin (Carotenoids / Beta-carotenes),
General knowledge suggests that beta-carotenes, the most familiar form of caretonoids in brightly coloured fruits and starchy vegetables have been proclaimed safe, and cannot be overdosed at any level. Yet other research suggest that more insight is needed. For instance "Caretonosis" has been a well documented symptom notably through yellowing and/or orange pigmentations; usually on hands. One meta-analysis (Zhang Y et al 2023) suggests that Beta-carotenes supplementation may be associated, albeit within sub-group analysis ~ with worsening state of lung cancer. And two more meta-analysis, one in 2022 (Yang J et al 2022) and previously in 2010 (Latino-Martel P et al. 2010) ~ found likewise associations with not only lung cancer, but also in the 2010 analysis ~ worsening CVD / cardiovascular disease association.
In 2022 in the public spotlight, there was an article on The Conversation. Attentive and convincing in the title, it reads "An expert panel has recommended against taking vitamin E or beta carotene supplements for the prevention of cancer and cardiovascular disease – here’s why".
At the very least from what we may take away from the above video references thus far:
Obviously the above only a grossly summarised attempt at providing a high level explanation. Therefore is not a permission to discount further reading.
<Draft WIP progress>
This is a Live-Draft WIP in Progress article. Embarrasments, non-sequitor's and the like are all in the show. Without shame. However I still retain the right to continue drafting elsewhere. And that this may be subject for complete (albeit temporary) omission altogether until I am confident or ready for their public release.
Nutritional Science carries "science" in the end for a reason. Such is what I believe to be open-ended for readers own introspection.
Live-It-forward
AW.