Vitamin A and fatty liver disease. Here are some special concerns. Hi, I’m Dr. Chris Masterjohn of chrismasterjohnphd.com. And this is Chris Masterjohn Lite, where the name of the game is “Details? Shmeetails. Just tell me what works!” And today we are going to talk about vitamin A and fatty liver disease. I’ve done a few episodes on vitamin A toxicity or excess vitamin A during pregnancy over the last couple of weeks, and now I want to focus in on one specific topic where I have some special concerns over vitamin A in the context of fatty liver. And this concerns many people because an estimated 70 million Americans have fatty liver disease. How do you know if you have fatty liver? Well, the best way to know is to have your doctor check for it, and the easiest way for your doctor to do that is with ultrasound.
Liver enzymes, so-called “liver enzymes,” are not useful in determining whether you have fatty liver. In fact, besides an ultrasound or a more advanced imaging technique, the best ways to know that you probably have fatty liver are being overweight, or obese, or having type 1 or type 2 diabetes. Basically if you are obese, then it makes more sense to assume you have fatty liver than to assume that you don’t. Not to say that you definitely do, but your likelihood of having fatty liver is about two-thirds. So, if you’re going to assume one way or the other rather than get an ultrasound to check, then it just makes tremendously more sense to assume that what I’m saying in this episode applies to you. So, my concern with vitamin A is, on the one hand, fatty liver would be expected to reduce your liver’s ability to store vitamin A, and when your liver’s storage capacity for vitamin A gets overwhelmed, you become more vulnerable to vitamin A toxicity because the vitamin A, the forms of vitamin A that are supposed to be stored in the liver are instead circulating in your blood, and that’s one of the things that drives the toxicity effect. But the second thing is that in animal experiments, when you make laboratory animals obese and you look inside their cells, they have markers of vitamin A deficiency inside their cells. So, my suspicion is that many people who have fatty liver will be stuck between a rock and a hard place where they have problems that are a result of cellular vitamin A deficiency, and yet they can’t tolerate high doses of vitamin A. And you could actually cause problems by trying to jam vitamin A into the system with more and more supplements. So, I believe the correct strategy is to do as follows. It’s always better to have actual data of whether you have fatty liver, but barring actual data for fatty liver, we assume fatty liver on the basis of obesity or on the basis of type 1 or type 2 diabetes. If we’re dealing with pre-diabetes, or insulin resistance or overweight, then we say we don’t know exactly the probability, but it may be it’s 50/50 that we should start getting concerned about it. And in those cases, I would say limit the preformed vitamin A, the retinol from animal foods or from supplements that come as retinol or retinol palmitate. Limit that to 3,000 IU per day and don’t go above that. And that includes a total of foods and supplements. So, if you’re eating eggs and dairy, you’re probably not going to ever hit 3,000 with those foods, but if you’re eating liver, you could hit an average of 3,000 IU per day just by eating liver once or twice a week. So look at all the retinol from foods or supplements, and you want that combination to stay at 3,000 IU. Then you want to specifically work to target the fatty liver. So I’ll, what I’m going to do is I’m going to make a second episode that’ll come next episode about how I would approach the fatty liver, but deal with the fatty liver first. Come to a resolution there, and then seek to optimize vitamin A status. After that, you may find that more than 3,000 IU of retinol per day does provide benefits, but it’s better to resolve the fatty liver issues before trying to jam vitamin A into a system that isn’t working right.
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The audio of this episode was enhanced and post-processed by Bob Davodian of Taurean Mixing. You can find more of his work at taureanonlinemixing.com. All right, I hope you found this useful. Signing off, this is Chris Masterjohn of chrismasterjohnphd.com. This is Chris Masterjohn Lite. And I will see you in the next episode.
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Source: Chris Masterjohn, PhD
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