The Vitamin A Toxicity Epidemic – Dr. Garrett Smith

00:00 – Introductions

Mike and Ben welcome listeners to the PricePlow Podcast and introduce their visitor, Dr. Garrett Smith, who Mike has adopted for almost two years now.

Dr. Smith’s background is launched, specializing in his experience in well being, diet, and detoxing. He comes from a background of power coaching, having begun weight lifting at age 11. This led to diet, and he realized how meals affected his well being.

He was a private coach, bought a level in physiology and a minor in chemistry and diet. He labored in a complement retailer, then headed to naturopath medical college.

Dr. Smith has now been training for 18 years, and explains many “phases” that everybody goes by means of, blaming quite a few elements for his or her ailments (heavy metals, carbs, and so forth).

The primary matter of dialogue is revealed: Vitamin A toxicity and its potential results on well being, and the way the liver and bile are related in illness.

03:45 – Discovering Grant Genereux’s Work on Vitamin A Toxicity

Dr. Smith mentions a Canadian engineer named Grant Genereux who went by means of persistent kidney illness, jaundice, and brutally painful eczema. He was heading to dialysis, however then realized that just about all “eczema meals” had been all excessive in vitamin A! So Grant determined to go on a really low vitamin A weight-reduction plan consisting of simply beef/bison, white rice, and beans.

Grant’s jaundice, eczema, and kidney illness fully went away as soon as he eradicated vitamin A from his weight-reduction plan. He wrote two books, Poisoning for Earnings and Extinguishing the Fires of Hell.

After studying half of Grant’s first guide, and connecting vitamin A with a lot of his affected person’s points, Dr. Garrett Smith realized that he needed to change all the pieces he was doing.

06:30 – Reconsidering Vitamin D Dietary supplements (Calcification and Joint Ache)

This wasn’t the primary time Dr. Smith had reversed course on utilizing a vitamin/complement/nutrient. He did the identical factor with Vitamin D3 (cholecalciferol) in 2013, after realizing by means of his sufferers’ hair mineral checks that:

Vitamin D3 dietary supplements elevate calcium ranges
Vitamin D3 dietary supplements decrease potassium ranges
Vitamin D3 dietary supplements induce hypothyroidism

Dr. Smith claims to be “one of the anti-vitamin D complement folks on the market”. He doesn’t assume it’s good for folks.

He states, in case you have a number of ache:

Get off of the vitamin A dietary supplements
Get off of the vitamin D dietary supplements
Cease consuming nightshades (which additionally include calcitriol, the lively vitamin D)

Give the above three an opportunity for a month and watch ache go down.

Understanding that our listeners could also be caught off guard listening to that vitamin D is poisonous, Ben asks Dr. Smith to rewind a bit and go deeper.

Whereas we do want daylight and ultraviolet gentle, do we all know that it’s by means of oxidized ldl cholesterol as cholecalciferol? Individuals have been bought an assumption about this, and it doesn’t pan out within the analysis whenever you simply give cholecalciferol to unhealthy folks.

Vitamin D raises the calcium ranges within the blood. It both will increase calcium absorption from the intestine, or it’s going to take it out of your bones. Males have been proven to have decrease bone density after 3 years of vitamin D supplementation.[1]

Vitamin D overdose induces hypercalcaemia.[2-8] He instructs everybody to lookup Vitamin D bone resorption. In the end, for those who’re stiff in your joints, cracking/popping, enhance magnesium (the anti-calcium) and take away vitamin D3. Give it some thought: X-rays search for calcium. Mammograms search for calcium. Calcification is an issue – most ailments contain it.

15:00 – Bettering Well being with a Low Vitamin A Weight-reduction plan

Again to Grant Genereux’s work, regardless of being a health care provider, Dr. Smith was nonetheless having points with BPH (benign prostatic hyperplasia — enlargement of the prostate gland), insomnia, decrease again ache, and a little bit of psoriasis. Urinary and prostate points at age 25 had been actually regarding given the truth that his dad had died of prostate most cancers.

After taking vitamin A out of his weight-reduction plan (however to not the intense that Grant goes), avoiding consuming liver in any respect prices, and stopping vitamin A / beta-carotene dietary supplements, his well being started to drastically enhance. And so did his sufferers who additionally adopted this suggestion.

Quick ahead to 2024, Dr. Smith has been limiting vitamin A consumption for six years, and Grant just lately celebrated ten years with extraordinarily little vitamin A consumption.

The onslaught of vitamin A is fierce. We get it from:

Cosmetics
Dietary supplements (beta-carotene, cod liver oil, liver capsules)
“Eat the rainbow”
Eggs
Dairy

Be aware: Mike will later level out among the information on beta-carotene, cod liver oil supplementation, and heavy egg consumption that reveals a number of elevated illness.

The toxicity can get handed down through being pregnant. The extra poisonous somebody turns into, the slower their detoxing is. One factor not talked about right here that we missed is how glyphosate slows retinoid metabolism as effectively![10-12]

19:30 – Vitamin A and Carotenoids

Ben will get to interject and ask a bit extra about Vitamin D, but additionally asks a basic query — are all carotenoids dangerous?

Dr. Smith first says that there isn’t any such factor as a zero vitamin A weight-reduction plan. It might be too unhealthy, there are simply not sufficient meals they usually’d don’t have any different diet. He doesn’t assume carotenoids are crucial, he’s not satisfied it’s important. FDA doesn’t actually assist any well being claims with them.

Basically, it’s only a math downside — we wish the quantity we’re ingesting to be lower than the quantity we’re excreting.

Dr. Smith will later state that there isn’t any animal-based vitamin A on the planet with out carotenoids first. Provitamin A carotenoids (beta-carotene, alpha-carotene, and β-cryptoxanthin) are the precursors.

23:15 – Extra on Vitamin D, Sunshine, and Well being Results

Again to vitamin D, one other basic difficulty: are research speaking about ranges, or are they speaking about cholecalciferol consumption? Dr. Smith agrees that somebody with larger vitamin D ranges and isn’t supplementing may have higher well being.

Nonetheless, there are quite a few critiques displaying that vitamin D supplementation doesn’t have that many internet advantages and the analysis reveals unconvincing, blended outcomes, with little or no when it comes to outcomes when it comes to bone mineral density, fractures, mortality, and illness.[1,8,9,13-22] For example, larger blood vitamin D ranges usually results in decrease bone mineral density,[18,22] opposite to in style perception.

Those that eat carotenoids have been recognized to show orange,[23-25] and liposuction sufferers who attempt to “eat wholesome” have fats that appears orange. There are additionally recently-discovered genetic circumstances that would make hypercalcaemia worse.[26,27]

What does sunshine do? Dr. Smith claims that it oxidizes vitamin A, and that his sufferers get much less sunburnt over time.

Vitamin A and D are additionally antagonistic to one another.[28] So are we “vitamin D poor”, or are we actually vitamin A poisonous?!

However the large difficulty is after we begin supplementing metabolites. These are fat-soluble, fat-storable molecules! Extra is just not higher. The liver is compelled to retailer these!

He then makes enjoyable of a outstanding physician (Dr. Ken Berry) who stated that the liver doesn’t retailer toxins,[29] which is verifiably false and has been recognized for a really very long time.[30-32]

27:45 – What’s Vitamin A? The Biochemistry of Vitamin A and Carotenoids

Mike notes that the FDA permits for lots of issues to be labeled as Vitamin A:[33,34]

Beta-Carotene / β-carotene
Alpha-Carotene / α-Carotene
β-cryptoxanthin
Retinol / all-trans-Retinol / “Vitamin A”
Retinaldehyde / “retinal” / all-trans-retinal / vitamin A aldehyde
Retinoic acid / tretinoin / all-trans-retinoic acid / Vitamin A acid / (bought as Retin-A)
13-cis-Retinoic acid / Isotretinoin / (bought as Accutane)
9-cis-retinoic acid / Alitretinoin / (bought as Panretin, utilized in chemotherapy)

The primary three, beta-carotene, alpha-carotene, and beta-cryptoxanthin are the “plant vitamin A” — these are provitamin A molecules that get transformed into retinaldehyde, which will get transformed into retinol, what we actually think about vitamin A.[30,35-37]

Be aware that beta-carotene, probably the most outstanding provitamin A carotenoid, will get transformed into two retinaldehyde molecules.[38,39] Additional, the scientific neighborhood usually hides the retinaldehyde’s molecule’s id as a poisonous aldehyde by calling it “retinal”.

“There isn’t a vitamin A wherever — animal, retinol, retinoic acid — with out carotenoids first.”

Different related molecules, like lutein and zeaxanthin aren’t provitamin A — they don’t break down into retinaldehyde, though they do activate the “retinoic acid receptor”, or RAR.[40]

Dr. Smith doesn’t just like the time period “retinoic acid receptor” although, as a result of it may be stimulated by many compounds, not simply retinoids and carotenoids. It will probably even be stimulated by nothing![CITATION] There are over 7500 retinoic acid receptor agonists – a really promiscuous receptor.

Again to beta-carotene, it will get chopped into two retinaldehyde molecules — and anybody who is aware of diet is aware of that aldehydes aren’t good for us (acetaldehydes trigger hangovers, formaldehyde, and so forth). It will probably go backwards into retinol, or forwards into retinoic acid:[37]

Retinol will get saved within the liver fats as retinyl esters. Why? To get it out of the blood. If in case you have an excessive amount of within the blood, free retinol is thought to be extraordinarily poisonous. It’s saved as a result of we are able to’t eliminate it quick sufficient.

Then you definately get into the retinoic acids, which might be excreted in varied methods:[41]

Retinoic acid / tretinoin / all-trans-retinoic acid / Vitamin A acid / (bought as Retin-A)
13-cis-Retinoic acid / Isotretinoin / (bought as Accutane)
9-cis-retinoic acid / Alitretinoin / (bought as Panretin, utilized in chemotherapy[42])

Under is a extra detailed picture:[41]

In case you ever hear the checklist of accutane uncomfortable side effects, it’s downright terrible, starting from IBS[43-45] to complications[44-46] to despair,[43,47,48] to suicide ideation and makes an attempt![43,47,49-51] It additionally causes horrific delivery defects (teratogenic).[43,52-55]

Retin-A isn’t a lot better, with research displaying considerably elevated mortality![56,57]

And for those who eat beta-carotene, you do get elevated ranges of 13-cis-Retinoic acid / Isotretinoin / Accutane.[41,58]

Taking Retin-A and Accutane are such disasters as a result of they’re metabolites — like vitamin D3 supplementation, ingesting metabolites forces the physique to take care of one thing it will have beforehand had management over.

35:15 – Retinoic Acid Toxicity – A Lethal Chemical Peel

Dr. Smith explains how poisonous retinoic acids are — they’re used as chemical peels, dissolving the highest layers of pores and skin. These are literally referred to as “managed wounds” for the pores and skin![59] It’s dissolving cells. It comes out of the bile in your meals, and causes tons of the intestinal issues we discuss — leaky intestine, as an illustration.

If you ingest the meals, the retinoic acid you metabolize will inhibit the quantity of future retinoic acid produced within the physique.[60] This can be a cautious, damaging suggestions loop. Whereas this does decelerate detox, it protects you from additional toxicity.

However for those who take retinoic acid as a drugs instantly, you override that suggestions loop. And you may get caught right here with out a number of work. For instance, Dr. Smith sees sufferers who’ve had dry eyes from Accutane for thirty years.

Then there’s the massive veteran’s research, giving them Retin-A for his or her faces. They shut the research down as a result of so many veterans had been dying![56] They usually had already filtered out the veterans who thought they had been going to die.

You possibly can completely get vitamin A poisonous by means of the pores and skin.

Ben then asks about how a lot Accutane will get created when consuming vitamin A meals, Mike factors to the 2 metabolic research cited above.[41,58]

By taking retinoic acids, your physique can’t ship it backwards (see the pathway maps above), so all it could actually do is decelerate the ALDH (aldehyde dehydrogenase) enzyme that might create extra of it. However this slows down all detoxing!

41:30 – Assessing Vitamin A Toxicity, a Scientific Catch-22

The 2 business lab checks out there to us are serum vitamin A and retinol binding protein 4 (RBP-4, what binds to vitamin A), however these don’t point out toxicity! Serum retinol is saved in a good homeostatic vary,[61-65] and RBP-4 follows with it (and generally goes down in case your zinc and protein ranges are too low).

The one approach to actually assess toxicity is a liver biopsy[61,66] or radioactive tracers[67-69] – most individuals don’t need to do both of those. The vitamin A merely stays in your liver, the place routine blood checks gained’t detect it.

Dr. Smith mentions a case research the place a affected person had liver issues, his serum retinol was solely 17 or 18 (something beneath 20 is taken into account “vitamin A deficiency”), so his medical doctors ordered a liver biopsy and his liver shops had been by means of the roof.[70] They gave him a “regular weight-reduction plan” and he was in a position to normalize serum retinol and RBP and start mobilizing it once more. The medical doctors additionally level out that protein deficiency was additionally holding him again.[70]

Serum retinol is just not good to check.

45:15 – What’s the Liver, and What’s Bile?

Dr. Smith claims that that is probably the most ignored a part of medication. Many individuals consider it as a form of “detox organ”. The liver positively makes tons of proteins, however that’s not the objective of this dialog.

The liver is a filter. By definition, a filter takes one thing out of one thing else, and the liver does precisely that. It takes stuff out of the blood.
The liver is a sewage processing plant. It takes compounds and turns them into different compounds.

These compounds aren’t at all times much less poisonous, although. Generally, by means of biotransformation, it creates compounds which might be additional intoxifying (frequent instance being acetaldehyde being extra poisonous than alcohol whenever you drink).

The liver shops endproducts, at the least till they are often disposed of. Within the analysis, you’ll see the phrase “accumulate”, not “retailer”.

The above three factors are Dr. Smith’s considerations when it comes to liver operate and well being.

So how does the liver excrete the processed and saved finish merchandise? It places them into the bile. Individuals appear to assume that the liver makes issues “magically disappear”, but it surely must be eliminated — usually through urine, stool, sweat, and so forth. Utilizing the pores and skin as a detox organ might be fairly damaging.

The bile is probably the most poisonous fluid in your physique[71] – it’s how your liver eliminates its waste. Your liver poops bile into the intestines, you should poop that each one out in your stool. However round 95% of bile acids recirculate again to the liver.[72]

Since you possibly can’t eliminate 100% of poisons immediately, it’s paramount that you just cease ingesting toxins within the first place.

50:00 – Poisonous Bile Principle

This brings us to “poisonous bile principle”, a time period that Dr. Smith coined to explain a brand new paradigm on well being and illness.

Not talked about within the podcast, however this was initially pioneered by a researcher named Anthony Mawson who revealed a number of papers, connecting trendy ailments to bile “spillover” from the liver into the serum, from flu to glioma to gulf conflict syndrome to rubella to the illness state often called “COVID”.[73-77] He truly first made the connection in 2009 when taking a look at persistent aggression and low resting coronary heart price from retinoid toxicity.[78]

Basically, poisonous bile principle states that when the liver turns into cholestatic (cholestasis is a situation the place the move of bile from the liver to the duodenum is impaired), the bile ducts get broken and the bile begins to “spill over” into the bloodstream. This liver harm is commonly (however not at all times) brought on by extra retinol shops, however will also be from copper toxicity, vaccine damage, and a number of other different issues like extra fructose and/or seed oil metabolites (extra poisonous aldehydes).

Vitamin A toxicity has been proven to trigger cholestasis.[79]

So for those who’re on this state, and bile is flowing the place it shouldn’t be, resulting in the varied manifestations of vitamin A toxicity (complications, joint issues, fatigue, pores and skin circumstances, and so forth.. extra are described under), then what do you do?

Facilitate elimination
Present vitamins (significantly minerals) to assist defend itself and run detoxing

The above two are the premise of what Dr. Smith works on.

Mike backs issues up to verify it’s all clear, and the blokes dig a bit deeper into bile and stool. One manifestation of cholestasis is constipation. Dr. Smith discusses a research the place constipated people have much less bile of their stool than regular, who’ve lower than these with diarrhea.[80]

Having much less bile popping out makes it extra concentrated, making for a horrible damaging suggestions loop.

55:45 – Usually Repair the Downside

So how will we flip that damaging suggestions loop right into a optimistic one?

Cease placing the toxins in. Cease intoxing earlier than you are concerned about detox.

The most important debate is what’s a toxin. Dr. Smith clearly believes is that the fats soluble vitamin A household is a fundamental perpetrator.

Begin supporting elimination

Dr. Smith likes soluble fiber, however it’s a must to watch your quantities, begin slowly, and use ones that agree with you. He likes psyllium husk, SunFiber, beta-glucan, apple pectin, beans, oats, barley.

Analysis reveals that apples are the healthiest fruit — it has a white flesh, not yellow, low in vitamin A, and the pectin may be very useful. It’s a daring declare, however there occurs to be a ton of analysis on apples.[81-93]

Activated charcoal can be a giant a part of Dr. Smith’s program, and we joke that it’s principally fully unknown in America, whereas Europeans comprehend it fairly effectively. It’s an excellent detox ingredient with a number of advantages.[94,95] Charcoal soaks up bile,[96] however doesn’t set off extra bile, so taking an excessive amount of can result in constipation.

Ideally, we detox by means of the stool. But when poisonous bile will get into the bloodstream, the kidneys get hit subsequent (that is what precipitated Grant Genereux’s issues), and after that, it’s typically the pores and skin.

1:02:15 – Vitamin A Toxicity and Subclinical Vitamin A Toxicity Signs

Since we’re not going to get a liver biopsy to find out vitamin A toxicity, how are you aware for those who’re probably poisonous or subclinically poisonous? Mike asks this, segueing from the pores and skin dialogue above, since pores and skin issues are most typical.

When you perceive poisonous bile principle above, you understand that the signs might be something. Nonetheless, pores and skin points, intestine points, and eye points are the most typical indicators of vitamin A toxicity. There’s additionally nervousness, despair, and lethargy.

The very best general chart of signs is definitely to take a look at the checklist of accutane uncomfortable side effects,[43] proven on this picture:

“Overs” vs. “Unders”

Individuals typically get obese and insulin resistant, however there are some individuals who get very underweight. The latter of those two — chronically underweight — is definitely worse. You will note these two patterns on lab checks, too. Dr. Smith calls the individuals who run excessive as “overs”, and the individuals who run low/underweight as “unders”. 95% of the folks he sees are overs.

LDL ldl cholesterol — the “dangerous ldl cholesterol” — carries retinol.[30,97,98] Dr. Smith sees that LDL is commonly excessive on vitamin A poisonous people, and the analysis reveals that LDL (low density lipoproteins) are compelled to hold retinol when RBP-4 manufacturing breaks down.[97,98] This has been recognized for over 50 years: LDL does a really poor job of retinol transport in comparison with RBP-4, resulting in extremely damaging results from these poorly-bound retinyl esters.

Triglycerides additionally go up when excessive vitamin A is given to animals or people.[99-102] Be aware that Accutane additionally causes triglycerides to go up.[103,104] Take it away and it goes again down.

Then there are the commonly-measured liver enzymes, ALT, AST, GGT, Alkaline Phosphatase (ALP), lactate dehydrogenase. But these numbers don’t at all times manifest even when there are liver operate issues. Researchers and medical doctors name this “silent liver illness”.[105]

Individuals who had been born jaundiced have a number of liver issues, Dr. Smith states that this fairly often vitamin A toxicity. Mike mentions that he had heard this on Smith’s Diet Detective Livestreams on YouTube, relating a private story and the way this revelation was a foundational studying second in his life.

However a jaundiced child isn’t a demise sentence, it simply means you began from behind — it may be fastened.

Pores and skin coloration modifications are additionally indicators of vitamin A toxicity. Mike jokes in regards to the well-known case research, “Carrot Man”,[24] which describes a person with carotenemia.[25] This additionally occurs in Zambia, a rustic that’s over-fortified with vitamin A — the youngsters flip orange throughout mango season.[106]

As soon as the pores and skin turns orange, the analysis signifies that that is principally hypervitaminosis A.[106]