Low Toxin Diet Grant Genereux's Theory Of Vitamin A Toxicity

Tarmander

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Joined
Apr 30, 2015
Messages
3,763
Greetings everyone,

I'm "tim-2" from Grant Genereux's forum.

I've been following a low VA diet for 12 months now.

This is what I eat most days now:

Breakfast: Granola with almond milk and banana.

Lunch: Battered fish, potato, leek, cabbage and mushrooms.

Dinner: Chicken and baked beans with most of the tomato sauce drained out.

I eat about 3 hard boiled eggs per week.

At first I went really low VA but I have since realized that it's a marathon not a sprint to reduce VA levels in the body and I've also seen science showing that the body works hard to conserve VA when we go really low. So I have a small amount of VA from leeks, a tiny bit of tomato, fish and chicken.

I had my serum retinol levels tested recently and it's 1.8 umol/L which is 50.4 ug/dL. My cholesterol and liver enzymes have normalized compared with a test I had 3 years ago.

I've seen a huge change in my seb derm over the past year. It is 95% better, almost completely gone. I've suffered with it on my scalp, face and chest for many years. I had to use 6% H2O2 on my body every few days to control it! Now I hardly ever have to use the hydrogen peroxide. The current theory for seb derm makes no sense because it doesn't cover all oily areas, it happens in patches. Maybe the RA is coming out in those patches and is creating dead skin cells which the yeast feeds on that causes seb derm. Riboflavin deficiency is likely a key player as well, seb derm is connected to riboflavin deficiency. I posted on Grant's forum showing evidence that over 70% of people are riboflavin deficient! And guess what? Riboflavin is needed to convert retinol to retinoic acid and then to convert retinoic acid to water soluble retinoids that get excreted in the urine! So VA toxicity is depleting people's riboflavin levels. I posted the relevant studies on Grant's forum about this: Riboflavin's role in an important VA detox pathway

I'm a WAPF survivor, the WAPF diet caused me a lot of damage. I took CLO, FCLO, ate liver and copious amounts of dairy fat.

Here is my take on the VA toxicity situation:

VA is an essential vitamin needed for vision and for RA which is a hormone used by the body. VA issues are simply a matter of too much VA in our diet and possibly chemicals, nutrient deficiencies and health conditions that slow down the elimination of it.

I believe that everyone that is dealing with VA toxicity should get serum retinol tested but also Vitamin D and then make sure they are Vit D sufficient as Vit A competes with Vit D in the body. VA also likely depletes K2, molybdenum and choline. It depletes riboflavin. Basically we need to supplement with some Vit D or get lots of sun. Sunlight breaks down carotenoids and retinoids into still toxic breakdown products that must be eliminated by the body.

We should follow a diet that is extremely rich in B vitamins. Legumes are essential as they are rich in molybdenum, thiamine and folate. Mushrooms are an excellent food as they are zero VA and zero pectin and are high in riboflavin. (As posted on the Grant Genereux forum pectin should be minimized as it breaks down into methanol in the gut. Fruit juice is a major source of pectin and should be avoided. Fruit, vegetables and legumes all contain pectin, we should avoid consuming an excess of these foods.) Squid is low VA and high in riboflavin too. Fish I consider essential as it contains DHA, iodine and selenium. I think a few eggs per week is a good idea for the choline and they also contain iodine, selenium and DHA as well.

What a blessing Grant's work has been to raise awareness of this issue. I am very thankful to Grant. However, I can't endorse his books as they are full of logical fallacies and I would question anyone's intelligence if they can't easily see that. Plants developed the ability to synthesize carotenoids billions of years ago as a form of sun protection. Animals developed the ability to convert them into retinoids and use them and they became essential. VAD is real and Grant will eventually get xeropthalmia, fortunately the onset is very slow so he will have time to replenish his VA reserves before permanent damage occurs. Grant denies that retinal is needed for vision which is just flat out denial of hard science.

I'm concerned about anyone getting pregnant or having children while following a very low VA diet longterm.

Mexicans consume about 1/5 of the RDA while Americans consume about 3x the RDA, Mexicans have far less autoimmune disease. I think about 1/3 of the RDA is a good figure to aim for long term although most of our VA toxicity issues have likely been caused by consuming VA far in excess of the RDA long term.

I would caution against following Garrett Smith's advice. He often gets things totally wrong. It's great that he is on board with the VA toxicity issue though.

Matt Stone, what a legend. He's the reason I heard about VA toxicity.
Great blend of criticism and pragmatism
 

charlie

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Location
USA
Greetings everyone,

I'm "tim-2" from Grant Genereux's forum.

I've been following a low VA diet for 12 months now.

This is what I eat most days now:

Breakfast: Granola with almond milk and banana.

Lunch: Battered fish, potato, leek, cabbage and mushrooms.

Dinner: Chicken and baked beans with most of the tomato sauce drained out.

I eat about 3 hard boiled eggs per week.

At first I went really low VA but I have since realized that it's a marathon not a sprint to reduce VA levels in the body and I've also seen science showing that the body works hard to conserve VA when we go really low. So I have a small amount of VA from leeks, a tiny bit of tomato, fish and chicken.

I had my serum retinol levels tested recently and it's 1.8 umol/L which is 50.4 ug/dL. My cholesterol and liver enzymes have normalized compared with a test I had 3 years ago.

I've seen a huge change in my seb derm over the past year. It is 95% better, almost completely gone. I've suffered with it on my scalp, face and chest for many years. I had to use 6% H2O2 on my body every few days to control it! Now I hardly ever have to use the hydrogen peroxide. The current theory for seb derm makes no sense because it doesn't cover all oily areas, it happens in patches. Maybe the RA is coming out in those patches and is creating dead skin cells which the yeast feeds on that causes seb derm. Riboflavin deficiency is likely a key player as well, seb derm is connected to riboflavin deficiency. I posted on Grant's forum showing evidence that over 70% of people are riboflavin deficient! And guess what? Riboflavin is needed to convert retinol to retinoic acid and then to convert retinoic acid to water soluble retinoids that get excreted in the urine! So VA toxicity is depleting people's riboflavin levels. I posted the relevant studies on Grant's forum about this: Riboflavin's role in an important VA detox pathway

I'm a WAPF survivor, the WAPF diet caused me a lot of damage. I took CLO, FCLO, ate liver and copious amounts of dairy fat.

Here is my take on the VA toxicity situation:

VA is an essential vitamin needed for vision and for RA which is a hormone used by the body. VA issues are simply a matter of too much VA in our diet and possibly chemicals, nutrient deficiencies and health conditions that slow down the elimination of it.

I believe that everyone that is dealing with VA toxicity should get serum retinol tested but also Vitamin D and then make sure they are Vit D sufficient as Vit A competes with Vit D in the body. VA also likely depletes K2, molybdenum and choline. It depletes riboflavin. Basically we need to supplement with some Vit D or get lots of sun. Sunlight breaks down carotenoids and retinoids into still toxic breakdown products that must be eliminated by the body.

We should follow a diet that is extremely rich in B vitamins. Legumes are essential as they are rich in molybdenum, thiamine and folate. Mushrooms are an excellent food as they are zero VA and zero pectin and are high in riboflavin. (As posted on the Grant Genereux forum pectin should be minimized as it breaks down into methanol in the gut. Fruit juice is a major source of pectin and should be avoided. Fruit, vegetables and legumes all contain pectin, we should avoid consuming an excess of these foods.) Squid is low VA and high in riboflavin too. Fish I consider essential as it contains DHA, iodine and selenium. I think a few eggs per week is a good idea for the choline and they also contain iodine, selenium and DHA as well.

What a blessing Grant's work has been to raise awareness of this issue. I am very thankful to Grant. However, I can't endorse his books as they are full of logical fallacies and I would question anyone's intelligence if they can't easily see that. Plants developed the ability to synthesize carotenoids billions of years ago as a form of sun protection. Animals developed the ability to convert them into retinoids and use them and they became essential. VAD is real and Grant will eventually get xeropthalmia, fortunately the onset is very slow so he will have time to replenish his VA reserves before permanent damage occurs. Grant denies that retinal is needed for vision which is just flat out denial of hard science.

I'm concerned about anyone getting pregnant or having children while following a very low VA diet longterm.

Mexicans consume about 1/5 of the RDA while Americans consume about 3x the RDA, Mexicans have far less autoimmune disease. I think about 1/3 of the RDA is a good figure to aim for long term although most of our VA toxicity issues have likely been caused by consuming VA far in excess of the RDA long term.

I would caution against following Garrett Smith's advice. He often gets things totally wrong. It's great that he is on board with the VA toxicity issue though.

Matt Stone, what a legend. He's the reason I heard about VA toxicity.
Welcome aboard, Tim. :hattip
 

sunraiser

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Joined
Feb 21, 2017
Messages
549
Greetings everyone,

I'm "tim-2" from Grant Genereux's forum.

I've been following a low VA diet for 12 months now.

This is what I eat most days now:

Breakfast: Granola with almond milk and banana.

Lunch: Battered fish, potato, leek, cabbage and mushrooms.

Dinner: Chicken and baked beans with most of the tomato sauce drained out.

I eat about 3 hard boiled eggs per week.

At first I went really low VA but I have since realized that it's a marathon not a sprint to reduce VA levels in the body and I've also seen science showing that the body works hard to conserve VA when we go really low. So I have a small amount of VA from leeks, a tiny bit of tomato, fish and chicken.

I had my serum retinol levels tested recently and it's 1.8 umol/L which is 50.4 ug/dL. My cholesterol and liver enzymes have normalized compared with a test I had 3 years ago.

I've seen a huge change in my seb derm over the past year. It is 95% better, almost completely gone. I've suffered with it on my scalp, face and chest for many years. I had to use 6% H2O2 on my body every few days to control it! Now I hardly ever have to use the hydrogen peroxide. The current theory for seb derm makes no sense because it doesn't cover all oily areas, it happens in patches. Maybe the RA is coming out in those patches and is creating dead skin cells which the yeast feeds on that causes seb derm. Riboflavin deficiency is likely a key player as well, seb derm is connected to riboflavin deficiency. I posted on Grant's forum showing evidence that over 70% of people are riboflavin deficient! And guess what? Riboflavin is needed to convert retinol to retinoic acid and then to convert retinoic acid to water soluble retinoids that get excreted in the urine! So VA toxicity is depleting people's riboflavin levels. I posted the relevant studies on Grant's forum about this: Riboflavin's role in an important VA detox pathway

I'm a WAPF survivor, the WAPF diet caused me a lot of damage. I took CLO, FCLO, ate liver and copious amounts of dairy fat.

Here is my take on the VA toxicity situation:

VA is an essential vitamin needed for vision and for RA which is a hormone used by the body. VA issues are simply a matter of too much VA in our diet and possibly chemicals, nutrient deficiencies and health conditions that slow down the elimination of it.

I believe that everyone that is dealing with VA toxicity should get serum retinol tested but also Vitamin D and then make sure they are Vit D sufficient as Vit A competes with Vit D in the body. VA also likely depletes K2, molybdenum and choline. It depletes riboflavin. Basically we need to supplement with some Vit D or get lots of sun. Sunlight breaks down carotenoids and retinoids into still toxic breakdown products that must be eliminated by the body.

We should follow a diet that is extremely rich in B vitamins. Legumes are essential as they are rich in molybdenum, thiamine and folate. Mushrooms are an excellent food as they are zero VA and zero pectin and are high in riboflavin. (As posted on the Grant Genereux forum pectin should be minimized as it breaks down into methanol in the gut. Fruit juice is a major source of pectin and should be avoided. Fruit, vegetables and legumes all contain pectin, we should avoid consuming an excess of these foods.) Squid is low VA and high in riboflavin too. Fish I consider essential as it contains DHA, iodine and selenium. I think a few eggs per week is a good idea for the choline and they also contain iodine, selenium and DHA as well.

What a blessing Grant's work has been to raise awareness of this issue. I am very thankful to Grant. However, I can't endorse his books as they are full of logical fallacies and I would question anyone's intelligence if they can't easily see that. Plants developed the ability to synthesize carotenoids billions of years ago as a form of sun protection. Animals developed the ability to convert them into retinoids and use them and they became essential. VAD is real and Grant will eventually get xeropthalmia, fortunately the onset is very slow so he will have time to replenish his VA reserves before permanent damage occurs. Grant denies that retinal is needed for vision which is just flat out denial of hard science.

I'm concerned about anyone getting pregnant or having children while following a very low VA diet longterm.

Mexicans consume about 1/5 of the RDA while Americans consume about 3x the RDA, Mexicans have far less autoimmune disease. I think about 1/3 of the RDA is a good figure to aim for long term although most of our VA toxicity issues have likely been caused by consuming VA far in excess of the RDA long term.

I would caution against following Garrett Smith's advice. He often gets things totally wrong. It's great that he is on board with the VA toxicity issue though.

Matt Stone, what a legend. He's the reason I heard about VA toxicity.

Thanks for sharing your thoughts. It's of note that riboflavin would only be an issue for those people that supplemented vitamin A - both liver and dairy are packed with riboflavin.

Sunshine is likely a cureall for many things, but when antioxidant status is bad it means sun tolerance is low. I think those that consume iron and copper rich foods with low metabolism for a long period are unlikely to be able to dispose of or metabolise them adequately. Subsequent iron/copper toxicity can impair antioxidant status meaning sun might be intolerable while still being needed (technically).
 

tim333

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Joined
Feb 27, 2020
Messages
276
Thank you all for the positive feedback, I've put a lot of thought into the VA toxicity issue so it means a lot.

Thanks for sharing your thoughts. It's of note that riboflavin would only be an issue for those people that supplemented vitamin A - both liver and dairy are packed with riboflavin.

Sunshine is likely a cureall for many things, but when antioxidant status is bad it means sun tolerance is low. I think those that consume iron and copper rich foods with low metabolism for a long period are unlikely to be able to dispose of or metabolise them adequately. Subsequent iron/copper toxicity can impair antioxidant status meaning sun might be intolerable while still being needed (technically).

You're welcome. Riboflavin in food is certainly protective against VA toxicity but I wouldn't say it protects against it. Liver is high in B vitamins yet it only stores a few days worth of riboflavin but can store a few years worth of Vit A. People can get a short term boost from consuming it but then they have to deal with the aftermath. Riboflavin passes through the body quickly, we need to replenish our stores daily. I think that low fat yoghurt is fine on a low VA diet but I see a lot of problems with dairy and don't consume it, I may start consuming it in moderation again though at some point.

Interesting that you mention iron and copper, riboflavin deficiency is quite likely to be the elephant in the room here. Riboflavin is required to mobilize iron stores and according to one book I've read likely to be needed for copper mobilization too. I donated blood for the first time about 1.5 months before my latest blood test. My test revealed borderline low iron stores which surprised me as previous tests in the past showed higher than optimal levels of ferritin. Could it be my low VA diet that has caused a normalization of iron levels without the need for blood donations? Perhaps when we are Vit B deficient we don't have adequate bioavailable iron and copper and our body absorbs more in an attempt to remedy that which then gets stored causing toxicity of these two minerals?

When I said lots of sun I should probably have said regular sun as you don't need a lot of full body summer sun in a day to get your Vit D.
 

Abcdefgmo

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Joined
Feb 25, 2020
Messages
39
Thank you all for the positive feedback, I've put a lot of thought into the VA toxicity issue so it means a lot.



You're welcome. Riboflavin in food is certainly protective against VA toxicity but I wouldn't say it protects against it. Liver is high in B vitamins yet it only stores a few days worth of riboflavin but can store a few years worth of Vit A. People can get a short term boost from consuming it but then they have to deal with the aftermath. Riboflavin passes through the body quickly, we need to replenish our stores daily. I think that low fat yoghurt is fine on a low VA diet but I see a lot of problems with dairy and don't consume it, I may start consuming it in moderation again though at some point.

Interesting that you mention iron and copper, riboflavin deficiency is quite likely to be the elephant in the room here. Riboflavin is required to mobilize iron stores and according to one book I've read likely to be needed for copper mobilization too. I donated blood for the first time about 1.5 months before my latest blood test. My test revealed borderline low iron stores which surprised me as previous tests in the past showed higher than optimal levels of ferritin. Could it be my low VA diet that has caused a normalization of iron levels without the need for blood donations? Perhaps when we are Vit B deficient we don't have adequate bioavailable iron and copper and our body absorbs more in an attempt to remedy that which then gets stored causing toxicity of these two minerals?

When I said lots of sun I should probably have said regular sun as you don't need a lot of full body summer sun in a day to get your Vit D.

How much supplemental Vitamin D do you recommend if one can only get sun 3 months out the year?
 

tim333

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Messages
276
How much supplemental Vitamin D do you recommend if one can only get sun 3 months out the year?

I took a megadose of 350,000 IU the first week I started it then I took much less. I don't get much sun exposure. About a month after that I had my serum level tested and it was 139 nmol/L. Some consider that optimal however there is a lot of debate about optimal D levels and I feel it's too high. I'll probably aim to be between 75 and 100 nmol/L. I'll take 2000 IU per day for a while and see what result I get from doing that. I take K2 and magnesium whenever I take a lot of D.

I highly recommend reading the article by Mawson linked to from this post of mine:
Important symptoms of the flu virus are likely caused by transient Hypervitaminosis A

He explains how VA released from the destruction of liver cells is likely largely responsible for the worst symptoms of flu (he also mentions coronavirus) and how Vit D is strongly protective against it. The video footage of Wuhan I've seen shows a foggy (the pollution probably blocks UVB too) wintery city, most people's D levels will be very low. People there that have high levels of VA and low serum D are possibly more at risk than others of a similar age.
 

Waynish

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Oct 11, 2016
Messages
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I took a megadose of 350,000 IU the first week I started it then I took much less.

So this is a major point that you disagree with the rest of the Vitamin A people on, right? That massive doses of Vitamin D are safe or even necessary?
 

LLight

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1,411
I took a megadose of 350,000 IU the first week I started it then I took much less. I don't get much sun exposure. About a month after that I had my serum level tested and it was 139 nmol/L. Some consider that optimal however there is a lot of debate about optimal D levels and I feel it's too high. I'll probably aim to be between 75 and 100 nmol/L. I'll take 2000 IU per day for a while and see what result I get from doing that. I take K2 and magnesium whenever I take a lot of D.

I highly recommend reading the article by Mawson linked to from this post of mine:
Important symptoms of the flu virus are likely caused by transient Hypervitaminosis A

He explains how VA released from the destruction of liver cells is likely largely responsible for the worst symptoms of flu (he also mentions coronavirus) and how Vit D is strongly protective against it. The video footage of Wuhan I've seen shows a foggy (the pollution probably blocks UVB too) wintery city, most people's D levels will be very low. People there that have high levels of VA and low serum D are possibly more at risk than others of a similar age.

Very interesting, thanks you. It shows that antimicrobial peptides are useful against viruses.

It might help against the dreaded cytokine storm:

"Vitamin D thus enhances the capacity of the epithelium to produce AMPs following exposure to microbes [34, 35]; it also dampens the proinflammatory peptides interferon gamma, TNF-alpha and IL-12 of the adaptive immune system, especially those responsible for acute inflammation “cytokine storms” [55]."

By the way, (dry) fasting may help for the production of these peptides.
 

Amazoniac

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I took a megadose of 350,000 IU the first week I started it then I took much less. I don't get much sun exposure. About a month after that I had my serum level tested and it was 139 nmol/L. Some consider that optimal however there is a lot of debate about optimal D levels and I feel it's too high. I'll probably aim to be between 75 and 100 nmol/L. I'll take 2000 IU per day for a while and see what result I get from doing that. I take K2 and magnesium whenever I take a lot of D.

I highly recommend reading the article by Mawson linked to from this post of mine:
Important symptoms of the flu virus are likely caused by transient Hypervitaminosis A

He explains how VA released from the destruction of liver cells is likely largely responsible for the worst symptoms of flu (he also mentions coronavirus) and how Vit D is strongly protective against it. The video footage of Wuhan I've seen shows a foggy (the pollution probably blocks UVB too) wintery city, most people's D levels will be very low. People there that have high levels of VA and low serum D are possibly more at risk than others of a similar age.
I remember reading that article. Mentioning it came in good time because I was trying to find confirmation on the antagonism at the liver level.

↳ [96] The influence of vitamin a on the utilization and amelioration of toxicity of cholecalciferol, 25-hydroxycholecalciferol, and 1,25 dihydroxycholecalciferol in young broiler chickens

upload_2020-2-28_19-56-46.png

It's kg of diet.
0.0
7.5
3.8
1.9
0.9
0.5
0.0
225.0
112.5
56.3
28.1
14.1
↳ [97] Effects of different levels of vitamins A and E on the utilization of cholecalciferol by broiler chickens

upload_2020-2-28_19-57-40.png

Same, kg of diet.​

- “Vitamin D and Human Health: from the Gamete to the Grave”: Report on a meeting held at Queen Mary University of London, 23rd–25th April 2014

@Birdie @whit
 

tim333

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Messages
276
So this is a major point that you disagree with the rest of the Vitamin A people on, right? That massive doses of Vitamin D are safe or even necessary?

Not really, I think many following a low VA diet are wary of fat soluble vitamins though. Are you talking about Garrett Smith? I think he is opposed to Vit D supplementation yeah.
 

tim333

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Joined
Feb 27, 2020
Messages
276
Very interesting, thanks you. It shows that antimicrobial peptides are useful against viruses.

It might help against the dreaded cytokine storm:

"Vitamin D thus enhances the capacity of the epithelium to produce AMPs following exposure to microbes [34, 35]; it also dampens the proinflammatory peptides interferon gamma, TNF-alpha and IL-12 of the adaptive immune system, especially those responsible for acute inflammation “cytokine storms” [55]."

By the way, (dry) fasting may help for the production of these peptides.

Yeah having adequate D levels seems to be the best and easiest way to improve ones immunity to viruses.

I remember reading that article. Mentioning it came in good time because I was trying to find confirmation on the antagonism at the liver level.

↳ [96] The influence of vitamin a on the utilization and amelioration of toxicity of cholecalciferol, 25-hydroxycholecalciferol, and 1,25 dihydroxycholecalciferol in young broiler chickens

That's some great data, I wasn't aware that Vit D reduces liver VA levels. Thanks for that.
 

Birdie

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I remember reading that article. Mentioning it came in good time because I was trying to find confirmation on the antagonism at the liver level.

Thanks.
 

Luann

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Messages
1,615
So the idea is that vitamin A, while biologically neccesary (which it is, to make ceruloplasmin at least)..
is over-dosed by most people?
That's interesting.
Vit. A plays a role in lipofuscin in the eye
I recently bought vitamin A and copper-glycinate as supplements rather than eating liver for them.
Not bc I thought Vit. A was toxic per se but the amount of liver you'd eat to get 6 - 8 mg of copper would net you like 22k IU of A and that seems unbalanced. Perhaps this was a good choice for me.
 

Luann

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holy peat. I think we could make an entire thread abt how common recommendations for nutrients are/ may be way off.

iron? eat less than DV.
salt? eat 2 x DV.
calcium & copper? eat more than you'd think.
vitamin a apparently: less than youd think.

NOTE: please do not follow these recommendations specifically, I am just using these numbers for example haha.
 

charlie

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So the idea is that vitamin A, while biologically neccesary (which it is, to make ceruloplasmin at least)..
is over-dosed by most people?
Yes it seems that way. Basically a vitamin that can easily become a poison in the wrong context. Peat himself warns of this. The added glyphosate and other liver burdening chemicals we are dealing with seems to set us up for vitamin A overload. This is the way I am viewing this issue but of course YMMV.
 

Luann

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Basically a vitamin that can easily become a poison in the wrong context. Peat himself warns of this. The added glyphosate and other liver burdening chemicals we are dealing with seems to set us up for vitamin A overload.
Ah, verry interesting. I tend to forget we do not live in ideal circumstances and this affects our capacity for some substances. thanks Charlie :eek:
 

Abcdefgmo

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Feb 25, 2020
Messages
39
So the idea is that vitamin A, while biologically neccesary (which it is, to make ceruloplasmin at least)..
is over-dosed by most people?
That's interesting.
Vit. A plays a role in lipofuscin in the eye
I recently bought vitamin A and copper-glycinate as supplements rather than eating liver for them.
Not bc I thought Vit. A was toxic per se but the amount of liver you'd eat to get 6 - 8 mg of copper would net you like 22k IU of A and that seems unbalanced. Perhaps this was a good choice for me.

Is Vitamin A 100% necessary for ceruloplasmin? Doesn't ceruloplasmin raise with inflammation and so the studies could be deceiving as a result?

Like how people think they're copper toxic, but it could just be the body raising copper to deal with inflammation, just like cholesterol
 

Luann

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Messages
1,615
That had actually occurred to me @Abcdefgmo !!

nutrition is confusing haha. like the ceruloplasmin has been summoned to fight against some kind of stress you mean? But I am def thinking along those lines now. And its possible that ceruloplasmin does require *some* A but just the little bit we get thru dairy and occasional yams etc
 

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