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7 case studies, "HYPERVITAMINOSIS AND CAROTENEMIA", paper from 1944

This paper is mainly written about 1 case study, however, the other 6 that are included are also very interesting.

Let this be clear...all of these case studies were from "natural" sources of Poison/"Vitamin A", one from halibut liver oil, the rest from carotenoids.

Make sure to read the later parts about carotenoids and how even back in 1944 they had been observed to be DIRECTLY ANTI-THYROID in nature. I will have another thread with more recent research showing the direct anti-thyroid activity of Poison/"Vitamin A".  Also note how a "high-Calorie" diet fixed several of them completely (I'm guessing the high-Calorie diet was also full of low Poison/"Vitamin A" fats and sugars, explaining its benefits).

HYPERVITAMINOSIS A AND CAROTENEMIA. (1944, full study PDF attached below)

REPORT OF A CASE

History--B.B., a 3 year old boy of Jewish parentage, had appeared well up to the fall of 1938, when he was about 18 months old. At that time his appetite diminished and he seemed to be disinclined to play. Six months later (May 1939) he had a severe attack of tonsillitis, for which he was given sulfanilamide for two days. Two months after this, July 26, 1939, he had a tonsillectomy followed by hemorrhage, after which he received three transfusions. A blood count done after the hemorrhage showed severe anemia and 2,900 white cells per cubic millimeter, of which 44 per cent were neutrophils. The patient's liver and spleen were found to be enlarged, and clubbing of the fingers was noted. At this time he lost much of his hair, and that which grew back was sparse, dry and coarse.

During the next eight months, the child failed to improve, and because of the enlarging spleen and the continuing anemia he was admitted to the Harriet Lane Home for study with the tentative diagnosis of Gaucher's disease (March 1940).

Physical Examination.--When the patient entered the hospital in March 1940, his hair was sparse, dry and rather coarse, and eyebrows and fine hair over the body were lacking. The fingers and toes were slightly clubbed. He was pale and sallow, but there was no increase in pigmentation and no jaundice and the scleras were clear. The heart and lungs showed no abnormality. The liver was felt 2 cm. below the costal margin, the edge being sharp and firm. The spleen was enlarged and firm and was palpable 3 cm. below the costal margin. The child's height was 89 cm. (about normal for his age).
[...]
Course.--The one outstanding feature of the examination that appeared to point to a possible etiologic factor was the enormously high content of vitamin A in the serum such as would not ordinarily be encountered except four to six hours after ingestion of an excessive dose of vitamin A. On questioning the mother, it was learned that beginning at 2 to 3 months of age the child had received a teaspoonful of halibut liver oil a day (about 240,000 U. S. P. units of vitamin A) up to the present time. Moreover, he had on occasion drunk the oil directly from the bottle in undetermined amounts.

As soon as it was appreciated that the case might be one of hypervitaminosis, the child was discharged with instructions that he should not be given any extra vitamin A. Improvement was immediate. Within two months, the appetite had improved, the patient had gained weight and his hair had begun to grow back normally. By the end of six months his appearance and the composition of his blood were normal and the vitamin A content of the serum was within the upper limit of normality. Certain features remained, however; the phosphatase was still elevated and the serum proteins were still depressed. For a time after he was discharged from the hospital the child showed a desire for butter and carrots, which led to a considerable though temporary increase in serum carotene and a temporary increase in serum lipids.

Two and a half years after leaving the hospital, the child was to all external appearances normal and of average height and development. He had had no illness except measles, and there was nothing in the mother's account to indicate that any pathologic change was still present. However, his liver was palpable as a firm sharp edge about 2 cm. below the costal margin ; the spleen was felt as a large, firm mass occupying the upper left quadrant of the abdomen, and his fingers were still slightly clubbed. The laboratory data were essentially normal except for a slight elevation of the phosphatase content of the blood. The bones appeared normal in structure, but skeletal development was slightly in advance of the chronologic age (7 carpal centers of ossification at 5 1/2 years of age).

Takeaways from this case study:

  • Removing the MAIN source of the poisoning was the most important step.
  • It should be well-known that in the drug world, a part of withdrawals is craving the very thing that was removed or taken away.  The child craving and eating enough carrots--after quitting the halibut liver oil--to get hypercarotenemia (high blood carotenoids) shows that he had simply found another source of Poison/"Vitamin A" to get his "fix".  This is analogous to someone "quitting smoking" only to take up a vaping or nicotine gum habit.  The only thing that really changed was the drug delivery system.
  • This child was still Poison/"Vitamin A" toxic at the end, they had NOT finished the job! This is evident in the symptoms that had not fully resolved. His liver and spleen were still hard and enlarged, fingers still clubbed, alkaline phosphatase still elevated (one potential blood test sign of Poison/"Vitamin A" toxicity" noted in conventional medical literature).  To truly get rid of all the signs & symptoms, this child needed a more thorough detox than just taking out the halibut liver oil and not eating an excess of carrots.

The other 6 case studies from this paper (keep reading for the anti-thyroid part):

Reports of Earlier Cases of Dietary Carotenemia.--In the records of the Johns Hopkins Hospital there are 6 cases of carotenemia in which the diet alone either was or might have been responsible. This series is exclusive of cases of carotenemia occurring in the course of diabetes or nephrosis or of hypothyroidism, in which the low thyroid function is definitely the primary factor. They are included at this point because they have a bearing on the discussion of hypervitaminosis and because they confirm the hypothesis that carotenemia may not be as harmless as heretofore pictured.

Case 1.--The patient was a child of 16 months, who had recently come from California, where she had been indulged in oranges, the only source of carotene that she could be ascertained to have received in significant amount. She recovered promptly, and at no time did untoward symptoms develop.

Case 2.--The serum of this patient, also a child, was received for diagnosis. All that I can ascertain is that no harm resulted from the carotenemia and that the clinical diagnosis was made from the yellow color of the skin. It is unusual to see xanthosis cutis [yellow discoloration of the skin from abnormal causes] with the serum carotene as low as it was in this case.

Case 3.--Carotenemia was diagnosed in a well-to-do, asthmatic man who enjoyed vegetables in large quantities. No special studies were made, and the case is included only as one in which the patient was not harmed by the carotenemia.

Case 4.—A 38 year old clergyman had as his only complaints yellowness of the skin and loss of weight. He had been supplementing his diet with carrots and carrot juice for about seven years. When carrots were removed from his diet, he recovered rapidly.

Case 5.—This patient, a colored farmer who had lived largely on vegetables, especially spinach, was extremely undernourished. Low blood pressure, emaciation and extreme muscular weakness led to a first impression of hypopituitary cachexia (Simmond's disease). Later, hypothyroidism was suggested on the bases of the high serum cholesterol and low basal metabolic rate. On a diet of high caloric value he improved extraordinarily rapidly.

Case 6.—A well-to-do woman of 45, because of imagined idiosyncrasies to meat, eggs, milk and starchy foods, had lived largely on vegetables and fruits for a number of years. In addition to having carotenemia, she was markedly underweight, with low blood pressure. and asthenia [abnormal physical weakness or lack of energy]. Hypothyroidism was diagnosed on two occasions when she was in the hospital. She was greatly improved by a diet high in calories, given in the hospital.
[...]
Perhaps the most confusing aspect is the relationship of carotenemia to hypothyroidism. Every symptom that has been mentioned as occurring with carotenemia except the loss of weight could occur in hypothyroidism. Only consideration of the fact that the diet came first and the symptoms followed will allow a correct evaluation to be made. A possible explanation of this similarity lies in the reported antagonism between carotene or vitamin A and thyroxin. According to this theory the symptoms of hypothyroidism may exist not only as the result of diminished activity of the thyroid gland, but as the result of "neutralization" of thyroxin by carotene or vitamin A.

Another point that must be emphasized is that it is the abnormal intake of carotene rather than the amount in the blood that is the cause of trouble. In conditions such as diabetes and nephrosis, in which carotenemia may occur without excessive intake, none of the symptoms cited are present. Apparently under ordinary conditions carotene must be ingested in excessive amount for a long time or must form the major part of the diet to the exclusion of other constituents in order to be harmful.

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