Vitamin A (Retinol)
Other marker
Vitamin A
Vitamin A (Retinol)
The serum level of retinol, the circulating form of vitamin A. Vitamin A is a fat-soluble vitamin essential for vision, immune function, skin and epithelial health, and cellular differentiation. Both deficiency and excess cause clinical problems.
PED Notes
Two angles matter for this population. First, vitamin A supports skin turnover and immune function, and its derivatives (retinoids like isotretinoin) are widely used for the acne that AAS often worsen; that overlap raises the risk of stacking retinoid exposure. Second, vitamin A is fat-soluble and accumulates: high-dose supplementation or heavy liver/organ-meat intake can cause hepatotoxic vitamin A excess, which is a concern in users who already stress the liver with oral steroids. Do not megadose vitamin A on top of a hepatotoxic cycle.
When high
When high (>80 mcg/dL, hypervitaminosis A):
- Almost always from supplementation or very high dietary intake (liver, cod liver oil, high-dose retinol products); review all sources including "skin/hair" formulas
- Chronic excess is hepatotoxic and can raise intracranial pressure (headaches, visual changes), cause bone pain, hair loss, and dry skin; it compounds the liver risk of oral 17-alpha-alkylated steroids
- Action: stop supplemental vitamin A, reduce preformed-retinol foods, and recheck; symptoms and levels usually improve over weeks to months. Persistent elevation with liver enzyme derangement warrants hepatology review
Note on retinoid drugs: If using isotretinoin or other retinoids for acne, avoid additional vitamin A supplements to prevent additive toxicity.
When low
When low (<30 mcg/dL, deficiency):
Supplements:
- Vitamin A (retinol or retinyl palmitate) -- 3000-10000 IU/day for repletion, or via a balanced multivitamin; avoid sustained high doses
- Beta-carotene (provitamin A from plants) -- a safer route to top up status because conversion is regulated and does not cause classic vitamin A toxicity
Lifestyle:
- Include colourful vegetables, eggs, and dairy; ensure adequate dietary fat for absorption (vitamin A is fat-soluble)
- Investigate fat-malabsorption (coeliac disease, pancreatic insufficiency) if deficiency is unexplained, and correct zinc status, which is needed to mobilise vitamin A from the liver
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