As we spoke before, 𝐕𝐢𝐭𝐚𝐦𝐢𝐧 𝐀 is 𝘧𝘢𝘵-𝘴𝘰𝘭𝘶𝘣𝘭𝘦.
⚠️We don’t eat Vit A, even in supplements.
When we consume 🍎fruits, 🥕vegetables or 💊supplements, in reality, we are taking something called “𝘳𝘦𝘵𝘪𝘯𝘺𝘭 𝘦𝘴𝘵𝘦𝘳𝘴” (also known as preformed Vit A) or 𝘱𝘳𝘰𝘷𝘪𝘵𝘢𝘮𝘪𝘯 𝘈.
✅One way or another, they suffer alterations to become 𝘳𝘦𝘵𝘪𝘯𝘰𝘭𝘴. This is simply because those are easier absorbed in the small bowel.
❎As they are absorbed, small molecules called “𝐜𝐡𝐲𝐥𝐨𝐦𝐢𝐜𝐫𝐨𝐧𝐬” will transport them into the Liver.
❎If the Liver has reached its full capacity of Vitamin A, other small molecules called 𝐕𝐋𝐃𝐋 (𝘝𝘦𝘳𝘺 𝘓𝘰𝘸-𝘋𝘦𝘯𝘴𝘪𝘵𝘺 𝘓𝘪𝘱𝘰𝘱𝘳𝘰𝘵𝘦𝘪𝘯𝘴) will transport it (often already changed into retinyl palmitate) to other tissues.
✴Those tissues are mainly:
1️⃣Adipose tissue (AKA fat)
❎Another group of molecules called 𝐋𝐃𝐋 (𝘓𝘰𝘸-𝘋𝘦𝘯𝘴𝘪𝘵𝘺 𝘓𝘪𝘱𝘰𝘱𝘳𝘰𝘵𝘦𝘪𝘯𝘴) might also do that transport.
‼️𝐕𝐞𝐫𝐲 𝐢𝐦𝐩𝐨𝐫𝐭𝐚𝐧𝐭 𝐭𝐨 𝐤𝐧𝐨𝐰:
▶️VLDL and LDL are what is called “bad cholesterol”
▶️HDL is what is called “good cholesterol”
✴Bear in mind any disease affecting the bowels (and I am referring to the 𝘴𝘮𝘢𝘭𝘭 𝘣𝘰𝘸𝘦𝘭) will affect fat absorption capacity. In turn, this will affect Vitamin A absorption as well.
❓Remember we spoke about Vit A being fat soluble?
✅Conditions that affect Vit A absorption:
➡️Inflammatory Bowel Disease
➡️Cholestasis (conditions preventing bile passing to the bowel, from the Liver)
➡️Small bowel bypass surgery
➡️Significant parasitic infestation
➡️Low fat in the diet
⚠️People with any of these conditions should take 𝐕𝐢𝐭 𝐀 𝐬𝐮𝐩𝐩𝐥𝐞𝐦𝐞𝐧𝐭𝐬.
When Vit A is not absorbed, it will be excreted in stools.
The one that becomes inactivated in the bloodstream will be excreted in the urine.
✴The big problem is that our body absorbs Vit A better than it destroys it.
⛔This can lead to excessive accumulation and 𝐕𝐢𝐭 𝐀 𝐭𝐨𝐱𝐢𝐜𝐢𝐭𝐲.
Also known as Retinol or Retinoic Acid.
Those names derive from an area in the back of the eye.
It was the first 𝘧𝘢𝘵-𝘴𝘰𝘭𝘶𝘣𝘭𝘦 but not the first Vitamin to be discovered.
🇪🇬It all started with the 𝘌𝘨𝘺𝘱𝘵𝘪𝘢𝘯𝘴, as they found that some types of 𝘣𝘭𝘪𝘯𝘥𝘯𝘦𝘴𝘴 could be cured by 𝘦𝘢𝘵𝘪𝘯𝘨 𝘭𝘪𝘷𝘦𝘳.
🔶️This Vitamin plays a vital role in 👁𝘷𝘪𝘴𝘪𝘰𝘯, 𝘨𝘳𝘰𝘸𝘵𝘩, 𝘤𝘦𝘭𝘭 𝘥𝘪𝘷𝘪𝘴𝘪𝘰𝘯 and 𝘪𝘯𝘵𝘦𝘨𝘳𝘪𝘵𝘺 (mainly 𝘢𝘪𝘳𝘸𝘢𝘺𝘴, 𝘶𝘳𝘪𝘯𝘢𝘳𝘺 𝘵𝘳𝘢𝘤𝘵 and 𝘨𝘶𝘵), 𝘳𝘦𝘱𝘳𝘰𝘥𝘶𝘤𝘵𝘪𝘰𝘯 and 𝘪𝘮𝘮𝘶𝘯𝘪𝘵𝘺. We cannot forget how important it is for foetal development.
🤰But beware, pregnant women DO NOT need a Vitamin A dose higher than the daily recommended dose.
✅Due to this, many believe it is 𝐭𝐡𝐞 𝐦𝐨𝐬𝐭 𝐞𝐬𝐬𝐞𝐧𝐭𝐢𝐚𝐥 𝐕𝐢𝐭𝐚𝐦𝐢𝐧 in animal life (not just humans).
🔻When there is a deficiency, it can lead to:
➡️Low immune response
➡️Dry skin and hair
✴𝐍𝐨𝐭𝐞 𝐨𝐟 𝐜𝐚𝐮𝐭𝐢𝐨𝐧: If you use creams containing Vit A, do not go on long sun exposures, leading to skin cancer development! On the other hand, sun exposure decreases skin Vit A.
✳𝗪𝐡𝐚𝐭 𝐭𝐨 𝐝𝐨?
Use it after sun and/or at nighttime.
❓Is there a connection between Vitamin A and allergies?
🔸️The only relationship found so far is between lack of it and increased risk of allergic asthma and allergic rhinitis (hayfever).
‼️There is a hypothesis saying that Vit A might help prevent an adverse reaction when eating different kinds of food.
❌Too much Vitamin A can also lead to problems. Such as:
➡️Pain in the joints and bone
They are bacteria that can lead to benefits to the large bowels when taken in an appropriate amount.
❓But are all Probiotics good?
📝For me to have a better idea about that, I went to find the evidence behind it.
✴There are over 2.5k articles focusing on 22 different probiotics.
✴From those articles, I found 249 RCTs (𝘳𝘢𝘯𝘥𝘰𝘮𝘪𝘻𝘦𝘥 𝘤𝘰𝘯𝘵𝘳𝘰𝘭𝘭𝘦𝘥 𝘵𝘳𝘪𝘢𝘭𝘴), with most of them being sponsored by the company selling them.
✔So take their conclusions with a pinch of salt…
✅The most effective use for them is diarrhoea, IBD (𝘐𝘯𝘧𝘭𝘢𝘮𝘮𝘢𝘵𝘰𝘳𝘺 𝘉𝘰𝘸𝘦𝘭 𝘋𝘪𝘴𝘦𝘢𝘴𝘦) and IBS (𝘐𝘳𝘳𝘪𝘵𝘢𝘣𝘭𝘦 𝘉𝘰𝘸𝘦𝘭 𝘚𝘺𝘯𝘥𝘳𝘰𝘮𝘦).
⚠️This image shows the conditions for which probiotics are helpful and the evidence's strength.
(𝘊𝘩𝘰𝘰𝘴𝘪𝘯𝘨 𝘢𝘯 𝘢𝘱𝘱𝘳𝘰𝘱𝘳𝘪𝘢𝘵𝘦 𝘱𝘳𝘰𝘣𝘪𝘰𝘵𝘪𝘤 𝘱𝘳𝘰𝘥𝘶𝘤𝘵 𝘧𝘰𝘳 𝘺𝘰𝘶𝘳 𝘱𝘢𝘵𝘪𝘦𝘯𝘵: 𝘈𝘯 𝘦𝘷𝘪𝘥𝘦𝘯𝘤𝘦-𝘣𝘢𝘴𝘦𝘥 𝘱𝘳𝘢𝘤𝘵𝘪𝘤𝘢𝘭 𝘨𝘶𝘪𝘥𝘦. 𝘩𝘵𝘵𝘱𝘴://𝘥𝘰𝘪.𝘰𝘳𝘨/𝟷𝟶.𝟷𝟹𝟽𝟷/𝘫𝘰𝘶𝘳𝘯𝘢𝘭.𝘱𝘰𝘯𝘦.𝟶𝟸𝟶𝟿𝟸𝟶𝟻 𝘋𝘦𝘤𝘦𝘮𝘣𝘦𝘳 𝟸𝟼, 𝟸𝟶𝟷𝟾)
❇This means, not all probiotics have any evidence based effect on your health.
➡️And the helpful ones are disease specific.
❗At least, from all of them, we know there are no absolute contraindications to their use.
✅Other benefits found are that they:
▶️Stimulate the immune system
▶️Can decrease the inflammatory response
▶️Can improve vaccine response
✅Where are they found:
▶️Fermented milk drinks
▶️Examples: kefir, kombucha, sauerkraut, pickles, miso, tempeh, kimchi, sourdough bread, some cheeses (Cheddar, Parmesan, and Swiss cheeses are soft cheeses that contain a decent amount of probiotics. Gouda is the soft cheese that delivers the most probiotics of all)
✅How to take them:
▶️There is scant evidence comparing which type of formulation may be more effective.
▶️The choice of formulation may be based on shelf-life, in that lyophilized capsules maintain high concentrations longer than probiotics in dairy products and enteric-coated capsules show higher survival rates than non-enteric coated capsules.
▶️Probiotic capsules requiring refrigeration are heat-dried (not lyophilized) and thus not stable at room temperature, limiting their portability.
▶️Besides, if the patient is lactose-intolerant, yoghurts or other types of fermented dairy products may not be advisable.
‼️Careful with quality control, some will have less than stated.
Dr Costa is a Consultant Paediatrician and fellow of the Royal College of Paediatrics and Child Health.