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A Deficiency in This Vitamin May Cause Eczema
Vitamin A is an important fat-soluble vitamin required for optimal vision and maintenance of the immune system. Topical vitamin A products have been successively used in the treatment of skin diseases such as acne but is this vitamin useful in the treatment of eczema? Can Vitamin A deficiency cause eczema? What is the best oral vitamin A supplement for eczema? This article answers all these questions and also discusses the different ways in which vitamin A can improve skin health and help eczema caused by leaky gut.
by Brad Chase
Vitamin A refers to a group of related fat-soluble compounds including retinol, retinal, retinoic acid and plant-derived carotenoids (provitamin A compounds) such as beta carotene.
Vitamin A has multiple functions in the body. It plays central roles in growth and development as well as in the maintenance of good vision, skin health and the immune system.
The recommended daily intake of vitamin A varies with age. While children only need 300 – 500 micrograms of the vitamin per day, adults require 600 – 900 micrograms. Lactating women have even higher demand for vitamin A (1200 micrograms per day).
Vitamin A deficiency is most common among children under the age of 5. It can be caused by poor diet or malabsorption.
Early weaning of infants is a leading cause of vitamin A deficiency. In addition, the deficiency can affect children and adults whose diets are poor in plant-sourced provitamin A (carotenoids) or preformed vitamin A from animal sources.
Malabsorption of dietary sources of vitamin A leads to secondary vitamin A deficiency. It is caused by impaired absorption of lipids.
Because vitamin A is a fat-soluble vitamin, it needs lipids to be absorbed into the bloodstream. The need for lipids also means that vitamin A absorption can be affected by reduced production and release of bile acids.
Other causes of secondary vitamin A deficiency include zinc deficiency and repeated exposure to harmful free radical oxidants from such sources as cigarette smoke.
One of the first signs of vitamin A deficiency is progressive loss of vision especially low-light vision. This can lead to night blindness if the deficiency is not immediately addressed. As vitamin A deficiency becomes prolonged, more damage is done to the eyes and other organs of the body.
Vitamin A deficiency causes negative changes in mucosal surfaces all over the body. Specifically, it causes the mucosa to dry up. Therefore, it can lead to the keratinization of soft tissues.
When this affects the eye, it dries up the conjunctiva and cornea. Similarly, this reaction can cause dryness of the skin. The changes to the moisture content of the skin can contribute to skin conditions such as acne, psoriasis and eczema.
Lastly, vitamin A deficiency impairs the body’s ability to fight off infections.
Eczema is more than a simple skin disease. There are strong, clinical evidences showing that the types of microbes colonizing the gut can determine the risk and severity of atopic eczema.
The most compelling of such evidences demonstrates that the state of gut flora (the microbes found in the gastrointestinal tract) in the first weeks of life can be used to predict whether an infant will develop eczema later in life.
So what is the link between the gut and eczema, a skin disease?
First, it is important to note that most of the body’s immune system is directly wired to the gut. And most of the symptoms of eczema are caused by the inability of the immune system to keep infectious microbes (both in the gut and on the skin) in check and the inflammatory response triggered by these pathogens.
A healthy gut flora is mostly made of beneficial bacteria. Besides contributing to metabolism and the synthesis of certain vitamins, these beneficial bacteria help keep pathogens in check.
However, when the balance is broken and the normal gut flora is destroyed, pathogenic microbes invade the gut. As they multiply and thrive, they damage the lining of the gastrointestinal tract.
When they make holes in the gut mucosa, harmful microbes, toxins, undigested foods and other foreign substances that should be restricted to the gut leak into the blood. This condition, known as leaky gut syndrome, is the root of a number of chronic diseases including atopic eczema.
Leaky gut syndrome is one aspect of GAPS (Gut and Psychology Syndrome).
The core tenets of GAPS also maintained that unhealthy gut flora and the destruction of the mucosa are the root causes of many chronic diseases that start out in childhood.
Even though the state of the gut flora is a big contributor to eczema, the damage to the skin is still an important factor. In fact, studies show that, in eczema, the skin experiences a “leaky” damage similar to the one found in the gut.
Recent studies also show that in eczema, both the outer and lower layers of the skin are “leaky”.
This leaky skin damage is caused by the increased colonization of the skin surface and gland ducts by pathogenic microbes.
The use of topical vitamin A analog in the treatment of skin diseases is not new. In fact, one of the most effective drugs for treating acne is isotretinoin.
A related drug known as alitretinoin is also approved for the treatment of severe hand eczema in Europe and Canada. Unlike isotretinoin, alitretinoin is an oral drug.
So, how can vitamin A (and its synthetic analogs) help eczema? First, these vitamin A analogs are known for suppress excessive cellular growth in the skin. They not only reduce bacterial population in the skin but also in the gland ducts of the skin.
This means that vitamin A compounds can help restore the protective barrier of the skin by stopping the bacterial damage that leads to leaky skin.
In addition, vitamin A can relieve eczema by reducing local inflammation in the skin. It achieves this by blocking proinflammatory immune cells such as neutrophils and monocytes.
Although vitamin A has no direct antimicrobial effect, it plays an important role in the immune system defense against invading microbes. By contributing to immune function, vitamin A can help the body recruit the immune cells needed to fight infective agents while relieving inflammation.
This means that vitamin A can boost the immune system and help reduce the effect of leaky gut syndrome in the development of eczema.
In eczema, the “attack” component of the immune system is impaired while the “defense” component is hyperactive. This causes a repeated cycle of inflammation as the invading pathogen keeps damaging the gut mucosa and the protective layers of the skin while the immune system scrambles to contain the damage with proinflammatory cytokines.
Vitamin A can break this cycle of inflammation because it boosts the “attack” component of the immune system while blocking the release of inflammatory cytokines.
Besides its immunomodulatory properties, vitamin A is also an antioxidant vitamin.
As an antioxidant, vitamin A can contribute to the detoxification of the body. Specifically, it can arrest the free radical damage to the protective mucosa of the gut and the barriers of the skin.
This antioxidant cover not only lowers the amount of damage done to the skin and the gut but also prevents the immune system from reacting with inflammation.
Vitamin A supplementation in eczema patients is important but should be done with care.
This is because there is always a chance of vitamin A toxicity with oral supplementation of the vitamin. However, most eczema patients also suffer from GAPS and, therefore, have impaired fat absorption coupled with low vitamin A absorption.
Food sources of vitamin A are also not better than oral supplements. This is because the absorption of the vitamin is reduced by the digestive problems caused by damage to the gut and reduced fat absorption.
The ideal source of vitamin A for GAPS patients is a natural supplement that can provide readily absorbed vitamin A even while healing the gut. Cod liver oil is one of the few ideal natural supplements that can be safely used to raise vitamin A level in eczema patients.
The vitamin A content of cod liver oil is sufficient to make up the daily recommended intake of the vitamin. Therefore, cod liver oil can be used solely as a vitamin A supplement.
Besides vitamin A, cod liver oil is also an excellent source of vitamin D as well as omega-3 fatty acids.
Omega-3 fatty acids are known for their anti-inflammatory properties as well as their ability to help heal the damaged mucosa in GAPS patient. In addition, these essential fatty acids can improve skin health and restore the gut flora.
Vitamin D is also another important natural supplement proven to be effective in the treatment of eczema.
Like vitamin A, vitamin D is a fat-soluble vitamin with antioxidant and immune-boosting properties. In addition, vitamin D can also improve skin health. Lastly, its antibacterial properties can help heal GAPS and leaky gut syndrome as well as seal up the leaky layers of the skin.
In conclusion, the form of vitamin A in cod liver oil, as well as the other natural supplements found in the oil, is ideal for treating GAPS patients with eczema.
In a 2006 study published in the British Journal of Dermatology, a group of researchers measured the levels of vitamin A in patients with certain skin diseases and compared these to the results obtained from healthy volunteers.
The researchers recruited 61 patients with such skin diseases as acne and atopic eczema. They measured the serum and skin concentrations of retinol (vitamin A1) and its metabolite, dehydroretinol (vitamin A2) as well as carotenoids in these patients and compared the results with those from 37 healthy subjects.
The results of the study showed that skin retinol concentrations were lower in the patients with atopic eczema than in healthy subjects.
In contrast, the level of dehydroretinol was higher in the skins affected by atopic eczema.
The researchers believed that the low vitamin A1 level in eczema was due to reduced supply of the active form of vitamin A to the skin from the blood. However, they noted that the higher level of vitamin A2 shows that vitamin A metabolism is affected by the inflammation and skin keratinization associated with eczema.
This study shows that the bioactive form of vitamin A is found in lower concentration in the skins of eczema patients.
Therefore, raising the vitamin A level in the skin can improve skin health and help treat eczema.
A 2006 study published in the Journal of Allergy and Clinical Immunology highlighted the difference between the effectiveness of water-soluble and oil-based forms of vitamin A (and vitamin D) for reducing the risk of allergic diseases such as eczema.
The researchers gathered data from over 4,000 children from birth up to the 4th year of life to determine the difference between both forms of vitamin supplementation.
Their data showed that the children who received water-soluble forms of vitamin A during their first year of life had twice the risk of allergic diseases when compared to those who took the peanut oil-based vitamin A during the same period.
The researchers, therefore, concluded that oil-based vitamins A and D are the right supplements of vitamin A (and vitamin D) for reducing the risk of allergic disease in children.
Although this study did not specifically study cod liver oil and eczema, its results can easily be used to justify the use of cod liver oil as a source of vitamin A for treating eczema especially in GAPS patients.
Cod liver oil qualifies as an oil-based vitamin A (and vitamin D) supplement. Therefore, this study provides an indirect support for the superiority of cod liver oil over other forms of oral vitamin A supplements for treating eczema.
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