Carotenemia & Hypothyroidism

Also see:
The effect of raw carrot on serum lipids and colon function
The Cholesterol and Thyroid Connection

“In other words, the thyroid has a profound effect on the liver. We have other evidence that a lack of thyroid is accompanied by a sluggish liver. In the first place, it has been apparents for a century that patients with myxedema (very low thyroid activity) have a yellowish tint to their skins. This has been found to be due to the presence of too much carotene in the blood. The liver converts carotene into vitamin A which is colorless. Under the administration of thyroid, the liver becomes more active and the carotene soon disappears. In the second place, the cholesterol level in the blood is usually elevated in hypothyroidism. Thyroid administration will lower cholesterol, and if too much is given, the cholesterol will fall below normal. The liver converts cholesterol into bile salts which are eliminated in the bile; this process is the usual means of eliminating excess cholesterol. The liver is sluggish in this function among thyroid-deficient individuals…Since a sluggish liver is the most common cause of hypoglycemia, it should follow that the hypothyroid patient is highly susceptible to low blood sugar.” -Broda Barnes, MD, PhD and Charlotte Barnes

Quotes by Ray Peat, PhD:
“In the 1930’s accurate diagnosis [of hypothyroidism] was made by evaluating a variety of indications, including basal oxygen consumption, serum cholesterol level, pulse rate, temperature, carotenemia, bowel function, and quality of hair and skin.”

“Vitamin B12 and thyroid will lower the carotene quickly, but the calluses take a long time to wear off.”

“If your cholesterol is above 200, and the thyroid supplements didn’t warm you up, it’s possible that something is interfering with your steroid synthesis, which might be a deficiency of something like vitamin A, or interference from something like iron or carotene.”

“Yes, it’s definitely hard to get them coordinated when there’s an imbalance in one direction or the other. For several years, when I had an extremely high metabolic rate, I needed 100,000 units per day during sunny weather to prevent acne and ingrown whiskers, but when I moved to a cloudy climate, suddenly that much was too much, and suppressed my thyroid. The average person is likely to be hypothyroid, and to need only 5,000 units per day. Avoiding large amounts of carotene, and getting plenty of vitamin B12 to be able to convert any carotene that’s in your food, helps to use vitamin A efficiently.”

“Thomas H. McGavack’s 1951 book, The Thyroid, was representative of the earlier approach to the study of thyroid physiology. Familiarity with the different effects of abnormal thyroid function under different conditions, at different ages, and the effects of gender, were standard parts of medical education that had disappeared by the end of the century. Arthritis, irregularities of growth, wasting, obesity, a variety of abnormalities of the hair and skin, carotenemia, amenorrhea, tendency to miscarry, infertility in males and females, insomnia or somnolence, emphysema, various heart diseases, psychosis, dementia, poor memory, anxiety, cold extremities, anemia, and many other problems were known reasons to suspect hypothyroidism.”

“I avoid carotene, because it blocks thyroid and steroid production, and very large, excessive, amounts of vitamin A, retinol, can do the same.”

“Yes, vitamin A and estrogen are antagonistic, and while estrogen promotes keratinization (shedding of skin cells), vitamin A opposes it. Since vitamin A is highly unsaturated, in excess it suppresses the thyroid, so it has to be balanced with the thyroid; the combination is effective for increasing progesterone and decreasing estrogen, slowing the turnover of skin cells, and making the skin cells function longer before flaking off.”

“Long ago, people knew that polyunsaturated fats blocked proteolytic enzymes. The first effect of too much PUFA is to block the ability of the thyroid gland to secrete the hormone by breaking down the thyroid globulin. If the thyroid does manges to secrete it, the transport of it on proteins in the blood is inhibited in proportion to the unsaturation. Fish oils with 5 and 6 unsaturated double bonds are the most powerful, almost total inhibitors of thyroid transport. Linolenic acid (omega -3) fats with 3 double bonds inhibits about 50%, linoleic acid (omega -6) with 2 double bonds inhibits about 30%. So the inhibition is proportional to the amount of double bonds. The responsiveness of the cell to thyroid is inhibited in proportion to the amount of unsaturated fats. Carotene is highly unsaturated and it has the same effect of interfering with thyroid function because of this series of unsaturations.“

Clin Pediatr (Phila). 1981 Jan;20(1):25-9.
Carotenemia. A review.
Lascari AD.
Awareness of carotenemia is important to avoid confusion with jaundice and unnecessary diagnostic studies. It is surprising how little information can be found about this relatively common condition in the standard pediatric textbooks. Ingestion of excessive amounts of carrots is the usual cause of carotenemia, but it can also be associated with ingestion of many other yellow vegetables, as well as some green vegetables. Mothers may unknowingly be giving their infants large amounts of carrots in the form of commercial infant food combinations. Carotenemia is a benign condition; vitamin A poisoning does not occur despite massive doses of carotene because the conversion of carotene to vitamin A is slow. Hypothyroidism, diabetes mellitus, hepatic and renal diseases may be associated with carotenemia, but are not caused by ingestion of carotene. The absence of yellow pigment in the sclera and oral cavities distinguishes carotenemia from jaundice. A similar disorder, lycopenemia, is associated with an orange-yellow skin pigmentation as a result of ingestion of large amounts of tomatoes.

The Journal of Pediatrics Volume 41, Issue 6 , Pages 784-791, December 1952
The carotenemia of hypothyroidism
Hugh W. Josephs, MD
Twenty-five cases of hypothyroidism were studied from the point of view of carotenemia, a number of them over a period of time during which thyroid medication was withdrawn and reinstituted.

The occurrence of carotenemia in hypothyroidism, long known, is confirmed. However, it is found only in those who ingest food containing carotene, so is not likely to be encountered in infancy.

It is regularly associated with lipemia and cholesterolemia, but the carotene tends to be relatively more increased than the lipids or cholesterol.

It was also found that when thyroid medication was withdrawn or instituted the resultant rise or fall in carotene tended to lag behind that of the total lipid. It was pointed out that carotene was probably “carried” by the lipids and as a result would not only show some lag in movement but would tend to accumulate in the blood stream when the lipids were increased.

It was felt that this behavior of carotene might well be a factor in the “failure” to convert carotene to vitamin A in hypothyroidism.

Acta Med Austriaca. 1993;20(1-2):17-20.
[Beta-carotene, vitamin A and carrier proteins in thyroid diseases].
[Article in German]
Aktuna D, Buchinger W, Langsteger W, Meister E, Sternad H, Lorenz O, Eber O.
The conversion of beta-carotene (provitamin A) to 2 molecules of vitamin A (retinol) is accelerated by thyroxine and hyperthyroidism, respectively. The characteristic yellow tint of the skin in hypothyroidism is due to hyper-beta-carotenemia. Both in hyper- and hypothyroidism in a retinol deficiency has been observed in literature. In a series of 36 patients (16 hyper-, 8 hypo-, and 12 euthyroid) serum samples were analyzed for retinol and beta-carotene levels (high pressure liquid chromatography) as well as retinol binding protein (radial immune diffusion), prealbumin (nephelometry), and serum zinc values (atomic absorption spectrometry) were established. The beta-carotene serum level in the hypothyroid group (mean 1.1 microgram/ml) was significantly higher (p < 0.05) in relation to euthyroid controls (0.6 microgram/ml), the hyperthyroid group showed significantly lower values (0.3 microgram/ml). RBP and prealbumin concentrations were significantly lower (p < 0.05) in hyperthyroid as against eu- and hypothyroid patients. Surprisingly, in all 3 groups the retinol levels were not significantly different, although the hyperthyroid group was slightly lower (0.6 microgram/ml) than the mean value of 0.7 micrograms/ml in the other groups. A vitamin A and protein rich food, customary in Central Europe, seems to rule out any vitamin A deficiency both in hyper- and hypothyroidism. However, the beta-carotene values are significantly higher in hypothyroidism, while in hyperthyroidism they were lower. As intrahepatic zinc content plays an important role in the synthesis of RBP and its secretion together with retinol, we also analyzed this component: The serum zinc levels in hyperthyroid patients were clearly higher (79.1 micrograms/dl) than in the hypothyroid group with 57 micrograms/dl (p < 0.05).

Pediatr Dermatol. 2004 Nov-Dec;21(6):657-9.
Carotenemia associated with green bean ingestion.
Sale TA, Stratman E.
Carotenemia is a condition characterized by yellow discoloration of the skin and elevated blood carotene levels. Excessive and prolonged ingestion of carotene-rich, yellow- or orange-colored foods such as carrots and winter squash is the most common cause, but more rarely it may be associated with consumption of other foods as well as with hypothyroidism, diabetes mellitus, anorexia nervosa, liver disease, or kidney disease. Though not uncommon in children, there are few reports in the pediatric literature since its early descriptions in the late 1800s and early 1900s. Awareness of carotenemia can help the provider resolve confusion with jaundice and avoid unnecessary worry and costly tests. Herein we describe carotenemia in an 8-month-old Caucasian girl secondary to increased consumption of commercial infant food green beans.

J Dermatol. 2006 Feb;33(2):132-4.
A case of carotenemia associated with ingestion of nutrient supplements.
Takita Y, Ichimiya M, Hamamoto Y, Muto M.
Carotenemia is characterized by an abnormal yellowish orange pigmentation of the skin, most prominently seen on the palms and soles. Although it is associated with several disease such as diabetes, hypothyroidism and anorexia nervosa, it is caused by excessive intake of carotene-rich food such as oranges and carrots in most cases. Herein, we describe an interesting case of carotenemia in a 66-year-old female secondary to increased ingestion of oral supplements of carotene in order to improve hemorrhage in the eyeground. There could be an increasing trend of intake of commercial nutrient supplements in which case it is necessary to remind ourselves that commercial nutrient supplements could cause various skin disorders as side-effects.