Let me be honest: out of the desperation and frustration that we all know too well, I decided to self-medicate with Vitamin A supplements (the "pre-formed", animal source, since the precursor form, beta-Carotene, is converted only on a need-basis and thus cannot reach therapeutic/toxic concentrations per kg of body weight).
I am 23, female, moderate acne (with a history of severe cystic). 5'7" and 115 lbs. I've been taking at least 10,000 iu / day, with some days at 50,000. I take it with food and with other supplements that are said to mitigate toxic effects.
In the 6 weeks since I began, my face has seen all of ~4 new zits, and when they come, they seem to be stopped in their tracks: they don't burgeon into what I'd call an outbreak, and they go away quickly. My skin is doing beautifully. The sense of relief and satisfaction cannot be put into words. I'm almost afraid to jinx it!
It seems too good to be true, and naturally, my worry is that the megadose of Vitamin A will in fact take a serious toll beneath the skin: on my liver, eyesight and more.
Because this mode of self-medication is not accepted in the mainstream medical community, I feel like I can't get sincere answers from doctors, including my dermatologist. The knee-jerk response is, "No! Stop! That's dangerous. You are getting your information from the internet. You are not a doctor. WebMD and medical journals and "studies have shown" are not doctors, either."
I get that. I don't want to be stupid or stubborn here. In fact, I came here to learn YOUR perspectives on this controversial question, because here we all are seasoned veterans of acne treatments; when we put our heads together and pool that common expertise, we can help each other.
I also came here because you guys are particularly sensitive to the risks that loom on either side of this situation:
- Risk 1: self-administering doses to so-called "toxic" (alternately called "therapeutic") levels.
- Risk 2: needlessly stopping the first thing in my life that has worked to clear up my skin. I say "needlessly" because my side effects are mild to none. Megadosing is dangerous in theory, but I'm the one living inside my body day in/day out, and I feel just like myself! Truly! If a "course" of 3+ months can put the acne in remission and give me my life back, then I'm THRILLED to be giving up drinking alcohol, smoking and sex (b/c of teratogenicity) for 12 weeks. In the scheme of dealing with this condition, it goes without saying that such sacrifices are worth their weight in gold. Oh yeah, and chapped lips and dry eyes and a mild headache from time to time (if a headache does come, I will skip the next doses. Gotta listen to your body).
While we are on this subject of, you know, god-awful side effects...let's quit beating around the bush and address the elephant in the forum, that is, isotretinoin, of course! Here is my central question: is there a practical difference between "toxicity" and "therapeutic dosage"?
The definition of "toxicity" is when excess vitamin A is forced to enter the circulation because the quantity ingested exceeds the liver's maximum retinoid storage limit. In short, "toxicity" means the presence of vitamin A in the blood, where it do all sorts of things, from dramatically lowering sebum production (yay!), to causing dryness, hair loss and, even, intracranial pressure ( yikes...). So, the toxicity that combats our acne-prone skin, is the same mechanism behind all the dangers. But we knew that already; accutane treatment is no walk in the park. You are swelling your bloodstream with toxic levels of retinoic acid.
Now, if you managed to stick it out and read all of that, you probably found that I jumped to conclusions without enough evidence, etc. Of course I did. I was a lowly humanities major in college! This is my best effort at getting a handle on the different factors involved, but my grasp is superficial at best. You are invited to correct me. For instance, I realize that isotretinoin is NOT exactly the same substance that is sealed into vitamin A gel capsules. (Obviously.) I've read in certain places that isotretinoin is more efficient in its side effects compared to the benefits that it gives the patient, whereas vitamin a needs to be taken in enormous quantities to achieve comparable therapeutic effects, while stacking greater dangers against the patient.
One big disclaimer: of course it would be ideal to take isotretinoin, because then you're under strict doctor's watch with regular bloodwork, etc, that protect the patient. However,  this is not an option for me at the moment, because half the time I am living in the Middle East for my job, often for more than 30 days at at time;  wouldn't it be ideal to steadily decrease my daily dosage to 10,000 iu (25,000 = the beginning of potentially toxic territory), and hopefully I will stay clear, and not have to deal with all the bureaucracy + complication of the iPledge program, not to mention the cost of the prescription?
Also, here's how I calculated my dosage vitamin a dosage.pdf 81.42K 176 downloads
Thank you in advance for any feedback!