Vitamins

In a retrospective study, 9 patients with severe dyskeratoses were treated with 20-40 mg of vitamin A daily, resulting in hepatomegaly in 3 cases, but no significant changes in liver function were observed. However, one female patient developed cirrhosis after taking vitamin A uncontrolled for 13 years, indicating the risks of long-term high-dose vitamin A treatment. In a study of 10 severe acne patients treated with 13-cis-retinoic acid, side effects occurred but did not necessitate stopping treatment. Retinoids caused dose-dependent, reversible side effects like cheilitis and hair loss, with hair loss starting 3-8 weeks after beginning treatment with 50-75 mg/day and stopping 6-8 weeks after discontinuation. Elevated serum triglycerides, which could lead to acute pancreatitis, were seen in 7 out of 10 patients with keratinization disorders treated with isoretinoin, and one patient developed liver necrosis after treatment with Ro 10-9359. Topical acne treatments with vitamin A derivatives showed tretinoin caused more severe erythema and desquamation than motretinide or placebo. Vitamin C was well-tolerated except for one reported allergy case. Vitamin D overdosage can lead to hypercalcemia, requiring careful monitoring. Vitamin E has been linked to adverse reactions like hypoglycemia, thromboembolism, and hormonal changes, with serious issues including thrombosis and pulmonary embolism, with about 80 cases reported. High doses of vitamin E can also depress leukocyte bactericidal activity and decrease lymphocyte proliferation. The document advises caution with megadoses of vitamins and suggests that unorthodox therapies, including high vitamin doses, may be related to unexpected symptoms in patients.