Vitamin A in anxiety disorder and panic attacks

I’ve come across some extremely interesting studies recently. Individually they may not be that interesting, but if you look at them all, quite an interesting web of relationships emerges.

But first, by way of introduction. Probably every “neurotic” has heard about how the best thing they can do is eat magnesium. But also after trying such supplementation, many times instead of improvement, we have deterioration. Eyelids and muscles begin to twitch, insomnia occurs. Unlucky person will start to search in google and will find it under “magnesium deficiency symptoms”, will start to eat even more magnesium, will feel even worse… a little less unlucky, or a more clever person will read a little more and will associate that these are symptoms of calcium deficiency, which was washed out of the blood by the unfortunate magnesium. Then he reaches for calcium and… it gets worse.

Let’s look at the research:

https://pubmed.ncbi.nlm.nih.gov/23226848/

Here, supplementation with a mixture of vitamins A (in provitamin form), C and E did not so much improve the health of people with depression and anxiety disorders, but simply cured them completely. The level of depression, as measured by a questionnaire, dropped from 35 to 3.5, the level of anxiety from 20 to 2. The vitamins were used in addition to “normal” drugs, but in the control group, which got only drugs, the effect was meager. The vitamins had many times stronger effects.

https://www.ncbi.nlm.nih.gov/pubmed/7553952

Here we have a study of magnesium levels in patients diagnosed with agoraphobia. In 90% of them, it turns out, the doctors diagnosis was wrong, they had severe magnesium deficiency and associated latent tetany. In 90% of the patients, the doctors made the wrong diagnosis! Magnesium levels in the blood were usually decent, but the levels inside the cells were very low.

https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0033-1343494

Here they directly measured the vitamin levels in the body of panic attack patients. They had deficiency of all antioxidants, but the biggest difference was in vitamin A, namely they had 34 with the average level in the population of 55. Vitamin E levels were also much lower, but the difference was not that significant.

https://www.ncbi.nlm.nih.gov/pubmed/27511521

Here, in turn, vitamin A has been shown to protect against the effects of vitamin D3 poisoning, specifically a spike in blood calcium levels.

https://pubmed.ncbi.nlm.nih.gov/10634373/

And here, in turn, it has been shown that, at least in some diseases, a lack of vitamin E causes magnesium not to be stored in cells.

If we now connect the dots, a pretty clear picture emerges from this chaos. People with panic attacks have low levels of magnesium inside their cells, and they have low levels of vitamin E. Supplementation does not raise their intracellular magnesium levels, as studies have shown that low levels of vitamin E can impede this process, even prevent magnesium from being deposited in cells.

People with panic attacks have a strong spike in blood calcium during calcium supplementation, by the way, in tests they usually have this level strongly elevated even without supplementation, this is my observation from the forum where people post their results sometimes. They can’t supplement magnesium, because the calcium inside their cells drops, leading to unpleasant symptoms, but they can’t supplement calcium either, because their calcium levels rise sharply, giving them even worse symptoms. They also have vitamin A deficiencies, and lack of vitamin A means that calcium levels in the blood cannot be properly regulated.

Finally, we have a study where supplementation with both of these vitamins greatly improved the patients’ condition.

Maybe this is the whole puzzle? Maybe this disease is simply that antioxidant levels are dropping, resulting in an imbalance of calcium and magnesium inside nerve cells?

So why am I writing about vitamin A instead of both? For two reasons.

The first is that in one clinical trial vitamin E increased patients’ anxiety levels instead of decreasing them:

https://pubmed.ncbi.nlm.nih.gov/24511708/

The second is the specific difficulty associated with supplementing A deficiency. It requires large doses. Very large ones.

https://www.sciencedirect.com/science/article/abs/pii/0304383585901600

Here, for example, the patients took different doses of vitamin A, and it was checked how much the levels in the blood increased. Six months of daily doses of 40,000 units of vitamin A, in the form of retinol, raised blood levels by only 16%. Each patient took a total of over 7 million units, and blood levels did not rise significantly!

Typically, the pills we buy at the pharmacy contain between 1000 and 2500 units. If one wanted to achieve a similar effect by taking tablets containing 2,500 units, one would have to consume almost 3,000 of them in six months. Taking one a day would take almost 8 years.

Fortunately, in the case of deficiency, the body absorbs retinol much better and raises the level in the blood faster, but still it is necessary to take doses of even 50 000 a day for several weeks, after which one takes smaller ones, but also high ones, for a month or two. It is important that it is retinol and not beta carotene, since one of the causes of A deficiency is impaired conversion of carotene to retinol in the body.

Will this therapy cure anxiety neurosis? It’s hard to say because no one has studied it. You can buy vitamin A in a dose of 25 000 units in a capsule, you can try to take it for 2 months, and for the first several days even two a day. Add 400 units of vitamin E, at least natural form, and preferably a mix of tocopherols. This should balance any deficiencies, but it would only be a prelude to raising magnesium and calcium levels.

It’s best to do level testing, of course, but keep in mind that patients with neurosis who had much lower levels than the population average did not have a clinical deficiency, and yet supplementation helped them. It’s no mystery, it’s just that the standards are set in such a way that a deficiency will only be in the results once you start going blind. The average result in the population is 1.8 μmol/L or 520 ng/ml and this is what you should aim for if you are suspected of having a deficiency.

There is also one problem with the test, magnesium deficiency can completely falsify the result, at least that’s how it turned out in rats, I don’t think they’ve tested it in humans yet, but logically it should be similar:

https://pubmed.ncbi.nlm.nih.gov/19271422/

Magnesium deficiency results in vitamin A deficiency in the blood, although liver stores are good. If this translates to humans, it’s possible that in the study cited above, where vitamin A deficiency was shown in patients with anxiety neurosis, there may not actually have been a deficiency.

Are there any contraindications? Probably only extreme liver disease, or severe calcium disorders such as parathyroid cancer or something equally serious.

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