THE PLASMA LEVELS OF VITAMIN A AFTER THE INGESTION OF STANDARD DOSES: STUDIES IN NORMAL SUBJECTS AND PATIENTS WITH CIRRHOSIS OF THE LIVER 1

Abstract

Standard doses of cod liver oil in the form of a cod liver oil concentrate were given orally to 12 normal subjects, to 5 patients with cirrhosis of the liver and to 1 case with acute catarrhal jaundice. Four of the normal subjects received doses of the cod liver oil concentrate containing 20,000 U.S.P. units of vit. A and 8 received doses containing 100,000 U.S.P. units of vit, A. The patients with cirrhosis of the liver and the patient with acute catarrhal jaundice received the larger amts. of the concentrate containing 100,000 U.S.P. units of the vit. Following the adm. of the cod liver oil concentrate the plasma levels of vit. A and carotene were detd. at 3, 6, 9, 12, and 24 hrs. In the normal group the smaller dose of vit. (20,000 U.S.P. units) was followed by a rise in the plasma level of vit. A which reached its peak in 6 hrs. and averaged 84 U.S.P. units of vit. per 100 cc of plasma. The larger dose (100,000 U.S.P. units) provoked a much greater increase in the plasma level, the avg. rise being 318 U.S.P. units. In both groups the plasma levels returned to the original fasting levels after 24 hrs. In the cases of cirrhosis of the liver, who all received the larger dose of the vit. and so are comparable to the 8 normals receiving the larger dose (100,000 U.S.P. units of vit. A), there was a much smaller rise in the plasma level of the vit. The avg. increase was only 99 U.S.P. units per 100 cc of plasma. The same was true in the patient with acute catarrhal jaundice. Again the plasma levels returned to the original fasting levels after 24 hrs. In these cases it was also interesting that the plasma levels were all much lower than in the normal subjects. The normal avg. fasting plasma vit. A was 156 U.S.P. units of vit. A per 100 cc plasma and in the cirrhotics the avg. fasting level was 44 U.S.P. units. The adm. of standard amts. of cod liver oil containing definite amts. of vit. A may provide a test which will serve as an index of the degree of vit. A deficiency in patients with cirrhosis of the liver. One of the cirrhotic patients was fed large amts. of cod liver oil concentrate for 9 wks. and this resulted in an increase in the fasting plasma level of vit. A and in a greater rise in the plasma vit. A following a test dose.