Doctors and Nutrition Part 1: My Yellow Skin Mystery

A few years back, Mrs M's mother decided that I looked yellow. At the time I was eating what I considered to be the ultimate in healthy diets and was as fit as I'd ever been, so you can imagine the scepticism with which I greeted this suggestion. I mentioned it to a few friends but was surprised to receive responses along the lines of Yeah, I suppose you do.

Made quite indignant by this apparent conspiracy, I wanted to know why no one had mentioned it before. I examined photos and disputed opinion, but eventually could see that the only way to put this one to bed would be to get medical opinion. I would go to the doctor, who would proclaim me to be entirely well.

At the doctor's I answered all the questions I had expected, was prodded in the traditional places and yielded fluids of various kinds. Since I knew I had no other symptoms, it was no surprise that this initial examination yielded nothing.

Low Fat Diet

Keen to impress with my diet and lifestyle but acknowledging I may not have it entirely right, I did some quizzing of my own. Could eating a very low fat diet cause it? What about my punishing running and weights regime? I described my diet in detail - the steamed white fish, the six pieces of fruit per day, the daily litre of freshly juiced fruit and vegetables, the eggs, muesli and the oatmeal.

This was when it started to dawn on me that doctors (I saw a number during this period) might not exactly be experts in the field of nutrition. When I explored with them the more nuanced aspects of my diet, a faint glaze would develop in their eyes, their polished bedside manner unable totally to conceal the lack of interest; and when I solicited opinion, there were so many hedges and caveats that I frequently departed with more questions than answers.

Tests

Yet one useful thing doctors can do is run tests - which is exactly what they did; and the good news was that they were now able rule out all kinds of obvious problems. No, it was not jaundice. My liver was fine. My vitamin profile was excellent. I had slightly elevated levels of creatinine, which might have been due to the exercise, but a subsequent retest proved this not to be a problem. Kidney function was also normal.

However, there was something that was not right. My blood counts. The red and whites were at the very low end of normal. So I wanted to know - could this make me yellow? No, not really, was the answer.

This is where the whole business changed. I was referred to a haematology specialist, who asked me many more probing questions and prodded in new places. She was no more interested in my diet, of course, and frankly even less interested in the yellowness. She was, however, very interested in my blood counts, and a regular schedule of tests quickly took shape. Soon, the yellowness had become a historical footnote and the blood test roller coaster was under way. With the blood I parted with over the following two years you could have fed an army of vampires.

Mystery Solved

For now I want to wind the clock forward. Two years later, roughly six months ago, there was an equally abrupt pronouncement about my skin colour, this time from Mrs M herself. You aren't yellow anymore, she had decided. Once again I canvassed wider opinion and this was confirmed. It was official - I was no longer yellow. Yet my blood counts remained the same.

By now my Googling skills and nutritional knowledge were more advanced, so I set about looking into it. Before long I had identified a harmless condition called carotenoderma, the primary symptom of which is yellow skin and the cause of which can be "...excessive dietary intake of carotenoids..."

Wikipedia lists many fruits and vegetables with which the condition has been associated and it looks startlingly like the diet I was eating at the peak of my yellowness. The 8 apples, 5 large carrots, 100g of spinach and whole cucumber that went into my juicer each day might alone be responsible, but on top of that were the fruit and vegetables I was eating in whole form.

Nutritional Wisdom

For me that was all the evidence I needed - because it had been almost exactly 6 months ago I had decided to ditch the juicing altogether on the basis that it was not in keeping with my Paleo lifestyle (I'm fairly sure hunter gatherers did not have access to Champion juicers.) So I had figured out in 10 minutes on the Internet what the collective nutritional wisdom of 3 doctors and a specialist had failed to diagnose in 2 years of consultations.

The low blood counts question does remain a mystery of its own and we will explore the possible dietary explanations for that in part 2.

See Also:
Doctors and Nutrition Part 2: My Wheat Experiment
My Wheat Experiment Blood Test Update
Doctors and their Good Intentions: the Blood Test Fiasco Continues
[Blood Test Update in Post on Weight Loss]