Saturday, 8 November 2008

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.
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]


Anonymous said...

Fifteen years ago my niece was a yellow-bordering-on-orange colored baby because of all the carrot, sweet potato, and pureed squash she ate while an infant. They were the only veggies she would eat at one stage. But it was known that the veggies were the cause and it wasn't a problem.

I noticed a few years back that my palms had a orangy hue to them, but I never found it particularly worrisome and figured it was carotenes, though I didn't have an especially high intake.

But not long after I started thyroid hormone replacement for hypothyroidism, I noticed my palms had lost their orange tint. Later I ran read in several places that hypothyroidism reduces the body's ability to convert carotenes into Vit A. Now I make sure I am eating enough foods with pre-formed Vit A so I don't have to convert so much.

Methuselah said...

Anon - thanks, that's really interesting. So if I have understood correctly, the hypothyroidism, pre-treatment, was preventing carotenes being turned into Vit A and therefore there were more of them in your body, causing the orangeness?

My Year Without said...

What an absolutely astonishing find...I thought my yellow hands were just a close-knit family joke! My mom teases that especially when I was a baby I ate so many sweet potatoes that I turned yellow.

I think I'm pinker now than a few years ago when family could not help but comment regularly that I must be eating too many carrots. What's changed? About a year or so ago I began taking liquid iron (just before that, I had this experience: a Chinese doctor pulled down my lower eyelid and said, "Tsk, Tsk, Tsk...You must eat red meat!" due to my pale looking lower lid.)
I'm much pinker and my lower lid is bright red!

Anonymous said...

I am having exactly the same problem as described. Someone suggested I looked yellow and what followed were tests which proves that I am but fine except for my red blood count being on the low side.

As I am a frequent blood donor, my Dad says it might be a cause of my low blood count and ask me to take a break from it for a while. There is also the fact that I don't eat too much food with carotenes.

Right now I'm taking some herbal medicine and hope to see improvements soon.

Methuselah said...

Ditto - I can't help wondering whether most people, if given blood tests, would show up something that doctors regard as 'abnormal'. Averages are just that - averages.On the basis of how widely people's diets and lifestyles vary I would think the vast majority of people would have at least one reading out of the normal range, yet be perfectly fine. Since most people never have blood tests, how would we know?

However, not being a doctor, I am only in a position to speculate.

Question - have you always been a bit yellow, or only recently become a bit yellow?

Yo may be interested to know that Dr Eades, in his book, says that giving blood regularly is a great way to control iron levels which are far too high in most modern people, particularly as they age.

pnw fitness said...

You too huh? Back in 01 people said I was turning orange. They knew I was juicing though.

I never believed them, but "Jay the Juiceman" did have me running a pile of carrots through my Juiceman II.

LOL! Maybe I really was? I no longer juice either. I just enjoy eating them way too much. Plus, juicing (for me at least) was wicked expensive!

Methuselah said...

pnw - good to hear about another yellow/orange experience! I stopped mainly because I decided it was totally non-paleo. First I transitioned away from fruit towards veg. Then I found the beetroot was turning not me, but my 'output' a different colour, if you know what I mean! And yes, also the cost and effort of hauling all that produce back from the market each week was just more trouble than I was willing to go to in the end.

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