A CASE-STUDY OF CAROTENEMIA IN ANOREXIA-NERVOSA MAY SUPPORT THE INTERRELATIONSHIP OF VITAMIN-A AND THYROID-HORMONE

Elevated serum carotenoids (carotenemia) of unknown etiology is associated with anorexia nervosa. This case study reports a subject with anorexia nervosa and carotenemia who was followed while consuming a carotene-free enteral feeding for 34 days. Blood was collected periodically for clinical evaluation. Thyroid hormones, T4 and T3, were analyzed by RIA and serum carotene was analyzed by HPLC. Despite the carotene-free diet, serum beta-carotene (the provitamin A carotenoid) remained elevated concommitted with low T3. The carotenemia of anorexia nervosa is compared with that seen in normal individuals chronically consuming purified beta-carotene supplements and normal subjects receiving a carotene-free diet. Recent studies suggest that vitamin A and thyroid hormone interaction may be linked at the level of gene expression. The argument is presented that the carotenemia of anorexia nervosa together with the alteration in thyroid hormone may represent a biochemical marker for the molecular events altering the physiological profile of this starvation-like syndrome.