“…Nonetheless, highly elevated serum retinol in excess of 3.49 mol/L (100 g/dL) usually is a diagnostic indicator of excess vitamin A intake and hypervitaminosis A (6,8). Some of this abnormal concentration of retinol circulates nonspecifically in association with plasma lipoproteins, as opposed to normal transport bound to retinol binding protein, and thus has a potentially destructive effect on cellular membranes leading to cell and tissue damage (22,36,37). During the course of the present study, no significant changes were noted in the serum retinol concentrations of unsupplemented patients in the trace group, whereas significant increases of Ϸ8% and 18% were observed at years 5 and 12, respectively, among those supplemented with 4500 RE (15 000 IU) vitamin A/d.…”