instruction: hi doctor I have low vitamin a and levels are vitamin a and supplements safe to take with liver disease what are the highest doses that are safe to take I have fatty liver but I do not know if it is a simple fatty liver or has progressed to nash and fibrosis I am a year old female I smoke and have a history of acid reflux low heart rates fat indigestion and fatty liver lab tests showed vitamin a 9 umol and vitamin 37 nmol previously I had an abdominal ultrasound and it showed liver 14 am in length which gives rise to a moderately coarse dense echo pattern consistent with fatty infiltration alt level was 58 l I am currently on acetyl cysteine nac thank you
output: hello your vitamin a level is marginal rather than low less than 7 or 5 is considered low and up to 05 is considered marginal so you will probably need supplements at a very low dose total intake of up to 10 units daily is unlikely to cause any harmful effects so supplements of 7500 units or even 10 units per day for a month or two would be enough for you I guess you do not have any symptoms of vitamin deficiency like xerophthalmia or visual difficulties where one would need higher doses also for vitamin supplements like calcirol sachet are recommended in dosing of 60 units once a week for eight weeks with milk and following which you may have it once a month for the next six months both these are unlikely to interfere with liver issues considering fatty liver and high alt level you are unlikely to have progressed to the severe liver disease within such a short period and without symptoms hope this helps you and get back if you have any doubts