Dietary sources

Diet-induced carotenemia is observed most frequently in infants and young children. [4] Mothers may induce the condition by giving their infants large amounts of carrots in commercial infant food preparations. [5]

In addition, vegetarians are more likely to develop carotenemia than nonvegetarians. The condition may also be associated with the ingestion of carotene-rich nutritional supplements. [6]

The health benefits of foods that contain retinoids may encourage their excessive intake, whether for the foods’ antioxidant vitamins [7] or to stimulate T cells. [8, 9] The consumption of fresh fruits and vegetables, such as carrots, may be beneficial to patients with psoriasis and porphyria because of their high content of carotenoids. [10, 11]

Carotenes occur in all pigmented fruits and vegetables, being synthesized as they ripen. In green vegetables, the color of carotene is often masked by the green color of chlorophyll. As a rule of thumb, the deeper the green or yellow of a fruit or vegetable, the more carotene it contains. Although often overlooked by parents, most strained baby foods on the market contain carrots. Ingestion of nutrient supplements is another source of carotenemia.

Human and cow milk also contain carotene. The occasional yellow color of milk is due to carotene content, and human milk provides a rich source of carotene, especially if maternal serum carotene levels are high. (The yellow color of colostrum is caused by carotene content.)

Diseases-related sources

Diseases, including hypothyroidism, [12] diabetes mellitus, [13] hepatic disorders, anorexia nervosa, and renal diseases, may also give rise to carotenemia. [14]

Diabetes mellitus

Many individuals with diabetes have elevated serum carotene levels, but only 10% of these individuals exhibit yellowing of the skin. Carotenemia may be related to restricted dietary habits, hyperlipidemia, or a deficiency in the conversion of carotene into vitamin A by the liver.

Hypothyroidism

The commonly accepted cause of carotenemia in hypothyroidism is a decrease in the conversion of carotene into vitamin A, as well as associated hyperlipidemia and hypercholesterolemia.

Thyroid hormone is antagonistic to vitamin A and controls its rate of consumption. In hypothyroidism, the consumption of vitamin A is decelerated, and the rate of conversion from carotene to vitamin A is reduced.

Anorexia nervosa

The association between carotenemia and anorexia nervosa is well documented. Carotenemia in patients with this disease is not thought to be associated with a high-carotene diet. It may instead be related to hypercholesterolemia, which is an occasional, albeit reversible, defect in the conversion of carotene to vitamin A, or it may result from a normal intake of dietary carotene in the presence of a decreased requirement.

Systemic amyloidosis

Systemic lambda-type AL amyloidosis may be associated with hyper–β-carotenemia with a prominent carotenoderma facilitating recognition of the diagnosis. [15]

Other

Disorders associated with the development of carotenemia also include the following: