Carotenemia is a clinical condition characterized by yellow pigmentation of the skin (xanthoderma) often on the feet and palms of adults, and increased beta-carotene levels in the blood. In most cases, the condition follows excessive consumption of carotene-rich foods, such as carrots, sweet potatoes and squash. It is usually harmless and remedied by cutting down on food with high carotene levels.
Carotenemia can also be a sign of an eating disorder, resulting from excessive consumption of foods that contain high levels of carotene, including carrots, oranges, sweet potatoes, squash and pumpkins. Many dieters, including anorexics, are using “juicers” and food processors as a way to consume larger amounts of healthy low-fat, high fiber whole foods, many of which are yellow or orange.
Yellow palms and soles are usually a result of:
- excessive carotene intake
- reduced biotransformation
Biologically, carotene is metabolized to vitamin A in the gut, then absorption into our tissue via the blood stream.
Carotenemia is often confused with jaundice due to the abnormal pigmentation. In the case of jaundice, the cause is increased bilirubin from the liver, suggesting hepatic pathology. However, carotenemia is easily differentiated from jaundice by simply examining the patient’s sclerae. I actually made this diagnosis on an adult with Anorexia Nervosa who asked me about her coloration at the gym. So, it can’t be all that difficult. Clear sclerae will rule out jaundice. When the clinical exam is inconclusive, or when there is a history of liver disease, a simple lab test can measure both bilirubin and carotene levels in the blood to either confirm or rule out a diagnosis.
Other diseases, including hypothyroidism, diabetes mellitus and renal diseases, may also cause carotenemia. Once organ disease has been ruled out, simply discontinuing food or nutritional supplements containing carotene will return the skin color to normal in a few weeks.