Vitamin A

Vitamin A Supplements in Australia

What is vitamin A and carotenoids?

Vitamin A is an essential fat-soluble vitamin critical for health and wellbeing. The main supplemental forms of vitamin A include:

• Retinol - The active preformed version of vitamin A found in animal sources. Used readily by the human body. Found in cod liver oil, multivitamins, and high-dose prescription tablets.
• Retinyl acetate and retinyl palmitate - Preformed vitamin A esters that are efficiently converted to retinol in the body. Common in multivitamin tablets.
• Beta-carotene - An antioxidant carotenoid precursor of vitamin A found in plant sources. Must be converted to retinol, so less potent. Often in mixed carotenoid supplements.

To ensure you get active vitamin A, look for supplements providing retinol, retinyl acetate or retinyl palmitate rather than only beta-carotene or carotenoid mixtures.

The importance of vitamin A

Vitamin A has many crucial roles in the body including:

• Maintaining healthy vision and eyesight
• Supporting immune function and fighting infection
• Ensuring healthy growth and development
• Playing a role in reproduction and embryotic development
• Maintaining integrity of skin and mucous membranes
• Regulating cellular growth and integrity

A deficiency in vitamin A can lead to symptoms like night blindness, frequent illness and infection, skin problems and impaired growth and development in children.

Symptoms of vitamin A deficiency

Some common symptoms of vitamin A deficiency include:

• Night blindness, poor vision in low light
• Dry eyes, eye infections, corneal damage
• Skin dryness, acne, eczema
• Slow growth and development in children
• Impaired immunity, frequent infections
• Reproductive issues like infertility, miscarriage

Mild deficiency is common globally but clinical deficiency is rare in Australia. Those at higher risk include premature infants, picky eaters, alcoholics, and those with cystic fibrosis or digestive disorders.

Benefits of Vitamin A Supplements

Why take vitamin A supplements?

While most people can get adequate vitamin A through diet alone, supplements can provide benefits such as:

• Preventing deficiency in at-risk groups
• Supporting immunity during illness
• Improving skin health and appearance
• Enhancing vision, especially night vision
• Supporting growth and development in children
• Protecting eye health and reducing risk of macular degeneration

Vitamin A supplements may be prescribed for deficiency treatment or taken prophylactically during illness recovery, pregnancy, lactation or rapid growth periods.

How much vitamin A should you take?

The recommended dietary intake (RDI) for vitamin A is:

Age/Condition	Vitamin A Requirement (mcg)
Infants 0-12 months	400-500
Children 1-8 years	300-400
Children 9-13 years	600-900
Adults 14-70+ years	700-900
Pregnant Women	800-850
Lactating Women	1100

Therapeutic doses for deficiency treatment are higher, around 5000-25,000 IU (1500-7500 mcg) per day. Always follow supplement directions and consult a health professional if using high therapeutic doses.

Reference: https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/vitamin-a

Sources of vitamin A from supplements

Some good supplemental sources of vitamin A include:

• Multivitamins - General multivitamins provide around 800-1000 mcg vitamin A to help bridge dietary gaps.
• Cod liver oil - High-dose cod liver oil capsules provide 2500-5000 IU (750-1500 mcg) of vitamin A per dose.
• Vitamin A tablets - High potency vitamin A supplements are available in 2500 mcg to 10,000 mcg tablets, usually as retinyl acetate or retinyl palmitate. These require medical supervision for therapeutic use.
• Prescription vitamin A - Doctors may prescribe very high dose retinol tablets up to 50,000 IU (15,000 mcg) to treat deficiency. This is for short-term therapeutic use only.
• Prenatal vitamins - Prenatal multivitamins contain around 750-770 mcg vitamin A for pregnant and lactating women.
• Multivitamin injections - Vitamin A may be administered via intramuscular injection, often alongside vitamin D, to treat deficiency.

For maintaining adequate intake, a general multivitamin is suitable for most people. Those with deficiency will need prescription high-dose vitamin A under medical supervision.

Vitamin A and Health

The link between vitamin A and overall health

Vitamin A supports several aspects of overall health:

• Immune function - Vitamin A keeps mucous membranes healthy and helps white blood cells fight infection. Deficiency is linked to increased risk of infectious disease.
• Vision - Vitamin A is essential for retinal health and night vision. Deficiency can lead to permanent blindness.
• Reproduction - Vitamin A is vital for embryotic development and reproduction. Deficiency impairs fertility and increases risk of birth defects.
• Growth - Vitamin A is critical for childhood growth and development. Deficiency can impair bone growth and development.
• Skin health - Vitamin A helps maintain integrity of skin and mucous membranes. Deficiency causes dry, scaly skin and acne.

How vitamin A supplements can improve health

Specific benefits of vitamin A supplementation include:

• Boosting immunity during illness recovery
• Improving night vision and eye health
• Reducing risk of vision loss and age-related macular degeneration
• Treating and preventing acne and skin conditions
• Supporting healthy growth and development in children
• Improving sperm health and fertility in men

Vitamin A supplements have therapeutic benefits in treating deficiency but also support overall health.

The role of carotenoids in vitamin A

Carotenoids like beta-carotene have additional antioxidant benefits and can be converted to active vitamin A in the body. High carotenoid intake is linked to reduced risk of:

• Heart disease
• Certain cancers
• Macular degeneration
• Cataracts

However, carotenoid supplements don't provide true preformed vitamin A. Focus on food sources rather than beta-carotene pills.

Preventing Vitamin A Deficiency

The importance of vitamin and mineral supplements

While food should always come first, vitamin and mineral supplements play an important role in preventing nutrient deficiencies. Supplements are especially useful for:

• Elderly people with reduced appetites
• Individuals with dietary restrictions or food intolerances
• Those recovering from illness or injury
• Vegans and vegetarians
• People with increased vitamin needs like athletes, smokers, pregnant women

Vitamin supplements are an affordable insurance policy against deficiency.

Taking vitamin A supplements for deficiency prevention

The best way to prevent vitamin A deficiency is to ensure adequate intake from your diet. However, supplements can help bridge dietary gaps and provide extra protection for those at higher risk including:

• Infants and growing children
• Pregnant and lactating women
• Elderly people
• Vegans and vegetarians
• Those with fat malabsorption issues

Multivitamins containing around 800-1000 mcg vitamin A are generally suitable for deficiency prevention in at-risk groups.

How to ensure sufficient vitamin A intake

To optimize vitamin A intake and prevent deficiency:

• Include good food sources at most meals - liver, eggs, oily fish, carrots, sweet potato, spinach, mango
• Take a daily multivitamin as an insurance policy
• Increase intake during high need periods - rapid growth, pregnancy, lactation
• If deficient, take prescribed high-dose supplements under medical supervision
• Get plenty of dietary fat to aid absorption of vitamin A
• Avoid excessive alcohol intake which impairs vitamin A availability

With a healthy varied diet and appropriate supplementation, vitamin A deficiency is readily preventable.

Potential Side Effects and Risks

Understanding the effects of vitamin A overdose

While vitamin A is essential, high doses can cause toxicity symptoms like:

• Headaches, nausea, vomiting, loss of appetite
• Dizziness, blurred vision
• Skin rashes, itching, peeling
• Joint and bone pain
• Hair loss
• Liver damage

Symptoms are more likely with chronic high dose supplementation above 10,000 mcg (30,000 IU) per day.

Monitoring vitamin A levels

To avoid negative effects, have vitamin A blood levels tested if taking high therapeutic doses for extended periods. Target range is 30-80 mcg/dL for adults and children over 6 months.

Infants under 6 months should not exceed 600 mcg (1800 IU) vitamin A daily. Pregnant women should avoid doses over 3000 mcg (10,000 IU) per day due to risk of birth defects.

Knowing when you've had enough vitamin A

Stop supplementation and see a doctor if you experience nausea, headaches, blurred vision, hair loss or cracking skin. These may indicate vitamin A overdose.

Routine liver function tests can also help detect excess vitamin A levels.

To avoid toxicity, do not exceed the tolerable upper intake level (UL) which is:

Age Group	Tolerable Upper Intake Level (mcg)
0-12 months	600
1-3 years	600
4-8 years	900
9-13 years	1700-2800
14+ years	3000

Reference: https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/vitamin-a

Frequently Asked Questions

Is vitamin A vegan?

No, only preformed vitamin A (retinol) is active and bioavailable to humans. This is found only in animal-based foods. Plant foods contain carotenoid precursors that must be converted to retinol. Conversion is inefficient though, making deficiency more likely on a vegan diet.

What are the best food sources of vitamin A?

The richest food sources are animal-based like liver, fish liver oils, egg yolks, whole milk and fortified dairy. Plant-based sources include sweet potato, carrots, spinach, and red or orange fruits and vegetables.

Can you get too much vitamin A?

Yes, high supplemental doses over an extended period can cause vitamin A toxicity. Symptoms include nausea, headaches, liver damage and hair loss. Do not exceed the tolerable upper intake level (UL) for your age group without medical supervision.

Does vitamin A help with acne and skin?

Yes, vitamin A is involved in regulating skin cell growth and turnover. Deficiency causes dry, scaly skin and acne. Supplements may help treat and prevent various skin conditions, although very high doses are often needed for therapeutic effect.

Is vitamin A vegan?

No, the only usable and bioavailable form of vitamin A for humans is retinol, found only in animal foods. Plant foods contain carotenoids that must be converted to retinol, but this conversion is inefficient. Vegans are at high risk of deficiency without supplementation.

Can taking too much vitamin A be dangerous?

Yes, high supplemental doses over 10,000 mcg daily can cause nausea, liver damage, hair loss and other toxicity symptoms over time. Do not exceed the upper tolerable intake level without medical supervision. Have blood levels monitored if taking high therapeutic doses.

Does vitamin A help vision?

Yes, vitamin A is essential for healthy eyesight. It supports eye development and reduces risk of night blindness and more serious vision loss. Vitamin A deficiency is the leading cause of preventable blindness in children globally. Supplements can support eye health.

When should you take vitamin A supplements?

Vitamin A supplements may be warranted for those at risk of deficiency, during high need periods like childhood growth and pregnancy, when recovering from illness, for vegans/vegetarians, and for therapeutic use in treating skin conditions and vision disorders under medical supervision.