American Journal of Clinical Nutrition, Vol 49, 358-371, Copyright © 1989 by The American Society for Clinical Nutrition, Inc

REVIEW ARTICLES

Safety of vitamin A

A Bendich and L Langseth
Department of Clinical Nutrition, Hoffmann-La Roche Inc, Nutley, NJ 07110-1199.

Vitamin A adequacy is discussed in terms of the recommended allowances appropriate for the needs of the majority of individuals. Deficiency can result in xerophthalmia and permanent blindness and in increased mortality rates among children. Toxicity has been associated with the overconsumption of vitamin A supplements. Acute hypervitaminosis A may occur after ingestion of greater than or equal to 500,000 IU (over 100 times the RDA) by adults or proportionately less by children. Symptoms are usually reversible on cessation of overdosing. Factors influencing chronic hypervitaminosis A include dosing regimen, physical form of the vitamin, general health status, dietary factors such as ethanol and protein intake, and interactions with vitamins C, D, E, and K. Both excess and deficiency of vitamin A in pregnant animals was shown to be teratogenic. In humans, congenital malformations associated with maternal over-use of high doses of vitamin A were reported but no cause- and-effect relationship has been established. Deficiency of the vitamin during pregnancy has also been associated with congenital abnormalities. Reported incidences of vitamin A toxicity are rare and have averaged fewer than 10 cases per year from 1976 to 1987.

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