The Truth About Vitamin A Safety in Prenatal Vitamins

The most common question that pregnantcolors. Carrots are a good example because their
women ask me is "My obstetrician says that it isorange color is reflective of an abundance of
very dangerous for me to take vitamin A whilecarotenoids and carotenes. There are over 600
I'm pregnant. As an expert in nutrition, what iscarotenoids/carotenes and less than 50 seem to
your opinion?"be able to be converted into vitamin A. This
No doubt, there is a lot of fear and confusion onconversion is essential, however, because the
this topic. So let's get right down to the truth ofhuman vision is dependent upon these pigments.
the matter. As usual, the truth is to be found inThe conversion of carotenes to vitamin A
the middle of two opposite points of view. Onedepends upon a number of factors including
point of view is that pregnant women shouldadequate zinc, vitamin C, protein status, bile salts,
avoid taking any vitamin A. The other point ofpancreatic enzymes and optimal thyroid gland
view is that pregnant women do not need to behealth. So women with inadequate levels of these
concerned at all with their vitamin A consumptionnecessary co-factors have more difficulty
because the risks are minimal.converting high pigment foods into vitamin A.
So let's clarify the issue so you can make theOne International Unit (IU) of vitamin A (retinol)
most informed choice for yourself and your baby:does not equal one IU of beta-carotene because
In 1995, the prestigious New England Journal ofonly between 40%-60% of beta-carotene is
Medicine published a study that showed strongabsorbed and converted into vitamin A. Also, the
evidence that approximately 1.7% of pregnantabsorption of beta-carotene is self-limiting. This
women in the U.S. consuming greater than 10,000means that beyond a healthy level, the more you
International Units (IUs) of vitamin A (retinol) pertake the less you absorb. Beta-carotene taken in
day during the first 7 weeks of their pregnancysupplement form absorbs better than
gave birth to children afflicted with some form ofbeta-carotene from foods. Betacarotene is safe
birth defect. This was one out of every 57and necessary.
women. This created a wave of fear inOn average, a healthy daily intake of vitamin A
obstetricians and their pregnant patients thatfor pregnant women is approx. 4000 IUs. This
continues to this day.means that if you have been told by your
The good news about this study is that it alertedobstetrician to avoid taking all vitamin A and you
doctors to strongly caution their pregnant patientsare receiving less than about 8000 IUs of
that consuming over 10,000 IUs of vitamin A percarotenes from your prenatal vitamin and your
day for the first 7 weeks of her pregnancy candiet combined, there is increased risk that your
be risky. To my way of thinking this should alsochild may suffer some degree of visual loss or
hold true for women of childbearing age who aregrowth retardation. The risk of pregnant women
actively trying to become pregnant. Women whoreceiving too little vitamin A is just as
are given very high dosages of vitamin A forunacceptable as too much vitamin A.
acne treatments should avoid becoming pregnantAs previously stated, the truth tends to be found
until their blood levels of vitamin A are well withinright in the middle of the two opposite points of
the normal range.view. Too much vitamin A brings a small but
The bad news about the effects the NEJMsignificant risk of birth defects. Too little vitamin A
vitamin A study is that it made far too manybrings a risk of visual loss or growth retardation.
obstetricians and obstetrical nurses overlySo what do you do when you become pregnant?
cautious, even paranoid, about women takingHere are some guidelines:
anyform of vitamin A, even supplements(1) To be on the safe side, it is best to avoid
containing beta-carotene. Obviously no pregnantprenatal vitamins that contain any of the retinol
woman wants to put her developing baby at risk,form of vitamin A.
so when their obstetrician tells them to avoid(2) Try to make sure that your daily intake of
taking all vitamin A they listen.vitamin A does not exceed 6000 IUs during the
The other side of the truth is that developingfirst 2 months of your pregnancy.
babies need somevitamin A. Vitamin A deficiency(3) Avoid eating foods very high in the retinol
can cause fetal and infant growth retardation. It isform of vitamin A on a daily basis, especially beef
well known that plant scientists have been tryingliver (43,900 IUs/3.5 oz serving) and calves liver
to perfect modified strains of rice to contain(22,500 IUs/3.5 oz. serving).
beta-carotene (orange in color) for third world(4) Make sure that your prenatal vitamin contains
countries. Why? To help prevent the large amountat least 3500 IUs of betacarotene.
of infants born blind every year because their(5) Try to obtain 4000-5000 IUs of carotenes and
mother's bodies did not have enough vitamin A tocarotenoids from your diet. You can do this by
donate an adequate amount to their developingeating lots of colored vegetables like carrots and
eyes!green leafy vegetables.
The World Health Organization (WHO) estimates(6) Eat brightly colored fruits.
that between 250,000 and 500,000 children are(7) If you cannot eat enough colored vegetables,
born blind every year. WHO also estimates thatfind a good tasting vegetable powder that can
13.8 million children have some degree of visualprovide you with 4000-5000 IUs of these
loss related to vitamin A deficiency.essential precursors to vitamin A.
Carotenes and carotenoids are natural pigments(8) Do your best to take this middle ground and
that give colored fruits and vegetables their brighttry not to worry.