Micronutrients

Vitamin A: Need, effect & deficiency

from Lisa Ressi, MSc
on 16.09.2024
A man well-supplied with Vitamin A

Vitamin A is an essential vitamin that plays an important role in numerous bodily functions. In this article, you will learn all the important information about the requirement for, the effect and the possible consequences of vitamin A deficiency.

What is vitamin A?

Vitamin A is a fat-soluble substance that is found in two main forms:

  • as retinol found in animal products and
  • as provitamin A (beta-carotene), found in plant-based foods.

While retinol can be used directly by the body, provitamin A (beta-carotene) must first be converted into the active vitamin A form.

Occurrence of vitamin A in food

Vitamin A is particularly present in high concentrations in liver and products containing liver. Other animal foods such as eggs and some fish (e.g. eel) also contain significant amounts of the vitamin.

In plant-based foods, vitamin A is not directly present, but rather in the form of provitamins such as beta-carotene and alpha-carotene, which the body uses as vitamin precursors. Some of these provitamins are already converted into vitamin A in the small intestine (approx. 17%). The other part is further metabolised into vitamin A by the liver, lungs, kidney and muscle cells after absorption into the body. Key plant sources of provitamin A carotenoids include vegetables such as carrots, pumpkin, red peppers, lamb’s lettuce, spinach and kale. People who rarely consume vitamin A-rich animal foods (e.g. liver) in particular should use these plant-based sources of vitamin A. In this case, it is necessary that the meal also contains fat to allow the vitamin to be absorbed into the body. Animal foods usually provide enough fat, so extra fat is not required.

An adequate supply of vitamin A is also possible in a purely plant-based diet, provided there are no digestive problems or fat digestion disorders and there are also sufficient active conversion enzymes. Furthermore, an adequate thyroid function is also crucial for the efficient conversion of provitamin A carotenoids to vitamin A.

Vitamin A and its effect

Vitamin A is involved in numerous metabolic processes. The best known function is probably its role in vision. It is a component of the visual pigment rhodopsin, which makes it possible to see in poor light. In addition, vitamin A supports the growth and differentiation of cells that are important for the renewal of the skin and mucous membranes. Our immune defence also benefits from strengthening the external body barriers. In addition, vitamin A supports the innate and acquired immune system by promoting the formation of white blood cells and thus helping to fight off infections. The fat-soluble vitamin also plays a role in maintaining the higher functions in the central nervous system. Adequate vitamin intake also promotes fertility. On the one hand, it contributes to the formation of the two sex hormones testosterone and oestrogen; on the other hand, it is also important for sperm production and quality as well as for egg cell, placental and embryonic development.

Daily vitamin A requirement

The daily need for vitamin A depends on age, gender and individual circumstances. The recommended daily dose for adults is:

  • Men: 850 μg retinol equivalent (RE)
  • Women: 700 μg RE

Pregnant and breastfeeding women have an increased need for vitamin A to support the healthy development of the child. Similarly, people with certain diseases that affect fat absorption may have a higher need.

Vitamin A during pregnancy, lactation and if you wish to have children

Vitamin A plays a role in the desire to have children. It helps in the production of testosterone as well as in the development of sperm cells and the placenta. However, even during pregnancy, a sufficient vitamin A supply is particularly important, as it affects cell division and the normal development of the embryo.

However, caution should also be exercised: Excessive intake of vitamin A, especially in the form of retinol, can be harmful during pregnancy. Therefore, women in this phase should pay particular attention to a balanced intake of food and should only take vitamin A preparations after consultation with their doctor.

Vitamin A in children

Vitamin A is equally important for children as it promotes growth and vision. Children between the first and fourth years of age require approximately 300 μg retinol equivalent (RE) per day, while older children and adolescents require between 350 and 950 μg RE, depending on age and gender.

Age Male Female
0 to less than 4 months 500* 500*
4 to less than 12 months 400* 400*
1 to less than 4 years 300 300
4 to less than 7 years 350 350
7 to less than 10 years 450 450
10 to less than 13 years 600 600
13 to less than 15 years 800 700
15 to less than 19 years 950 800

* This is an estimate of the µg/day.

Vitamin A deficiency: Influencing factors and symptoms

Vitamin A deficiency is common in developing countries, but can also occur in developed countries if the diet is permanently one-sided or certain diseases impair vitamin absorption. Typical symptoms of vitamin A deficiency include night blindness, increased susceptibility to infection, dry skin and corneal changes in the eye. In children, a deficiency often manifests as growth disorders and an increased susceptibility to disease.

Supplementing vitamin A: Vitamin A capsules, etc.

Supplementation may make sense for people who do not consume sufficient vitamin A through their diet or who have an increased need. There are various forms of food supplements, including vitamin A capsules, drops or multivitamins. It is important not to exceed the recommended dose.

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Frequently asked questions about vitamin A:

Vitamin A is taken to support vision and to strengthen the immune system. It promotes cell growth and is important for healthy skin and mucous membranes. Vitamin A also plays a central role in reproduction.

Vitamin A should be taken if there is a proven deficiency, which may also be noticeable by symptoms such as night blindness, dry skin or increased susceptibility to infection. In addition, taking the medicine may be useful if there is an increased need (e.g. while breast-feeding). People with diseases that impair fat absorption or with a strong one-sided diet can also benefit from supplementation. It is important to use higher doses only under medical consultation. Vitamin A preparations such as capsules should always be taken with meals to support the absorption of fat-soluble vitamins.

The recommended daily dose of vitamin A is 850 μg retinol equivalent (RE) for adult men and 700 μg RE for women. Pregnant and breastfeeding women have an increased need, while children and adolescents require between 300 and 950 μg RE, depending on age and gender.

These amounts can be covered by a balanced diet and, if necessary, by additional dietary supplements. Ideally consult your doctor about a vitamin A dose that is right for you.

Further reading:

Alkhouri, R. H. et al. 2012. Vitamin and Mineral Status in Patients with Inflammatory Bowel Disease. J Pediatr Gastroenterol Nutr. 56 (1):89-92.

Bao, Y. et al. 2012. Low maternal retinol as a risk factor for schizophrenia in adult offspring. Schizophr Res. 137(1-3):159-65.

Beurskens, L. W. et al. 2010. Retinol status of newborn infants is associated with congenital diaphragmatic hernia. Pediatrics. 126:712-720.

Biesalski, H. C. et al. Ernährungsmedizin: Nach dem Curriculum Ernährungsmedizin der Bundesärztekammer und der DGE, 4. Auflage. Stuttgart: Georg Thieme Verlag, 2010.

Biesalski, H. K., Nohr, D. 2004. New aspects in vitamin a metabolism: the role of retinyl esters as systemic and local sources for retinol in mucous epithelia. J Nutr. 134(12 Suppl):3453S-3457S.

Bonifant, C. M. et al. 2014. Vitamin A supplementation for cystic fibrosis. Cochrane Database Syst Rev. (5):CD006751

Bonifant, C. M., Shevill, E., Chang, A. B. 2012. Vitamin A supplementation for cystic fibrosis. Cochrane Database Syst Rev. 8:CD006751.

Checkley, W. et al. 2010. Maternal vitamin A supplementation and lung function in offspring. N Engl J Med. 362(19):1784-94.

Checkley, W. et al. 2011. Supplementation with vitamin A early in life and subsequent risk of asthma. Eur Respir J. 38(6):1310-9.

Clagett-Dame, M., Knutson, D. 2001. Vitamin A in reproduction and development. Nutrients. 3:385-428.

Elmadfa I., Leitzmann C. (2004) Ernährung des Menschen. 4. Auflage. Verlag Eugen Ulmer, Stuttgart

Fiebrich, H. B. et al. 2010. Deficiencies in fat-soluble vitamins in long-term users of somatostatin analogue. Aliment Pharmacol Ther.32(11-12):1398-404.

Fisher, G. J., Voorhees, J. J. 1996. Molecular mechanisms of retinoid actions in skin. FASEB J. 10(9):1002-13.

Gely-Pernot, A. et al. 2012. Spermatogonia differentiation requires retinoic acid receptor γ. Endocrinology. 153(1):438-49.

Glover, J. C., Renaud, J. S., Rijli, F. M. 2006. Retinoic acid and hindbrain patterning. J Neurobiol. 66:705-725.

Gröber, U. Mikronährstoffe: Metabolic Tuning – Prävention – Therapie, 3. völlig überarbeitete und erweiterte Auflage. Stuttgart: Wissenschaftliche Verlagsgesellschaft Stuttgart, 2011.

Gröber, U. Orthomolekulare Medizin. Ein Leitfaden für Apotheker und Ärzte, 3. Auflage. Stuttgart: Wissenschaftliche Verlagsgesellschaft, 2008.

Hahn, A. et al. Ernährung: Physiologische Grundlagen, Prävention, Thera-  pie, 2. Auflage. Stuttgart: Wissenschaftliche Verlagsgesellschaft, 2006.

Hogarth, C. A., Griswold, M. D. 2010. The key role of vitamin A in spermatogenesis. J Clin Invest. 120:956-962.

Hoover, L. L., Brooks, B. A., Kubalak, S. W. 2008. The expanding role for retinoid signaling in heart development. Sci World J. 8:194-211.

Jiang, W. et al. 2012. Vitamin A deficiency impairs postnatal cognitive function via inhibition of neuronal calcium excitability in hippocampus. J Neurochem. 121(6):932-43.

Kaufman, D. R. et al. 2011. Vitamin A deficiency impairs vaccine-elicited gastrointestinal immunity. J Immunol. 187(4):1877-83.

Kim, S. C. et al. 2012. Vitamin A deficiency induces fluid hyposecretion from the airway submucosal glands of mice. J Nutr. 142(4):739-43.

Leitzmann, C. et al. Ernährung in Prävention und Therapie: Ein Lehrbuch, 3. Auflage. Stuttgart: Hippokrates Verlag, 2009.

Ono, K., Yamada, M. 2012. Vitamin A and Alzheimer‘s disease. Geriatr Gerontol Int. 12(2):180-8.

Quadro, L. et al. 2005. Pathways of vitamin A delivery to the embryo: insights from a new tunable model of embryonic vitamin A deficiency. Endocrinology. 146:4479-4490.

See, A. W., Clagett-Dame, M. 2009. The temporal requirement for vitamin A in the developing eye: mechanism of action in optic fissure closure and new roles for the vitamin in regulation cell proliferation and adhesion in the embryonic retina. Dev Biol. 325:94-105.

Silva, I. T. et al. 2013. Is plasma alpha-tocopherol associated with electronegative LDL in obese adolescents? J Nutr Sci Vitaminol (Tokyo). 59(2):100-7.

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