Vitamin A

The emerging story of vitamin A dosage and birth defects is needed to understand some of the possibilities of the things to come. (Enter vitamin A on website for interview with Dr Stephen Byrnes). Researchers in the 1930s described vitamin A, the first vitamin discovered, as the "anti-infective vitamin" as it is intimately involved in the health of the mucous membranes and in fighting off infections. Vitamin A has been shown to be pivotal in several bodily functions: the formation of "visual purple" allowing vision in partially in low light and maintaining healthy vision and proper eye function; the repair and maintenance of epithelial tissues, especially those of the skin and mucous membranes; the maintenance of the endocrine system, especially the thyroid gland; proper utilization of dietary proteins; and the stimulation of the thymus gland, a major part of the immune system. When approaching supplementation, a couple of things need to be kept in mind: 

Supplements of beta-carotene are NOT the same as those with vitamin A.  Beta-carotene is the metabolic precursor of vitamin A; it must be converted into real vitamin A in the intestines along with the help of bile salts, thyroid hormone, and dietary fat. Infants, and those with diabetes, alcoholism, hypothyroidism, and/or liver or gall bladder problems cannot make this conversion. Additionally, the body's conversion of beta-carotene to active vitamin A is very poor: it takes roughly 6 units of beta-carotene to make just one unit of vitamin A. Be sure to purchase supplements that very clearly state that they are REAL vitamin A and not beta-carotene. 

Consumers are often warned that vitamin A can be toxic if taken to excess. Pregnant women are also warned that too much vitamin A can cause birth defects. Such warnings are overblown. Though vitamin A can produce toxicity symptoms if taken to excess, it takes a huge and massive amount to generate them. There have been studies done of people who have taken 300,000 units of vitamin A a day for over a year with NO adverse effects. One has little to fear of overdosing on this nutrient. Additionally, the toxicity symptoms of excess vitamin A disappear quickly once supplementation is stopped. Studies done on pregnant women with vitamin A were actually done with an acne medicine made from a synthetic derivative of synthetic vitamin A--in other words, a drug, not real vitamin A.  Native peoples the world over take special care to feed vitamin A-rich foods to pregnant women: liver, fish roe, eggs, butter, and cream. One does not see birth defects in these people. As far as the amount to take, this is a matter of debate. Obviously, children need to take less than adults. Also, the right amount for one person may not be the same as another. Dr Stephen Byrnes notes, "A safe amount I've used with my adult HIV/AIDS clients is 25,000 IU's a day. In case of respiratory or urinary infections, I'll increase it to as much as 200,000 IU's a day for 5-10 days (along with other substances needed by the body to overcome the infection)." Dr Mercola further notes that vitamin A and B12 deficiency are two major concerns in people who chose to have a vegetarian lifestyle.

"Prevention of Congenital Abnormalities by Vitamin A," Czeizel AE and Rockenbauer M, Internat J Vit Nutr Res, 1998;68:219-231.  Of 35,727 pregnant women who had control infants without birth defects, 3,399, or 9.5%, were treated with vitamin A.  Of 20,830 pregnant women who had case offspring with congenital abnormalities, 1,642, or 7.9%, were treated with vitamin A, a rate that is significantly lower than that of the control group.  This case-control pair analysis taken from a data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1994 showed a lower rate of vitamin A treatment during pregnancy and in the first trimester of gestation in most congenital abnormality groups.  The use of low or moderate doses of vitamin A of less than 10,000 IU during the first trimester of pregnancy is not teratogenic but may have some protective effects to the fetus.  A multivitamin preparation containing doses of vitamin A lower than 10,000 IU/day is safe and important in the primary prevention of certain major congenital abnormalities. Higher exposures later in pregnancy, which is after organogenesis, do not appear to be toxic.  Widespread vitamin A deficiency may be of greater public health importance than the small number of cases of vitamin A overdose. 

"Randomized Trial to Assess Benefits and Safety of Vitamin A Supplementation Linked to Immunization in Early Infancy," Martines J, et al, The Lancet, October 17, 1998;352:1257- 1263. In a randomized, double-blind, placebo- controlled trial, 4716 mothers of infants in the vitamin A group received 200,000 IU of vitamin A, and their infants were given 25,000 IU of vitamin A with each of the first 3 doses of DPT/poliomyelitis immunization at 6, 10 and 14 weeks.  In the control group of 4,708 mothers and their infants, a placebo was given at the same time.  At 9 months, infants receiving the measles immunization in the vitamin A group were given another dose of 25,000 IU and those in the control group received 100,000 IU of vitamin A.  Infants were followed up to age 12 months.  At the 6- month follow-up, there was a small decrease in vitamin A deficiency in the vitamin A group compared with controls which was no longer apparent at 9 and 12 months.  There were no significant between- group differences in mortality throughout the study.  Vitamin A appears to be safe when given with immunizations but there is no sustained benefit in terms of vitamin A status beyond 6 months on infant morbidity. 30915B 

"Vitamin A Supplementation for Extremely-Low-Birth-Weight Infants," Tyson JE, N Engl J Med, June 24, 1999;340(25):1962-1968. In 405 extremely-low-birth-weight infants compared with 402 controls, intramuscular administration of 5,000 IU of vitamin A, 3 times per week for 4 weeks, reduced biochemical evidence of vitamin A deficiency and slightly decreased the risk of chronic lung disease in extremely-low-birth-weight infants. 

"Randomized Placebo-Controlled Clinical Trial of the Effect of a Single High Dose or Daily Low Doses of Vitamin A on the Morbidity of Hospitalized, Malnourished Children," Donnen P, et al, Am J Clin Nutr, 1998;68:1254-1260.The effect of a single high dose or daily, low doses of vitamin A on diarrhea, acute lower respiratory tract infections (ALRIs), and all-cause fevers in 900 hospitalized preschool-age children was evaluated in a randomized, double-blind, placebo-controlled trial. Subjects were given either 200,000 IU of vitamin A orally on the day of admission (100,000 IU if the child was under 12 months), or a low-dose treatment of vitamin A at 5,000 IU/day until discharge, or placebo.  Mortality rates were not significantly different among the 3 groups.  High-dose vitamin A supplementation had no significant effect on the duration of moderate or severe diarrhea nor on the duration and the incidence of ALRIs and all-cause fever. Children in the high-dose group with no edema had an increased risk of severe nosocomial diarrhea.  Low-dose vitamin A supplementation significantly reduced the incidence of severe diarrhea in severely malnourished children.  In this population of malnourished and subclinically vitamin A-deficient children, daily low doses of vitamin A appeared to be more beneficial for severely malnourished children.

"Synergistic Effect of  Zinc and Vitamin A on the Biochemical Indexes of Vitamin A Nutrition in  Children," Rahman MM, Wahed MA, et al, Am J Clin Nutr, 2002;75:92-98. In a randomized, double-blind, placebo-controlled trial of  children who were between 12 and 35 months of age, subjects randomly  received 1 of 4  interventions: 20 mg of zinc/day for 14 days; 60,000 retinol equivalents  (200,000 IU) of vitamin A on day 14; zinc plus vitamin A; or a placebo syrup and  placebo capsule. It was found that in vitamin A-deficient children, the proportion of children who remained vitamin A deficient (serum retinol <0.7  umol/l) after supplementation was 40.6% in the zinc-supplemented group, 37.5% in  the vitamin A group, and 47.0% in the placebo group. Only 13.3% in the zinc plus  vitamin A group remained vitamin A deficient. This study showed that combining  zinc and vitamin A supplementation improves vitamin A nutriture in vitamin  A- deficient subjects.

"Effects of Oral Zinc and Vitamin A in Acne," Michaelsson G, et al, Arch Dermatol, January, 1977;113:31-36. Thirty-eight male patients and 26 female patients with acne who were between 13 and 25 years of age received 1 of 4 treatment regimens which included a zinc sulfate group at 135 mg of elemental zinc daily from 3 effervescent tablets, placebo effervescent tablets without zinc, vitamin A palmitate at either 150,000 IU, 2 times daily, or 200,000 IU, 2 times daily, or a fourth group which received zinc at 135 mg of elemental zinc daily in conjunction with vitamin A at the above doses. After 4 weeks, there was a significant decrease in the number of papules, pustules and infiltrates in the zinc-treated group. The effect of zinc plus vitamin A was not better than zinc alone. After 12 weeks, the mean acne score had decreased from 100% to 15%.

"Effect of Vitamin A Supplementation on Morbidity Due to Plasmodium falciparum in Young Children in Papua New Guinea: A Randomized Trial," Shankar AH, et al, Lancet, July 17, 1999;354:203-209. In an endemic area of Plasmodium falciparum, 480 children who were between 6 and 60 months of age participated in a double-blind, placebo-controlled trial. Subjects took vitamin A capsules containing 200,000 IU of vitamin A in 200 ul peanut oil, with 10 ug of vitamin E (n=239) compared with identical capsules containing peanut oil as a placebo (n=241), every 3 months for 13 months. The number of P. falciparum febrile episodes (with a temperature =37.5°C with a parasite count of at least 8,000/ul) was 30% lower in the vitamin A group than in the placebo group, and at the end of the study, the P. falciparum geometric mean density was lower in the vitamin A than in the placebo group, as was the proportion with spleen enlargement. Children between 12 and 36 months of age benefitted the most, having 35% fewer febrile episodes, 26% fewer enlarged spleens and a 68% lower parasite density. This study it is quite remarkable on several counts. Vitamin A at 200,000 IU, every 3 months, would be equivalent to 4 doses over 13 months, which is a significant amount of vitamin A in young children without apparent side effects. Also, the simplicity and cost-effectiveness of this therapy for a developing country is quite an exciting medical breakthrough. We wait eagerly for confirmatory studies.

"A Randomized Trial of Vitamin A Supplements in Relation to Mortality Among Human Immunodeficiency Virus-Infected and Uninfected Children in Tanzania," Fawzi WW, Mbise RL, Hertzmark E, et al, Pediatr Infect Dis J, February 1999;18(2):127-133. In evaluating 687 children who were between 6 months and 5 years of age, subjects were admitted to a hospital for pneumonia. The children received placebo or 400,000 IU of vitamin A, given in 2 divided doses of 200,000 IU, while those under 1 year of age received half this dose. The children received additional doses utilizing the same regimen 4 and 8 months after hospital discharge. Of the 648 children, 9% were HIV-infected. Compared with uninfected children, all-cause mortality was higher among HIV-infected children, as was mortality caused by pneumonia or diarrhea. Overall, vitamin A supplements resulted in a 49% reduction in mortality. Vitamin A supplementation reduced all-cause mortality by 63% among HIV-infected children. Vitamin A supplements were also associated with a 68% reduction in AIDS-related deaths and a 92% reduction in diarrhea-related deaths. 

Biotics Research offers supplements of exceptional quality. Vitamins A, D, E, K and Coenzyme Q 10 are normally fat-soluble vitamins that must first be emulsified by the liver in order to enter the blood stream to be available to the body cells.  Some manufactures add detergent materials so as to micellize the product so that it is more easily absorbed. But as such, this would compromise cell membrane selectivity and logically cause leaky cell membranes throughout the system, not to mention the burden placed on the liver to eliminate it, especially if there is excess. Biotics Research has a unique system of emulsification of fat-soluble materials so that its ADP, Bio-AE-Mulsion, Bio-AE-Mulsion Forte, Bio-D-Mulsion, Bio-E-Mulsion Forte, Chlorocaps (Vitamin K), CoQ-Zyme Forte, CoQ-Zyme 30 and E-Mulsion 200 are naturally water-soluble. These products may then logically be able to enter the serum through the lymphatic ducts and able to bypass the hepatic portal system, which is often compromised and overwhelmed in so many due to meds, poor diets, excess transfatty acids, etc.  These products, already made water-soluble, are naturally available to the cells and any excess would be easy to process out of the system. We know that the kidneys do not process out fat-soluble materials. Such materials, some quite toxic, are stored in the liver or adipose tissue until made water-soluble by the liver. Stored as such, they often injure the liver and tissue where it is stored. Obesity and the presence of C-reactive protein help bear this out. There is a tremendous safety factor needed for supplements that are natural for easy absorption, utilization and elimination without compromising a system usually taken by those already under duress. Check out Bio-AE-Mulsion.