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Nutritional Supplement

Vitamin A

Vitamin A is a fat-soluble vitamin with four major functions in the body: (1) It helps cells reproduce normally—a process called differentiation (cells that have not properly differentiated are more likely to undergo pre-cancerous changes). (2) It is required for vision; vitamin A maintains healthy cells in various structures of the eye and is required for the transduction of light into nerve signals in the retina. (3) It is required for normal growth and development of the embryo and fetus, influencing genes that determine the sequential development of organs in embryonic development. (4) It may be required for normal reproductive function, with influences on the function and development of sperm, ovaries and placenta.

References

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2. Glasziou PP, Mackerras DE. Vitamin A supplementation in infectious diseases: a meta-analysis. BMJ 1993;306:366-70.

3. Stephensen CB, Franchi LM, Hernandez H, et al. Adverse effects of high-dose vitamin A supplements in children hospitalized with pneumonia. Pediatrics 1998;101(5):E3 [abstract].

4. Bresee JS, Fischer M, Dowell SF, et al. Vitamin A therapy for children with respiratory syncytial virus infection: a multicenter trial in the United States. Pediatr Infect Dis J 1996;15:777-82.

5. Quinlan KP, Hayani KC. Vitamin A and respiratory syncytial virus infection. Serum levels and supplementation trial. Arch Pediatr Adolesc Med 1996;150:25-30.

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8. Murphy S, West KP Jr, Greenough WB 3d, et al. Impact of vitamin A supplementation on the incidence of infection in elderly nursing-home residents: a randomized controlled trial. Age Ageing 1992;21:435-9.

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10. Ross AC. Vitamin A supplementation as therapy—are the benefits disease specific? Am J Clin Nutr 1998;68:8-9 [review].

11. Fawzi WW, Mbise RL, Fataki MR, et al. Vitamin A supplementation and severity of pneumonia in children admitted to the hospital in Dar es Salaam, Tanzania. Am J Clin Nutr 1998;68:187-92.

12. Semba RD. Vitamin A, immunity, and infection. Clin Infect Dis 1994;19:489-99 [review].

13. Glasziou PP, Mackerras DE. Vitamin A supplementation in infectious diseases: a meta-analysis. BMJ 1993;306:366-70.

14. Stephensen CB, Franchi LM, Hernandez H, et al. Adverse effects of high-dose vitamin A supplements in children hospitalized with pneumonia. Pediatrics 1998;101(5):E3 [abstract].

15. Bresee JS, Fischer M, Dowell SF, et al. Vitamin A therapy for children with respiratory syncytial virus infection: a multicenter trial in the United States. Pediatr Infect Dis J 1996;15:777-82.

16. Quinlan KP, Hayani KC. Vitamin A and respiratory syncytial virus infection. Serum levels and supplementation trial. Arch Pediatr Adolesc Med 1996;150:25-30.

17. Kjolhede CL, Chew FJ, Gadomski AM, et al. Clinical trial of vitamin A as adjuvant treatment for lower respiratory tract infections. J Pediatr 1995;126:807-12.

18. Pinnock CB, Douglas RM, Badcock NR. Vitamin A status in children who are prone to respiratory tract infections. Aust Paediatr J 1986;22:95-9.

19. Murphy S, West KP Jr, Greenough WB 3d, et al. Impact of vitamin A supplementation on the incidence of infection in elderly nursing-home residents: a randomized controlled trial. Age Ageing 1992;21:435-9.

20. Fawzi WW, Mbise R, Spiegelman D, et al. Vitamin A supplements and diarrheal and respiratory tract infections among children in Dar es Salaam, Tanzania. J Pediatr 2000;137:660-7.

21. Ross AC. Vitamin A supplementation as therapy—are the benefits disease specific? Am J Clin Nutr 1998;68:8-9 [review].

22. Fawzi WW, Mbise RL, Fataki MR, et al. Vitamin A supplementation and severity of pneumonia in children admitted to the hospital in Dar es Salaam, Tanzania. Am J Clin Nutr 1998;68:187-92.

23. Committee on Infectious Diseases, American Academy of Pediatrics. Vitamin A treatment of Measles. Pediatrics 1993;91:1014-5.

24. Penn ND, Purkins L, Kelleher J, et al. The effect of dietary supplementation with vitamins A, C and E on cell-mediated immune function in elderly long-stay patients: a randomized controlled trial. Age Ageing 1991;20:169-74.

25. de la Fuente M, Ferrandez MD, Burgos MS, et al. Immune function in aged women is improved by ingestion of vitamins C and E. Can J Physiol Pharmacol 1998;76:373-80.

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27. Swartz-Basile DA, Rubin DC, Levin MS. Vitamin A status modulates intestinal adaptation after partial small bowel resection. JPEN J Parenter Enteral Nutr 2000;24:81-8.

28. Ehrlich H, Hunt TK. Effects of cortisone and vitamin A on wound healing. Ann Surg 1968;167:324-8.

29. Hunt TK, Ehrlich HP, Garcia JA, et al. Effect of vitamin A on reversing the inhibitory effect of cortisone on healing of open wounds in animals and man. Ann Surg 1969;170:633-41.

30. Ehrlich HP, Tarver H, Hunt TK. Effects of vitamin A and glucocorticoids upon inflammation and collagen synthesis. Ann Surg 1973;177:222-7.

31. Hunt TK. Vitamin A and wound healing. J Am Acad Dermatol 1986;15:817-21 [review].

32. Semba RD, Graham NMH, Caiaffa WT, et al. Increased mortality associated with vitamin A deficiency during human immunodeficiency virus type 1 infection. Arch Intern Med 1993;153:2149-54.

33. Semba RD, Miotti PG, Chiphangwi JD, et al. Maternal vitamin A deficiency and mother-to-child transmission of HIV-1. Lancet 1994;343:1593-7.

34. Coutsoudis A, Pillay K, Spooner E, et al. Randomized trial testing the effect of vitamin A supplementation on pregnancy outcomes and early mother-to-child HIV-1 transmission in Durban, South Africa. South African Vitamin A Study Group. AIDS 1999;13:1517-24.

35. Kennedy CM, Coutsoudis A, Kuhn L, et al. Randomized controlled trial assessing the effect of vitamin A supplementation on maternal morbidity during pregnancy and postpartum among HIV-infected women. J Acquir Immune Defic Syndr 2000;24:37-44.

36. Fawzi WW, Msamanga G, Hunter D, et al. Randomized trial of vitamin supplements in relation to vertical transmission of HIV-1 in Tanzania. J Acquir Immune Defic Syndr 2000;23:246-54.

37. Coutsoudis A, Bobat RA, Coovadia HM, et al. The effects of vitamin A supplementation on the morbidity of children born to HIV-infected women. Am J Public Health 1995;85:1076-81.

38. Hanekom WA, Yogev R, Heald LM, et al. Effect of vitamin A therapy on serologic responses and viral load changes after influenza vaccination in children infected with the human immunodeficiency virus. J Pediatr 2000;136:550-2.

39. Humphrey JH, Quinn T, Fine D, et al. Short-term effects of large-dose vitamin A supplementation on viral load and immune response in HIV-infected women. J Acquir Immune Defic Syndr Hum Retrovirol 1999;20:44-51.

40. Benn CS, Aaby P, Bale C, et al. Randomised trial of effect of vitamin A supplementation on antibody response to measles vaccine in Guinea-Bissau, west Africa. Lancet 1997;350:101-5.

41. Semba RD. Vitamin A as “anti-infective” therapy, 1920-1940. J Nutr 1999;129:783-91 [review].

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44. World Health Organization. Expanded programme on immunization: programme for the prevention of blindness nutrition. Joint WHO/UNICEF statement. Vitamin A for measles. Wkly Epidemiol Rec 1987;62:133-4.

45. Coutsoudis A, Broughton M, Coovadia HM. Vitamin A supplementation reduces measles morbidity in young African children: a randomized, placebo-controlled, double-blind trial. Am J Clin Nutr 1991;54:890-5.

46. Rosales FJ, Kjolhede C. A single 210-mumol oral dose of retinol does not enhance the immune response in children with measles. J Nutr 1994;124:1604-14.

47. Rahmathullah L. Effect of receiving a weekly dose of vitamin A equivalent to the recommended dietary allowances among pre school children on mortality in south India. Indian J Pediatr 1991;58:837-47.

48. Vijayaraghavan K, Rashmiah G, Suryaprakasam B, et al. Effect of massive dose of vitamin A on morbidity and mortality in Indian children. Lancet 1990;336:1342-53.

49. Glasziou PP, Mackerras DE. Vitamin A supplementation in infectious diseases: a meta-analysis. BMJ 1993;306:366-70.

50. Frieden TR, Sowell AL, Henning KJ, et al. Vitamin A levels and severity of measles. New York City. Am J Dis Child 1992;146:182-6.

51. Committee on Infectious Diseases, American Academy of Pediatrics. Vitamin A treatment of Measles. Pediatrics 1993;91:1014-5.

52. Coutsoudis A, Coovadia HM, Broughton M, et al. Micronutrient utilisation during measles treated with vitamin A or placebo. Int J Vitam Nutr Res 1991;61:199-204.

53. Campos FA, Flores H, Underwood BA. Effect of an infection on vitamin A status of children as measured by the relative dose response. Am J Clin Nutr 1987;46:91-4.

54. Ozsoylu S, Cemeroglu AP, Gunay M. Vitamin A for varicella. J Pediatr 1994;125:1017-8 [letter].

55. Rumore MM. Vitamin A as an immunomodulating agent. Clin Pharm 1993;12:506-14 [review].

56. West CE. Vitamin A and measles. Nutr Rev 2000;58:S46-S54.

57. Glasziou PP, Mackerras DE. Vitamin A supplementation in infectious diseases: a meta-analysis. BMJ 1993;306:366-70.

58. Markowitz LE, Nzilambi N, Driskell WJ, et al. Vitamin A levels and mortality among hospitalized measles patients, Kinshasa, Zaire. J Trop Pediatr 1989;35:109-12.

59. Arrieta AC, Zaleska M, Stutman HR, Marks MI. Vitamin A levels in children with measles in Long Beach, California. J Pediatr 1992;121:75-8.

60. Butler JC, Havens PL, Sowell AL, et al. Measles severity and serum retinol (vitamin A) concentration among children in the United States. Pediatrics 1993;91:1176-81.

61. Frieden TR, Sowell AL, Henning KJ, et al. Vitamin A levels and severity of measles. New York City. Am J Dis Child 1992;146:182-6.

62. Fawzi WW, Chalmers TC, Herrera MG, Mosteller F. Vitamin A supplementation and child mortality. A meta-analysis. JAMA 1993;269:898-903.

63. Barclay AJ, Foster A, Sommer A. Vitamin A supplements and mortality related to measles: a randomised clinical trial. BMJ 1987;294:294-6.

64. Hussey GD, Klein M. A randomized, controlled trial of vitamin A in children with severe measles. N Engl J Med 1990;323:160-4.

65. Kawasaki Y, Hosoya M, Katayose M, Suzuki H. The efficacy of oral vitamin A supplementation for measles and respiratory syncytial virus (RSV) infection. Kansenshogaku Zasshi 1999;73:104-9 [in Japanese].

66. Ellison JB. Intensive vitamin A therapy in measles. BMJ 1932;2:708-11.

67. Patty I, Benedek S, Deak G, et al. Controlled trial of vitamin A therapy in gastric ulcer. Lancet 1982;2(8303):876 [letter].

68. Patty I, Tarnok F, Simon L, et al. A comparative dynamic study of the effectiveness of gastric cytoprotection by vitamin A, De-Nol, sucralfate and ulcer healing by pirenzepine in patients with chronic gastric ulcer (a multiclinical and randomized study). Acta Physiol Hung 1984;64:379-84.

69. Russell RM, Smith VC, Multak R, et al. Dark-adaptation testing for diagnosis of subclinical vitamin-A deficiency and evaluation of therapy. Lancet 1973;2:1161-4.

70. Frommer DJ. The healing of gastric ulcers by zinc sulphate. Med J Aust 1975;22(21):793-6.

71. Dvorak AM. Vitamin A in Crohn's disease. Lancet 1980;i:1303-4.

72. Skogh M, Sundquist T, Tagesson C. Vitamin A in Crohn's disease. Lancet 1980; i:766 [letter].

73. Wright JP, Mee AS, Parfitt A, et al. Vitamin A therapy inpatients with Crohn's disease. Gastroenterology 1985;88:512-4.

74. Fawzi WW, Mbise R, Spiegelman D, et al. Vitamin A supplements and diarrheal and respiratory tract infections among children in Dar es Salaam, Tanzania. J Pediatr 2000;137:660-7.

75. Lithgow DM, Politzer WM. Vitamin A in the treatment of menorrhagia. S Afr Med J 1977;51:191-3.

76. Mejia LA, Chew F. Hematological effect of supplementing anemic children with vitamin A alone and in combination with iron. Am J Clin Nutr 1988;48:595-600.

77. Block E. The use of vitamin A in premenstrual tension. Acta Obstet Gynecol Scand 1960;39:586-92.

78. Argonz J, Abinzano C. Premenstrual tension treated with vitamin A. J Clin Endocrinol 1950;10:1579-89.

79. Romney SL, Palan PR, Duttagupta C, et al. Retinoids and the prevention of cervical dysplasias. Am J Obstet Gynecol 1981;141:890-4.

80. Hunt TK. Vitamin A and wound healing. J Am Acad Dermatol 1986;15:817-21 [review].

81. Hunt TK, Ehrlich HP, Garcia JA, et al. Effect of vitamin A on reversing the inhibitory effect of cortisone on healing of open wounds in animals and man. Ann Surg 1969;170:633-41.

82. Kligman AM, Mills OH Jr, Leyden JJ, et al. Oral vitamin A in acne vulgaris. Preliminary report. Int J Dermatol 1981;20:278-85.

83. Lithgow DM, Politzer WM. Vitamin A in the treatment of menorrhagia. S Afr Med J 1977;51:191-3.

84. Mejia LA, Chew F. Hematological effect of supplementing anemic children with vitamin A alone and in combination with iron. Am J Clin Nutr 1988;48:595-600.

85. Block E. The use of vitamin A in premenstrual tension. Acta Obstet Gynecol Scand 1960;39:586-92.

86. Argonz J, Abinzano C. Premenstrual tension treated with vitamin A. J Clin Endocrinol 1950;10:1579-89.

87. Hunt TK. Vitamin A and wound healing. J Am Acad Dermatol 1986;15:817-21 [review].

88. Hunt TK, Ehrlich HP, Garcia JA, et al. Effect of vitamin A on reversing the inhibitory effect of cortisone on healing of open wounds in animals and man. Ann Surg 1969;170:633-41.

89. Smolle J, Wawschinek O, Hayn H, Eber O. Vitamin A and carotene in thyroid disease. Acta Med Austriaca 1983;10:71-3 [in German].

90. Aktuna D, Buchinger W, Langsteger W, et al. Beta-carotene, vitamin A and carrier proteins in thyroid diseases. Acta Med Austriaca 1993;20:17-20 [in German].

91. Hussey GD, Klein M. A randomized, controlled trial of vitamin A in children with severe measles. N Engl J Med 1990;323:160-4.

92. Anastasakis A, Plainis S, Giannakopoulou T, et at. Xerophthalmia and acquired night blindness in a patient with a history of gastrointestinal neoplasia and normal serum vitamin A levels. Doc Ophthalmol 2013 Apr;126(2):159-62. doi: 10.1007/s10633-012-9370-x. Epub 2013 Jan 20.

93. Fok JS, Li JY, Yong TY. Visual deterioration caused by vitamin A deficiency in patients after bariatric surgery. Eat Weight Disord 2012 Jun;17:e144-6.

94. Rankov BG. Vitamin A and carotene concentration in serum in persons with chronic conjunctivitis and pterygium. Int J Vitam Nutr Res 1976;46:454-7 [in German].

95. Little DR. Ambulatory management of common forms of anemia. Am Fam Physician 1999;59:1598-604 [review].

96. Hodges RE, Sauberlich HE, Canham JE, et al. Hematopoietic studies in vitamin A deficiency. Am J Clin Nutr 1978;31:876-85 [review].

97. Bloem MW. Interdependence of vitamin A and iron: an important association for programmes of anaemia control. Proc Nutr Soc 1995;54:501-8 [review].

98. Lane M, Alfrey CP. The anemia of human riboflavin deficiency. Blood 1965;25:432-42.

99. Orehek AJ, Kollas CD. Refractory postpartum anemia due to vitamin B6 deficiency. Ann Intern Med 1997;126(10):834-5 [letter].

100. Iwama H, Iwase O, Hayashi S, et al. Macrocytic anemia with anisocytosis due to alcohol abuse and vitamin B6 deficiency. Rinsho Ketsueki 1998;39:1127-30 [in Japanese].

101. Hirschmann JV, Raugi GJ. Adult scurvy. J Am Acad Dermatol 1999;41:895-906 [review].

102. Summerfield AL, Steinberg FU, Gonzalez JG. Morphologic findings in bone marrow precursor cells in zinc-induced copper deficiency anemia. Am J Clin Pathol 1992;97:665-8.

103. Freycon F, Pouyau G. Rare nutritional deficiency anemia: deficiency of copper and vitamin E. Sem Hop 1983;59:488-93 [review] [in French].

104. Borgna-Pignatti C, Marradi P, Pinelli L, et al. Thiamine-responsive anemia in DIDMOAD syndrome. J Pediatr 1989;114:405-10.

105. Neufeld EJ, Mandel H, Raz T, et al. Localization of the gene for thiamine-responsive megaloblastic anemia syndrome, on the long arm of chromosome 1, by homozygosity mapping. Am J Hum Genet 1997;61:1335-41.

106. Stich HF, Rosin MP, Hornby AP, et al. Remission of oral leukoplakias and micronuclei in tobacco/betel quid chewers treated with beta-carotene and with beta-carotene plus vitamin A. Int J Cancer 1988;42:195-9.

107. Garewal HS, Katz RV, Meyskens F, et al. ß-Carotene produces sustained remission in patients with oral leukoplakia. Arch Otolaryngol Head Neck Surg 1999;125:1305-10.

108. Liede K, Hietanen J, Saxen L, et al. Long-term supplementation with alpha-tocopherol and beta-carotene and prevalence of oral mucosal lesions in smokers. Oral Dis 1998;4:78-83.

109. Toma S, Benso S, Albanese E, et al. Treatment of oral leukoplakia with beta-carotene. Oncology 1992;49:77-81.

110. Garewal HS, Meyskens FL Jr, Killen D, et al. Response of oral leukoplakia to beta-carotene. J Clin Oncol 1990;8:1715-20.

111. Lippman SM, Batsakis JG, Toth BB, et al. Comparison of low-dose isotretinoin with beta carotene to prevent oral carcinogenesis. N Engl J Med 1993;328:15-20.

112. Johnson J, Ringsdorf W, Cheraskin E. Relationship of vitamin A and oral leukoplakia. Arch Derm 1963;88:607-12.

113. Stich HF, Mathews B, Sankaranarayanan R, Nair MK. Remission of precancerous lesions in the oral cavity of tobacco chewers and maintenance of the protective effect of ß-carotene or vitamin A. Am J Clin Nutr 1991;53:298S-304S.

114. Anastasakis A, Plainis S, Giannakopoulou T, et at. Xerophthalmia and acquired night blindness in a patient with a history of gastrointestinal neoplasia and normal serum vitamin A levels. Doc Ophthalmol 2013 Apr;126(2):159-62. doi: 10.1007/s10633-012-9370-x. Epub 2013 Jan 20.

115. Fok JS, Li JY, Yong TY. Visual deterioration caused by vitamin A deficiency in patients after bariatric surgery. Eat Weight Disord 2012 Jun;17:e144-6.

116. Crary EJ, McCarty MF. Potential clinical applications for high-dose nutritional antioxidants. Med Hypotheses 1984;13:77-98.

117. Gaby, AR. Nutritional Medicine. Concord, NH: Fritz Perlberg Publishing, 2011.

118. Tyson JE, Wright LL, Oh W, et al. Vitamin A supplementation for extremely-low-birth-weight infants. N Engl J Med 1999;340:1962-8.

119. Smolle J, Wawschinek O, Hayn H, Eber O. Vitamin A and carotene in thyroid disease. Acta Med Austriaca 1983;10:71-3 [in German].

120. Aktuna D, Buchinger W, Langsteger W, et al. Beta-carotene, vitamin A and carrier proteins in thyroid diseases. Acta Med Austriaca 1993;20:17-20 [in German].

121. Polidori MC, Mecocci P, Stahl W, et al. Plasma levels of lipophilic antioxidants in very old patients with type 2 diabetes. Diabetes Metab Res Rev 2000;16:15-9.

122. Rothman KJ, Moore LL, Singer MR, et al. Teratogenicity of high vitamin A intake. N Engl J Med 1995;333:1369-73.

123. Mastroiacovo P, Mazzone T, Addis A, et al. High vitamin A intake in early pregnancy and major malformations: a multicenter prospective controlled study. Teratology 1999;59:7-11.

124. Biesalski HK. Comparative assessment of the toxicology of vitamin A and retinoids in man. Toxicology 1989;57:117-61.

125. Azais-Braesco V, Pascal G. Vitamin A in pregnancy: requirements and safety limits. Am J Clin Nutr 2000;71(5 Suppl):1325S-33S [review].

126. Wiegand UW, Hartmann S, Hummler H. Safety of vitamin A: recent results. Int J Vitam Nutr Res 1998;68:411-6 [review].

127. Fawzi WW, Mbise R, Spiegelman D, et al. Vitamin A supplements and diarrheal and respiratory tract infections among children in Dar es Salaam, Tanzania. J Pediatr 2000;137:660-7.

128. Sibulesky L, Hayes KC, Pronczuk A, et al. Safety of <7500 RE (<25000 IU) vitamin A daily in adults with retinitis pigmentosa. Am J Clin Nutr 1999;69:656-63.

129. Bendich A, Langseth L. Safety of vitamin A. Am J Clin Nutr 1989;49:358-71.

130. Cartmel B, Moon TE, Levine N. Effects of long-term intake of retinol on selected clinical and laboratory indexes. Am J Clin Nutr 1999;69:937-43.

131. Melhus H, Michaelsson K, Kindmark A, et al. Excessive dietary intake of vitamin A is associated with reduced bone mineral density and increased risk for hip fracture. Ann Int Med 1998;129:770-8.

132. Binkley N, Krueger D. Hypervitaminosis A and bone. Nutr Rev 2000;58:138-44 [review].

133. Frame B, Jackson CE, Reynolds WA, Umphrey JE. Hypercalcemia and skeletal effects in chronic hypervitaminosis A. Ann Intern Med 1974;80:44-8.

134. Patel P, Hanning RM, Atkinson SA, et al. Intoxication from vitamin A in an asthmatic child. CMAJ 1988;139:755-6.

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2019.