Pregnancy Use

In the USA sources state that doses up to 10 000 lU/day are safe in pregnancy, but Australian authorities recommend that supplements containing >2500 IU of vitamin A per dose must have pregnancy warning statements on their labels.

It is important to note that beta-carotene, found naturally in plants, is not associated with teratogenic effects or vitamin A toxicity.

The teratogenicity of 13-cis-retinoic acid, a synthetic derivative of vitamin A available in Australia as Roaccutane, is well established and that substance is contraindicated in pregnancy.

PRACTICE POINTS/PATIENT COUNSELLING

• Vitamin A is a fat-soluble antioxidant that is chiefly stored in the liver.

• It is involved in maintaining vision, healthy immune function, necessary for growth and development, reproductive capability and healthy epithelial cell function.

• It is used to treat and prevent deficiency states, and there is clinical evidence that supplementation reduces the incidence and severity of infections during childhood, particularly measles and infectious diarrhoea, reduces the incidence of croup and otitis media in children with measles, and may be useful in retinitis pigmentosa.

• Vitamin A deficiency is widespread in some countries, increasing the risk of childhood infectious disease, mortality and deficiency-associated blindness.

• Excessive vitamin A supplementation can induce a toxicity state that can have serious, sometimes irreversible consequences.

ANSWERS TO PATIENTS' FREQUENTLY ASKED QUESTIONS

What will this vitamin do for me?

Vitamin A is essential for health and is involved in many different biochemical processes in the body. Some research has suggested that it reduces the incidence and severity of some infectious diseases in children. Vitamin A or its synthetic derivatives have also been used in many skin conditions such as acne, psoriasis, UV-induced skin damage and photo-ageing and the treatment of some cancers.

When will it start to work?

This will depend on the form of vitamin A being used and the indication it is being used to treat.

Are there any safety issues?

Taking high doses of vitamin A long term can cause side-effects and is contraindi-cated in pregnancy.

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