VITAMIN A IN PREGNANCY
by Belinda Barnes, May, 2003
FORESIGHT - the Association for the Promotion of Preconceptual Care


The measurement of Vitamin A has recently been changed from the old "iu" (international units), with which we were all familiar, to the new "European Correctness" of "mcg" or micro-grams.

These two measurements do not reflect exactly the same thing. The international units used to give the potency of the source (which can vary with the oil soluble vitamins). The mcg only gives the weight. However, the powers-that-be have ruled that to convert iu of Vitamin A to mcg, we divide by 3.33, and so for all practical purposes this will now have to serve us. To avoid confusion we will give both measurements in this leaflet, as you may find either in papers, or on tubs of supplements.

For pregnancy, Foresight advises 2,500iu (833mcg) - 5,000iu (1,501mcg).

Vitamin A excess can be dangerous in pregnancy, but so can Vitamin A deficiency. The dangers of Vitamin A deficiency have been too little understood or published over the last decade.

Scientific advice on what constitutes excess Vitamin A is very variable. The Denner Report quoted 10,000isiu (3,003mcg). Professor Merlyn Werbach of the University of California (arguably the world authority on fetal nutrition) says 40,000iu (12,0l2mcg). An Australian source gives 25,000iu (7,507mcg).

Foresight programmes are always very conservative, as the obvious approach is to give enough to avoid any danger of deficiency, while giving very little more than this, to be sure of staying within the safe limit.

The maximum we at Foresight usually give is:-

The minimum we give is the 2,500iu (750mcg) present in two Foresight Multi-Vitamins.

Even our most generous programmes give less than half the most conservative upper limit, which was the Denner Report's 10,000iu (3,003mcg).

It is interesting to note in this context that during the 2nd World War (when, despite rationing, most people's diet was more nutritious than that of today), the Government decreed all pregnant women should have "a teaspoonful of cod liver oil" daily. It is hard to assess the amount of Vitamin A, as a lot would have depended on the size of the teaspoon, but it is likely to have been in the region of 5,000iu (1,501mcg). At the present time, in the USA, pregnant women are given 5,000iu (1,501mcg) Vitamin A daily. In some areas of Australia, they are given 10,000iu (3,003mcg). UNESCO campaigns for funding to give Vitamin A to pregnant mothers in the Third World to stop babies from being born blind.

Vitamin A deficiency deformities in experimental animals have been recorded by Dr Isobel Jennings of Cambridge, and by Dr Weston Price of California.

From: Isobel Jennings. MRCVS. Cambridge Fetal animal studies by a veterinary pathologist.

Vitamin A:-		Excess		Deficiency
		Cranial anomalies		No eyes (Anopthalmia)
		Cleft Palate		Micropthalmias
		Hare Lip		Blindness
		Eye defects		Hydrocephalus
		Hydrocephalus		Cardiovascular Anomalies
		Spina Bifida		Urogenital Anomalies
		Exencephalus		Diaphragmatic Hernia
				Hydrospadias
				Cryptorchidism

Dr Weston Price, of California, lists Vitamin A deficiency as causing problems with the development of the eyes, ranging from impaired sight, to blindness, to being born with no eyes (anopthalmia). Dr Price also reported damage to the nerves leading to the ears, and therefore impaired hearing, ranging to total deafness. Prolongation of the gestation period and long and difficult labour were reported in rats. Calves were reported as being born small and less likely to survive. Farm animals generally were reported to have had less successful reproduction and lactation, and less resistance to infection, where Vitamin A levels were less than optimum.

Lack of Vitamin A in the diet of pigs resulted in "extreme incoordination and spasms", and a tendency to abortion and farrowing dead piglets. Another researcher quoted by Price showed that lack of Vitamin A produced disturbances in oestrus and ovulation", leading to sterility.

Professor Hale of the Texas Agricultural Experimental Station, found that as well as piglets being born blind, "depriving pigs of Vitamin A for a sufficient period produced severe nerve involvements, including paralysis and spasms so the animals could not rise to their feet." (Could this be relevant to cerebral palsy in the human infant?)

Professor Hale also found that if the sire (ie: father) of any species were deprived of Vitamin A he would become sterile.

Disturbances of the development of the upper and lower jaw and tooth decay were also reported in humans whose diets lacked Vitamin A. Further information can be found on the web at: www.pricepottenger.org/articles/noeyes.html and also at: www.westonaprice.org/vitamins/vitaminsaga.html

In 24 years of running Foresight we have not seen any of the deformities listed above in "our" babies. I would not therefore be tempted to supplement above 5,000iu (1,501mcg), although you could probably take up to l0,000iu (3,003mcg) without harm. However, I think there could be a case made out for a little more with the multiple births, especially triplets.

I would also not be confused or bullied into taking less than 2,500iu (750mcg) daily as this could lead to the risk of serious malformations. 45,000 babies (1 baby in 16) are now born in Britain with malformations annually. The largest groups include those with malformations listed above which are proven by scientific research to be due to Vitamin A deficiency. This is a tragedy probably greater than the thalidomide debacle, and it should be more easily preventable, as all the research is out there, and has been for many years.

At the present time, The Department of Health (DoH), say they have "no position on Vitamin A in pregnancy". They passed me on to the Food Standards Agency who passed me back to the DoH. On second contact, we have had an exchange of correspondence that you will find on our website.

We continue to advise you to take between 2,500iu (750 mcg) and 4,232iu (1,270mcg) daily, before and throughout pregnancy.

You are welcome to take this leaflet to your GP, midwife or health visitor if this would be helpful. If they (or you) have any scientific papers that contradicts what I am saying, or supports it, I would be particularly grateful to be sent a copy, as I would be very interested to study them.



NOTE:-
This is one of a series of documents published by FORESIGHT, the Association for the Promotion of Pre-conceptual Care. The purpose of these documents is to make the great wealth of information that can be found in medical and other scientific journals available to prospective parents, health professionals or anyone else who does not have the time and/or the facilities to read them for themselves.

More:- Foresight Literature Summaries

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