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Vitamin A supplements: Is your kid getting too much A?

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© 2022 Gwen Dewar, Ph.D., all rights reserved
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Vitamin A supplements are helpful for children who have a vitamin A deficiency. But most healthy, well-nourished kids don't demand supplements. And some kids may be getting too much vitamin A — consuming excessive levels of preformed vitamin A in liver, dairy products, fish oil, multivitamins, and certain vitamin-fortified foods.

What is vitamin A?

The term "vitamin A" refers to a group of organic compounds that include

  • preformed vitamin A (compounds like retinol, retinal, retinoic acids, and retinyl palmitate, which are derived from animal products, and easily used by the man body); and
  • provitamin carotenoids (plant-based pigments that our cells can convert into provitamin A).

Perhaps the all-time-known provitamin carotenoid is beta carotene, which give carrots, sweetness potatoes, apricots, and other fruits and vegetables their bright orange color.

Why do we need vitamin A?

Small amounts of A are essential for good wellness.

  • During gestation, babies demand vitamin A for the normal development of their organs.
  • Vitamin A is required for gene transcription, and for the proper functioning of the immune organisation.
  • Vitamin A is crucial for the development of the middle, and for everyday visual function, including the ability to encounter nether dim lighting conditions.
  • Vitamin A deficiency may worsen symptoms of autism for children with autism-spectrum disorders (Guo et al 2018).

Worldwide, children with clinical deficiencies of vitamin A are more probable to suffer from a variety of infectious diseases, and are at chance for visual problems, including blindness.

Vitamin A deficiencies are relatively rare in wealthy countries like the The states. But in developing countries, vitamin A deficiency is common, and a major cause of both blindness and child mortality (World Health Organization 2009; Bendich and Langseth 1989).

What are skillful sources of vitamin A?

In that location are two chief dietary sources — animal and establish.

The most full-bodied sources of preformed vitamin A come from animal livers, but, as I annotation beneath, liver may actually be too rich in vitamin A. People should consume information technology in small amounts.

Other, more moderate animal sources of preformed vitamin A include oily fish, similar salmon, and dairy products made from milk fat, like butter and ghee.

Found sources of vitamin A include the beta carotene vegetables mentioned above — carrots, pumpkin, sweet potatoes, apricots, mangoes, papaya, and cantaloupe. Beta carotene is also found in dark, green, leafy vegetables, like spinach and kale.

What about vitamin A supplements?

Commercially-prepared vitamin A supplements normally consist of retinyl palmitate — preformed vitamin A. Some supplements contain beta carotene.

And some foods are artifically fortified with preformed vitamin A. These may include milk products, cooking oils, and cereals.

Tin also much vitamin A injure you?

We demand a certain amount of vitamin A, and consuming found-based carotenoids is generally safe. Because of the way the trunk processes carotenoids, you tin't really overdose of vitamin A by eating fruits and vegetables.

Only likewise much of the creature class of vitamin A — preformed vitamin A — tin cause health problems.

When consumed in excess, preformed vitamin A can cause weakness, headaches, nausea, dry out skin, and other symptoms. Over time, a chronic backlog of preformed vitamin A can cause joint pain and the decalcification of bone — leading to osteoporosis (Rutkowski and Grzegorczyk 2012).

So vitamin A supplementation — prescribed by a dr. — tin be a helpful therapy if you suffer from a vitamin A deficiency. But if aren't deficient, supplements can be problematic, considering it's relatively easy for an otherwise healthy, well-nourished person to take in too much preformed vitamin A.

For example, in the United States, a random, national sample of more than 3,000 children found that 97% of toddlers taking multivitamins were getting excessive amounts of vitamin A — amounts above the "Tolerable Upper Intake Level." Fifty-fifty among toddlers who didn't take supplements, fifteen% were getting also much vitamin A (Briefel et al 2006).

But what, exactly, do we hateful by "too much" vitamin A?

Consider the recommended daily allowances for vitamin A promoted by the U.Due south. National Institutes of Health. These reflect how much vitamin A a kid should go, on average, each day.

I listing them here in RAE ("retinol action equivalents"), which measured in micrograms (μg) per day. I likewise provide the equivalent in "international units" (IU), which are found on some food and vitamin labels.

Recommended daily allowances per mean solar day by age

1-three years — 300 RAE µg/solar day (g IU)

four-8 years — 400 RAE µg/day (1330 IU)

9-13 years — 600 RAE µg/day (2000 IU)

Now consider the "Tolerable Upper Intake Level" (UL)—the amount of preformed vitamin A that kids shouldn't exceed:

Recommendedmaximum intake per solar day by age

1-3 years — 600 RAE µg/day (2000 IU)

iv-8 years — 900 RAE µg/day (3000 IU)

9-13 years — 1700 RAE µg/twenty-four hours (5660 IU)

Again, note that this 2nd chart lists the maximum recommended daily intake ofpreformedvitamin A. It doesn't address carotenoids.

If your kids are satisfying their vitamin A requirements by consuming carotenoids, y'all don't need to worry about limiting their intake.

Just if your child is consuming the animal class of vitamin A — from animal products, supplements, and fortified foods, you need to exist conscientious.

How sources of preformed vitamin A can add up

Co-ordinate to the U.S. National Institutes of Health, three ounces of beef liver contains 6,582 RAE µg of preformed vitamin A — more than than twice the maximum recommended daily intake for children under the historic period of viii.

Conspicuously, immature children should eat liver very sparingly, if at all. But even if you avoid liver, at that place are other sources of preformed vitamin A, and they can add together up.

For example, take a await at these dairy products:

  • Ice cream, French vanilla. Ane loving cup has 278 RAE µg (83 IU).
  • Milk, 2% fatty, fortified with A. 1 cup (237 mL) has 139 RAE µg (464 IU).
  • Butter. One tablespoon (15 mL) has over 95 RAE µg (317 IU).
  • Cheddar cheese. One ounce (28g) has most 84 RAE µg (281 IU).
  • A boiled egg has approximately 78 RAE µg (260 IU).
  • Whole milk yogurt. Eight ounces (227 thou) has 67 RAE µg (225 IU).
  • Cottage cheese, 2% fat. One cup (237 mL) has 50 RAE µg (167 IU).

And the amount of preformed vitamin A in oily fish:

  • Pickled Herring. Three ounces has 219 RAE µg (731 IU)
  • Mackerel. Three ounces has about 65 RAE µg (214)
  • Salmon, sockeye. Iii ounces has 59 RAE µg (176 IU)

Next, consider how much preformed vitamin A has been added to sure candy foods, like breakfast cereal and frozen waffles. According to the National Institutes of Health, a cup of fortified cereal might contain as much equally 130-150 RAE µg of preformed vitamin A.

And read the label on your multivitamins and dietary supplements. Hither in the Usa, I have found a number of children's multivitamins that contain retinyl palmitate, a blazon of preformed vitamin A. Their labels typically advise parents to requite their children doses of upwardly to 630 RAE µg (2100 IU) per day.

So it'southward like shooting fish in a barrel to come across how a child could get too much preformed vitamin A by consuming a combination of animal products, vitamin-fortified processed foods, and multivitamins.

A young child who eats just a few of the food items on these lists — a  cup of milk, a loving cup of fortified cereal, an ounce of cheese, and a bit of butter — will have already taken in approximately 400 RAE µg of preformed vitamin A. Add together a multivitamin, and that child will be exceeding the Tolerable Upper Intake Level.

How much does this matter? Should I worry if my kid has been getting too much preformed vitamin A?

In the study of American toddlers, the vast majority of kids taking vitamin supplements were getting likewise much vitamin A. But that doesn't mean they were suffering adverse effects.

When health agencies set a tolerable upper intake level, they include a safety margin. Typically, the value is set at two.five-fold lower than the daily intake associated with documented health issues.

It's as well not clear how often multivitamin supplements and fortified foods actually evangelize what they claim.

For case, sunlight reduces the potency of retinol, and many children's vitamins are sold in trasparent plastic bottles. How potent are kids' vitamins, actually? I haven't plant any answers to that question. Maybe researchers will address this bespeak in the future.

What's more than certain, however, is that many children — good for you, well-nourished children — are taking in more preformed vitamin A than they need. It'due south wasteful at all-time.

If a child is consuming lots preformed vitamin A, it may contribute to long-term health problems.

As noted above, chronic over-consumption of preformed vitamin A can cause symptoms of illness, and os loss.

Vitamin A overdose during tin can also crusade birth defects, which is why prenatal vitamin supplements are supposed to incorporate beta carotene–NOT preformed vitamin A.

And children'due south multivitamins are often packaged as sweets or sticky candies, which can entice kids to consume too much. It's important to keep vitamins stored in kid-proof bottles, and talk to your medico if you suspect your child has gotten into them.

In short, there's no reason to panic. Only it'south wise to exist enlightened of the sources of preformed vitamin A in your child's diet, read labels, and chose vitamin supplements advisedly.

Unless a child is vitamin A scarce, he probably doesn't need to consume anypreformed vitamin A supplements at all. In fact, a well-nourished kid tin can satisfy her vitamin A requirements by eating fruits and vegetables high in carotenoids. A half loving cup of raw carrots contains more than 450 RAE µ of vitamin A.

More data

The numbers cited in this commodity — about the vitamin A content in foods — come from the US government sources.  Yous can read more in this opens in a new windowfact sheet past the National Institutes of Health. It includes a listing of foods rich in beta carotene. In addition, you can look up nutritional information virtually specific foods in the opens in a new windowUSDA Nutrient Database.

And to see other Parenting Science articles about nutrition, see this opens in a new windowindex.

References: Vitamin A supplements

Bendich A and Langseth L. 1989. Safety of vitamin A. Am J Clin Nutr. 49(2):358-71.

Briefel R, Hanson C, Play a trick on MK, Novak T, and Ziegler P. 2006. Feeding Infants and Toddlers Study: practice vitamin and mineral supplements contribute to nutrient adequacy or excess among US infants and toddlers? J Am Diet Assoc. 106(1 Suppl 1):S52-65.

Guo M, Zhu J, Yang T, Lai X, Liu X, Liu J, Chen J, Li T. 2018. Vitamin A improves the symptoms of autism spectrum disorders and decreases v-hydroxytryptamine (5-HT): A pilot study. Brain Res Bull. 137:35-40.

Institute of Medicine (Us) Panel on Micronutrients. 2001. Dietary Reference Intakes for Vitamin A, Vitamin One thousand, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington (DC): National Academies Press (United states); 2001.

National Institutes of Health Function of Dietary Supplements. Vitamin A: Fact sheet for professionals. Accessed five/three/2019 at https://ods.od.nih.gov/factsheets/vitamina-healthprofessional/.

Rutkowski M and Grzegorczyk Thou. 2012. Adverse effects of antioxidative vitamins. Int J Occup Med Environ Health. 25(2):105-21.

Earth Health Arrangement. 2009. Global prevalence of vitamin A deficiency in populations at risk 1995-2005: WHO global database on vitamin A deficiency. Geneva: World Wellness Organization.

Content last modified 5/2019

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