Vitamin A Deficiency Treatment & Management

  • Author: George Ansstas, MD; Chief Editor: George T Griffing, MD   more...
 
Updated: Dec 28, 2010
 

Medical Care

  • In the United States, VAD can easily be prevented through the consumption of foods recommended in the Diet subsection.
  • Treatment for subclinical VAD includes the consumption of vitamin A–rich foods, such as liver, beef, chicken, eggs, fortified milk, carrots, mangoes, sweet potatoes, and leafy green vegetables.
  • For VAD syndromes, treatment includes daily oral supplements, as follows:
    • Children aged 3 years or younger - 600 mcg (2000 IU)
    • Children aged 4-8 years - 900 mcg (3000 IU)
    • Children aged 9-13 years - 1700 mcg (5665 IU)
    • Children aged 14-18 years - 2800 mcg (9335 IU)
    • All adults - 3000 mcg (10,000 IU)
  • Therapeutic doses for severe disease include 60,000 mcg (200,000 IU), which has been shown to reduce child mortality rates by 35-70%.
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Consultations

  • Consult endocrinologists, gastroenterologists, ophthalmologists, nutritionists, infectious disease specialists, and dermatologists, as indicated.
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Diet

  • The Dietary Guidelines for Americans, from the US departments of Agriculture and Health and Human Services, recommend consumption of a variety of foods for a comprehensive nutrient intake.[22] Vitamin A – rich foods include the following[22, 23] :
    • Liver
    • Beef
    • Chicken
    • Eggs
    • Whole milk
    • Fortified milk
    • Carrots
    • Mangoes
    • Orange fruits
    • Sweet potatoes
    • Spinach, kale, and other green vegetables
  • Eating at least 5 servings of fruits and vegetables per day is recommended in order to provide a comprehensive distribution of carotenoids.
  • A variety of foods, such as breakfast cereals, pastries, breads, crackers, and cereal grain bars, are often fortified with 10-15% of the RDA of vitamin A.
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Contributor Information and Disclosures
Author

George Ansstas, MD  Chief Resident, Department of Internal Medicine, St Louis University Hospital; Assistant Professor, Department of Internal Medicine, St Louis University

George Ansstas, MD is a member of the following medical societies: American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Jigna Thakore, MD  Fellow, Department of Gastroenterology, Dayton Veterans Administration Medical Center

Jigna Thakore, MD is a member of the following medical societies: American College of Gastroenterology and American Society of Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

N Gopalswamy, MD  Chairman, Professor of Internal Medicine, Department of Gastroenterology, Wright State University/Veterans Affairs Medical Center

Disclosure: Nothing to disclose.

Specialty Editor Board

Udaya M Kabadi, MD  Professor, Department of Medicine, University of Iowa College of Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Romesh Khardori, MD, PhD  Professor and Director, Division of Endocrinology, Metabolism, and Molecular Medicine, Southern Illinois University School of Medicine

Romesh Khardori, MD, PhD is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Medical Association, American Society of Andrology, Endocrine Society, and Illinois State Medical Society

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD  Professor of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

References

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  2. Pazirandeh S, Burns DL. Overview of fat-soluble vitamins I. UpToDate. 2002.

  3. Russell RM. Vitamin and trace mineral deficiency and excess. In: Braunwald E, Fauci A, Kasper D, et al, eds. Harrison's Principles of Internal Medicine. vol 1. 15th ed. New York, NY: McGraw-Hill; 2001:465-6.

  4. Jimenez C, Leets I, Puche R, et al. A single dose of vitamin A improves haemoglobin concentration, retinol status and phagocytic function of neutrophils in preschool children. Br J Nutr. Dec 15 2009;1-5. [Medline].

  5. Munoz EC, Rosado JL, Lopez P, et al. Iron and zinc supplementation improves indicators of vitamin A status of Mexican preschoolers. Am J Clin Nutr. Mar 2000;71(3):789-94. [Medline]. [Full Text].

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  9. Imdad A, Herzer K, Mayo-Wilson E, Yakoob MY, Bhutta ZA. Vitamin A supplementation for preventing morbidity and mortality in children from 6 months to 5 years of age. Cochrane Database Syst Rev. Dec 8 2010;12:CD008524. [Medline].

  10. Rothman KJ, Moore LL, Singer MR, et al. Teratogenicity of high vitamin A intake. N Engl J Med. Nov 23 1995;333(21):1369-73. [Medline]. [Full Text].

  11. Alaimo K, McDowell MA, Briefel RR, et al. Dietary intake of vitamins, minerals, and fiber of persons ages 2 months and over in the United States: Third National Health and Nutrition Examination Survey, Phase 1, 1988-91. Adv Data. Nov 14 1994;1-28. [Medline]. [Full Text].

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  16. Al-Saleh I, El-Doush I, Billedo G. Age and gender-related reference values for serum dl-alpha-tocopherol and all-trans-retinol levels in Saudi population. Int J Vitam Nutr Res. Sep 2007;77(5):326-35. [Medline].

  17. Gomes MM, Saunders C, Ramalho A. Placenta: a possible predictor of vitamin A deficiency. Br J Nutr. Dec 15 2009;1-5. [Medline].

  18. de Pee S, Dary O. Biochemical indicators of vitamin A deficiency: serum retinol and serum retinol binding protein. J Nutr. Sep 2002;132(9 Suppl):2895S-901S. [Medline]. [Full Text].

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  20. Gorstein JL, Dary O, Pongtorn, et al. Feasibility of using retinol-binding protein from capillary blood specimens to estimate serum retinol concentrations and the prevalence of vitamin A deficiency in low-resource settings. Public Health Nutr. May 2008;11(5):513-20. [Medline].

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  22. Dietary Guidelines for Americans, 2005. 6th ed. Department of Health and Human Services, Department of Agriculture; Jan 2005. [Full Text].

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